The Fracture Reduction

Forget the ancient period when the knowledge was shared only among a few select persons, often in a secretive society or cult; even just a few years ago, there were many who were secretive about their knowledge or techniques. 

Dr. Ashok Tiwari, senior professor of orthopaedics, in Kota Medical College, recalled the scenario just a few years ago giving the example of treatment of fracture. 

After fracture of the bone of the limbs, depending on the bones involved and exact place they are broken the distal or lower part of the limb may become deformed. In health, there is a complex system of muscle surrounding the bones, fulfilling their function and balancing the action of each other. With fracture, this coordinated action of the muscle becomes unbalanced, causing the distal/lower part of the arm or leg to take a deformed position. Just putting a simple plaster cast or splinting the fractured limb may result in the bones joining in a deformed position, causing cosmetic and functional problem to the patient. 

The distal / lower part of the limb has to be manipulated in a precise sequential manner, depending on the site and type of fracture to bring the limb in normal position, known technically as 'reduction of facture' before applying a plaster cast. Some orthopedicians used to practice great secrecy about their technique to bring the fractured limb in proper position. They did not want other to learn their methods so that they can have a monopoly. 

Some orthopedicians used to ask other doctors and staff members to leave the room when they would do this manipulation to bring the fracture in the proper place. One orthopedician used to throw a heavy cloth or blanket over the fractures arm or leg then manipulate it blindly covered with the blanket so that others including the nursing staff assisting him do not learn how to bring the fractured part in proper position.

In contrast, now when Dr. A. K. Tiwari goes to medical conferences, he notices that the best orthopedicians from India and abroad, freely talk about their methods and techniques to various orthopedic problems, and demonstrate them by an on-screen presentation.

As Dr. Tiwari had so aptly said, ‘In old times surgery used to done behind the screen. Now it is done on the screen!’ or ‘पहले सर्जरी परदे के पीछे करते थे अब सर्जरी परदे के ऊपर करते है!’

This is true in almost all fields now. There are many workshops, courses, classes, seminars, etc. available nowadays in almost all subjects. With the advent of internet, YouTube, bloggers, Wikipedia like sites, there has been a tremendous change in the knowledge and information available to any person with desire to learn something new. There are lots of educational resources available on internet such as video lectures and online courses both in orthopaedics and diverse subjects from medical and engineering science, arts, craft, technical and vocational subjects and what not.

The present students should be thankful that they live in such an open society. Please use wisely the available resources to increase your knowledge and expertise to enrich your life and better serve humanity.

(Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

The Unwanted Consultation

A common problem faced by many doctors is that people ask them to prescribe some medicine or other in the market place, social gatherings, religious gathering, etc. This disturbs the doctor’s personal work and there is also the danger of inadequate or wrong prescription as a proper evaluation, clinical history and examination are not possible in a setting out of hospital or clinic. 

For the safety and wellbeing of the patient and doctors themselves, many doctors generally politely decline to write or suggest some medicine without proper consultation.

If the doctor refuses, he is vilified as uncooperative, anti-social, misanthropist, insensitive to the suffering of others or greedy for getting consultation fees. 

When faced with such a situation, Dr. Richard Daswani (Fictional Name), a famous surgeon of the city, responded in a unique manner. But this is not possible for most of us as not many among us can pull this off.

When Dr. Richard was buying some grocery item from a shop in the main market, the shopkeeper started saying, ‘Sir, I lots of stomach related problems. I get bloating sensation on eating food. There is a lot of ‘gas’ and ‘acid’ formation’.

Dr. Richard understood what the shopkeeper was leading at, yet feigning ignorance he asked, ‘Why are telling me your medical problem?’

The surprised shopkeeper replied, ‘Why sir, you are a doctor in the medical college. I saw you working there when I went to visit my relative admitted there last week. Please just write me some capsule and syrup for my stomach problem.’

Dr. Richard replied, ‘You have mistaken me with my brother. He is a doctor in the medical college. I am just a junior government servant.’

The surprised shopkeeper countered, ‘Why sir, you must be joking? I never forget a face. You are looking exactly the same as I had seen you in the hospital’.

Dr. Richard answered, ‘Of course my doctor brother looks just like me. After all, he is my twin brother!’

The shopkeeper became speechless after that.

The danger of advising medicines without proper consultation is illustrated in 'Just Some Tonic Please'

(Based on an allegedly true incident)

— ND

© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

The Microanatomy Lesson

A friend of Dr. Dev (Fictional Name), during his MBBS days, in AIIMS, New Delhi, asked him to help him revise the micro-anatomy slides before his exams. He had arranged a microscope and anatomy slides for the revision session.

For Non-medicos: Anatomy is the study of the structure of the human body. Microanatomy is the study of the anatomy at a microscopic level, i.e. how the different parts of the body look under a microscope.

Dr. Dev took a slide of the small intestine and after focussing the slide in the microscope, he started explaining that this is small intestine as we can see the simple columnar epithelial cell in the mucosal (inner) side, the smooth muscle cells in the middle and serosal cells in the outer most part.

On hearing this, his friend got irritated and asked angrily, ‘What are you talking about this cell and that cell? Please explain and teach properly!’

As his friend was midway in his first-year course, Dr. Dev got surprised that what details he could not understand. Dev asked his friend to clarify what he wanted him to e,xplain. His friend replied, ‘what is this columnar epithelial cells, that muscles cells and serosal cells you are talking about’?

Dr. Dev got surprised. The cells are like alphabets to sentences. Cells come together to forms tissue, like alphabets makes words. The tissues are organized to form organs like words form sentences. Finally, the sentence makes paragraph like the organs make the human body.

If someone does not know the alphabet how can he read a paragraph? Similarly, if someone does not know how the different types of cells look under the microscope he or she cannot identify what tissue he or she is seeing. If one cannot identify the tissue being seen under the microscope then one cannot identify the organ being seen. 

Dr. Dev did some background digging. As his friend was a foreign student, due to administrative delay he joined AIIMS, New Delhi, late when the classes had already started. The basics of microanatomy, the different types of cells, was taught in the first few classes that he had missed due to his late joining. This spoiled the entire understanding of microanatomy for the rest of the academic period. It was a wonder that he scored at least some marks in his first exam. 

Once Dr. Dev learned this fact, he started explaining to his friend right from the basics which were taught in the beginning classes and slowly build up his knowledge to the level of his other classmates.

Sometimes students miss the early classes of a subject for a variety of reasons. Some reason such as late joining due to late allotment of college may be beyond the student’s control. But sometimes students deliberately miss the first few classes as they think they are not important or they want to enjoy, relax and just chill for some times after studying so hard to crack the entrance exam to the college. They do not understand the importance of starting to study seriously from day one as the early classes form the foundation of later knowledge.

Without a good strong foundation one cannot build a strong building of knowledge.

 

So, whether microanatomy or any other subject, do not miss the early first classes and take them seriously.

If due to some reason you miss the classes, then start at the earliest to study and cover up the missed course, either by extra classes or with the help of your teachers and classmates.

 (Based on allegedly true incident)

— ND

© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm.