Patient Is An Open Book: The More You Entertain The More You Learn

When there is life, there will be disease. Doctors are there to find the disease and treat. From time immemorial, there had been seers and thinkers who have diagnosed diseases on the basis of its symptoms. The same funda still works now. We need symptoms  and signs to identify diseases. The only thing that has changed is we are more dependent on laboratory tests than the clinical assessments.

When we were in medical colleges, our professors were imposing the importance of the history taking and identifying the disease from only the history and clinical examinations. But time has changed. Sometimes neurologist come and write down to do CT scan or MRI without any formal clinical neurological examination. I used to consider neurological examination is the toughest of all and need time to perform all examinations but today all neurologists are busy;  they see and advice without any sensory or motor examination. Gait and reflexes have become historical importance.

Very few years has passed since my under graduation and graduation but the gap which has been created is uncoverable. There are laboratories all around the countries from villages to the tehsils. Doctors practising there are almost given upto the laboratories; thy can believe a false laboratory report rather than their own intuition. What a shame!

When you listen to a patient its like reading a medical book. Patient will start telling you the story of his own, every details of his problem and all the needful a doctor need. The only thing you need is patience and patience and patience. Sometimes we think they are just talking irrelevant but may be we don’t know the disease and its presentations. There were many instances i was not believing what i was writing now, but i definitely accept my failure in those instances.

The very reason we call medical profession is a practice or experience, is the truth we entertain how many patients we see. We remember medicines, take a brand name for example, when a patient come to us and spell is differently and that strike your mind and you never forgot. All the time i have wanted to master on on painkillers or NSAIDs, the most commonly used medicine, with their combinations as sometimes they do magic. But I had only remembered those when i have entertained any patient taking any medicine and getting cured.

We never follow up patients when we write something to them. How can we say they are getting better, they may visit some other doctor and never return back. We have phones and calling free of cost, all you need is you need time to talk. Patients are always there to talk to you when you entertain. And like always you entertain, you learn.

My phone is free to my patients, anytime, anywhere. I have changed myself. You too can. And i assure you, you will learn and feel good.

 

 

 

 

 

How History Can Change The Surgical Steps

After a busy yesterday, it was fresh new day to start. For today, only one patient had been posted. Yesterday we had performed a Mitral Valve Replacement with LA clot removal. I was not scrubbed in the case; nor i had any idea how the surgery had went. Nobody has spoken a word about the patient. When I wished my professor, Namaskar, he looked at me and queried, ” you have taken history of that lady?”

I looked strangely. He added, ” The lady who had undergone MVR yesterday.”

“yes Sir” I said and was curious to know what happened.

He added with a smile, ” That lady had undergone CMV not BMV 17 years back.”

I said, ” I did not know, She had no previous report and she did not told anything and was getting agreed along with her family members as she had undergone BMV.”

“But she had a scar” my professor fired at me. ” And you did not check”

I had nothing to say as I have not examined the patient. Specifically I was not feeling comfortable to examine in the area below breast. I quickly added, ” I will change it to CMV, sorry sir”

Sir told with a tone of hesitation, “Because of your wrong history taking we had a mess during surgery. We had lot of adhesions and we did not know why.”

My professor left me as i was standing dumb and speechless. I rushed into the recovery room to check the scar mark and realised what a big mistake i had done.  I was blaming myself, ” How can i manage to take such a fake history.”