The magic of a healthy doctor-patient relationship

The relationship between doctors and their patients has received philosophical and spiritual attention since the time of Hippocrates and still remains a keystone of care. But, unfortunately over the years, this special relationship has undergone a drastic transition. The onus for this actually lies on both the parties. On one hand, increasing number of litigations and the irrational use of social media has made the doctor fraternity more cautious while on the other, many patients claim that doctors treat them as consumers and the healing touch and warmth has gone.

Bobby Fischer once said “Nothing is so healing as the human touch”. As a doctor, it’s very important to counsel & interact with patients, so that their fears regarding the disease can be alleviated.

As a cancer surgeon, I feel that a healing touch is as important as a good surgical hand. Every doctor should make a sincere effort to strike a healthy relationship with their patients.

May the force be with you!!

 

 

 

(This was a card I recently received from one of may patient’s, whom I had treated for cancer)

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What is the colour of a doctor’s money??

It can be anything but black! It is basically made of two layers of sodium chloride. The first layer was prepared by the sweat of the medical school. The second was formed slowly after obtaining the so called degree. The denomination of this money is determined by the degree one obtains, slogging it out in a rat race, sometimes also missing out on how their kids grow up. If you are on the surgical side, it has some blood red patches here and there. A physicians’ money may have grey (matter) color sprinkled about. A colleague working in anesthesiology, intervention cardiology or emegency medicine have it soaked in adrenaline. There might be a few dots of yellow on some money. Believe me, no pathologist spills the sample intentionally! Also don’t blame any body if E. Coli grows on some money. So, my friends, a doctor’s money can never be black. And the most amazing thing is that he can keep it minting till Alzeihmer’s or Parkinson’s!

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Post shared from Dr. Deepak Arora – a motivational speaker and a dear friend.

 

 

Thank You Doctor!

bigstock-young-child-holding-thank-you-37152475The signboard which clearly stated that it was the office of ‘Dr. Nausheen Khan’ glistened after the compounder wiped it with a damped cloth. The nailed signboard was the only thing that made that ugly wooden door worth looking at. It was the 1st of July, 2016 and the cuckoo clock was readying itself to make that annoying noise that it always made when the time was 9.00 am.

The waiting area had already accommodated 3 patients and a kid who was busy saving Mario’s princess on his Gameboy. ‘Umair’ the sticker which was on the back of his Gameboy read. The wait of the patients didn’t last long and at 5 past 9, Dr. Khan entered her cabin. After a minute or two, the compounder came out of the cabin and told the woman who was combing the kid’s hair that she could go in and see the doctor.

The woman, who must be in her early 30’s told her son, Umair, that she’ll be back in 10 minutes and to not go anywhere. He nodded, without even paying heed to what had been said to him. 8 minutes passed since his mom went inside the cabin but Umair was still not able to clear the stage on which he had spent the past 30 minutes. He got irritated and reached for his bag which sat upright on the seat beside him. He threw the Gameboy inside his bag carelessly and started searching his bag for something.

He seemed to struggle with whatever he was trying to find and finally stopped when something purple in color fell from his bag. He kept his bag on the empty seat beside him and got up to pick up the thing wrapped in purple paper. Just as he bent to pick it up, something else caught his eye. Only a few steps away from him was lying a piece of paper which seemed more like a pamphlet. It had footprints over it, raising questions about its importance.

He picked up the purple thing and then directed his countable steps towards that paper which had been abandoned by someone. He picked it up and shrugged off the footprint from it. ‘Happy Doctor’s Day’ he mumbled to himself while carefully examining the sheet of paper. It had that day’s date and ‘Have you thanked your doctor today?’ printed on it. He heard the cabin door open and turned around to see his mother coming out.

‘You still haven’t eaten the chocolate? If you didn’t want to eat it then why did you create such a ruckus at the general store that time?’ She said in a condescending tone. She grabbed his hand and started walking towards the exit. Umair, with an innocent smile on his face, freed his hands and jogged towards Dr. Khan’s cabin.

Before his mom could utter a word to stop him he had already opened the door of the cabin and was greeted by an expected question from the doctor. ‘What happened son?’ She asked. With the innocent smile still intact on his face, he moved towards her and gave her the chocolate wrapped in the purple cover.

She took the chocolate with a surprised look and let her mouth speak her mind. ‘What is this for?’ She asked in a happy tone. ‘I just wanted to thank you for keeping my mom healthy’ and after a pause ‘Happy Doctor’s Day’ he gratefully said. Dr. Khan was awestricken and wasn’t able to find words for a reply.

She wiped a tear which purposely kissed her cheek, revealing the impact that gesture had on her. All she managed to say was ‘Thank you’ in very soft tone. Umair gave her a smile which revealed all of his 25 teeth and merrily walked back to his mom. Her mom, patted her son as he came and said ‘Come, let’s buy you another chocolate.’

They left the clinic and so did the footprint on the paper. Both left a lesson behind.

Is Left-Handedness a Handicap for Training in Surgery?

Despite the progress made by our society, left handedness is still not widely accepted. Parents like to see their children write with their right hand initially and start correcting them if they use their left hand. Despite coming from a family, where my mother is left handed, I have faced the music many times in my life for using my left hand. My teachers at school used to scold me for my awkward way of writing despite having a reasonable hand writing (which is uncommon for doctors 😉 ). In spite of the scoldings, I persisted with my own way of writing and one advantage of my style was that nobody could copy my work during the exams 😉 ;-).

Uncommon way of writing in India but common in the west.

Uncommon way of writing in India but common in the west.

I always wanted to become a surgeon from the second year of medical school and while observing my seniors (who were mostly right handers) operate, the thought of a left handedness being a handicap crossed my mind many times. My teachers, most of whom were right handed, did not have much to say when I approached them with this query as a medical student but none of them discouraged from taking surgery as a career.

The thought of working as a left handed surgeon started haunting me again when I started my residency. Initially, I did find things a bit difficult because all the instruments were designed for right handed surgeons and left handed instruments (like left handed golf clubs) were not widely available. Most of my seniors, initially found it difficult to teach me the basics and used to get a bit annoyed when I used to start operating by standing on the left side of the table (for those who are not aware, most of the procedures are done by standing on the right side of the table). My mother, who is a successful left handed gynaecologist, was a constant source of inspiration during this tough period.

After the initial hiccough’s, my seniors became accustomed to my left handedness and taught me the skills more patiently. In no time, I mastered the techniques with my left hand and then started to hone my skills with the right hand as well. In fact, I tie right handed knots better than left handed knots (probably because I was taught by a right handed surgeon).

Now when I look back, being right handed or left handed really does not matter in the long run (in terms of a surgical career) and I would urge an aspiring surgeon not to give up the dream of pursuing a career in surgery because of being left handed. There have been many studies conducted on this topic and  they have found no difference in surgical outcomes between right and left handed surgeons.

Some helpful points for a left handed surgical trainee:

1. Don’t switch away from your dominant hand. Get good at doing the basics with your left hand (cutting straight with a scalpel, basic dissection, basic suturing), then learn how to do everything right-handed. If you start too early trying to do everything with both hands, you’ll probably flounder around and not improve as quickly as you should.

2. Learn to tie knots right handed first, since you’re going to learn to tie with both anyway.

3. Use scissors with your right hand initially. Learning to cut left handed with right-handed scissors is tricky, especially with heavy Prolene or other sutures.

4. Once you’re good with your dominant hand, by all means work on ambidexterity. Being able to operate with both hands has been advantageous to me as I’ve progressed through residency.

5. Don’t let being a lefty deter you in any way from pursuing a surgical career.

In the end I can just say one thing,

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🙂 🙂

When do I write my blog posts?

Different methods of time keeping at Warwick castle

Different methods of time keeping at Warwick castle

 

Somebody asked me the other day that when do I take out time from my busy schedule to write on the blog?

I replied back by quoting these words by Charles Buxton – “You will never find time for anything. If you want time you must make it.”.

Many people write their daily diaries just before going off to sleep. It is a matter of habit and they make sure that they take out time for it, even if they are very tired. Ideas for these blog posts keep on popping into my mind and whenever they do, I just make a note of them and then work on these ideas once I have finished the hospital work and my daily quota of reading textbooks and articles. I finalize the posts before going off to sleep and then publish them whenever I get time. This has become a daily habit since I have started this blog.

About the photo – This was clicked by me at Warwick Castle and it shows two methods of time keeping. The lower one is sun-dial and the upper one is a regular watch. The picture goes well with the theme of the post.

Smile language

All-people-smile-in-the-same-language

I recently started working at a Cancer center in Bangalore and I am not fluent in Kannada (the local language). This poses a challenge when I am communicating with my patients. In the OPD my colleagues help me out but during the morning rounds there is a problem as most of the nurses (being Malyali), don’t understand Kannada very well either.

Although I have always used “smile language” with my patients in the past but over the last few days I seem to be using it more frequently and effectively. Every morning I greet the patients with a smile and get a lot of information about their condition without speaking a word. Rest of the conversation takes place in ‘sign’ language (another universal language) and broken Kannada. Patients also respond in the same language and a patient’s smile can answer many questions without a word being spoken.

This approach not only provides key information about the patient’s condition but also helps in making a rapport with the patient and is an integral part of the doctor-patient relationship.

Everyone (specially doctors) should follow this universal language, when interacting with people!! 🙂 🙂

Sweetest gift

Can't get sweeter than this

Can’t get sweeter than this

A very old breast cancer patient came to my OPD one day and started crying. She had been diagnosed with breast cancer at a hospital close to her village but because she could not afford treatment in a private hospital, she came to Delhi for free treatment. After examining her, I explained to her the treatment plan and got her investigated for surgery.

Within a couple of weeks we operated her and she went on to receive chemotherapy and radiotherapy afterwards. Following the completion of her treatment, I did not see her for a few months.

Then one day I reached the OPD slightly late as I was taking care of a sick patient in the ward and as I was approaching my room, I was greeted by the same lady with her short curly hair (this is what chemotherapy does to the hair…will write a post about this sometime later) and a wide smile on her face.

Once I settled down in my chamber, she came rushing in and put this huge packet on the table and said that it was for me. When I told her that I could not accept it, she became very sad and said that she had carried it 150 kms specially to gift it to me and insisted that I open it in front of her. I eventually gave in to her request and what I saw when I unwrapped the packet was really overwhelming. Inside it was a 2 kg fresh jaggery cake, which this lady had carried specially for me and I was very touched by her gesture. It truly was the SWEETEST GIFT I have ever received from a patient and that too from someone who was having difficulties funding her own treatment.

Sometimes the smallest gestures turn out to be the sweetest ones.