Medical Science and Education : Do we lack Focus ?

I am writing a few thoughts wrt medical vision especially cardiac surgery future in India. This can be treated as part one. 

We are currently heavily focussed on the treatment or curative part of medical sciences. I feel equal balance should be given to the preventive and research/innovation part of medical sciences also. Only such an approach will make our enormous population healthy or in other words only then will we be able to provide health for all. If we focus on creating only doctors and hospitals for providing the treatment component of health, our resources will always be strained and we will always be short of the need. 

Hence research to produce things in India is very vital, not only to bring down the cost, but to save our foreign currency also. and also to make purchases easy. Imagine a highly advanced computerised automatic Mercedes or BMW comes at a cheaper cost than a heart lung machine, which has only a few metallic roller pumps, not even a computer. This is nothing but white collar loot by foreign multinationals. Look at heart valves, they cost nothing to manufacturers, once their R & D cost is over, they are just moulded pieces of high quality metals. If India can make the finest of jewellery from diamond and gold, what stops us making these heart valves ? 

If we can make Chandrayaan , why can't we make ventilators, heart lung machines, infusion pumps, Defibs, OT lights , tables and so on .... there are hundreds of medical equipment which we import all over india. It's unimaginable that we even import surgical scissors and forceps thus making those countries richer and ourselves poorer. This should stop by making India a hub of manufacturing surgical and medical equipment along with new innovations.

Research should also be directed in preventing diseases rather than a curative aspect only. Prevention is better than cure, we all know and preach. But in reality we all do the reverse due to control of world wide medical superpowers or drug mafias. Our ancient wisdom clearly says that prevention is key to health for all. Then why not to follow the same. We should invest more and more in research for controlling diseases. 

For example we should have a National Programme for prevention of Rheumatic Heart Disease and its eradication. West is making metallic valves to be implanted in RHD patients , whereas in their own countries they have eradicated RHD. One a metallic valve is implanted, the patient is actually living with a time bomb inside the heart. 

Preventive Cardiology is of tremendous need in India than mere Cardiology. Morre and More preventive and social medicine graduates should actually become the backbone of the Indian Health System.

Coming to the education and training part, I feel that with most of the training seats ( MCh )   in Cardiac Surgery going vacant, policy makers should shift focus on post mbbs five year MCh or DNB in CTVS. Else there will be many hospitals but no well trained CTVS surgeons. 

Spirituality and Humanities should be a compulsory subject in medical training.

Facebook vs Fakebook

We had a debate amongst colleagues and students on this topic. Some conclusions of that debate, though nothing new, but still sharing. These conclusions are not truth for all, but are merely conclusions of the group that had debate. 

1. This platform will be remembered in History as a nuclear bomb for majority of society relationships. 

2. Never judge life of an individual through his or her posts, you can never know about the pains, struggles and sacrifices one might be undergoing through their FB wall. They might have posted only happy posts And vice versa is true too. 

3. Slowly addicted people get connected to virtual friends more than to real people around their life, and only in times of disease when their virtual friends are wishing get well soon on FB, they remember real people around them, because then they need someone to take them to hospital, stay with them in hospital or bring medicines for them.

4. Addicted people become too judgemental and comparitive.

5. One good thing is it connects you with your otherwise forgotten friends and brings new virtual friends, but rarely few of them become real life friends but at a cost, which is realised later.

6. Like other social media platforms, it has certainly helped world to see many things which we didn't even knew that they existed.

7. It helps you to pass your time in otherwise busy world, where everyone is rushing and rushing, but then there are many other ways of time pass too

8. It helps you to share your message, activities, information etc on wider large platform.

The conclusions were many, but writing a long essay means too much time on FB.

The take home message was to maintain balance as required in all schemes of universe. Saying and writing is easy, following is difficult. A particular thing may not be harmful to a particular person, but when it's harmful to society as a whole, then it needs to be moderated. Like everything there is a lakshman rekha for freedom too

What you think about FB ?

Feelings of a Surgeon

 "A career in surgery is a wonderful thing. Especially when everything is going good. But the sad thing about surgery is that everything will not be going good all the time. It is not like travelling by a plane or by a train where the chances of getting into an accident are near zero. Surgery is at times travelling in a car or a bike in the night when its raining heavily and your head lights have failed. And you land up in trouble. There will also be times when everything seems to be going well in a particular week and suddenly you land up in trouble with one patient , you had least expected to get into trouble. And for those who tackle difficult patients and complex problems, getting into trouble becomes a norm.

One sick patient, especially after an elective surgery under your care and you do not feel good. You do not enjoy your meal with your family and you look pretty upset and your family can easily make out that something is not right. Over the years I had noticed that you get into some sort of depression/low esteem whenever some patient does not do well. This is some sorrow which cannot be shared with anyone and often goes off slowly once either the patient recovers or dies. I wonder what will someone come with if he or she is asked to talk about ' My morbidities and mortalities'. One thing is for sure. Everyone will have some material at hand. Some will have less and some, more. How much do these adverse things affect a surgeon is a thing of intrigue. While some brush them off casually and move forward while many cannot take them easily. Their 'milieu interior' gets disturbed considerably for long periods of time.

Surgeons are not taught how to cope with surgical stress in their curriculum. There should be some method. There should be some counselling for surgeons to heal themselves. Lest their bodies and souls will take a beating. And for all you know some may die younger than they should. Surgery is a risky profession."

As read on FB wall of Dr. Shweta Sharma, Pediatric Surgeon

Here comes the role of your other hobbies, passion, family and friends. For sake of many other patients, surgeons need to come out of stress induced by one sick patient.

Is Medicine an Art or Science

Surgery or any other branch of Medicine is just not a pure Science subject, it's a beautiful and very intricate combination of Art and Science both. After spending around 30 years in world of Medical Sciences, I feel there are many aspects of this field, which are purely an art, and many are more art and less science. In the era where technology and machinery is overtaking the human touch in every field of our life, the artistic element is slowly dying in our medical field too. Yes undoubtedly science and technology has played a great great role in advancement of medical sciences, but without the artistic element involved, science alone can not heal. Without the emotional and spiritual quotient , EQ and SQ, intelligence ie IQ has boundaries.

Artistic element is deeply present from history taking to clinical examination, making diagnosis, writing prescriptions, giving counselling, operating on live human tissues and almost in every step of medical world.

Every surgery is actually a beautiful work of art mixed with highest level of science, done by the surgeon on the human tissues. A surgery is actually a Live Painting or a Live Art on a Live Canvas ( human body ) by group of scientifically trained artists : the operating team.

In medicine Art of History taking is taught and not the science of History taking. History taking is still considered to the most important and first step in arriving a diagosis and every text book of medicne calls it an Art. 

In same way , have you ever wondered why places where surgeries are done are called Operation Theatres ? From where the word theatre has come ? Actually surgery was always considered the highest form of art and the surgical team used to perform surgery on the patient, and from the gallery overhead, medical students used to watch the surgery, like a drama is watched by the audience in a theatre. So this again proves that surgey is art and science both since it's evolution. 

So if anyone says that Medicine is a Science subject, I beg to disagree with all the due respect. For me it has been a beautiful , complex yet simple, intricate combination of Art & Science. ( I don't know why but I felt to keep the Art word before ). Science can never be practiced wihout Art and vice versa is also true. Both are just two branches of the same stem with same roots.

Justice for Patients and Resident Doctors

We request Honourable Supreme Court of India to listen and give decision regarding EWS reservation criteria on a high priority basis, so that NEET PG Counseling can take place and justice is given to suffering junior doctors as well as ailing humanity. It's almost six months delay in the counselling and resident doctors as well as post intern doctors have suffered enormously in their learning and academics.

They studied more than twenty medical subjects day and night ,revised whole of MBBS curriculum once more in just one year and qualified one of the toughest entrance test NEET PG to enter into three years residency course, again an extremely tough journey, both mentally and physically, where day and night merges and hunger becomes secondary. Why these young medicos have to face this mental agony, a mess ,created by someone else ?

Already their training and teaching have received a big jolt due to corona , and now these kind of delays , which crop due to insensitive system leaves scars on minds and hearts of young doctors.

One complete batch has not joined, leaving severe shortage of junior resident doctors in government hospitals across the country. The second year batch is overloaded and thus patient care is suffering, their academic and research including thesis is facing big setback. And this is also one reason why many of our bright young students leave India after doing MBBS.

In the interest of patient care , academics and training of future doctors of our country , honourable Supreme court is humbly requested to listen the matter as early as possible. Such strikes lead to great hardships for both students and patients as well as for country. They should not be allowed to occur at the very beginning. Our beurucratic system should not be so lethargic and in sensitive that such situations arise.

Hope the God will soon listen and justice will be delivered.

My Thoughts in Lines

 Sometimes storms brings your boat to Shore

Heart is Happiness, Mind is Madness

Wise is who, who understands that he knows nothing

We all have our journies, but final home is one for all

In past lies the hidden secrets of future happiness

Can we ever decode the mysteries of Nature ? More we decode more they are coded.

When love becomes your eyes and heart becomes your tool of analysis, then the world is shown to you in a way, which is extra ordinary deep and divine. 

For me God is the supreme energy present in all that we can see and feel and also that which we can't.

Every story that we see around us has hundreds of stories behind us.

Two big lessons from Corona :

a. Change definition of development

b. Control Human population

Back to roots is real development with right mix of flying towards sky

Nature will never go extinct, we will be in process of doing so. She will recover, but we will perish.

Faith is beyond science

Core of any scientific field is art and in art science exists.

When one journey ends, another starts

Beautiful sunset needs clouds

Seeds germinates in Silence

Beautiful Birds from India / Part 2 by Master Atharv Lakhotia / Nikon P ...

These photographs have been taken by Atharv Lakhotia during 2020-21 at Varanasi, Amarkantak, Parsilli ( Madhya Pradesh ) and Little Run of Kitch, Gujrat.