Science, Stories and Sevagram: A Physician-Teacher's Reflections
Clinical stories and reflections on evidence-based medicine, research, and patient care.
She lay on the hospital bed, grateful to the doctors for successfully fixing her broken bone. Just wheeled from the operating room to the ward, she looked forward to going home the next day. Her post-op orders were simple: nil by mouth for two hours and two liters of intravenous fluids. The surgeon also instructed … Read more
Every Wednesday morning, physicians and medical residents in my department gather in the seminar room to discuss morbidity and mortality data of the previous week. Our residents tell us how many patients were admitted to our wards, how long did they stay, how many went home and how many couldn’t. A resident tells a story … Read more
Very soon, our teaching hospital, located in a village in central India, shall use a new computed tomography (CT) equipment for obtaining high-quality radiologic images. The previous CT scanner- it had served us well for 10 years – was living a borrowed life. The hospital, therefore decided to invest into a new CT scanner. The … Read more
Parsimonious. My teachers taught me this principle at the bedside during my residency. A single diagnosis should explain all symptoms and signs whenever possible. That was in 1980. Physicians relied on their brains and stethoscopes. They took detailed histories, examined patients thoroughly, ordered few tests, discussed differentials, and took pride in getting the diagnosis right. … Read more
Are the medical professionals so poor, as a BMJ editorial asked long ago, that they cannot afford to buy their pen, pad or pizza? And are the doctors so ignorant about the new therapies and new drug discoveries that they need help from medical representatives and the drug industry? Very few doctors learn during their … Read more
A well-focussed research question is one of the most important components of the research study. Here is a link to the PowerPoint presentation on YouTube:
Sunday morning. I was rounding with my residents. We moved as a group to the ICU, stopping at each bed. A middle-aged woman with a heart attack. A boy fighting malaria. A young man battling HIV and TB. We checked their vitals, reviewed test results, and adjusted their treatment. At bed 7, a young woman … Read more
Last week, a previously healthy 50-year-old man died in our hospital following a massive stroke. A CT scan revealed a deep intracerebral hemorrhage. Sudden death evokes a torrent of emotions—shock, denial, frustration, anger, and grief—not necessarily in that order. Shortly after the patient’s death in our ICU, a furious mob of nearly 50 people bypassed … Read more
A couple of days ago, I happened to see my friend’s grandchild. The three-month old baby, the child’s mother noted, had slow wandering eye movements and did not seem to focus well. The child had albinism- a disorder that affects colour of hair, skin and eyes. The mother was getting jittery. Will my son be … Read more
On 15 November 2009, The Week released its annual list of the country’s best hospitals, categorized by specialties such as cardiology, oncology, orthopaedics, gastroenterology, ophthalmology, and paediatrics. The rankings were based on a 14-city survey conducted by The Week in collaboration with IMRB, a market research agency. The survey included responses from 10 specialists across … Read more