The Art of Exploring Anatomy & The Explorer in a Surgeon

All hold this tantrum (shalya-chikitsa, surgery) to be the most important of the all the other branches of Ayurveda ( the Science of Life and traditional medicine in ancient India), in as much as instantaneous actions can be produced. 

It is eternal and source of infinite piety, imparts fame and opens the gates of heavens to its votaries, prolongs the durations of human existence on earth, and helps men in successfully completing their missions and earning a decent competence in life. 

                                           

Sushruta-Samhita 5 century BCE.

The Sibling Rivalry

Surgery undoubtedly is superior to Medicine for the following reasons:

1. Surgery cures more complicated maladies, such as towards which Medicine is helpless.

2. Surgery cures diseases that cannot be cured by any other means, not by themselves, not by nature, nor by medicine. Medicine indeed never cures a disease so evidently that one can say that the cure is due to Medicine.

3. The doings of Surgery are visible & manifest while those of medicine are hidden, which is very fortunate for many Physicians.

Treatise on Surgery,
HENRY de MONDEVILLE (1260-1320)

Hi-Story !

Hello....How are you...?


          The art of history taking, an ultra-essential component of any medical consultation, is just an obvious extension of our daily human encounters across the planet - Hello, How are you ? But, in the diseased, deformed and stressed out  world of medicine, it focuses exclusively & extensively with knowing the maximum about an individual, rather than the another who presumable plays the healer. The primary concern here is a process of suffering, that the person being interviewed, may be suffering with.

The art of Communication, verbal or non-verbal, is nowhere put to such a strenuous test, as in these time-constrained, emotionally charged medical encounters or consultations. A physician stands to gain an immense insight into the covert terrain of the sufferer, through this inter-woven art of asking, listening, questioning, answering with or without expressing. This empowers him to optimise and individualise his management strategy for each individual. 
Unfortunately, the few, far-apart but scary medical murderers were immensely gifted in this very subtle skill; which rendered them powerful enough to execute their cruelties with such an uncanny sophistication, that too without being detected for a long time.

With every technological innovation, impatience is automatically being encouraged and nurtured in our practice and our consciousness as well. Sadly, in this modern world dotted with technological eagerness to peep inside the dynamic anatomy, physiology & biochemistry - comes across as a strong challenge to the art of communication that our predecessors had mastered so amazingly well over their training years. 
The patients also these days are also evolving and more inclined to have tests & get scanned to feel much better within themselves than their historical counterparts. The physicians are also demonstrated a similar trend, keeping pace with the technological invasion of medical diagnostic tools, workplace demands and patient satisfaction indices. 

Technological proliferation aimed at easing or expediting a diagnostic challenge was never designed to diminish or replace the role of a physician-centered historical and physical exploration of a sufferer's mental, emotional, physical, and spiritual state of well-being. Optimal use of available technology to ensure a sufferer's well being, is a task hard to learn, retain, recall, practice daily and teach to young trainees with each successive patient encounter, by our generation of practitioners. 

The Patient Selection - NOW, LATER or NEVER.

"Not every patient presenting to a Surgeon, should automatically qualify to be an eligible candidate for a specific surgical procedure. But, a Surgeon's earnest endeavour should be to ensure that each selected patient, would in all probability, re-present as a satisfied patient post-procedure."

Indication & Contraindication: WHEN TO DO & WHEN NOT ?

The relative ability or familiarity of a Surgeon to perform a specific surgical procedure, should never become the sole indication to perform a specific surgical procedure. 

Whereas, a Surgeon's relative inability or unfamiliarity to perform a given surgical procedure, should constitute an absolute contra-indication to do the same, following the basic non-violent principle of medical practice 'Primum non nocere' - 'First do no Harm', which should encompass everyone - the patient, the procedure, the surgeon, the team, the speciality, and even the health care facility.

The OR Tantrum - DRAMA in Scrubs.

Observing surgeons loose their composure in OR for simple things is a known event, but what makes it amazingly remarkable and hilarious is whenever a surgeon blames everyone around for things that no one has anything to do with. 

To me, it is representative of a commander of an engaged battalion stuttering in panic with fear of an imagined impending doom, wherein his outbursts only reinforce his insecure state of mind by blaming everyone except himself; whilst he is expected to be calmly directing the proceedings with the available resources towards a safe & smooth conclusion, no matter what circumstances or situations are arise or are encountered during an emergent or even an elective operation. 

Surgery is mostly about absorbing tortuous pressures with tremendous patience and grace powered by an honest intention to heal a life in physical pain; like a sponge soaks every single time it is shoved into a pool of blood to absorb, to contain & reveal the bleeder, irrespective of the reason, the quality, the quantity, the origin or the consequence of haemorrhage.

The only time it is to considered acceptable, is when his serious instructions are to be executed with equal swiftness, when probably he realises and is trying to prevent an organ, a limb and/ or consequently a life from falling apart.

Fear & Panic are spoilt twins of Chaos & Mishap.

The Struggle with Surfing - Locating the Suffering Planes.

The more I try to struggle with comprehending the phenomenal human anatomy and its subtle but super-intelligent layout, the less I seem to struggle with my supposedly stressful, surgical surfing endeavours. 


The Summum bonum being, like any where else, its all about getting your basics right. No matter what art employs you to serve humanity, big things surprisingly have a culture of religiously towering on a foundation of simple but strong & beautiful basics.