that tube around your neck

That tube around your neck..

By Vivek Hande

 

The stethoscope has evolved over the years and the origin of the stethoscope and its history is as fascinating as the history of medicine itself. The origin of the stethoscope is credited to Linnaeus in 1816, who initially devised a cone made of thick paper and used it to hear sounds!!

The stethoscope or “steth” as it is popularly referred to has come a long way. The tubing has changed in length and consistency and keeps evolving. The bell and the diaphragm keep changing to improve acoustics. The ViScope can, in addition to hearing sounds can also see the heart beating under vision.

For a medical student, the acquisition of the steth marks the transition from theoretical to practical medicine. A doctor is synonymous with a stethoscope and the point of a time when a medical student starts using it is quite a milestone in his medical career. Though, many may not really use a stethoscope for the rest of their careers!

Teachers and professors would continue to stress the fact that more important than the stethoscope on the ears is what is undoubtedly between the ears- that is the brain and its ability to make sense of what one hears!

The steth is a bit of a status symbol for someone in clinical medicine. It could set you behind by an amount ranging from Rs . 200  to Rs. 20000  and beyond.  It really depends whether you are going in for a Nano or a BMW!

The way you carry a steth is also a very individual style statement. Most sling it casually around ones’ neck. There are some who bunch it into a very ungainly mass in one’s trouser pocket. I have seen doctors affixing it on to their trouser belt loop and the steth literally marches with the doctor. There was a lady I knew who use to drape it very gracefully across one shoulder like the “pallu”of a saree and it would miraculously remain in place , defying laws of gravity inspite of her vigorous forays all over the hospital.

Doctors also vary in the ways in which they embellish their steth and look after it. Many pediatricians have small teddy bears or dolls stuck on the tubing to make them look less intimidating to kids. I knew an oncologist who had a miniature skull with a cigarette dangling from the lips affixed on the tubing –conveying the message in no uncertain terms.

There are some who very religiously clean the diaphragm every morning with spirit and dab some cologne for good measure- don’t know if it improves the acoustics but I am sure it is a pleasanter experience for the patient. One is taught to warm the diaphragm by rubbing it against one’s own skin or clothes before placing it on the chest of the patient, especially in winters. I knew of a doctor who took this rather seriously and had a woolen cap knitted by his wife to store the steth , when not in use!

The steth has functions beyond the obvious. At times, it is used to convey an air of maturity, confidence and worldly wisdom and give the impression of a veteran in business. It is sometimes used as a paper weight. Often, it is brandished and waved emphatically to make a forceful point in heated medical debates. An unusual case in point is the story of this very attractive post graduate resident in Medicine who had the habit of leaving her stethoscope all over the hospital. We, as interns, would  keep retrieving it and returning it to her and be rewarded by a dazzling smile and a cup of coffee. I think I got addicted to coffee and developed a fondness for stethoscopes during my internship and that triggered off my career in Internal Medicine!

Needless to say, a stethoscope does not a doctor make; it is the doctor who makes it the stethoscope an invaluable tool and a faithful ally!!

Hospital Rounds

Hospital Rounds!

By

Vivek Hande

 

I work in a rather busy hospital in  Mumbai. It is true that OPD figures seem to be only going up and all specialist and super-specialist OPDs seem to be bursting at their seams. Patients seem to be entering in large numbers to avail the facilities of the hospital and most of them do walk out reasonably happy and hopefully rid of their ailments.

 

I like to walk up to my fifth floor office rather than take the elevator. Apart from providing me some much needed exercise, it also provides me an opportunity to see the hospital in action from different floors. I also get to see patients going about the various OPDs and at times, I am even able to direct some patients to the right department. Earn some Brownie points while you burn off the Brownies, in a manner of speaking!

 

However, during my forays, through the hospital, I saw some people very frequently  day after day. The faces became familiar and we wished each other as we went past. I thought they were far too often in the hospital and did not seem particularly sick. Curiosity got the better of me and I ventured to ask many of my new found friends what was ailing them.

 

I was more than surprised by their candid admission that nothing at all was wrong with them and they were perfectly healthy and intended remaining so. I was genuinely intrigued. I asked an elderly couple whom I used to invariably cross on the sloping ramp from the ground to the sixth floor at various levels. They pointed to their track -suits and the torrential rains outside and said, ‘No better place in Colaba for a walk during the rains. This ramp is easy on our old knees, you know!” Another young man, who always seemed to be in a tearing hurry- he told me he worked in a school close to the hospital. He would rush in  for a mid morning Idli Sambhar in the cafeteria, grab a cup of steaming hot tomato soup from the vending machine in the hospital lobby and charge back to the school , refreshed and fortified to face the rowdy bunch of  boys in class eleven!

 

And then there was this very distinguished looking elderly gentleman who would religiously come every evening; park his car and walk across to the lush lawns behind the hospital overlooking the sea. A widower, he told me, he was staying with his son in an apartment close to the hospital and his best time of the day was the half hour he spent on the hospital   lawns. He would watch the patients and their relatives ambling and rambling gaining strength from each other; he would enjoy the bracing winds, he would watch the waves lap the rails, the birds chirping and   feel alive and vital. He told me that the half hour in the hospital in close contact with nature and the serene surroundings and in the midst of so many people whom he did not know at all would revitalize him like nothing else could!

 

Then there was this middle aged lady whom I saw periodically on different floors and in various OPDs , often helping people and directing them to their destinations . At times she would stand in the Dispensary queue for ladies with babes in arm. She looked animated and seemed to enjoy helping out. I asked her what her story was-she confessed to me that she was a case of severe depression for several years and was on long term medication. She said she had gradually recovered with medication and psychotherapy and was off   treatment for the past two years. Her visits to the hospital and efforts at helping out people kept her happy and gave her a sense of well being. I thought that was really touching.

 

I, thus realized during my hospital rounds that the hospital  was really more than a hospital. It meant several things to several people and the hospital touched lives in more ways than one could imagine. It was not only about sickness and health and caring and curing; it was and would remain a part of peoples’ lives in a million different ways.