Remembering the Gurus

 


Today is Guru Poornima. A perfect occasion to reflect on the blessings of the many Gurus( teachers) who went to great lengths to impart everything they knew, without any reservations. Whatever footing I am on now was erected brick by brick starting with my parents who were my first gurus to my teachers in kindergarten and elementary schools to higher education and of course the Almighty who guided in the realm of Adhyatma. 


I thought it may be relevant to share anecdote of a recent experience I had. 

I had just returned from the wari and my sister in law sought my help for a friend of hers. This friend Anita(name changed),I was initially told, was having dizziness for last 3-4 years. She had seen many doctors, including specialists and undergone multiple tests and trials of various treatments. But her symptoms had remained unchanged. She was frustrated and worried.

I met her one evening. She had brought all her test results and records of medications given to her. Blood tests, ecg, an audiogram and MRI of brain were all normal. I reviewed each of them carefully. Really there was nothing remarkable about any of these.

I asked her to describe to me her symptoms, asking for clarifications and more details as she tried to explain. Everything had started in 2019. From what I heard the symptoms were vague but certainly did not fit into a picture of vertigo. Although the entire basis of her work up started when the first doctor who had spoken to her, a curb side opinion from a family member, made the initial diagnosis of vertigo.

Thereafter she was referred to a noted ENT specialist in the city. She did not meet him personally. Instead two of his junior associates saw her and ordered blood tests and an audiogram, and gave her medication for vertigo. When that made no improvement they gave her some maneuvers to do at home. Nothing has helped. She went to other doctors for second opinion and they told her nothing is wrong with her! It is hard for her to accept that because her symptoms are for real. 

I asked her if she had stress of any kind. None whatsoever, she said. 

Has any doctor who you went to since 2019 take a look inside your ears ? Not X-rays or audiograms, but in person look in the ears with a simple otoscope? 
No.
 I asked again. 
No. 

All sorts of inexpensive and expensive tests later, multiple consultant fees later and 4 years later, not one person had sat and taken a good history or done a basic physical exam based on the history!

I could take a history but I didn’t have an otoscope or stethoscope with me that day. I told her to go see her GP( general practitioner) and ask them to look inside both ears. I explained to her what I would be looking for. Something very simple like built up of wax or evidence for allergies by looking at her ear drum ( tympanic membrane). I reassured her that although her symptoms are real, they do not appear to indicate anything life threatening. She didn’t seem to believe me.

She called me the very next day. She had seen her GP and they found one of ears was completely blocked by dense wax. The other ear wasn’t as bad but also had wax. The doctor could not get the wax out by irrigation so told her to get some ear drops, use them as directed and return for follow up next week. I confirmed my agreement with this plan of action. She was already feeling improved.

Why am I sharing this anecdote today? What is its connection with Guru Poornima? 

As far as I am concerned it has everything to do with Gurus. 

I come from the generation when our teachers paid great emphasis on taking a good history from our patients and following it with a good physical exam. Any extra testing was to be considered with deep thought about necessity and utility. Each case had to be looked at in its unique context. Tests were not ordered automatically, habitually, randomly or indiscriminately. The costs of the tests and level of their invasiveness was taken into account. In fact with a good history and physical exam there was often no need for other tests. The diagnosis was made right there. 

Our generation was trained by such masters of clinical medicine whose eyes, ears and hands knew what to look for and more often found the answers before having to poke with a needle or probe with an X-ray. 

Our generation was also one that practiced medicine in an era that saw the emergence of highly sophisticated testing devices and applied technologies. 

Thus sandwiched between these two vastly different times we saw the good, bad and ugly of medical practice. 

The incident I shared about is classic example of today’s medical practice. Before even spending time with a patient to listen to their symptoms and concerns or putting a hand on them for a physical exam, the doctors write out prescriptions and order tests. History and physical exam come at the end of whole circus, if at all someone thinks of it. The current situation has turned medical providers into robots. And now there is talk about robots/ AI replacing doctors!! I wonder how AI will interpret “ kasa tari hota ahe “ kind of symptoms? πŸ€”. ( I feel uneasy. Vague symptoms that really don’t give any more clue leaving the doctor to make sense out of it). 

How I miss those teachers who trained us the good old way. What they gave us was pure gold. The value of that gold has been appreciated even more today and my head just bows in gratitude and reverence for what we got from these masters. We can only hope that the newer generations of doctors can sit and think about where and how their practices are failing their patients and themselves when the thinking mind is replaced by too much reliance on technology. This post is not intended to show that I am smarter than anyone.  It is also not intended to ridicule anyone but to bring attention to the misguided path that many are taking in present times. To make students aware of the dangerous trend where human intelligence takes a back seat to technology.

My eyes are welling up with tears as I remember all my teachers today. They knew how to turn dust into gold. Many of them are not there in the physical bodies today but they live on. I hope they will live on much after me and continue to inspire more than just the generations that they taught πŸ™πŸΌπŸ™πŸΌπŸ™πŸΌπŸ™πŸΌ

Today was the official first day of start of my Department of Preventive Medicine OPD at Deenanath Mangeshkar Hospital. The team sat in my office to discuss strategies and work flows. Wore this white with black fine cotton jamdani to work today. Photo taken on the staircase of the hospital. The medical director Dr. Kelkar loves traveling, watching birds and animals. Many of his photographs hang on the walls of the hospital.


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