In 1988, during my housemanship, LKH, a dedicated doctor who was excellent with his ears and eyes, related to me his experience in a medical rounds taken by his professor during his medical school days. The professor was describing the methodical but laborious ways to examine the chest and to appreciate the various sounds that were audible via a sthesthoscope. An American medical student doing his elective posting, who was amongst them, raised his hand to suggest, "Professor, wouldn't it be easier if we just ask for a Chest X-Ray to be done?"I am afraid we have come to this. Gone are the days where a proper medical examination starts with a good history taking. After developing a rapport and trust, the ancillary tests aid diagnosis, not the way to diagnose a condition!
Now, it appears that patients or symptoms are triaged to undergo complicated tests and imaging before a proper examination is done. Furthermore, simple Roentgenogram (Xrays) are deemed worthless now. Why do Xray when you can do an MRI?
A friend was all excited when his wife delivered a healthy son after a late marriage. So naturally, when his parents, who acted as their babysitter, told them that his 4month old boy had jerky movements of the one the hands, sometimes, he flipped.
A rush to the biggest private hospital with the state of the art equipment and workforce brought him to the office of a healer. Within a jiffy, before you can say, 'POOF", the infant was MRIed and an EEG was down together with a battery of blood tests with crimson hued sanguine filling test tubes with various colour coded more than the rainbow. After a few days' stay and a few thousand ringgit poorer, he was told that everything was A-OK. Diagnosis? "I think we will keep an eye again and do some more tests if it recurs"! In other words - Idiopathic, G.O.K (God only knows)!
The next few days were unsettling. Every grunt and every hiccough from the infant raised everybody's eyebrows and everybody's pulse rate. Ventilating with friends and relatives brought them again to an experienced paediatrician in a humble clinic without the flashy glare of new medical equipment. An old dog in this field, he resorted to the oldest trick in the book. He took a detailed history and a complete examination to come to a conclusion that the jerky movements were probably related to the improper way of carrying the baby and nothing more.
Now, it appears that patients or symptoms are triaged to undergo complicated tests and imaging before a proper examination is done. Furthermore, simple Roentgenogram (Xrays) are deemed worthless now. Why do Xray when you can do an MRI?
A friend was all excited when his wife delivered a healthy son after a late marriage. So naturally, when his parents, who acted as their babysitter, told them that his 4month old boy had jerky movements of the one the hands, sometimes, he flipped.
A rush to the biggest private hospital with the state of the art equipment and workforce brought him to the office of a healer. Within a jiffy, before you can say, 'POOF", the infant was MRIed and an EEG was down together with a battery of blood tests with crimson hued sanguine filling test tubes with various colour coded more than the rainbow. After a few days' stay and a few thousand ringgit poorer, he was told that everything was A-OK. Diagnosis? "I think we will keep an eye again and do some more tests if it recurs"! In other words - Idiopathic, G.O.K (God only knows)!
4 months after the visit, there are no more abnormal movement and everybody sleeps well in the house - father, mother, son and grandparents.
My friend, an accountant by training, realizes that medicine is not a science that has to have black and white proof like the receipts that he needs to balance his accounts but is an art by itself.
No comments:
Post a Comment