C. Ashokan Nambiar
Sr Consultant and Head of Cardiology, Baby Memorial Hospital
Calicut.
Key Words:
Technology; Medicine
One is stuck at the amazing strides in technology as applied
to medicine these days. When I had just finished school and
was about to join college my seniors said if you learn zoology
it is the stepping-stone for a career in medicine. However I
was fascinated with chemistry, physics and maths. Later in
medical college I soon realized knowledge in chemistry and
physics was worthwhile. Zoology was not relevant. Much later
while training in cardiology it was that the advantage of
learning mathematics really helped. Calculations of cardiac
output, valve areas, resistance, impedance and a host of other
measurements were made easy. Principles of fluid-filled
catheters or ultrasound transducers were understood better
without any struggle. Of late we deal in strain, strain rate,
fractional flow reserve and other advances.
Simultaneously the advent of computers revolutionized medicine
as in no other field. While students of my generation burnt
the midnight oil analyzing hemodynamic data using natural
calculators stored in our cortex, the present generation can
get all the data by the click of a mouse. We learned medicine
at the bedside and in lecture rooms where teachers gave
eloquent speeches with just a blackboard and some pieces of
white chalk. There was a lecturer in pathology who used to ask
at 7 in the morning to a packed full house - "What topic you
want to hear today?" And we will listen spell-bound for an
hour in the most elegant language to the most intricate
details of various diseases. As post-graduates it was sheer
magic to listen to the mature physician going into the minute
points of clinical history elicited patiently over a good 40
minutes coming with the correct diagnosis without even
touching the patient in some cases. And there was a professor
who could keep you engrossed in clinical examination from
morning till night without even worrying about food in
between. These all happened before technology hijacked
clinical medicine.
Compare that to the dark room where slides will come one after
the other at a pace beyond the comprehension of even the
quickest mind. Half the people will be sleeping-some even
snore! Videos will roll out, slides will fly in, animators
have a field time and finally audience will be woken from
their sleep when they hear clapping. This is modern teaching.
One cannot help being nostalgic.
Where did we lose the romance of medicine? No one wants to
listen to a patient's history. Either there is no time or many
will consider it not cost-effective. Who wants to look at
jugular pulsations or listen to a late systolic murmur or S4?
The knowledge derived from the scans or other images has
sidelined the graphic picture you could have gathered by a
more systematic logical acquisition of data. Machines and
computers have taken over medicine in a big way and the
younger generation may be left behind if there is no
proficiency in them. While some of our teachers travelled by
ship to alien shores and struggled to acquire foreign degrees
now even that can be got if you use laptops or iPads
intelligently.
In an ever-increasing pace of life in every field is there any
place for human values like love, compassion, patience,
understanding, gratitude, honesty, justice and similar
feelings? I wish these values also would guide one's progress
while pursuing material milestones.