And so, we learn something new every day.

Laser Surgery Conference, 2014.

I am writing this at the end of a long and tiring day, a Sunday when I could have been at home resting after the rigors of last week although I must say that the mental exhaustion is far more than the physical tiredness. But I guess you can’t avoid it when you spend all day on screen- talking to a live audience watching you perform on giant screens placed all around a stadium sized auditorium with everyone hanging on every word of yours from morning to evening- so what in effect I am suffering from is performance fatigue as familiar to every showman.

Now before you imagine any naught things about me, let me assure you that the live show I am talking about here relates to work- doing surgeries live on the big screen for the audience to watch and learn- an audience I might add who has spent quite an hefty amount for the privilege of watching me teach them how to do laser surgery. And it would all have been well and proper if I had been previously prepared and mentally ready to give the performance of my lifetime- but i was not- which is the story i am going to share now. 

Last week all of a sudden I got a call from one of the local organizers of a prestigious state level laser surgery conference who sounded desperate on the phone. He asked me if I could do him a little favor and when I asked him what the favor involved he told me that they had arranged a grand laser surgery conference for the coming Sunday and had lined up eminent speakers and famous surgeons to do demonstration surgeries to teach the conference attendees and now when everything was ready and all the invitations were printed and sent out weeks ago, they were suddenly one person short for the surgery team as one of the ladies on the panel had pulled out citing some unavoidable circumstances. They had six surgeries lined up for the day - six difficult procedures to showcase how lasers can be used- and now they had just five surgeons and he wanted me to pitch in at the last minute as a personal favor.

Now regular readers of this blog would remember me bitchin’ often about how unless you are well connected (second generation or so) or prepared to spend all your time ass-kissing you cannot expect to be invited to these conferences which run purely on patronage and quid pro quo. So even though I would be a nameless, faceless entity at this surgical workshop for someone else had already had her name plastered all over the invitations as the surgeon who would do the demo- I agreed to step in at the last minute in the hope that at least now they would recognize my talent and at least next year they would invite me as one of the recognized speakers and not as a temporary stop-gap. But what really happened there was quite the reverse.

So this morning when I reached the venue for the conference I was quite surprised to see the magnificent arrangements made by the local organizers- the host university. The auditorium was quite large by normal standards of scientific conferences and the operation theater set-up was first class. The first thing I did was go down to the wards and check in with the local people on the types of cases- the patients and their diseases- they had made available for the demonstration surgeries. The post grad students in charge of preparing the cases told me that one of the patients had suddenly taken a turn for the worse so the anesthetist had refused to give fitness for surgery and hence they were down to five patients. Which sobering news suddenly made me realize that I was now superfluous- my entire journey had been made in waste.

Well, left at a loose end I just went back to the auditorium and settled down to watch the conference with a free mind- after all my whole day had just become free. So when the welcoming ceremony and the felicitations on stage started I was surprised to note that all six of the original invitees were on the dais - surprise, surprise -including the unavoidable circumstance lady. Now I felt like a double idiot. Why did they call me at all? And for what purpose had I made the long journey on an early Sunday morning? Was it just to watch people who are second best to me muff up their surgeries? While I who was a kick ass surgeon sat among the watching audience. but the story was not done yet and there were still twists to come.

After all the dignitaries on stage had made their speeches, accepted their mementos and certificates from a grateful conference host team there was a lull in the proceedings. It was right about then that one of the organizers- the one who had called me originally- sidle up to me and tell me that they still needed me to do the surgery I had promised to do as one of the other surgeons had a sudden family emergency and had to leave early- right after getting her memento. And he asked me which surgery I would like to do? Nonchalantly I told him that anything would be fine with me- I was equally competent at all surgeries. And that’s when he told me to go down to the theater and start off the conference as the first surgeon – which he put it to me as a marquee post and a great honor. So happily I traipsed down, changed, put on gloves, mask, head-cap and the heavy duty black goggles we put on for laser surgery to avoid damage to our eyes (the retina is very sensitive to laser beams and so all laser surgeries require black goggles) from the powerful laser rays and looking like a space suited astronaut I was ready to start the surgery.

They hooked me up with a mike, they positioned three powerful video cams for the live feed to the auditorium and when the cameraman said we were live, I introduced myself (my only chance to have at least someone know who was the real surgeon) to the audience explained the procedure and started  doing the surgery. Immediately there was feedback from the auditorium that I was going too fast for them to see properly and they requested me to make my cuts slower which i reluctantly accepted for I am usually a very fast worker. As I was working and explaining I kept getting questions from the audience in the auditorium who were questioning my every decision during the surgery and I had to keep convincing them as to why my decision was best.

There was the usual assortment of cranks among the audience who kept asking questions just for the limelight. One of the questions was why plastic surgery was at all necessary- it is of no actual benefit to human health. For answer I asked the old gentleman what kind of smart phone he had- whether an i-Phone or a Galaxy something or the other and then hectored him with the knowledge that as long as any basic phone can make and receive calls why go for smart phones? Why pay extra? Because the smart phones add value beyond making calls. Similarly plastic surgery adds value to basic health and makes a healthy life happy. And I then reminded him of Steve Jobs dictum on the first “i-Phone” as an “aspirational device" which everyone would value and taking the analogy forward told him that plastic surgery too is an aspirational specialty as everyone wants to look good and was there anyone, anyone at all in the audience who had not looked at the mirror before coming out of the house that morning? By then I had completed the surgery and I told the PG student assisting me (a nice looking girl) to call up the organizers and inform them to send down the next surgeon for the subsequent surgeries.

So after washing up I was getting ready to go back up to the auditorium when the organizers as a group came up to me and started fidgeting. I could see that something was up but did not guess how far they had screwed up things. After a little hemming and hawing the chairman of the scientific committee said that the others had all left. As I stared flabbergasted at them they said that the other surgeons on the panel had one family emergency after another, had relatives visiting, had children crying and all sorts of excuses to give and they had all left the place leaving me to hold the can. I felt like asking them how stupid they could be to let all those “experts” escape like that and how all these emergencies had suddenly developed only after the welcome function and certificate (memento/shawl) distribution. To me it looked clearly like a case of cold feet. They had come expecting something else but having taken a look at the large and hostile audience they had quaked and run away on flimsy excuses and the organizers had allowed them to leave without holding them to account.

Anyway the organizers were now requesting me to complete the rest of the surgeries- all five at a stretch single-handedly. For a minute I thought of screaming at them, throwing a temper tantrum and just walking away like everyone else had done. After all who could stop me?  I had taken no payment from them and made no firm commitment beyond one case. But when I looked around everyone especially the poor students from the host institution were watching me expectantly and I could see they were thirsting to learn something from me today.

And there were also the patients to think of, the poor patients who had all been told they would get to have their surgery today and had been waiting for days for the surgery. After that, I just didn’t have the heart to walk away and leave them to stew on their own juices. So I agreed like the sacrificial goat to do the rest of the surgeries on my own and went on to do the first three before lunch and hurried away to eat a couple of spoonfuls of curd rice (I had to avoid sleepiness) before getting back to the theater to finish the remaining two surgeries. Late in the evening, after wrapping things up I accepted the organizers empty thanks and then started back home.

As I came back home this evening, all the way back I was thinking of what had gone on today. I had spent an entire Sunday working like a donkey doing case after case for free. I had spent my own money on petrol to travel to and fro from the university venue situated outside the city limits. For the price of two spoonfuls of curd rice I had done five surgeries and had answered question after question (while doing the surgery too) leaving my throat dry. And all the while no one knew that it was I who was doing the work. My name was nowhere on the invitations- the ladies who had run away had got all the name fame and certificates for doing a splendid job. All I had was back pain, a stiff neck, a raw throat and mental fatigue. So what did I actually achieve?

Well for one, I got my lesson. I gained firsthand knowledge about how things actually work in the real world. How people can get others to do their work for them in the background while they bask in the limelight getting all the recognition. I also realized that I am not as clever as I thought I was- it was a wake-up call for me to be more streetwise and not fall a prey to such tactics again.  I learned that I still had a lot to learn about life - even if I knew a little about surgery - that there are umpteen numbers of excuses to get out of firm commitments. I learnt that giving our word is no longer sacrosanct and people don’t always keep their word.  I learned that organizers of conferences who go after famous names are at their mercy and have to beware of being tripped up by those very same big names. And I learned that when push comes to shove I don’t have the heart to abandon a challenge but am ready to bear the cross of others failings too.

So at last I came away filled with equal parts contentment and equal parts chagrin. The chagrin because once again I was the nameless faceless entity working hard behind the scenes for others success. The contentment because- all said and done- minus the affront to my ego and my envy at the well connected few- I got something out of this experience that I had never imagined I could get- I got to strut my stuff on the big screen, live, all day long, with my own dialogues and no one to say cut or action or to edit me. Even the biggest stars get just 3 hours on the big screen and here I was a rookie- with thrice that screen time. And so I have finally made my big screen debut and all the pain and fatigue finally sounds worthwhile. And in the end the take home message- damn I love the big screen. Plus- I have arrived- a new star is born. Take that, you guys.

But Where Is The Other Banana?

But Where Is The Other Banana?

Patient : “Doctor, doctor, look at my lips, this is all because of you, all because of the medicines you gave me, my lips are all ulcerated and painful” screamed the patient at me.

I took my time trying to process it all in but the early warning signs were clear- my life as I knew it till then was probably over. This patient was going to scream and create a scene, maybe even file a court case against me and some stupid judge who had probably been in a fight with his wife over breakfast will find me at fault and order a compensation amount enough to wipe me out and all this doomsday scenarios revolved around in my mind in the ten seconds after I heard that screaming voice before my training automatically took over and careful to keep a blank professional look on my face (hiding my inner terror) I commenced further enquiry.

Me: "Mrs.So-and-so...I don’t remember you, when was the last time I saw you? And for what? Do you have any prescription of mine? (Denial is the best offence right?)

Patient: “I didn’t bring the prescription because I lost it, but I came to you for an infection and you gave me two tablets to take morning and night for two days”

Me: “And when was this?”

Patient: “Oh, I don’t remember, around ten or fifteen days ago I think”

Me: “Was it ten? Or fifteen? How many days ago did you see me? Tell me correctly for its very important”

Patient: now in a milder voice- “Hmmm, I think two weeks ago, but I don’t know the exact date”

Me: “And I told you to take the tablets for two days, right? Did you take it?”

Patient: “Yes, of course, I took it for the two days”

Me:  “And I must have definitely told you to come back after two days, right? I tell all 

my patients to come back for a check-up without fail. Why didn’t you come back after two days?”

Patient: now in a definitely hesitant voice – “I was busy”

Me:- moving my voice up a notch “Busy? Busy? Very busy? What’s more important than your health?”

Patient: “But that is exactly why I couldn’t come doctor- I had severe fever- viral fever they diagnosed it- for ten days after that- and then I was admitted in so-and-so corporate hospital for ten days to treat the fever and was not discharged till three days ago and so I couldn’t come see you as you said- only now I am free to come see you”

Me: in an exaggeratedly patient voice – “Yes Madam and can you tell me when exactly these lip ulcerations developed? When you first saw them?”

Patient: in a wary-unwilling voice- “Two days ago, I think, but I definitely noticed them yesterday” 

Me: “Madam, are you aware that fevers, especially, severe fevers like viral fevers (with increased body temperatures) can cause lip eruptions all by themselves - especially if they are of Herpes simplex virus origin (which is a sexually transmitted disease by the way, so where have those lips been hey?) And also the drugs they must have given you for a ten day old severe fever could also have been strong enough to cause an allergic reaction to your lips?” 

I took a significant pause to wipe my specs and stare at her in my most intimidating professional “who-are-you-kidding” manner

Me: “So how do you connect the mild, probably vitamin tablets I gave you fifteen days ago for two days with the lip eruptions you developed yesterday? Can you think of any reason?”

Patient : “Oh, ah, but the hospital I was admitted in for the past ten days told me that my lip ulcers were not caused by them, they didn’t even listen to me doctor like you are doing, they just chased me away, saying it’s a very minor thing and they will give me an ointment for it to apply for one week and they asked me to leave and so I was confused and then I remembered you”

Me: and so you thought about whom to vent your anger on and decided poor old me was the person to scream at? You know what, I am happy you got what you deserved there- such a crappy response- from that big corporate hospital – “Madam, what they said was correct, no need to panic for such a small thing, I think that ointment they gave you is enough and your ulcers will soon heal if you apply it.”

Me: “And oh, no fees, please no fees, you are after-all an old patient” and I will never touch your goddamned money as this will be the last time I will ever see you, bitch.

And that’s how some of the patients are. They blame doctors for everything which goes wrong in their lives (even unconnected things) and remind me of that famous banana joke of comedians Senthil and Goundamani (You-tube link of comedy scene) in which when Goundamani asks where are the two bananas he paid for, he keeps getting the same answer from Senthil “but this is the other one” a perfect example on how to do a matter-of-fact pulling of the wool over the eyes when wide-awake.

And this is just to show that some patients have no qualms in ripping-off doctors and contrary to what the media keeps telling all the time it’s not fair to accuse doctors as being always wrong while patients are angels.

A New Hope….The “Wow” Of Stem Cell Treatments

A New Hope….The “Wow” Of Stem Cell Treatments

Stem Cells under High Magnification

 There I was sitting in the audience of the darkened convention center staring at the slides running on the screen feeling a slight tinge of envy and an odd sense of disappointment thinking that it could have been me there presenting these results, if only. Ah, that "if only" plays a major part of all our lives doesn’t it?

Anyway to start from the beginning I had spent the last three days at a specialty national conference as part of my commitment for annual medical education to learn what’s new in the field of regeneration. Too many times we get caught up in the everyday worries of clinical practice and forget that there is a whole lot of innovation taking place out there in science some of which may be a game changer to how we practice medicine in the near future.

Take for example stem cells. Those who follow this blog regularly know that i have in the past been dismissive of what I have thought was the highly inflated claims of the stem cell propagandists in touting it as a cure for all diseases (read here and here). Well I am happy to confess that i have now changed my mind. I too believe in stem cells now. I believe that soon, very soon we might have actually workable stem cell therapies at hand- something which i would have argued against a few months ago.

There is a thin line separating skepticism and cynicism- what with all the false stuff floating around in the name of miracle cures - science needs us to be ever vigilant and skeptic and believe any claim only if it is proved or disproved with reliable evidence. But to reject the hypothesis without examining the evidence at all is a sign of a closed mind and cynical in the extreme. Thankfully I am not a cynic and if you show me the evidence and it stands rigorous examination then I am happy to change my mind and jump onto the bandwagon too. That’s the advantage of having an open mind.

As I said earlier, I sat there (for three days) in the darkened auditorium staring rapt in attention watching slide after slide of before and after treatment photographs and micro-photographs (histological slides under high magnification) of various diseases where stem cells had been used and I came away impressed. I could see jaws which had been amputated halfway- hemi-mandibulectomy done- grow back into normal jaws with stem cells. And i saw unhealed diabetic ulcers and amputation wounds close down normally with no sweat at all and I couldn’t help thinking that this stem cell therapy thing is definitely a breakthrough in medicine.

Best of all these were all mesenchymal stem cells harvested from routine menstrual blood and not embryonic stem cells with all its hassles (complicated procedures) of cord blood collection and storing even as the child is being born. That old adage of women being life givers is once again being reinforced with even their menstrual blood which is usually discarded as unsanitary -being put to life giving use. And it made me think of that quaint old Indian habit of women being considered as untouchables during their three days of menses and often set apart from the pooja rooms and other religious ceremonies. Science is now providing a fitting reply to religious obscurantism isn’t it?

If you think I am painting too rosy a picture i would be the first to agree that there are still a lot of steps to go through- there are unresolved issues in collecting the stem cells, culturing them (growing them) in the lab and making use of them in the proper way for the proper disease to get the proper result - for the cure should not be worse than the disease, right? There are also worries about stem cells helping cancer cells to grow faster along with normal cells and their cessation of growth by contact inhibition is yet to be elucidated- that is how does the stem cell know that your kidney is only this big and it stops growing further once your size is reached? What if it decides to keep on growing in size till you have the mother of all kidneys? What stops it actually? Food for thought right?

But anyway all these are technical issues and once the proof-of-concept is validated then these can be tackled by multiple people working simultaneously everywhere. Its like somebody inventing the first car and showing that it can indeed run on the road and then people everywhere get in to solve the practical issues- like one person inventing the accelerator, someone else somewhere inventing the brake and someone else inventing the gear box- none of which was possible till people believed that a car could actually run as said.

And as the researchers stressed again and again they were still only dipping their toes in using stem cells  for treatment, exploring the possibilities of its application in a blind "let’s try this and see what does happen" way and it was still in the experimental stage with no long term results available YET. But if the initial results are anything to go by then we are just that nearer to growing back lost or damaged organs- like a kidney, liver or even an amputated limb. We can hopefully cure diabetes, restore lost memory in dementia cases and even make sure that those with spinal cord injuries and paralyzed in bed can take up their beddings and walk again- as the bible says

It might take us another ten years or fifteen for the treatment to go through all the approved regulatory agencies and for all the working mechanisms involved to be studied fully - for we still don’t know much about how/why it works - just that it works but eventually we are going to be able to get commercially mass produced stem cells which can be injected in a wound site and the damaged part is going to heal over nicely without any sign of the original injury or scar.

I even got offers from one or two companies which are early pioneers in this business (start-ups) offering to supply me with stem cells for competitive rates at RS------for a million cells- the total dosage to be determined by the wound size and disease. Of course if I did buy them and use them on my patients it would have to be an experimental trial (clinical study) only and i would have to go through all the prescribed procedures for conducting such a trial prior to doing the treatment. Or I could wait till it becomes mainstream in a few more years and then start using it on my patients along with every other doctor.

As I said right at the beginning of this post, over the three days I was there at the conference I did feel slightly (well, a lot) envious of all the cutting edge advances taking place, more so from the fact that i too could have been one of those up on the podium getting the applause from the audience if only i had not been chased away from all research by the memory of my bitter experiences during college days.

For those readers who have been with this blog for some time I have in some of my past posts mentioned how when I was a promising young researcher working on my thesis some of my results were stolen in the pre-publication stage by a trusted mentor and I had to practice a scorched earth policy in making sure that no one, including me, could ever use that research anywhere. Not the wisest of options I guess- wasting two years of my hard work in the bargain but I simply wasn’t willing to sit back and allow myself to be cheated without fighting it to the bitter end.

Come to think of it now when i have a far more mature head on my shoulders I feel that I overreacted and let the shock of betrayal lead me to burn down the entire house to deal with a backstabbing rat but for good or bad I swore off research forever and decided to stick to clinical practice (and making money) for the rest of my life. So for years and years i have been happily practicing my cutting and sewing working with real patients instead of petri dishes and microscopes and making me a comfortable living in the bargain- but there is always a tiny bit of regret buried somewhere in my heart that i did not follow through with my research ambitions, especially when i attend conferences like these and see such cutting edge scientific advances.

I know it’s just presumptuous to assume that I might have been a success as a researcher but who knows? The future is a closed book to us and if destiny guides me to a path of research again I might even chuck my scalpel away and start ogling at microscopes. Even if I have to sacrifice some/lot of my current income and get accustomed to a lower standard of living just so future generations can benefit from my research findings. Besides there is a hidden thrill in research - that moment when you see the first evidence of your hunch being proven right- a sense of winning against your own doubts which is almost an orgiastic experience and it pays off for all the sacrifices you made till then.

So that’s all about the stem cell therapies i learned about recently which might provide a far more brighter and enriching life (disease-free) to future generations of humanity- so much so that I am tempted to label it "A New Hope" - a phrase familiar to all Star Wars fans. The future, ladies and gentlemen, looks far, far bright than the present. God bless us all.

No Red Lights – The Unstoppable March Of Technology In Healthcare

No Red Lights – The Unstoppable March Of Technology In Healthcare

(Disclaimer: This post was written for a competition organized by Indi-blogger and Apollo hospitals on the topic of “How does modern healthcare touch lives” – please check this link for further details: http://www.apollohospitals.com/cutting-edge.php)

The other day I was at a swanky new private medical college on the outskirts o the city, the venue for a surgical workshop. They had invited me over for a small live-demo surgery of the trapdoor technique of harvesting connective tissue. For those who don’t know what a trapdoor is (go Google it) - sometimes when you need a bit of skin to graft someplace you can take it off from the patient by cutting up the patients skin on three sides, lifting up the patch of skin and then by cutting off the layers underneath (the skin has many layers) you can take them and use them elsewhere and meanwhile stitch back the upper layer of skin in the same place with no hint of anything missing underneath. The technique is first taught to youngsters by asking them to cut an orange by peeling off a little bit of the skin carefully and getting the pulp out from underneath without damage and then putting back the skin of the orange so that no one who looks at the orange should ever suspect that it’s hollow inside.

I trained in a government hospital which has a big reputation for many, many years and so we used to get a lot of patients from all over the state and even from our neighboring states. We used to get such a surfeit of patients that after a few times practicing surgery on oranges, we immediately shifted over to real patients and real skin. But unfortunately the same cannot be said for the kids in some of these newly started private colleges. The students (who have often paid extremely large amounts of money to get a seat) have to keep on practicing on oranges for a long time and wait and wait for a chance to do it on real patient’s skin. 

Being fairly familiar with this technique I had been invited to visit one such college and do a small demonstration surgery to teach the kids there the differences between an orange skin and human skin. As my surgical workshop was scheduled for the afternoon and the lectures in the morning session were boring me, I took to wandering all over the swanky new campus taking in the sights. And that’s when I noticed something which really brought home to me the advances in health care from the times I had studied and the situation now.

Impact On Hospitals –Tablet Computers In Wards

As I wandered around the bright and gleaming wards, i could see that there were ward rounds going on with the chief issuing instructions and the students taking down notes diligently. But unlike in my student days when we had small scribble pads for jotting down the chiefs muttered instructions (one of this and two of that etc) these kids were using tablets for note taking, real tablets of the electronic kind - i-pads and galaxy tabs etc. The students were taking photos of the patient with their tab cameras, attaching it to the case notes and whenever there was something they didn’t understand or when the chief asked them a sudden question they were checking for it on Google, like the values for sodium or potassium in normal human body. We on the other hand used to mug up the entire values table and carry all that useless information around on our brains for instant recall but these kids were just storing it all on the cloud- on Google’s servers and accessing the relevant info when needed. That was quite a revelatory moment for me when I realized how much new technology can impact on health care.

Impact on Investigations –Digital X-rays

Take x-rays for instance. Previously any x-ray we got from the radiology department was iffy at the best. On some days the radiography technician would send us clear x-rays, some days they would send us cloudy x-rays with nothing visible depending on their moods (or what their wives said to them at breakfast). The only way to get a guaranteed good x-ray (for any complicated case) was to personally go to the x-ray department, take an x-ray by yourself, head into the dark room (pinch a few girls there- under the red lights) and develop the x-ray by yourself by alternately dipping them into the large tanks full of developer and fixer solutions. If you were skilled at it, you could make even an average x-ray gorgeous by timing the developing (by under or over developing) and fixing processes.

But now all that’s become superfluous for you have digital x-rays. Now it’s all about pixels and values and the results can be seen in seconds on a monitor. Every digital x-ray is standardized to the same incredible level of detail and clarity- by idiot proofing (removing the human being off the loop). Of course when you press a button and get an x-ray immediately, you are tempted to order more and more x-rays sitting in your chair compared to when you had to haul your ass off to the radiology department every time you wanted to get an x-ray. So digital x-rays do have the drawback of tempting doctors to order more x-rays then necessary. That and missing out on all the fun and romances which used to take place in the x-ray dark rooms, behind the developer tanks, under the red lights.

Impact on Surgeries –Using Simulation Software

The same kind of technological ease of use is seen with surgical planning nowadays. With all the modern CT’s- with their various slices of info- 64/128 etc, you get all the info as bits and bytes which you can take and feed into a simulation program to recreate the CT as a 3-D human dummy and virtually practice the surgery. If you have ever played Microsoft Flight Simulator, then you would understand how awesome it is do a simulation practice before doing the actual thing. Previously we used to lie back with our eyes closed and imagine the entire thing in our minds from cutting to stitching in a step by step imagination. Now we just switch on the simulation program and start cutting. But again with all this wealth of detail available, it’s so tempting to order more and more CT’s for every stage of diagnosis rather than being satisfied with just one preliminarily.

On a related note, I know that a lot of patients feel that doctors nowadays order a lot of useless investigations and tests. But the best person to decide the necessity of that test is the person who might ultimately be held responsible for the consequences- your doctor is the best judge for what is needed or not. And for every extra investigation ordered by the doctor, which you feel is useless, think how you would feel if the doctor had not ordered that test and you ended up getting that disease. And how thankful you should be that your test results came back negative, rather than cribbing about paying for that test.

Using Robotic Surgery Machines – Da Vinci Robots

When it comes to the actual surgery, only the best surgeons were said to be confident enough to make their incisions (cuts) in one long fluid single stroke at the correct length, depth and angle. But now with robotic surgical machines and lasers replacing scalpel blades even mediocre surgeons can make the cuts with the same precision as, hey they aren’t actually making it, they just have to set the depth and length on the touchpad screen and the laser does it for them – thereby leveling the field between good surgeons and great surgeons. But there are also drawbacks to these robots, for we hear that the Da Vinci Surgical Robot has been known to freeze up halfway during surgery – once with a patient’s liver grasped tightly in its clamps- due to a software glitch (or virus attack) and they had to shut down the whole system (the robot) and re-boot it again to get the robot to release the patients liver. So if you ever have a robot doing your surgery and it stops suddenly- don’t panic, just press Ctrl+Alt+Del to have it re-start (if its windows based).

Using Stem Cell Therapy- Via Star Trek The Series

Finally we come to the big daddy of medical technology- stem cell therapy for organ replacement. Let me share a small personal anecdote here. When I was a little kid they used to show Star Trek the original series on Television. One episode of which was quite an unforgettable experience for me. The episode I am talking about involves the Star Trek crew coming back in time to the 20^th century to save the whales from destruction. In one point in the serial as Captain Kirk, Spock and the rest of the crew of Starship Enterprise rush through the corridor of a typical 20^th century hospital Dr.Bones is stopped by an old woman who asks for some relief from her severe pain. The surprised Dr.Bones hangs back (while the others leave) to ask her what she is suffering from and she says that both her kidneys had failed and she was going to die soon.

Dr.Bones looks around carefully to see that no one is observing his actions and pulls out a pill and gives it to the old woman to swallow. At the end of the episode we are shown a television reporter standing outside the hospital and talking about a medical miracle where an old woman with kidney failure suddenly grew two new kidneys inside herself and everyone turns to stare at Dr.Bones. That decided me in my career – that exact moment. I wanted to be the guy who handed over such magical pills to cure patients in pain- I wanted to be a doctor. I wanted to be Dr.Bones. With today’s technology I know that we are very far from such instant organ replacements. But who knows about the future? A breakthrough might happen any time or any day. We can always hope.

The Future Is Here- As Google Glass.

And some of those hopes might even be coming true in our own times- example – Google Glass. Do you recall those medical students I was jealous of? The ones using i-pads to review notes? Now imagine using Google Glass to get real time information about all the medicines being taken and test results of each patient who is lying on the bed as we walk down the wards – is there any way we can miss anything important about the patient?. Imagine using Google Glass to layer a real time surgical simulation as we do the actual surgery- is there any way we can miss any important step? I am very, very excited about Google glass and its effect on how we practice medicine. Off-hand I can think up a dozen new ways I can use Google glass in my daily practice to help my patients.

So to come back to the premise of this post. Technological advances stop for no person. Technology keeps developing at a rapid pace and it is up to us to evolve to keep pace with the advances in technology. This is as true for the healthcare profession as it is for any other profession. We cannot close our eyes and insist on practicing medicine the old way, for the old ways are dead. Evolve or perish is the new mantra. As wise master Yoda once said "There is only Do, there is no Try"

And finally, technological advances can make a mediocre doctor a good doctor, a good doctor into a great doctor and a great doctor into, ahem, ahem, me…(just kidding).