I was secretly ashamed of working with the Professor…Not only was he called the “Old Pete” (Behind his back of course), He was a full time surgeon at the Sion Hospital…It meant that he was paid a salary by the government and was not allowed to practice outside the hospital…The salary that he received was a pittance and didn’t do justice to his expertise…He also was very short with his patients, the motto being “Too much coddling makes an uncooperative patient”..Strangely, his patients loved him, with several long term follow ups for decades…..His rounds could be an ordeal when he would blast you for real or imaginary lapses in management….My registrar who had to phone him every evening informing him about the status of patients would always be on the brink of a nervous breakdown…I wanted out…I spoke to our Associate Professor, asking him to broach the topic with Prof….
“So you want a change of scenery eh?” was his greeting the next day after the rounds….Yes, I stammered, I wanted to get an experience of how other surgeons thought, how they treated the patients…I also wanted to know how they conducted their lucrative private practices….”All right, I am posting you from next week as Dr Joshi’s Lecturer” I was ecstatic…Dr Joshi had a very vast private practice and was known to give his Lecturers a lot of independence, the thing that was in short supply with Prof..He kept you a short leash…But surprisingly, there was a rapid turn over of residents who worked with Dr Joshi….
Next week, I saw a thirty year old man with a swelling on the sternum (breast bone)….It looked like a typical squamous cell carcinoma of the skin….x-ray of the chest showed thickening of the periosteum suggesting involvement of the bone. Surgery would have involved the removal of the sternum or a part of it and reconstruction with a Prolene mesh..I called Anil, the Cardiothoracic Surgeon…He saw the x-rays, spoke to his consultant on the phone and turned to speak to me….”Guru, this a general surgery problem. It is basically a skin tumor with possible involvement of the sternum. The heart and intra-thoracic structures are normal. You will have to do it yourself. If it were a cardiac myxoma I would have jumped at it…..” He left.
I showed the patient and the x-rays to Dr Joshi…”You want to do this case?” he asked. Of course I did..”Ok post him next week. I will give you a hand” he said…I was ecstatic..It would a test of my skill..
The patient was on the table….No sign of Dr Joshi…I called him at one of the large private hospital….”Start Guru, induce the patient..I will join you in half an hour’s time.” I gave a thumbs up sign to the anesthesiologist and went to scrub up…..
It was half an hour after induction of anesthesia…Still no sign of Dr Joshi…I asked my registrar to contact him…He returned in ten minutes..”Dr Joshi is busy with a hemorrhoids operation…It will take him at least another hour and a half to come…He has asked if you can go ahead on your own or contact the Professor and request him to make alternate arrangements.” Call the Prof after I had deserted him? I was helpless….The anesthesiologists were giving me dirty looks….
I scrubbed out and called Prof….He listened to me without interruption. “I will be there right away”..
We excised the tumor. It was surprisingly easy…We reconstructed the sternum with a mesh….The Prof left the OR without a word of praise….I felt wounded…
The patient did wonderfully….I never saw the Prof seeing my patient after surgery…I was very angry at him..This was being small minded. Not see the patient at all? He had drummed it into us that post op care was very crucial…
“You know something?” The old tobacco chewing nursing assistant told me. “Prof was praising you the other day after he saw this patient.” You mean he actually saw him post op? I asked….Every day after duty hours, he would visit the patient…He would suggest changes in treatment….The Registrar was told ” Don’t tell Shirahatti that this was my suggestion. Let it appear as though this was your idea”
The next month, I requested a transfer back to the Prof’s unit…..