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Leader of the Team - 7

Leader of the Team - 7

Dr.V.N.Shrikhande 

A surgeon is the leader of the team. He must have the capacity of a manager, organiser and planner. He should be a pillar of strength in times of distress and emergency. He has to compensate for the deficiency of his team without grumbling. He has to take quick decisions in unexpected and uncertain situations. He must be consistent in his behavior, cautious, confident and trust-inspiring. He must have physical stamina and be capable of intense concentration for long hours. This calls for a disciplined life. A surgeon may have to work for ten continuous hours but the last stitch of the last operation should be as precise as the first stitch in the morning. And a surgeon must know when to quit.

Very few people realize that in every operation we first make patient seriously ill in order later to cure him. Every anaesthesia and every invasive surgery constitutes a stress. Whenever I am asked whether the operation I am going to perform is a major or minor one, my. Answer is that for a good surgeon, no operation is minor. For an experienced pilot, no flight is minor. It can be a short flight or a long one, but he had the engine, gather speed on the runway and take off in the air and the flight is not complete until he lands safely on the runway. Every landing is a crash landing but it is a planned crash. A plane moving with spend meets resistance on the ground and this is the crucial moment. I have been told by pilots that maximum number of accidents take place during take-off or  landing and that during these moments, they experience a good deal stress and there must be fluctuations in their blood pressure and pulse rate.

I am always present when a patient is anaesthetised because the surgeon is the only person he knows in the O.T. He would not know the Theatre sister, wardboy, assistant or anaesthetist.

I have noticed abroad that a patient is taken to the anaesthetist’s room where there are no instruments, no individuals with masks on and no trolleys with arrays of instruments. He is wheeled into this room after a dose of tranquilisers. However there is no better tranquiliser than the surgeon's assuring word and presence. In a hospital abroad I saw a child kept in an anaesthetist's room with some cartoons on the ceiling for him to see. This put the child in a relaxed, even pleasant mood. The child is frightened of being away from his parents or of seeing men in masks but the atmosphere can change the moods. India is yet to have such innovative ideas executed in hospitals. Builders talk of the expense involved. But considering the vast amounts we spend on defence and war preparations, Executing innovative ideas could not be all that "expensive”. These are matters of priorities.

 

The argument is frequently made that when millions have no access to ordinary medical aid is there any point in spending money on modem hospitals? Such an argument is reflective of emotion than balanced thinking. We need modern hospitals. Simultaneously we also need to propagate the fact that prevention is better than cure.

There is another point that I would like to make in this connection. It is idle to blame doctors for not going to villages to set up their practice. We must first create a village-oriented culture. Good food, plain living abstinence from tobacco and alcohol would make most doctors redundant. There would then be no need for doctors to go to the villages except for preventive vaccination.

We are wrong in thinking that diseases like leprosy, tuberculosis and worms are tropical diseases. These diseases were rampant in Europe and England only a few decades ago. They have now been eradicated. We can eradicate them in India provided we give adequate sanitation and a liberal supply of clean water to the villages.

Meanwhile, we do not have to wait for setting up our scientific laboratories till we banish poverty and ignorance. The two should go hand-in-hand. One should not be undertaken at the cost of the other. Cavendish Laboratory in Cambridge created nine Nobel Prize winners and twenty five winners of Royal Society under the leadership of Prof. Thomson. Berkeley, in California has bagged the maximum number of Nobel Prizes in the States. India can well take a lesson from them. Let us encourage a few individuals with great talent to soar to high achievements. That does not mean that we have to ignore the masses. When I say that we must create centres of excellence, we must also make the spread of literacy a time-bound programme which must be introduced rigorously.

In this acquisitive world everything has a price. Money can buy a bride or a bridegroom, degrees, contacts, school and college admissions, honours, licences and even votes and a place in a Political Party.

Compilation of professional reminiscences of specialists - edited by M.V.Kamath and Dr.Rekha Karmarkar