Tag Archives: humor

Anesthesia Vs. Anaesthesia: Does It Really Matter?

Ashish Khanna, 1998 batch

Connections-May 2013 (Volume 10, Issue 2) 

The Oxford dictionary definition of Anaesthesia is “insensitivity to pain, especially as artificially induced by the administration of gases or the injection of drugs before surgical operations”. The Merriam-Webster dictionary defines Anesthesia as “loss of sensation and usually of consciousness without loss of vital functions artificially produced by the administration of one or more agents that block the passage of pain impulses along nerve pathways to the brain” Synonymous: yes?

Anyone would agree that the difference between Anaesthesia (British English) versus Anesthesia  (American English) is above and beyond the addition of a single alphabet of the English language. I started my journey as an anesthesia resident in a country where Anaesthesia was the correctly spelt version of the branch of medicine that dealt with this specialty. Today, three years after re-training the art and re-learning Anaesthesia to be spelt as Anesthesia in the United States, it is time to look back and ponder on the finer points.
The decision to leave your own country after finishing a residency always comes with a pinch of salt. As you look to expand your clinical and academic training beyond the horizon, you are faced with the uncertainty of the unexpected. The challenge is a system of medicine distinctly different from your home country and a culture to healthcare that demands considerable understanding. A question that I am very often faced with when I make my frequent trips back home is “What is different about Anesthesia practice in the United States?” It might come as a surprise to a lot of people if I say “nothing at all” in reply. Well, what is different is not Anesthesia or Anaesthesia, only the fine print!! The other very frequent question that is thrown at me is the almost rhetorical “Is it better there?” Let me step back today and say let’s keep all this better – worse talk aside. It never was and it will never be fair to compare two vastly different systems of medicine. As I direct this piece of writing to those friends of mine who are faced with doubts and internal struggles before they leave the comfort of their own homes I would like to emphasize one singular fact: forget about quality of medicine or quality of life and remember the biggest challenge is the ability to train to re-train or put
in more simple words another residency program after a prior residency in your home country. Starting a residency program in Anesthesia under the Accreditation Council for Graduate Medical Education (ACGME) at the Cleveland Clinic Foundation, I realized early on that the essence of getting the most out of this education is to wipe my slate clean and restart again. Tell the world that you are trained in your specialty in your own country and you are capable of doing your thing does provide you with the much-needed independence of clinical work at times, but can be your worst
enemy if you want to acquire new knowledge. It is important to understand that there will be days where the attending will hold your hand when you are doing a procedure that you have done so many times before or might tell you that “this is the way it is done here”. Days, when you need to keep you’re your ego at home. Days when you will feel your neurons are struggling to cope with erasing old skills and acquiring new skills for the same procedures again. But, hey did you want to  do things the way you were doing them in your own country? That said, what is the reason you
made this trip across 4000+ miles half way across the planet? The answer to these questions will help you understand that unless you let your guard down in a foreign land and show that you are an open book you will never learn anything new and in essence never grow as a clinician. Medicine is repetitive science; it is very easy to be lulled into a false sense of satisfaction practicing the same
things over and over again, the same very way every day. The only way to appropriately imbibe your area of expertise and to mature as a clinician is to step out and see what else can be done differently and is being done differently. My message here is not to train in the United States after training in India, but to train at different places and in that process acquire a new set of skills all the time.
Going further, another area of distress for the physician from India as he or she steps onto alien soil is the cultural aspect of medicine. The interaction between peer groups as resident doctors and patient physicians as healthcare providers is different to say the least. As you move away from the “yes sir/ma’am” policy to “yes Dr. XYZ” even when that Dr. XYZ might be your department chair, you will quickly realize that you have to prove your worth as a resident by the sheer quality of your work and not the weight of your courtesy and multiple salutations directed to your staff. Decision making for the betterment of your patient is another area where the young resident here is thrown into the deep end every single day. An ICU attending will ask you for your plan, and so will your anesthesia attending in the operating room. And yes, your plan will be plan that will be executed as long as you can justify it. And that holds true for every provider from the lowest level of an intern to upwards.
Protecting patient privacy and respecting that the patient is the true owner of his or her healthcare information is another moot point here. Not to discuss patients with names or anything that could identify them, not to talk about them in the hospital corridors or the escalators is a habit that is difficult to get rid of. The tendency to try to force your decision as a clinician on the patient or the patient’s family is also something that we live by all the time in India. The patient is the master of his/her own destiny here and whether it be morbid obesity, chronic smoking in a vasculopath or narcotic abuse in a chronic pain patient, your job will be to ask them whether they feel they can change theirlifestyleand not to enforce that change on them. Difficult times will also revolve around “End-of-Life” decisions in the ICU and DNR (Do Not Resuscitate) statuses. The ability of families here to think very practically for their dying loved ones and to let go of them when there is point of futility, is commonplace. Another challenge that is
beyond the understanding of anesthesia and different from back home, and is something that you
have to deal with on a regular basis.
How can I forget to include in my set of challenges also, the change from using pharmaceuticals as brand names versus names of salts back home. Or the different abbreviations that come inherent with another healthcare system. Yes, I gave my senior resident a quizzical look when he said “Did you tube your patient” ( a.k.a intubation) or “Can you do the A-line first?” ( a.k.a arterial line) or “ Is he off the vent ?” (weaning from the ventilator) or “When is your ICU patient going to the sniff?” (a.k.a skilled nursing facility). There are numerous more such which define the distinct cultural differences in healthcare here in the United States.
As I look back today, I know that things have evolved for me as a clinician but also more importantly as a human being. I look at medicine differently; I look and understand a patient’s emotions differently. That to me is the pivotal change. For all those fellow friends who are getting ready to step out on this often-treaded path of training in another country after training as a specialist in India, I hope this writing will give a better idea of what to expect. All said and done, the
difference is not in quality of healthcare or the quality of life that you can expect to live, but in what you can assimilate from the new system of medicine.

In the end, it is not Anesthesia versus Anaesthesia, and it really does not matter!

Dr.Khanna

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Filed under Anesthesia, attitude, GMCH, health, humor, life, Residency, USMLE

Technology That Touches Lives – Everywhere !!!

tombstone

Headstone of Internet Era

A wonderful cartoon depicting how the future gravestones on this technocratic generation would like .

Perfect example of “Technology That Touches Lives – Everywhere

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Filed under cartoon, Death, gravestone, humor, imagination, Life and Death, technology

Your Safety Our Concern !!!!

Animals police

Traffic Controllers ??

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Filed under attitude, Bizzare, dog, effort, funny, humor, life, news, pets, safety, WORK

Beware of Owners !!!

pet owner

Beware

 

Came across this picture ,just couldn’t wait for everyone to see this funny picture.

Reminds of modern day truth where humans seem to be more dangerous than the lovely animals.

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Filed under competition, dog, humor, life, pets

An Ordeal of AIIMS

Preparing for competitive exams can screw up the greatest of students

and when the final Dday arrives your all preparations depend upon that those three hours and they are like walking on pieces of burning coalfeet will be burnt if u stop
and only thing you can do is run through it as there is no other way to escape the ordeal

Now this year AIIMS brought a new ordeal to about at least 1000 students in country
it was not only a test of intelligence but physical and mental toughness

although they were only set in eligibility criterion for giving the exam

aiims

AIIMS,NEW DELHI



this year roll numbers were not dispatched by AIIMS authorities on time and add to your woes were their highly evolutionary phone lines and super speedy site where you could spend hours to receive a fat phone bill at end along with a training on mental toughness and patience control



well i was victim of this gracious opportunity given by the apex institute so had to leave for duplicate roll number a day before

THE INCIDENT :

As i set my my foot on AIIMS campus at 8 am in morning thinking i was clever to come early i noticed a line of fellow doctors outside office and it was toooooo long i say so because i had my number at about 200 to 250 and within half an hour it stretched to 500 people This was biggest doctor gathering i had seen and that too representing whole country an example of “UNITY IN DIVERSITY” courtesy AIIMS
AT about 9 :30 am there came a blink of hope
we realized the lines were useless as authorities started distributing papers for issuance of duplicate roll numbers randomly

and to deposit them required another line to be mad
e

so in craze of hour everyone was found running along to get that paper
now imagine 500 people jumping on 4-5 people who had those precious papers

it was craziest moment I remember being into pushed here and there for a small piece of paper
as if admission depended on getting that

but this was not end it marked beginning of new session
after filling we were asked to report in hour

and then we were made to sit in ground with an old gentleman n center shouting at helm of his voice because the loudspeaker battery was not working and giving roll numbers

for those who could hear it was okay but those who couldn’t must come in afternoon

after waiting for 2 hours when I has started loosing hope of getting roll number I heard my name

I remember joy it brought me as if I had cleared all India exam and this was only though I had got duplicate roll number…………………
and next morning the exam that followed was much like ordeal I felt with array of difficult questions which has been trademark for AIIMS


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Filed under exams, life, negligence, WORK

Sex education Health Poster

The following is most bizarre health poster I have seen in recent times

Sexually transmitted imagination

Artist’s vivid imagination demands appreciation ???

It was put up by health department of

South Africa in various hospitals to inform against STD’S

well full marks to artists imagination for capitulating the minors details

and if u dont agree with me look at it carefully u are bound to note a few yourself

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Filed under ART, Bizzare, cartoon, funny, humor, imagination, medicine, mind, people, secret, STD

How do Doctors Study ?

exam life

All In a Days Work

Well Life can be tough and grueling sometimes
there will moments of joy and sorrows
well competition can take a toll on everyone and preparing for pg exam really requires best effort
he was spotted in lib at night had done days duty and still braved to come to study but sometimes its just not your day i believe


but still salutation to spirit behind the effort

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