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| Sunday, March 27, 2011 |
| Phonetics and phone tricks... doctor's dilemma
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DR. G. RAMANUJAM
From : http://www.thehindu.com/opinion/open-page/article1574365.ece
“Statutory warning: Getting prescriptions over phone is injurious to health.”
A phone call can become an acid test for one's language skill. Even though my wife doesn't rate my linguistic skills highly, I was thinking so. The first thing she does on receiving my romantic messages is to correct them. Of course, no man is hero to his wife.
Once, a school teacher received his wife's suicide note. It said, “As there is no love between you and me, I am going to commit suicide.” He immediately responded: “You should have written you and I, and not you and me. Me should be used as an object.”
Coming back to phone calls, so many times we are in a situation, having to spell some words on the phone. Be it our address, email ID, or website, spelling matters much.
Once I went through the ordeal of answering the customer centre of a bank. The honey-tongued girl asked me to spell almost every word. When I mentioned my degree as M.D, she asked for the spelling. When it comes to alpha-numerals like PAN, the confusion never ends. There is always the confusion whether it is zero or the letter O.
Just like for Radia-friendly politicians, a telephone conversation might become a nightmare for both the doctor and the patient.
Medical terms are neither tongue friendly nor telephone friendly. Many times, my relatives or friends would read a scan or laboratory report on the phone. Out of curiosity, they would spell every printed word, right from the scan centre's name to the reporting doctor's name. Of course, there would be terms like salphingo-oophoritis in between. By the time they finish reading, my hair would have grown two more inches. Nowadays, I ask them to e-mail them. Phone calls can never become a better alternative to personal appearances.
But there are things worse than this. As a doctor, I sometimes have to spell the names of drugs on the phone. I always discourage this practice. Of course, there is no remuneration for a phone consultation. It so happens that the drug that I have prescribed might not be available in the pharmacy and I could not be seen in person. Usually I ask the person to hand over the phone to a nearby pharmacist or doctor. Sometimes, you have no option other than spelling the names.
You cannot simply spell a drug name like “ASPRIN” and get away with it. The person at the other end usually wants to be very sure and immediately asks “A for?” or “P for?” It is only then I start experiencing word-finding difficulty. I have difficulty with at least 25 alphabets.
For some letters I use to think hard as if I were Samuel Johnson but only to remain clueless. Words with a silent first letter cause confusion like when I say “K for knight or T for tsunami.” Due to a lack of words, I sometimes give many phonetically funny statements like “B for bee” (a spelling bee question?) or “Q for queue.” Once a person asked, “W for what, sir?” I had to reply, “Yes! W for What!”
The final blow came one day. While I was spelling the name of a drug, I was searching for a word starting with the letter N. Neptune.. Nebula ..Nest.. not even ‘Nothing' came to mind. Suddenly, I said N for Nayanthara! The caller was an old religious man. I didn't know what he thought of me. But he never turned to me again. Maybe, he expected a Narayana from me or probably he is a Trisha fan!
In psychiatry, we use a test called ‘FAS' to test verbal fluency. It tests how many words a person can tell in one minute starting with these letters (F, A and S). I never dare to attempt it on myself.
With the advent of the mobile phone, now I have the option of sending an SMS. But, at times, I find my daughter's alphabet book handy. Never forget your basics!
(The writer's email is: ramsych@sify.com)Labels: 1993to1999_Batch, Author, Media, MSM_Articles, Ramanujam
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posted by புருனோ Bruno @ 10:43 AM   |
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| When doctor's prescription becomes injurious to health!
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DR. G. RAMANUJAM
From : http://www.thehindu.com/opinion/open-page/article1574291.ece
In many of the celebrity writer Dan Brown's novels, the famous Harvard symbologist Robert Langdon would be summoned to decode a symbol, the meaning of which only he can unearth on earth. But he too will meet his Waterloo deciphering some of the doctors' prescriptions.
Why do doctors pre-scribble? Handwriting itself is on the verge of extinction. But we find that most of the prescriptions are handwritten if not hand-scribbled. A prescription usually has two parts. The first part contains some notes about the disease and the patient .Next come the names of drugs per se.
Doctors usually like to keep some facts about the patient secret even though the latter fully deserves to and, invariably, is curious to know them. Of course, the doctor and the patient never tell each other the whole truth.
Once I worked under a doctor a decade ago. He used to write something like EO or AOO in his prescriptions. Even after referring to many international medical journals, I was not able to decode them. So I dared to ask him and came to know that the secret code stands for his fees. Alphabets represent numbers and thus EO becomes Rs. 50 and AOO, Rs. 100.
Many times doctors write something mystically to mask their limitations. I have heard patients saying that they suffer from a serious disease called NYD fever or NYD chest pain while, in fact, NYD stands for Not Yet Diagnosed!
Regarding drugs, essentially they have to be written in capital letters and any ambiguity can create serious problems. Unfortunately, some write in such a way that only a particular pharmacist, usually attached to the same hospital, can understand the drug names pre-scribbled. Probably, the doctor might have a noble ambition of getting his name included in the Forbes list of billionaires.
Some are too busy to spend time on writing legibly. But that cannot be taken as an excuse when it causes damage to a patient's health. But some are habitual poor in handwriting and they can better switch to typewriting or hire a ghost writer. Once, a pharmacist, failing to understand the name of a particular drug, substituted it with another drug. On cross-checking with the doctor, the patient was informed that it was not the name of a drug but was his own.
All doctors might have the experience of being woken up in their sleep and scribbling something in a trance-like state. Such somnambulistic errors may cause the danger of sending the patient to unwakable sleep.
A study by The Royal College of General Practitioners found that 3-5 per cent of doctors' prescriptions contain errors mostly harmless (grade D) but sometimes lethal (grade A). Stringent guidelines have been laid down but they need to be followed more vigilantly.
Interestingly, a doctor wrote a romantic letter to his lady love. It was the pre-email era and hence was handwritten. The poor girl could not identify even a single word. But she was very clever that she went to a pharmacist and got the letter read though at the expense of their privacy.
There are many ways of taking care of a patient, and prescribing legibly is certainly one of them. Luckily, I just have to e-mail this article, instead of writing!Labels: 1993to1999_Batch, Author, Media, MSM_Articles, Ramanujam
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| posted by புருனோ Bruno @ 10:42 AM |
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well said sir... Now doctor,s in country side don,t write diagnosis.. straight away to prescription which even fellow doctors find difficult to decode
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| Sunday, January 02, 2011 |
| Epidemic musicitis - Dr.G.Ramanujam in Hindu 02 Jan 2011
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From http://www.hindu.com/op/2011/01/02/stories/2011010250011200.htm
Online edition of India's National Newspaper
Sunday, Jan 02, 2011
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Epidemic musicitis DR. G. RAMANUJAM
 New Delhi was recently the epicentre of a crisis involving NDM-1 bacteria. In Chennai too, there is a seasonal serious infection that is grossly under-diagnosed. It is caused by a resistant bacterium, Musicobacter, which has two species Musicobacter Carnatica — which is more common — and M.Hindustania. The infection peaks in winter, especially December and January. Though it is epidemic in Chennai, sporadic cases can be found in other cities or countries. It is probably the only bacterium that spreads through ears. The affected individuals show the following symptoms and signs: Selective amnesia: The person forgets exactly the name of the raga in which the singer sings and recollects a list of related albeit wrong ragas (Rathipathi priya or Rashtra pathi priya?). Sometimes, long-term memory will be hyper-active. He may say “I heard GNB singing this in 1948 at Academy on a Sunday evening when it was raining heavily.” Violent epileptic-fits like movements: These include shaky movements of the head associated with uttering of words like “ Sabash! Besh Besh!” even though the concert has not yet started and the sound system person is checking the mikes. Sometimes violent, jerky, highly irregular movements of hands collide with each other and also on one's (sometimes the next person's) own lap. These movements are erroneously called talams. Acalculia (difficulty in calculating): The above said movements are sometimes associated with chaotic counting of fingers or even toes! It may occur even during an Aalapana. There is always a perfect mismatch between their counting and the singer's. Voracious appetite: The affected individuals have voracious appetite. They visit the canteens soon after a varnam (usual opening number) is sung. Not visiting the canteen during the thani avarthanam (solo percussion) is considered a sin. Hypersomnia (Increased sleep): They are found sleeping with a snore that perfectly synchronises with the shruthi box's ‘SA Pa SA'. This is commonly seen in morning lecture demonstrations like ‘Simmendhra madhyamam and its Sisters'. Hearing disturbances: The infected people have severe hearing disturbances. On hearing a music they may ask, “Is it Seshagopalan?” while, in fact, the tape may be a violin recording. Praecox performances: The individuals develop intense belief of delusional proportion that their offspring is a prodigy. On hearing them sing ‘Ba ba black sheep,' they immediately identify an M.S. lying dormant inside. They arrange for praecox (premature) performances of their children, sometimes known as Arangettram. Podio philia: This denotes the intense craving for occupying the podium. This is common among the chief guests who invariably talks at length about the singer to the extent that the audience may not at all get a chance to hear him sing. Sometimes the podiophilic chief guest sings a few lines to show his knowledge or even make a few choreographic steps in a dance concert. Hyper logia: This refers to increased speech or loquacity. The persons talk uninhibitedly, over a wide variety of subjects like CAG, CWG, and ECG, especially when the singer is at his peak. Treatment: As the disease is self-limiting it settles by mid January only to recur next year. Since the severity is inversely related to music knowledge improving good music appreciation is the best prevention. Annex: One symptom that has not been mentioned is Hypergraphia or increased writing wherein everybody (including psychiatrists) becomes a music critic and starts writing about music and concerts. ( The writer's email id is: ramsych@sify.com)
Labels: 1993to1999_Batch, Author, Media, MSM_Articles, Ramanujam
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| posted by புருனோ Bruno @ 6:57 PM |
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| Sunday, November 21, 2010 |
| For a doctor, everything is in a name - Dr.Ramanugam (1993 -1999 Batch) Article in Hindu
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From http://www.thehindu.com/opinion/open-page/article902026.ece
If you forget the patient's name, it is often taken as lack of concern for him. Doctors are often expected to have a good memory. They memorise umpteen Greek and Latin terms like ‘pneumohydropericardium.' A doctor has to remember the names of at least 100 scientists given to the syndromes they discovered. They may range from names as easy as Down's tongue-twisters like the Steele-Richardson-Olszewski syndrome. Many scientists worked throughout their lifetime to describe syndromes which were named after them. With due respect to them, let us just see the lighter side of it. Names haunt a medical student throughout. No day will dusk without a question about a named syndrome. Sometimes, your knowledge is measured in direct proportion to the number of names you know. Sometimes, the same person might have invented more than one disease. So the answer depends on whether you are appearing for the obstetrics or orthopaedics exam. It goes to the extent that a student wishes that he were born two or three centuries before so that only a few names needed to be remembered just like a history student's wish to have been born a millennium earlier! To rub salt into the wound, almost all names are completely alien to our tongues, which are familiar to Ramaswamys and Subramaniams. There exist unique ways of pronouncing those names. (We even pronounce Shakespeare as ‘Jagapriyar' in an Indological way). I have heard 11 varieties of pronouncing the ‘Mayer-Rokitansky-Kuster-Hauser' syndrome. The student patriotically wishes that the Indians discover more syndromes to take revenge on foreigners. Now coming to dysnomia, it is a difficulty in recollecting names (especially of persons and objects) or frankly forgetting names. Doctor's dysnomia does not stop with the student days. When he starts practice, a doctor has to remember the names of his patients. You can make a grave mistake in diagnosing a patient's disease or probing his heart on the right side with a stethoscope. But if you forget the patient's name it is often taken as lack of concern for him. During the golden period of family physicians, doctors remembered not only patients' names but also their complete psycho-social milieu. Patients felt completely reassured when they were greeted with something like, “Hello, Raju! How is your fever”? But now not everybody expects his name to be remembered! Thanks to the era of specialists, patients are often seen as files with reports and prescriptions. There is an old aphorism: ‘Don't treat the lab report! Treat the patient!' I feel guilty whenever I am not able to remember a patient's name. But I have few tricks to cover myself up. If he has brought old prescriptions or reports, then the problem is over. But if he is unarmed, then I become clueless. I usually guess a few names which are invariably misnomers. When I stumble at Mr. or Mrs., many of them volunteer with their names, of course, some with a small tangible disappointment. It is with tele-conversation that I stumble the most. People may just say their name and take my memory for granted. (There is a famous Tamil poem by Nakulan about a name that goes like neither I asked which Ramachandran he is nor did he say it). When the matter becomes so serious that it may jeopardise his health I usually admit that I do not recognise him. But there are many whom I remember clearly and, invariably, they are the ones who introduce themselves every time in detail. Probably one more vignette to Murphy's laws! Sometimes they did not want me, a psychiatrist, to remember their names so as to avoid my calling them in a crowded mall. Juliet might have said “What is in a name?” But, to some at least, it matters. So I have resolved to do two things. Try still harder to remember names; and not to name any syndrome discovered by me Ramanujam's syndrome. (The writer is a consultant psychiatrist. His email is: ramsych@sify.com) Labels: 1993to1999_Batch, Author, Media, MSM_Articles, Ramanujam
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| posted by புருனோ Bruno @ 7:51 AM |
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Discussion Forum: At present this post has 2 comments: |
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Interesting article!
Nowadays, its little bit easy as I ask the nurse to bring the file into the consultation room before the patient comes in. In case of rounds,if I don't remember the patient's name,I always ask the nurse whose is standing by the side (she is the scape goat,if she doesn't remember either)
Another interesting and important issue is, referring the pharmaceutical books for accurate dose and side effects of the medications. In India, if a doctor refers a book in front of a patient, imagine what would happen! But, in Western countries, if a doctor refers a book infront of a patient, he or she will take that as an extra care thinking that the doctor is very careful to avoid unnecessary problems. See the difference in the attitude of people!
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//. In India, if a doctor refers a book in front of a patient, imagine what would happen! //
:) :)
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| Sunday, October 26, 2008 |
| New Website in Cardiology by Dr.Refai
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Dear all,
I have developed a website related to Cardiology- information about heart conditions, treatment and advice. This is mainly aimed at patients and relatives in India who would like to get more information, as I feel the information given to them is limited. The information here are collected from various sources and put on a single website. This may be helpful for your family or friends. Have a look at the website which is
www.thecardiosource.co.in
and spread the message to those this may be of help. I would be keen to get your suggestion and feedback about this website, as I am planning to develop this further to include information for health care professionals.
You can either reply to drrefai@yahoo.com or via the "contact us" section on the website.
Thanks and Regards
RefaiLabels: 1993to1999_Batch, Cardilogy, Career, Website
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| posted by புருனோ Bruno @ 7:22 AM |
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| Monday, March 24, 2008 |
| 1991 Batch Easter Celebrations
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Hi Friends!
We got together on Easter day at my home in Chennai. (23rd March, 2008)
1. I ( Dr. Arul Vijaykumar)1991 batch-Registrar Cardiothoracic Surgery, Apollo Hospitals, Chennai.
2. My wife- Dr Annline Nirmala Vijaykumar, 1992- Asst Professor, ObG, Chettinad Health City
3. Dr Sundarapandian,1991, Asst Prof Ortho, Chengalpattu Medical College
4. Dr Thirumuruganand, 1991 batch, Asst Prof in CTS, ICH, Chennai
5. Dr Jeshur kumar, 1991 Batch, Psychiatrist-Middlesex, UK (visited us!)
6. Dr Jeyakumar, 1993 batch, Research fellow in endocrine surgery, MMC
Dr.Arul VijayakumarLabels: 1991to1997_Batch, 1992to1998_Batch, 1993to1999_Batch, Alumni_Messages, Photos
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| posted by Bruno_புருனோ @ 12:29 PM |
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Discussion Forum: At present this post has 6 comments: |
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dear all,
Happy to see jeshur after a long time. he looks like adrian brodie. nice makkale.
P.Velayutham DM
Endocrinologist, KMCH, Coimbatore
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Hi,
Its nice to see u all.
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Dear most friends,
Nice to see you all. COngratulations on all your achievements.
Hope to meet you sometime soon.
Anand.
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MAKKALE
Just saw this photo. brings back memories.
maakkaan, are you still in the US or have you decided to check out another country elsewhere?!?!
V.Velayutham
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Hai to all our batch i am Mehraj Beevi
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Hai i am Mehraj Beevi still i am in the same college doing my MD (GM)pray for my success May is our Final Exam ... tx
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| Friday, September 21, 2007 |
| Message from Dr.Refai (1993 to 1999 Batch)
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Dr.Refai (1993 to 1999 Batch) writes in
Hi all,
I am Refai from 1993 batch, presently doing Cardiology
SpR rotation in UK. We will come out with more
information about our batch soon.
For those from 1993 batch, please join our yahoo group
"tvmcbatch93-99". There is already 25 members in the
group, so come and join in our fun club. My email id
is drrefai at yahoo dot com
Thanks
Refai Labels: 1993to1999_Batch, Alumni_Messages, Overseas
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| posted by Bruno_புருனோ @ 9:54 AM |
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Discussion Forum: At present this post has 2 comments: |
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Good job Refai...I am posting the link.
http://uk.f505.mail.yahoo.com/ym/Compose?To=tvmcbatch93-99%40yahoogroups.com
Rajaram
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Sorry...hopefully the link will be usable this time around.
http://groups.yahoo.com/group/tvmcbatch93-99/
Rajaram
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| Tuesday, November 09, 2004 |
| Dr.Somasundaram (93 Batch) Invites for his marriage
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Dr. Somasundaram (93 - 99) Batch of Tirunelveli Medical College invites you all for his marriage with Dr.Kiruba
on
22 Nov 2004 9 to 9:45 am
at
AVM Rajeswari Tirumana Mandapam,
Dr.Radhakrishnan Salai, Mylapore,
Chennai - 4
Reception at Chennai
21st November 2004, 6PM to 9PM
at
AVM Rajeswari Tirumana Mandapam,
Dr.Radhakrishnan Salai, Mylapore,
Chennai - 4
Reception at Nagerkoil
28th November 2004, 6PM to 9PM
Sardar Raja Tirumana Mandapam
Vetturinimadam
Nagerkoil
 Labels: 1993to1999_Batch, Alumni_Messages, Marriage
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| posted by Doctor Bruno @ 3:31 AM |
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Ha Ha, very humourous!