Raising Lazarus
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《加拿大医疗协会学报》
Grand rounds in medicine are, well, grand affairs. In my student days the senior don, a super-cat physician, would lead us, a motley flock of interns, final-year medicos and postgraduate students as he tapped a chest here and palpated a liver there. He was a genius, this man, and he knew it. He could verily see through the patient. We were in awe of him.
One morning, as we scurried behind him through the wards, we heard an unearthly groan rising from a corridor-side bed: laryngeal stridor producing a nerve-freezing wheeze and splutter. But this was more. The last throes of death. A desperate attempt to ward off the designs of Atropos. We novice interns, as yet unschooled in the proximity of death, went jittery. The professor moved on. It wasn't his patient. But one of my fellow novitiates, a fresh house-surgeon, stood transfixed. Just beyond, a man lay flailing, fending off with weakened fists and weakening resolve the machinations of Yama.
"Can we do something, Sir?" my classmate gingerly queried the professor, who turned round to wonder why this joker, this dodo in a white coat, wasn't moving with the herd.
"Do what, Doc? Just a few pages of Davidson & Price and already a cardiologist, eh? Do something, indeed," the don snorted.
The rest of us shivered in our pants. The man's temper was as famous as his wizardry in his subject. But the stubbornly stupid Subbu was unfazed. He blurted, "Something, Sir, anything! Intracardiac adrenaline?"
"Oho, adrenaline indeed! I wonder how could I have forgotten that, Doctor? Now, shall we try and resurrect this Lazarus!"
We all stood motionless. This dodo, why couldn't he keep his mouth shut like the rest of us? We were all going to get it now, in style, and in ample measure, too. As we braced ourselves for Vesuvius to erupt, the senior don snatched a stethoscope from the nearest student and purposefully entered the ward, striding up to the dying (and, mercifully, now dead) patient. With a derisive earnestness he dabbed the bell of the stethoscope this way and that, unplugged the earpieces, and handed them to the insolent dodo, his right hand firmly affixed on bell, which he held exactly over the heart-sounds zone. The message was: Now take over, the patient is yours.
The imbecile, Subbu, was as dumb as they come. Instead of blurting out an apology and calling curtains, he, the numbskull, plugged the stethoscope into his ears and auscultated the dead man's chest. The don's fuse was sputtering with electricity and smoke. He had to explode soon.
Then, to our amazement, Subbu trotted to the medicine counter, filled up a syringe with adrenaline, ran back and drove the needle home, straight into the chest between and through the left parasternal intercostal space.
He had hardly finished when we heard in the deafening silence that now enveloped the ward a low growl and groan rising from the throat of the dead man. Lo, his chest began to heave. The dead man had returned to life.
Suavely, Subbu dabbed the stethoscope over the thoracic wall, this way and that, and in a final show of utter contempt pulled out the earpieces and handed them over to the grandmaster of cardiology, keeping his right palm firmly affixed on the bell, which he held over the heart sounds.
What the don heard through the stethoscope, I don't know. But I suspect it was a voice that drubbed, over and over, "Physician, heal thyself."(Arunachalam Kumar)
One morning, as we scurried behind him through the wards, we heard an unearthly groan rising from a corridor-side bed: laryngeal stridor producing a nerve-freezing wheeze and splutter. But this was more. The last throes of death. A desperate attempt to ward off the designs of Atropos. We novice interns, as yet unschooled in the proximity of death, went jittery. The professor moved on. It wasn't his patient. But one of my fellow novitiates, a fresh house-surgeon, stood transfixed. Just beyond, a man lay flailing, fending off with weakened fists and weakening resolve the machinations of Yama.
"Can we do something, Sir?" my classmate gingerly queried the professor, who turned round to wonder why this joker, this dodo in a white coat, wasn't moving with the herd.
"Do what, Doc? Just a few pages of Davidson & Price and already a cardiologist, eh? Do something, indeed," the don snorted.
The rest of us shivered in our pants. The man's temper was as famous as his wizardry in his subject. But the stubbornly stupid Subbu was unfazed. He blurted, "Something, Sir, anything! Intracardiac adrenaline?"
"Oho, adrenaline indeed! I wonder how could I have forgotten that, Doctor? Now, shall we try and resurrect this Lazarus!"
We all stood motionless. This dodo, why couldn't he keep his mouth shut like the rest of us? We were all going to get it now, in style, and in ample measure, too. As we braced ourselves for Vesuvius to erupt, the senior don snatched a stethoscope from the nearest student and purposefully entered the ward, striding up to the dying (and, mercifully, now dead) patient. With a derisive earnestness he dabbed the bell of the stethoscope this way and that, unplugged the earpieces, and handed them to the insolent dodo, his right hand firmly affixed on bell, which he held exactly over the heart-sounds zone. The message was: Now take over, the patient is yours.
The imbecile, Subbu, was as dumb as they come. Instead of blurting out an apology and calling curtains, he, the numbskull, plugged the stethoscope into his ears and auscultated the dead man's chest. The don's fuse was sputtering with electricity and smoke. He had to explode soon.
Then, to our amazement, Subbu trotted to the medicine counter, filled up a syringe with adrenaline, ran back and drove the needle home, straight into the chest between and through the left parasternal intercostal space.
He had hardly finished when we heard in the deafening silence that now enveloped the ward a low growl and groan rising from the throat of the dead man. Lo, his chest began to heave. The dead man had returned to life.
Suavely, Subbu dabbed the stethoscope over the thoracic wall, this way and that, and in a final show of utter contempt pulled out the earpieces and handed them over to the grandmaster of cardiology, keeping his right palm firmly affixed on the bell, which he held over the heart sounds.
What the don heard through the stethoscope, I don't know. But I suspect it was a voice that drubbed, over and over, "Physician, heal thyself."(Arunachalam Kumar)