MadMEDicine is a series of medical cartoons created by Dr. Prasanna Vadhanan. The cartoons reflect real life situations (well, almost) seen or that will be seen in hospitals. You can view more of the cartoons and give some feedback at his Facebook page and his modest website.
Surgical knots are supposed to be strong. Whereas pyjama knots are known to loosen up a bit and things start to go down south, literally. Here an added misfortune is an awake patient which once again, is the anaesthesiologist’s fault.
A dark room and a busy sonologist can interact in abnormal ways. Partly it is the patient’s fault for having a tummy indistinguishable from a pillow cushion. At least she is shrewd enough to point out the mistake else her visceral feelings would have been hurt, pretty deep.
How to identify a future surgeon early in medical school? Well, this is one of the signs. Viewing the patients in bits and pieces, rash decision making, general disdain for life… are some of the other signs.
Real life is strange. Things which seemed easier in workshops become so complicated and bloody in real life, partly because real patients bleed, unlike the lovely cadavers who lay still and never complain. And the best part is cadavers don’t need Anaesthesia.
An important paradigm in surgical teaching is “How to play and win the blame game peri operatively?” A proper blame should be plausible, believable, acceptable and reproducible. If played properly, it is easy to make the anaesthesiologist believe it is actually his fault the patient has adhesions in the abdomen. Poor relaxation can cause adhesions and vessel injuries.
Anaesthesiologists are known to work with old and outdated gadget, as nobody buys them new toys. The surgeon was disappointed as the old intercom never works, only last week he got a weird shock from that device after pressing few buttons. Still nobody had bothered to repair that.
Using high flow of anaesthetic agents and diverting the exhaled gases towards the surgeon helps in avoiding those unnecessary surgeries posted at the end of the list. A low dose of nitrous can make a grumpy surgeon into a more tolerable creature.
Using rapidly absorbable sutures is risky at the hands of a meticulous surgeon who respects tissues and identifies every structure half a mile around the surgical field and takes time admiring the marvel of human anatomy and also explains them to his juniors, sometimes by phone. They say we should not dwell in the past. Time to put another set of sutures.
Asking the surgeon to commit a time scale for the surgery will help the anaesthesiologist to give a mean look, once the limit exceeds and the surgeon demands better relaxation. The validity of the formula to calculate the actual time based on the surgeon’s perceived duration is proven by several randomized trials, which unfortunately remain unpublished till date, as the peer review process is taking more time than anticipated.
All pathology reports should be correlated clinically. Probably the patient has a funny condition, that’s why the cells are looking funny. Other descriptions found in pathology reports include indeterminate cells, suspicious cells, strange cells, sad-looking cells, nothing-I-Know-about cells, and dead cells.