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.