What’s in a name?

What’s in a name?
Once a patient ran out of questions so he asked, whether to take the Medication before or
after he sleeps!!
I told him, “If possible try to take it before you sleep!, so that you get a good sleep!”
And that is how private practice works! Sometimes patients run out of questions while other
times the doctor has no answers! He or she does not have the NAME for your diagnosis!
Once a couple came and I did not see the file at first; just the name, Jyothi.
She explained in detail about her problem. Hearing loss, throat irritation, headache and what
not! The history was long, symptoms vague and I knew that it will a long day!
She also had ear pain and when I asked which ear? She replied; this year! 2015!
After fifteen minutes of the most elaborate history ever when I proceeded to examine her, she
suddenly went away! And literally screamed, “What are you doing doctor?”
I told her, "madam without examining you I can't tell your problem!".
She replied, "I don't have any problems!"
I said (thinking to myself, I am the doctor and not you!), "I will just examine you madam since
you have so many complaints and it is I who has to decide whether you have any issues or
problems madam!"
She looked at me shocked and said, "those are not my complains! That's my husband's! One
more problem is that he does not speak much!"
That is when the husband who was sitting in the corner silently observing and listening to his
wife rattling his complains, spoke albeit reluctantly and in a low voice.
He said, “Hello sir, I am Jyothi, Jyothi Srinivasa Murthy!"
Another incident comes in my mind when I think of this!
Now the National Board examination especially the practical one is a horror festival! Sleepless
nights to prepare for the unexpected! It's called objective structured clinical examination or
OSCE! It was one of the toughest central examinations at the time.
Sometimes you will have a healthy patient and all you have to do is ask for history! And if you
forget to ask an important point then it's gone! You are expected to do procedures like
AUDIOMETRY test and not believe the technician to do it!
During my examination, I was on duty till one day before the main examination and we had to
catch a train from Chennai all the way to Calicut, Kerala and give the examination under
nervous condition! Luckily I cleared the examinations because I was prepared by reading and
by attending mock tests!
In one such mock test; this station had a CT Scan film! Since it was CT of the sinuses, of
course we knew it from top to bottom! Even now, Sinus films are read much better by
Rhinologists since we know what to look for and since we have the experience of doing the
endoscopy and in effect we have the inside view!
Now this film had Sinusitis, mucous collection, a deviation septum, a concha bullosa and
narrow meatus and what not! I did not miss anything! I even wrote the complicated Keros
classification of frontal sinus and olfactory fossa depth! Since we were given paper for rough
notes, I wrote everything on the paper and was pretty sure that I did not miss anything since I
was trained from a hospital which used to train endoscopic surgeons all over the country and
there was no procedure we did not do and no finding we did not see or miss! With that air of
confidence and surety (Of course since it was a mock test, the tension was not that much!) I
marched on to the next station to answer the questions thinking to myself if these people who
have put the questions have even seen a complicated sinus lesion!
The next station was of ten vital marks! Only two questions! The first carried 9 marks while
the second carried 1! The Second question of one mark was; List any one finding in the scan!
The first question which had nine marks was; WHAT IS THE NAME OF THE PATIENT!?
That was one of the biggest lessons we learnt! You DO NOT treat the scan! You treat the
patient! You do not get diverted by the findings! And most importantly; you first read the
NAME!
Even now I may miss the finding but never miss to read the name and age!
So what is in a name you ask?....well, EVERYTHING!
The sketch of one of the most famous doctor/ Surgeon of the country; everyone will know his
NAME! Dr Devi Shetty!

Dr Sriram Nathan