A nurse, Caroline Petrie, has been suspended from her job for offering to pray for an elderly patient's recovery from illness.(1)

Alison Withers, Mrs Petrie's boss at the time, wrote to her at the end of November saying:

"As a nurse you are required to uphold the reputation of your profession. Your NMC [Nursing Midwifery Council] code states that 'you must demonstrate a personal and professional commitment to equality and diversity' and 'you must not use your professional status to promote causes that are not related to health'."

Reading this made me recall some of my conversations with scientific surgeons, some of my closest friends and teachers

“A good surgeon can be a good physician, but a good physician cannot be a good surgeon� my Head of Surgery during MBBS days used to often repeat this aphorism on his weekly rounds. We MBBS students used to think he was “God� and were always overawed in his presence.

“He is a complications expert� the surgery registrar with whom I used to share a room in my residency days used to tell me of the new complications created by his famous Faculty member. This famous surgeon had a knack of telling what possible complications one should be careful to avoid and then begin surgery, and after some time, lo and behold-that very complication would occur during his surgery. Then he would abuse himself in front of everyone (in choicest English and local language) and go ahead and correct it.

Initially the surgery registrar and I used to laugh, but over a period of time, we both realized that this expert surgeon could handle his complications, keep his nerve when the whole field would be filled with blood. The wise man also taught me to be a bit less impulsive.

“The world has many wheels running it. And there are wheels within wheels� he told me one quiet afternoon sitting in the Resident’s hostel. I did not take his advice then, because it was beyond me to understand. But over the years, I have seen many “wheels within wheels� and whenever I see them, I remember this teacher of mine.

As one grew through residency there was successive demystification of the surgeons.

They were no more “God� but they remain some of the most respected, courageous and wisest of doctors and persons from whom one can learn.

They tend to be a bit depressed at times. “All the super specialties have eaten into us. We are left doing cholecystectomy and trauma� one of them confided over a cup of coffee.

Uro-surgeons, Gastro-surgeons..all superspecialties are eating into what used to be General Surgery. The lamentation goes on. Then one of them became a Transplant surgeon. Another has specialized in Breast reconstructive surgery. Two of them have bought a Laparoscope and are going to peripheral centers as the main cities have the big established names.

As they became more specialized I too had to learn new things, to keep my reporting relevant to their growing subspecialty experience.


RED VERSUS GREY SCALE

A good surgeon can be a good physician. Listening to the raw confidence of the “Flesh and Blood� surgical colleagues, makes one feel a bit nervous in our grey scale worlds.

Where does that leave non-clinical subjects like Radiology?

A young lady with came with pain in the stomach. No one could make out what was wrong with her till we did a CT scan on her. She was eating her hair. The Grey scale helps the “flesh and blood� surgeons in the complex world of modern medicine.

We have to constantly keep pace with our clinical partners to remain relevant.

I have met many wise surgeons with great spirit, just like the Greek Philosopher Socrates.

Anyway, once the field is red, one cannot make out much. It is the grey scale of Radiology which will help you.


WHEN NOT TO OPERATE

“ A good surgeon is not one who knows when to operate but one who knows when not to operate. Any fool can go inside in the middle of the night and further complicate things.It requires a wise man to be able to decide to hold on, and then be able to justify his decision in the rounds next morning.� One old friend said.

That is one of the places when a radiologist can really help, in the middle of the night.

BEYOND BEING COBBLERS

“Most of the teaching faculty I know will not pass their MBBS examinations if they sit again� one senior surgeon told me one day, adding further to the demystification process which had started during my residency.

“If I teach a cobbler to do hemorrhoidectomy he will be able to perform better than most of the senior surgeons if he practices 40-50 times� he went on, in a particularly depressed-cum-agitated mood at the lack of application by his senior colleagues.

This experienced and spirited surgeon was once the faculty of New York Medical college but left it all to work again in his home country.

“A good surgeon needs to be able to evaluate data. He should be able to bring together the different information got from the investigative diagnostic departments, the biochemistry and the radiology, and then make a proper decision on how best to manage the case.� He told me, explaining further what a good surgeon and good doctor should be.

“Instead, these fellows are busy running to different clinics to mechanically do more surgeries which even a cobbler will be able to do better than them. There are others who are degrading their profession by sitting with ministers and financers and lobbying.�


TOGETHER WE WIN-TOGETHER WE LOSE

This same angry but not-so-young man taught me a great guideline-

Together we win-Together we lose.

Having trained and worked in New York, he is one of the best surgeon readers of the abdomen CT cross section I have come across. But he never intimidates, only shares his knowledge and experience, lifting you with him, not belittling.

“We have to work together and improve our facilities. Together we win-Together we lose. The Radiologist is part of the team. My pre-operative diagnosis is only as good as the radiological guideline I get. I cannot win, if you lose. You cannot win, if I lose. Together we will win or together we will lose. We are part of the same team.� he said one evening over a cup of coffee.

Here is another “Spirit of Socrates� which I have met.

No, he is not a God, but he is wise, as Socrates, just as my other old teacher-friends who taught me about ‘wheels-within-wheels’ and ‘when-not-to-operate’.


FORMS CHANGE

“So you do not believe in God� he asked me one evening, a bit disturbed. He loved reading the wall-magazines which I put up in the department. But now, that he came to realize that appreciating them would somehow mean being ‘atheistic’ he became a bit guarded.

“I would have believed in him 500 or 1000 years ago. But unfortunately, I was born in the 20th century and now live in the 21st.� I smiled.

“Leonardo Da Vinci started dissecting the human brain to find the seat of the soul. He could not. Neither has any radiologist been able to tell me where it is. And I know some very brilliant neuroradiologists who can see subtle sulcation anomalies and heterotopias very well.�

I tapered off the discussion as I knew it would disturb him, just as it used to disturb my father, a doctor, army veteran and pious man who prayed regularly without fail, two times a day when I used to ask him-

“If taking a dip in the river Ganga was going to make you attain purity and heaven, why are the fishes and tortoises of the Ganga not the purest of us all and not already in ‘heaven’?�

When you are in your twenties, you think the whole life is ahead of you and there are many a rebel. But as one reaches mid-fifties, one tries to come to terms with one’s mortality, it is natural that one can try to seek solace in ‘God’.

But I would rather talk about the Human Scientific spirit, which made Darwin discover the Species concept rather than the Genesis theory which suddenly created Adam.

I tapered off the discussion, but I could not stop myself from telling him-

“You are a man of Science and have trained and worked in the most prestigious of Universities of the world in an age when mankind has gone into the depths of the atom and explored the far reaches of the Universe. When you talked about your patient last night you were correlating Glycosylated hemoglobin and MR imaging for knowing whether there is gangrenous cholecystitis in a diabetic. Why fall into superstition, obscurantism and witch-doctorism?�

In the passing forms there are changes that affect, mind, life and body, there are things which come and go. But that which remains behind them all, the Spirit, is for ever.

When Crito asks, “In what way shall we bury you , Socrates?�

Socrates answers, “In any way you like, but first, you must catch me, the real me. Be of good cheer, my dear Crito, and say that you are burying my body only, and do with that whatever is usual and what you think best�

Salutes and many thanks to the many “Socrates� who have taught many about the Scientific and Human Spirit.