Interdisciplinary medical specialities

Aeons ago, when you had a severe cold/sore throat, a concoction of lemongrass, ginger, cumin,cinnamon , ajwain , a "Mendel's paint" swab in the throat (done with a knitting needle), and a decent steaming of your throat, under a towel, held on your head(over boiling water), often did the trick. Not to forget gargling. Some super conscientious folks even forced you to drink hot milk with turmeric, to the intense delight of your siblings.

Sometimes, some of the household solutions were delicious. Diarrhoea often resulted in someone making a wonderful concoction of nutmeg, ginger, ghee, and I think, honey(could be jaggery), all stirred together in an cast iron kadhai. The patient as well as his/her siblings partook of this with great relish, and often hankered for more, till a parental stern look intervened.

Doctors entered the fray only when fevers and stuff happened. And even then it was mostly the family doctor, who you could never fool.

While medical folks of my generation might remember these household solutions (which they swallowed till they got their degree), today's folks are more interested in specializing . Last counted, there were at least 53-60 specialities.

About 50 years ago, one heard basically about G.P.'s , gynaecologists (because they delivered kids), and orthopaedicians (who plastered the relevant fractures when these kids managed to acquire them).

Around 30 years ago, we were suddenly familiar with pediatricians, neurologists, ENT specialists, Ophthalmologists, urologists and so on.

Today, the field is studded with neonatologists, endocrinologists, oncologists, surgeons (of various subspecialities), fertility specialists, gerontologists, internal medicine (physician), cosmetologists, pain specialists, cardiologists, anesthesiologists, pathologists.

And several other things I cannot spell.

What has intrigued me is guys called Intensivists. These guys are supposed to specialize in Critical care medicine, and basically treat people who are in life support situations in ICU's.

In India, this particular speciality takes on a slightly exciting flavour. In keeping with blurring of distinctions between disciplines, and newly favoured interdisciplinary approach to things, it is possible that intensivists may have to take special courses, in ethics, sociology, psychology and political science.

ICU's in India , particularly in public hospitals, keep on standby, one or more VIP ICU beds.

While you and I have to get in line, and god forbid, wait for one, these beds are often patronized by politicians, who have something to hide.

A few decades ago when the government was after the Indian smuggler mafia, it was a routine thing, for one of them to complain about chest pain , uneasiness, and get admitted to the ICU. Particularly of government hospitals. This disallowed police interrogation, till the doctors agreed. It also gave decent security to the hounded man, and his minions periodically came by and his business continued unabated through the hospital corridors.

Recently, there was a case of a leading elderly politician, head honcho of an industrial and educational empire, who had also periodically bumped off his election opponents in a casual manner, supremely confident that no one could touch him. Greatly successful at organizing crowds in his own support even when an accused, when things got too dicey, he complained of chest pain, uneasiness, and got himself into an ICU. And the speed of investigations suddenly fizzled out.

Within this week itself, a politician, ex Chief Minister from the north who was being investigated for embezzling an amount ( that would have , if allocated, changed the face & fate of the peoples of certain agrarian parts of India), suddenly complained of abdominal pain, giddiness, nausea, and vomiting. He was promptly admitted into the ICU of the local hospital, where investigative reports are taking their own time coming in.

Politicians are getting smarter. While chest pain would always have you wired up for an ECG , which cannot lie, abdominal pain is a masterpiece. You can claim it at will. It can happen. it can stop. You can't be electronically diagnosed in real time with this. With all the indiscriminate imbibing of edible and monetary goodies, existence of gas suitably obscures ultrasonic images. Suits you admirably. There are so many causes for it. Currently, the patient is off all investigative enquiries of the non-medical type. And the doctors are "watching" the patient.

Intensivists who have to deal with such entities, must get extra training in linguistics, psychology, recreational political thought and dramatics.

"You are fine" may imply (a) "Your BP is 120/80", or (b) " We've fobbed off the journalists/police/investigators for a week". In addition, the intensivist may be an expert at hiding his real emotions on initially examining the eminent patient on admission. An ability to make a variety of worried and serious faces would help. Inventing hospital rules that disallow outside security, would get him a huge stamp of approval from the eminent patient.

We might define a new name for this speciality. Intensive Escapology.

Which brings to mind some other escape efforts.

Papers are often replete with stories about people, predominantly Nigerians, being arrested and taken to hospital for trying to smuggle high value narcotics in various places in their bodies. Some desperate types even swallow the stuff , packaging and all, when faced by the police. They are then admitted to hospitals, scanned for movement of the stuff , and treated for outputting the same, through all possible body apertures. I have never heard of anyone quickly operating on the chaps to retrieve the drugs. I wonder why.

But maybe, we need to define another super speciality. Guys who watch the crooks' alimentary canal, and the stuff bobbing down through it, driven by reluctant peristalsis, all the way down, or up, as the case may be.

Great investigative medicine. Doesn't need an ICU. Just a keen eye, and detective proclivities.

AlimentaryMyDearWatson-itis ?

Maybe Sherlock Holmes would approve...