History repeats itself.
A year ago, there was a patient in the ward. She had undergone a myomectomy. For those who don't know, myomectomy is an operation which is done for removal of a benign tumor called leiomyoma(s) (formerly known as fibroid) from the uterus and then restoring the uterus. Leiomyomas can cause different symptoms in different parts of the uterus, and sometimes they cause no symptoms and no complications at all. Which means all leiomyomas need not be removed by myomectomy (or hysterectomy). In a young, married, aymptomatic woman with small leiomyomas, the best advise would be to have the babies she wants before doing anything to the leiomyomas. In case of a near or post menopausal woman with asymptomatic leiomyomas, just observation may suffice, as the leiomyomas shrink after menopause.
"Sir, this patient underwent myomectomy in another hospital" my Registrar told me during our ward round.
"Why did they do myomectomy?" I asked, which meant 'what were her symptoms for which myomectomy was done?'
"For fibroids" she answered brightly. Though she did not say so, I heard what she meant 'for fibroids, silly'. The 'silly' was silent because she probably understood one did not call the Boss silly in his presence.
I kept quiet, but my face must have spoken volumes. The Associate Professor hurriedly explained what I meant. Then the Registrar proceeded to check the patient's old papers and find out the indication for myomectomy. I was not surprised that she believed her Professor perhaps would not know that myomectomy was done for leiomyomas. It is quite fashionable with residents to believe their professors do not know their stuff.
A year later, the Second year Resident of the previous year was Registrar now. We were taking round in the antenatal ward. This one should have witnessed the educational proceedings of the previous year and remembered. One of the two (witnessing or remembering) must have failed. When we came to a pregnant woman who had undergone hystereoscopic and laparoscopic myomectomy in another hospital prior to this pregnancy, I asked the old question "why did they do myomectomy?"
"For fibroid" the Registrar answered after wondering for a second why I asked that silly question. I heard the answer and kept as straight a face as I could when I asked, "is Dr XXXXXX, our previous Registrar your cousin? She had also given me the same answer to this question, about another patient who had undergone a myomectomy.
"She is not my cousin" she answered. She could have said, 'cousins don't think similarly and speak the same thing, silly' and would have been more right than when she had answered my first question. But I did not sense that answer in her voice. ThisReistrar probably believed I was testing her knowledge. It turned out she did not know the indication for that myomectomy.
"When you say myomectomy was done for a fibroid, it implies that in your opinion every fibroid needs to be removed. If your examiner senses that in your answer, you may not pass your MS examination. Be careful" I said.
A year ago, there was a patient in the ward. She had undergone a myomectomy. For those who don't know, myomectomy is an operation which is done for removal of a benign tumor called leiomyoma(s) (formerly known as fibroid) from the uterus and then restoring the uterus. Leiomyomas can cause different symptoms in different parts of the uterus, and sometimes they cause no symptoms and no complications at all. Which means all leiomyomas need not be removed by myomectomy (or hysterectomy). In a young, married, aymptomatic woman with small leiomyomas, the best advise would be to have the babies she wants before doing anything to the leiomyomas. In case of a near or post menopausal woman with asymptomatic leiomyomas, just observation may suffice, as the leiomyomas shrink after menopause.
"Sir, this patient underwent myomectomy in another hospital" my Registrar told me during our ward round.
"Why did they do myomectomy?" I asked, which meant 'what were her symptoms for which myomectomy was done?'
"For fibroids" she answered brightly. Though she did not say so, I heard what she meant 'for fibroids, silly'. The 'silly' was silent because she probably understood one did not call the Boss silly in his presence.
I kept quiet, but my face must have spoken volumes. The Associate Professor hurriedly explained what I meant. Then the Registrar proceeded to check the patient's old papers and find out the indication for myomectomy. I was not surprised that she believed her Professor perhaps would not know that myomectomy was done for leiomyomas. It is quite fashionable with residents to believe their professors do not know their stuff.
A year later, the Second year Resident of the previous year was Registrar now. We were taking round in the antenatal ward. This one should have witnessed the educational proceedings of the previous year and remembered. One of the two (witnessing or remembering) must have failed. When we came to a pregnant woman who had undergone hystereoscopic and laparoscopic myomectomy in another hospital prior to this pregnancy, I asked the old question "why did they do myomectomy?"
"For fibroid" the Registrar answered after wondering for a second why I asked that silly question. I heard the answer and kept as straight a face as I could when I asked, "is Dr XXXXXX, our previous Registrar your cousin? She had also given me the same answer to this question, about another patient who had undergone a myomectomy.
"She is not my cousin" she answered. She could have said, 'cousins don't think similarly and speak the same thing, silly' and would have been more right than when she had answered my first question. But I did not sense that answer in her voice. ThisReistrar probably believed I was testing her knowledge. It turned out she did not know the indication for that myomectomy.
"When you say myomectomy was done for a fibroid, it implies that in your opinion every fibroid needs to be removed. If your examiner senses that in your answer, you may not pass your MS examination. Be careful" I said.
