The surgical note

I have come to you because my neurosurgeon retired a few years ago and Irsquove been asked to do an MRI every two years to make sure my tumour hasnrsquot come backrdquo an elderly lady stated as she pulled out a note from amidst a heap of medical records neatly filed and crisply labelled ldquoHe was the most wonderful human being I have met in my liferdquo she added handing his note to me One glance at the offwhite paper tastefully inked with a fountain pen in handwriting that would make an artist blush made me realise why she felt the way she did for himThe note summarised her past records and clinical findings with such finesse that even textbooks would pale in comparison It meticulously mentioned a pattern of thinking and a plan for how her treatment should proceed in the future It was written in handwriting that was mesmerisingI am someone who finds it exacting to read my own handwriting a few days after I have written something leave aside trying to decipher that of other doctors of my generationBut this note exuded a deep level of care and concern of nobility and kindness in treating a patient as a whole rather than simply focusing on a crevice in her brain through which he had removed her tumour a few decades ago It had resulted in an unblemished MRI till date ldquoCan I take a picture of thisrdquo I asked the lady as she gazed at me perplexed by my awe ldquoWe donrsquot see this kind of beauty in our generationrdquo I explained soaking in the equivalent of a Rembrandt or Monet ldquoWe are wrapped in the trappings of technology which is invaluable but it ironically takes away from us something that is pricelessrdquo I told her that her scan looked perfect and that I would see her again after a few years with yet another MRI that I was confident would look unchangedEvery time I find myself falling short in some way or feeling mediocre I scroll up to the photograph of that note on my phone thinking of a generation of doctors with half the resources we have and yet being twice as diligent Despite being such a stately figure in the field the esteemed gentleman who had written that note lived his life with a simplicity and an elegance that one could only dream of emulating He is still a constant feature in most esteemed neurosurgical conferences reminding the fraternity to continually do the right thing at a time when nearly everything seems flawedMy personal interaction with him had been minimal as he had retired by the time I started practice in the city until he wrote me an email a few months ago to say how much he enjoyed reading my articles in the papers He signed off with ldquomore power to your elbowrdquo followed by his first name As I reply to a handful of such emails each week I wrote to acknowledge his email with gratitude but erroneously addressed him by his first name not registering it was ldquothe neurosurgical matriarchrdquo until after I hit ldquosendrdquo I wrote back immediately telling him how embarrassed I was with my blunder but he brushed it away explaining that such reverence was reserved for teachers and saints and that we were merely colleagues He invited me over to his home and we spent a lovely afternoon chatting about cabbages and kingsRecently a chirpy patient of mine with unremitting back pain sought an opinion from a senior physician who the country unequivocally considers the God of medicine ldquoCan I write a letter to your doctorrdquo he asked her after having analysed her case ldquoOf courserdquo she proclaimed ldquoHersquoll end up framing it in goldrdquo she said confidently In a few words this medical luminary detailed what he thought was going on suggesting a few modifications and advising that she continue treatment under my care Within a few sentences decades of wisdom were handed over with no other reason but to enlighten and encourage a complete strangermdashmeA candle loses none of its light by lighting another I realised when I thought about what contributes to such magnanimity I wrote back requesting a personal meeting and he obliged immediately He autographed for me copies of books written by him and when he agreed to allow me to take a picture with him with me reverentially maintaining a safe distance he instructed ldquoCome stand a little closerrdquo and put his arm around me I felt like how a teenage footballer would after getting snapped with Messi or a fledgling actor after sharing the frame with Mr Bachchan These moments happen in medicine tooldquoA letter should be regarded not merely as a medium for the communication of intelligencerdquo advised an 1876 guide to the art of epistolary etiquette ldquobut also as a work of artrdquo Surgical notes are a primer in the art of medicine The charm of writing and sharing letters can never be replaced by the curtness of the efficiencyobsessed electronic generation Even so modern technology is indeed a boon in enhancing patient care Budding doctors can spiral images to their more seasoned counterparts and seek hypersonic guidancemdashonly because ldquowhat to do rdquois always more pivotal than ldquohow to dordquo The latter is simply technique the former tenacity ldquoYou not only save the lives of patients you save the lives of other doctors toordquo I joked with a senior neurosurgeon friend who had recently advised me on a case I needed an opinion onMedicine is fraught with doctors who want to give give of their time effort and insight That is one indisputable way to carry onersquos legacy forward What they know will go with them but what they teach will live on forever These greats live their lives with a sentient generosity of spiritTo accomplished doctors who look out for the burgeoning counterparts may you all be blessed with a healthy life that is energised by the insurmountable goodwill of the millions you have healed and even more that you have inspiredThe writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals