Corona times: Clinical cardiology gets up from graveyard, for a while !
Surprised to see many of my colleagues, physicians and fellows are beaming with new pride even in this troubled corona times. Paradoxically, I could see some fresh clinical sense in their approach to problems as well.
Each one of them had a story to tell
- Sir, I could suddenly diagnose heart failure for the first time with my eyes and ears without NT- Pro BNP or E/E’ . I agree with you sir, textbooks seem to be right. There was indeed basal rales and JVP was elevated. I was astonished I could diagnose CHF clinically!
- I feel proud, that I have acquired the rare expertise of giving fitness to an emergency appendectomy just by ECG.Its unbelievable, I had the courage of not asking for a pre-op echocardiogram.
- Oh yes, it was a real flash of bedside brilliance. I could rule out Infective endocarditis, in a patient with prolonged fever, without caring to call for a bed side screening echo for vegetation. I am really proud of my acumen! I realised, Duke criteria is far more deep than our urge to have a glimpse on vegetation.
- I can’t believe myself, yesterday, I was able to Ignore a 90% LAD lesion, first time in my life, by clinical means without FFR and QFR stuff.
- This one is again from the Echo lab. I sent home a patient with Aortic stenosis without bothering with all those low flow and high gradient conundrum. I was sure it was severe AS. The dense calcium and LVH were good enough to tell the complete story.
Finally, one of my senior colleagues, who lives half his awake time in cath lab, confessed to me. “Yes,Venkat, it’s all happening right in front of my eyes. Miracles based on absolute truths . I have since learnt the ultimate lesson in cardiology. How to treat, many of my CAD patients, without knowing coronary anatomy, that too without any major adversaries”
After listening to these sobering stories , I got into a mid-afternoon nap, where in, my good old professor came in my dream. He blessed me with his famous smile and hug for practicing and propagating clinical cardiology, as he taught to me.
But sir, I blinked, sorry sir, I don’t deserve your compliments. It is going to vanish with this dream.Its all about, terrible corona times, which has forced us to deliver this low-quality care based on the antique clinical methods
My mentor’s happiness was short lived, as he realised these guys will soon be consumed again, by the glamor machines that runs medical science.He left silently , still pleading us to try our best.