Why did the Potter’s Hand shake?

One more piece from Dr. Akhila Prasad, Sr. Specialist, Dr. RML Hospital, New Delhi that makes her think. You can reach her at akhil43 at yahoo.com. She earlier wrote the piece, “The Physician Buried Inside the Radiologist”.

 

A vessel of more ungainly make…

What! Did the Hand then of the Potter shake?

The Rubaiyat of Omar Khayyam.

 

Who among us radiologists, are not familiar with the sickening, sinking feeling we get when we are scanning a blissfully, happily pregnant woman’s abdomen and the various shades of grey slowly reveal to us, “Yes! The Potter’s Hand must have shaken while making this pot!”

This is about the number of times we have diagnosed some form of congenital anomaly on an antenatal scan! The mother is smiling and looking at us in anticipation, often in a blissfully ignorant, content state, lying in front of us, so trustingly exposing her pregnant belly carrying that magical life inside her!

We have to continue to maintain a poker face as if nothing is amiss and everything is fine and first try to figure out what the hell is happening on the screen, and having quickly figured out how the Potter’s Hand shook and having frozen all the shakings into eternity (images), comes the next issue of how to tell, what to tell and how to manage the patient!

Sometimes the patient guesses even before we say something, our body language perhaps or the facial expression or her own intuition…or the number of postgraduate students excited beyond imagination at the unimaginable cosmic mistake in front of them!

Thoughts of all kinds, all at the same moment, fleet past in our minds…to err is human, but here is where the Divine seems to have erred! Is it possible? How? But the results are in the front of us on the screen! “What was that unborn child’s fault dammit!” you ask yourself. It has not even come into this world yet, or committed any mistake and it has had to pay…like this?” your brain argues. “Karmic”, the word echoes somewhere in your brain, a general one-stop shop answer to every Indian problem! “Whose Karma?” immediately your brain asks. “The unborn body? Or the unborn soul? Or the previous birth body? Or the previous birth soul??…you don’t have any answers!

And by that time anyway you have more pressing problems at hand to handle! To handle the patient at hand! To handle her mother or husband standing next to you! To gently reveal to them that something is wrong! God forgot to put a head! Or He shortened a couple of limbs! He decided to put the baby’s abdomen into the chest! God!!! What do you say? How do you say it? And why doesn’t it get easier over the years? Why is it as troubling and as painful each time? And the irony is that despite what you feel inside, you automatically tend to stick to your professional training and duty and deal with it as if it is perfectly normal to have an abnormal unborn child. And so you write out the report and say, “Next!”

This brings us to one more core issue in our training. We must drill it into every resident’s head to mentally and morally treat every obstetric ultrasound after the relevant period of gestation, as a Level II study! The patient has come to us at this instance for a scan, after fighting God knows what odds and under what difficult circumstances. It does not matter whether the ultrasound form or receipt says, “Level II”! We have to scan her child head to toe, no matter what the form says, no matter whether it is her nth ultrasound…it has to seep into our very being, that we have to quickly and systematically declare normalcy or detect anything abnormal. The mother and the child both deserve that!

Comments

  1. Rajesh Gothi says:

    As usual a well written article. But just make sure you are right. Take the help of your colleagues and ask for a second opinion when in doubt. Explain the findings to the patient and her relatives in the quiet of your room and not in front of the public. Get her phone number. Keep in touch and tell her you are concerned and will be happy to talk to her anytime. After all you also need the follow up!

    • Dr.Akhila Prasad says:

      Very well said sir,esp the second opinion, which becomes so important and crucial at times bcos crucial decisions need to be taken..esp with better machines and better technologies available now,

  2. Raj Mani says:

    Written with feeling and flair!A physician’s(and a radiologist’s) job is made more meaningful(if more complicated) by the larger human side intruding into our consciousness. The Potter’s hand doth shake but His arms do cleave all to his chest-whether comely or ungainly! Therefore like our Maker our communication should not be matter-of-fact but mixed with compassion..As Rajesh Gothi says this should reflect in the way we sit the family down and give them the time they deserve! – something difficult at a busy clinic,but the way is found when the heart is in the right place!

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