Syedyshev Oleg
Syedyshev Oleg

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Humorous Essays Based on students' memories

"All have died
except for those who are alive, and those whom we remember"Confucius

Essay 73. Inhale through your mouth, please

For two years the students are trained before they meet patients. For two years they study different subjects. And there the third year comes. By that time all the students become owners of stethoscopes and tonometers. And when we were students there was a fashion to replace producer's rubber pipes on stethoscopes by the pipes of a kidney machine or at least of a disposable dropper. At that time those were extremely hard to get things. Somehow it happened so that those pipes were found somewhere, and many of us had them. Anyway all the students of my group had them.

So to the subjects we studied there was added propaedeutics of internal diseases. Professors did their best to teach us palpation, percussion and auscultation to examine patients. Theory goes first. We were taking into our heads that (the following is according to Wikipedia) palpation (from Latin palpatio -stroking) is one of the main methods of clinical examination, based on sensing by an examiner of various textures of a patient's tissue and organs when palpating them, and on assessing of the patient's feelings during the examination. The method allows to determine location of some organs and pathological formations, to assess some physical parameters of the examined tissues and organs: firmness, elasticity, character of natural motion, temperature, as well as to determine painful areas, identify location and type of trauma. Everyone was familiar with that method even before the study. When you strike against something, you involuntarily rub and feel the spot.

The next method (from Medical Encyclopedia) of percussion consists of tipping on some areas of a body and analyzing internal sounds, caused by this. By the type and characteristics of the sound a doctor determines topography of internal organs, their physical condition and to some extend their function. That method was more complicated. One had to know the technique of tapping of different organs and tones of tissues' sounds and tones when percussion is performed, for instance, in case of pneumonia.

And the last one (from Wikipedia) is auscultation (from Latin auscultatio); this is a method of physical diagnostics in therapy, phthisiology, cardiology, obstetrics, pulmonology, and more seldom in surgery; it consists of listening to the sounds, which are formed in man's parenchymatous and hollow organs. Auscultation can be direct - when an ear is pressed against the organ to be examined, and indirect - with the help of special devices (stethoscope, phonendoscope). Like I have already said, every student had a stethoscope. When we had seminars or lectures, practically all of us had stethoscopes hanging on our necks. We were extremely proud of ourselves and considered ourselves to be real doctors. So at the very beginning of a fall semester, after another seminar, during which Lena Sokhareva's group studied heart sounds and types of lung respiration, the students were finally trusted to supervise patients. The students were divided into groups of two and sent to the patients, but the medical reports were hidden in order not to let the students read them and copy everything from them.

Lena and her friend got a good patient. He was eagerly talking, describing his complaints and telling the anamnesis. Lena's friend was leading the conversation, and Lena was diligently writing everything. They came to the point when the patient had to be examined. Lena's friend in a bright white starched doctor's smock, a stethoscope clipped on her neck according to the third year students' fashion, approached the patient, took the stethoscope and pressed it to the patient's chest and loudly and confidently started describing what she was hearing during the auscultation: Breath sounds are amphoric, and there is the second tone's accent, and Lena, like in Shifrin's sketch (Yefim Shifrin is a popular comic actor) was writing and writing. And there the patient spoke to them looking down. He spoke somewhat quietly, but the whole group heard: Miss, when I had been examined before, those little things (he pointed at the stethoscope's branches) had been put into ears. The group was laughing till the end of the training playing up the situation in different ways. That was how the first supervision went in Lena Sokhareva's group. I will repeat myself, the first supervision.

Associate professor G.L.Khasis

Associate professor G.L.Khasis

And the trick my friend Zhenya Romashov played at a propaedeutics examination is also worthy of your attention. Poor associate professor Georgiy L'vovitch Khasis almost had a stroke, when Yevgeny explained to him that during percussion he put his finger on a patient's chest not parallel to a rib into intercostal space, but perpendicular to the rib, because it was more convenient that way to perform the percussion of a patient. And a bit later when performing auscultation of a patient he asked him politely: Inhale through your mouth, please. It is still a secret how Zhenya managed to extricate himself out of that situation and get a satisfactory.

The plot was kindly given by Elena Zhuk.

15 October, 2011

© Copyright: Oleg Syedyshev, 2012
Publishing licence #21206220646

Translated by Viktoria Potykinato content ↑


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