The PET and The VET

THE ART OF MEDICAL PRACTICE

Clinical Diagnosis versus Evidence Based Diagnosis

By

VIKRAM KARVE

Now-a-days SPECIALISATION is the buzzword. 

Here is a story for all you who believe only in Specialists. 

This story is about doctors but the moral of the story is equally applicable universally in all professions.

When I was a small boy living in Pune in the 1960s, if you fell ill you called your family doctor home and he checked you up.

Every family had their own family doctor, a General Practitioner (GP), who was like a member of the family. He knew all about your medical and family history and you had explicit faith in your family doctor and you had a mutually rewarding relationship.

After a thorough physical examination to diagnose what was wrong, your family doctor either gave you medicines or an injection there and then or he asked someone to come over to his clinic to collect medicines which were mostly mixtures of ground tablets or liquid concotions prepared by the compounder and given to you in bottles with dosages indicated by stuck paper strips.

My doctor friend tells me that this approach is called Clinical Diagnosis. 

Surfing the internet I found that clinical diagnosis is a diagnosis based on a study of the signs and symptoms of a disease (The American Heritage® Medical Dictionary 2007) or a diagnosis made on the basis of knowledge obtained by medical history and physical examination alone, without benefit of laboratory tests or x-ray films (Mosby's Medical Dictionary, 8th edition, 2009, Elsevier).

Nowadays GPs seem to have vanished and you have to go to a specialist if you fall ill. And the specialist sends you for a series of laboratory tests – blood, urine et al – and then studies the reports and prescribes medicines accordingly. 

My doctor friend tells me that this is called Evidence Based Diagnosis.

In a lighter vein let me share with you a humorous story, surely apocryphal, that my doctor friend narrated to me on this subject.

THE PET and THE VET

A woman brought her unconscious pet parrot to a veterinary doctor (vet).

The vet physically examined the lifeless bird and told the woman that her pet parrot was dead.

The distressed woman wailed, “Are you sure…?”

“Yes. I am sure. Your parrot is dead…” the vet said.

“How can you be so sure…? You haven’t done any tests or anything on my parrot…” the distraught woman said, “I don't believe you … You are just an ordinary vet … I want to show him to some good specialists … I want a specialist opinion.”

The vet nodded his head and said, “Okay...”

He then turned around and left the room and returned a few minutes later with a dog – a black Labrador retriever.

As the woman looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the parrot from top to bottom. 

The Labrador then looked up at the vet with sad eyes and shook his head. 

The vet patted the dog on the head and the Lab went out of the room wagging its tail.

A few minutes the vet returned with a cat. 

The cat jumped on the table and also delicately sniffed the parrot from head to foot. 

The cat sat back on its haunches, shook its head, meowed softly and the vet lifted the cat and sent it out of the room.

Then the vet looked at the woman and said, “I am sorry, but as I said, your parrot is definitely dead.”

The vet then went to his desk and wrote out his bill which he gave to the woman.

The woman, still recovering from the grief of the death of her beloved pet parrot, was totally stunned with disbelief when she saw the bill.

“What…!!! Two Thousand Rupees…?” the woman protested in bewilderment and she said, “You are charging me Rs. 2000 just to tell me that my parrot is dead…? This is ridiculous…!”

The vet shrugged and said, “I am sorry but it is you who wanted to show your parrot to specialists. If you had taken my word for it, my bill would have been just Rs. 50, but you were not satisfied with the diagnosis of an ordinary vet like me and you insisted that I refer your parrot to specialists and get some tests done - so the Lab Report cost Rs. 950 and the Cat Scan a further Rs. 1000 so that totals Rs. 2000 …”

VIKRAM KARVE

Copyright © Vikram Karve 2012

Vikram Karve has asserted his right under the Copyright, Designs and Patents Act 1988 to be identified as the author of this work.
© vikram karve., all rights reserved.

Did you like this story?

I am sure you will like the 27 stories in COCKTAIL

To order your COCKTAIL please click any of the links below:

http://www.flipkart.com/cocktail-vikram-karve-short-stories-book-8191091844?affid=nme

http://www.indiaplaza.in/cocktail-vikram-karve/books/9788191091847.htm

http://www.apkpublishers.com/books/short-stories/cocktail-by-vikram-karve.html

About Vikram Karve

  

A creative person with a zest for life, Vikram Karve is a retired Naval Officer turned full time writer. Educated at IIT Delhi, ITBHU Varanasi, The Lawrence School Lovedale and Bishops School Pune, Vikram has published two books: COCKTAIL a collection of fiction short stories about relationships (2011) and APPETITE FOR A STROLL a book of Foodie Adventures (2008) and is currently working on his novel and a book of vignettes and short fiction. An avid blogger, he has written a number of fiction short stories, creative non-fiction articles on a variety of topics including food, travel, philosophy, academics, technology, management, health, pet parenting, teaching stories and self help in magazines and published a large number of professional research papers in journals and edited in-house journals for many years, before the advent of blogging. Vikram has taught at a University as a Professor for almost 15 years and now teaches as a visiting faculty and devotes most of his time to creative writing. Vikram lives in Pune India with his family and muse - his pet dog Sherry with whom he takes long walks thinking creative thoughts.

Vikram Karve Academic and Creative Writing Journal: http://karvediat.blogspot.com

Professional Profile Vikram Karve: http://www.linkedin.com/in/karve

Vikram Karve Facebook Page:  https://www.facebook.com/vikramkarve

Vikram Karve Creative Writing Blog: http://vikramkarve.sulekha.com/blog/posts.htm

Email: vikramkarve@sify.com          

vikramkarve@gmail.com 

Fiction Short Stories Book

COCKTAIL : Short Stories about Relationships By VIKRAM KARVE

http://www.flipkart.com/cocktail-vikram-karve-short-stories-book-8191091844?affid=nme

Foodie Book:  Appetite for a Stroll

http://www.flipkart.com/appetite-stroll-vikram-karve/8190690094-gw23f9mr2o 

© vikram karve., all rights reserved.

  

DIAGNOSIS - The Art of Medicine

THE ART OF MEDICINE

Clinical Diagnosis versus Evidence Based Diagnosis

By

VIKRAM KARVE

Now-a-days SPECIALISATION is the buzzword. 

Here is a story for all you who believe only in Specialists. 

This story is about doctors but the moral of the story is equally applicable universally in all professions.

When I was a small boy living in Pune in the 1960s, if you fell ill you called your family doctor home and he checked you up.

Every family had their own family doctor, a General Practitioner (GP), who was like a member of the family. He knew all about your medical and family history and you had explicit faith in your family doctor and you had a mutually rewarding relationship.

After a thorough physical examination to diagnose what was wrong, your family doctor either gave you medicines or an injection there and then or he asked someone to come over to his clinic to collect medicines which were mostly mixtures of ground tablets or liquid concotions prepared by the compounder and given to you in bottles with dosages indicated by stuck paper strips.

My doctor friend tells me that this approach is called Clinical Diagnosis. Surfing the internet I found that clinical diagnosis is a diagnosis based on a study of the signs and symptoms of a disease (The American Heritage® Medical Dictionary 2007) or a diagnosis made on the basis of knowledge obtained by medical history and physical examination alone, without benefit of laboratory tests or x-ray films (Mosby's Medical Dictionary, 8th edition, 2009, Elsevier).

Nowadays GPs seem to have vanished and you have to go to a specialist if you fall ill. And the specialist sends you for a series of laboratory tests – blood, urine et al – and then studies the reports and prescribes medicines accordingly. My doctor friend tells me that this is called Evidence Based Diagnosis.

In a lighter vein let me share with you a humorous story, surely apocryphal, that my doctor friend narrated to me on this subject.

THE PET and THE VET

A woman brought her unconscious pet parrot to a veterinary doctor (vet).

The vet physically examined the lifeless bird and told the woman that her pet parrot was dead.

The distressed woman wailed, “Are you sure…?”

“Yes. I am sure. Your parrot is dead…” the vet said.

“How can you be so sure…? You haven’t done any tests or anything on my parrot…” the distraught woman said, “I don't believe you … You are just an ordinary vet … I want to show him to some good specialists … I want a specialist opinion.”

The vet nodded his head and said, “Okay...”

He then turned around and left the room and returned a few minutes later with a dog – a black Labrador retriever.

As the woman looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the parrot from top to bottom. The Labrador then looked up at the vet with sad eyes and shook his head. The vet patted the dog on the head and the Lab went out of the room wagging its tail.

A few minutes the vet returned with a cat. The cat jumped on the table and also delicately sniffed the parrot from head to foot. The cat sat back on its haunches, shook its head, meowed softly and the vet lifted the cat and sent it out of the room.

Then the vet looked at the woman and said, “I am sorry, but as I said, your parrot is definitely dead.”

The vet then went to his desk and wrote out his bill which he gave to the woman.

The woman, still recovering from the grief of the death of her beloved pet parrot, was totally stunned with disbelief when she saw the bill.

“What…!!! Two Thousand Rupees…?” the woman protested in bewilderment and she said, “You are charging me Rs. 2000 just to tell me that my parrot is dead…? This is ridiculous…!”

The vet shrugged and said, “I am sorry but it is you who wanted to show your parrot to specialists. If you had taken my word for it, my bill would have been just Rs. 50, but you were not satisfied with the diagnosis of an ordinary vet like me and you insisted that I refer your parrot to specialists and get some tests done - so the Lab Report cost Rs. 950 and the Cat Scan a further Rs. 1000 so that totals Rs. 2000 …”

VIKRAM KARVE

Copyright © Vikram Karve 2012

Vikram Karve has asserted his right under the Copyright, Designs and Patents Act 1988 to be identified as the author of this work.
© vikram karve., all rights reserved.

Did you like this story?

I am sure you will like the 27 stories in COCKTAIL

To order your COCKTAIL please click any of the links below:

http://www.flipkart.com/cocktail-vikram-karve-short-stories-book-8191091844?affid=nme

http://www.indiaplaza.in/cocktail-vikram-karve/books/9788191091847.htm

http://www.apkpublishers.com/books/short-stories/cocktail-by-vikram-karve.html

About Vikram Karve

  

A creative person with a zest for life, Vikram Karve is a retired Naval Officer turned full time writer. Educated at IIT Delhi, ITBHU Varanasi, The Lawrence School Lovedale and Bishops School Pune, Vikram has published two books: COCKTAIL a collection of fiction short stories about relationships (2011) and APPETITE FOR A STROLL a book of Foodie Adventures (2008) and is currently working on his novel and a book of vignettes and short fiction. An avid blogger, he has written a number of fiction short stories, creative non-fiction articles on a variety of topics including food, travel, philosophy, academics, technology, management, health, pet parenting, teaching stories and self help in magazines and published a large number of professional research papers in journals and edited in-house journals for many years, before the advent of blogging. Vikram has taught at a University as a Professor for almost 15 years and now teaches as a visiting faculty and devotes most of his time to creative writing. Vikram lives in Pune India with his family and muse - his pet dog Sherry with whom he takes long walks thinking creative thoughts.

Vikram Karve Academic and Creative Writing Journal: http://karvediat.blogspot.com

Professional Profile Vikram Karve: http://www.linkedin.com/in/karve

Vikram Karve Facebook Page:  https://www.facebook.com/vikramkarve

Vikram Karve Creative Writing Blog: http://vikramkarve.sulekha.com/blog/posts.htm

Email: vikramkarve@sify.com          

vikramkarve@gmail.com 

Fiction Short Stories Book

COCKTAIL : Short Stories about Relationships By VIKRAM KARVE

http://www.flipkart.com/cocktail-vikram-karve-short-stories-book-8191091844?affid=nme

Foodie Book:  Appetite for a Stroll

http://www.flipkart.com/appetite-stroll-vikram-karve/8190690094-gw23f9mr2o 

© vikram karve., all rights reserved.

  

Neuro Linguistic Programming - NLP - Self Improvement Part 2 - Quit Smoking and Addictions

Neuro Linguistic Programming ( NLP ) for Self Improvement 

PART 2 -  QUIT SMOKING

By

VIKRAM KARVE

Whenever I undergo any training or course, I try and apply the concepts and skills I learn during the program upon myself in order to ascertain efficacy of the training for I firmly believe in the time-tested adage that “The Proof of the Pudding is in the Eating”.

Thus, the first thing I decided after completing NLP Practitioner Training was to try and apply the concepts I had learnt and imbibed on myself.

NLP stands for neuro-linguistic programming. 

Sounds complicated and high falutin, isn’t it? 

Actually NLP is quite simple – let’s see how I applied it in my daily life.

At that point in time, I was a smoker. 

I had tried to quit smoking many times with little success. 

Now I’d try a simple concept from NLP to give up smoking.

I succeeded beyond my expectations and gave up smoking in a day. I conquered the craving, the urge, for smoking and never suffered any “withdrawal symptoms”. 

I quit smoking forever in one go.

Let me describe to you, Dear Reader, that red letter day of my life. 

I woke up early in the morning, as usual, made a cup of tea, and the moment I took a sip of the piping hot delicious tea, I felt the familiar crave for my first cigarette of the day.

I had identified my first “Smoking – Anchor” – Tea.

 

I kept down the tempting cup of tea, made a note of the craving [anchor] in my diary, quickly heated a glass of water in the microwave oven, completed my ablutions, stepped out of my house, and embarked upon my customary morning constitutional brisk walk-cum-jog deeply rinsing and cleansing my lungs with pure refreshing morning air, which made me feel on top of the world.

I felt invigorated and happy. I had overcome my craving and not smoked my first cigarette of the day.

 

Returning refreshed from my brisk bracing morning walk, I stopped to pick up the newspaper, and spotted my friends ‘N’ and ‘S’ across the road beckoning me for our customary post-walk tête-à-tête with tea and cigarettes at our favorite the tea-stall.

Here lurked my second “Smoking – Anchor” – my smoker friends.

I felt tempted, but I steeled my resolve. I waved out to my smoker friends, turned away and briskly headed home.

They must have thought I’d gone crazy, but it didn’t matter – I had avoided my second cigarette of the day.

 

That’s what I was going to do the entire day. Be aware, look inwards, fully cognizant and mindful in order to ensure that I identify all the stimuli that triggered in me the urge to smoke – my “smoking anchors” which could be anything, conscious and unconscious, internal and external, tangible or intangible – people, situations, events, feelings, smells, emotions, tendencies, moods, foods, social or organizational trends, practices, norms, peer-pressure.

Then I would conquer and triumph over these stimuli, demolish these negative “smoking-anchors” and establish and reinforce new positive healthy “non-smoking anchors” using a Technique called Force Field Analysis.

I’ll tell you more about Force Field Analysis later. Dear Reader, read on and see how my first non-smoking day progressed.

After breakfast, I didn’t drink my usual cup of coffee – a strong “smoking anchor” which triggered in me a strong irresistible craving and desperate desire to smoke. I drank a glass of cold bland milk instead, and thereby averted my third cigarette of the day.

It was nine as I reached my workplace and I had not smoked a single cigarette. Rather I had not smoked my customary three cigarettes!

It was a long day ahead and I had to be cognizant, observe myself inwardly and devise strategies to tackle situations that elicited craving for smoking – recognize and conquer my “smoking anchors”.

Anchoring is a naturally occurring phenomenon, a natural process that usually occurs without our awareness. 

An anchor is any representation in the human nervous system that triggers any other representation.

Anchors can operate in any representational system (sight, sound, feeling, sensation, smell, taste). 

You create an anchor when you unconsciously set up a stimulus-response pattern.

Response [smoking] becomes associated with [anchored to] some stimulus; in such a way that perception of the stimulus [the anchor] leads by reflex to the anchored response [smoking] occurring.

Repeated Stimulus-Response [SR] action reinforces anchors and this is a vicious circle, especially in the context of “smoking anchors“. The trick is to identify your “smoking anchors”, become conscious of these anchors and ensure you do not activate them.

And then transcend from the SR Paradigm to the SHOR Paradigm to set and fire new positive anchors. 

What is SHOR?

SHOR stands for Stimulus-Hypothesis-Options-Response – I will tell about this management model soon too.

The moment I reached office I saw my colleague ‘B’ eagerly waiting for me, as he did every day. 

Actually the freeloader was eagerly waiting to bum a cigarette off me for his first smoke of the day -  “I only smoke other’s cigarettes” was his motto!

I politely told him I had quit smoking and told him to look for a cigarette elsewhere. He looked at me in disbelief; taunted, jeered and badgered me a bit, but when I stood firm, he disappeared.

I had not smoked my fourth cigarette of the day!

I removed from my office my ashtray, my lighter, all vestiges of smoking, declared the entire place a no-smoking zone and put up signs to that effect.

The working day began. 

It was a tough and stressful working day. 

I was tired and suddenly my boss called me across to his office and offered me a cigarette. 

I looked at the cigarette pack yearningly, tempted, overcome by a strong craving, desperate to have just that “one” cigarette.

Nothing like a “refreshing” smoke to drive my blues away and revitalize me – the “panacea” to my “stressed-out” state! It was now or never!

I politely excused myself on the pretext of going to the toilet, but rushed out onto the terrace and took a brisk walk rinsing my lungs with fresh air, and by the time I returned I had lost the craving to smoke and realized that physical exercise is probably the best antidote – a positive “non-smoking” anchor – and, of course, I had not smoked my fifth cigarette of the day!

 

It was the famous Stoic philosopher Epictetus who said: "Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. It is only after you have faced up to this fundamental rule and learned to distinguish between what you can and cannot control that inner tranquility and outer effectiveness become possible.”

We often let our feelings set our anchors, govern our lives. 

We let feelings drive our thoughts, not realizing that thoughts drive actions, actions produce results, and results in turn produce more feelings, reinforce anchors, causing a vicious circle which may ultimately lead to loss of self-control.

Such “feeling-anchors” not totally controllable, as many times feelings are produced by external circumstances beyond your control, and if negative feelings are allowed to drive our thoughts and actions, then undesirable results emanate.

The best solution is to establish “thought-anchors” as drivers of your actions. It is well within your control to think positive, good and interesting thoughts.

In fact, the happiest person is the one who thinks the most interesting and good thoughts, isn’t it? 

That’s the essence of NLP.

Reprogram your anchors, recondition your mind, control your own life, change for the better and enhance your plane of living.

This technique works for me, and I’m sure it’ll work for you too. 

Maybe NLP is so effective because it is breathtaking in its simplicity.

VIKRAM KARVE 

Copyright © Vikram Karve 2010

Vikram Karve has asserted his right under the Copyright, Designs and Patents Act 1988 to be identified as the author of this work.

© vikram karve., all rights reserved.

VIKRAM KARVE educated at IIT Delhi, ITBHU Varanasi, The Lawrence School Lovedale, and Bishop's School Pune, is an Electronics and Communications Engineer by profession, a Human Resource Manager and Trainer by occupation, a Teacher by vocation, a Creative Writer by inclination and a Foodie by passion. An avid blogger, he has written a number of fiction short stories and creative non-fiction articles in magazines and journals for many years before the advent of blogging. His delicious foodie blogs have been compiled in a book "Appetite for a Stroll". Vikram lives in Pune with his family and pet Doberman girl Sherry, with whom he takes long walks thinking creative thoughts. 

Vikram Karve Creative Writing Blog - http://vikramkarve.sulekha.com/blog/posts.htm

Academic Journal Vikram Karve – http://karvediat.blogspot.com

Professional Profile of Vikram Karve - http://www.linkedin.com/in/karve 

Email: vikramkarve@sify.com
Foodie Book: Appetite for a Stroll  

© vikram karve., all rights reserved.