DILEMMA IN SURGICAL PRACTICE

In those days, general surgeons were doing all surgeries, including Ortho, Neuro, Thoracic and Gynec cases. The surgeons depend on their clinical experiences in making the diagnosis. Surgical technique is never static. It changes for newer techniques to improve the quality of the outcome. Some of the cases where I had a dilemma in diagnosis are discussed. How scabies was eradicated in hostel inmates and how major surgeries were done in the district headquarter hospital without proper blood bank may be interesting for the readers. 

Sometimes, the surgeon must have some humanitarian considerations in treating the cases, for example, surgery for congenital pyloric stenosis, volvulus sigmoid and a patient who had gastrojejunostomy kept in the ward for more than one month for hospital food. With a full team sprite, 40 cases of injury in a fire accident in a cracker shop were treated. Emergency tracheostomy, Burr hole in head injury, intercostals drain in thoracic injury and even bilateral thoracotomy done in chest injuries by general surgeons are discussed. Appendicular abscess was drained with calculated risks. Duodenal perforation in situs inverses totalis and enteric perforations are discussed. The topics are arranged as per organ pathology for easy reading. 

Dilemma in Surgical Practice is documentary evidence that surgeons in those days were real general surgeons dealing with all sorts of cases to save the life of the patients. The senior surgeons who read this book will recollect with their experiences.