Hands-on diagnosis

In this age of super-specialisation and multi-million dollar gadgets, it is not surprising that the humble stethoscope has become more of a ceremonial badge of office than a serious tool of the trade.

The chances are that the only place where a doctor is still seen using the implement — and also going through the time-tested ritual of feeling the pulse (with an eye on a wristwatch), checking the tongue and other basic parameters — is in old movies.

While the celluloid physicians did not really inspire confidence, the old fashioned techniques they used still have a relevance despite untouched-by-human-hands laboratory diagnostics. And the ‘Stanford 25’ compendium may be just what the doctor ordered to breathe life into a dying art.

Indian-origin doctor and best-selling writer Abraham Verghese’s eloquent articulation of the importance of physical examination to batches of medical students at Stanford University via this must-do list could not only reduce medical bills for cash-strapped people, but more importantly it can help re-establish the diminishing connect between the doctor and patient. Which, it is clear, is the bane of today’s antiseptic world.

There is always an important place for sophisticated machinery in hospitals to suss out hard-to-identify problems, but traditional techniques can often provide answers in many cases, too.

A stethoscope can gauge a heart problem when being used to measure blood pressure along with an inflatable armband, as Verghese points out, just as a tap on the Achilles tendon can indicate possible nerve damage.

Examining the pupils, palpating the stomach , even probing the rectum, can all provide crucial inputs. Properly used, all these can go towards enhancing the efficacy of what Verghese considers the most state-ofthe-art diagnostic implement of all: the apparatus that lies between the earpieces of a stethoscope. What more should a patient want?