Scope of stethoscope

December 01, 2013 01:26 am | Updated 01:26 am IST

Kids are expert at delivering a ‘googly’ without a warning; it suddenly comes after a few ‘good-length’ ones. It can be devastating when the pitch is the dining table, and the players are my schoolgoing son and college bunking daughter.

‘Dad, orthopaedicians are bone specialists who treat fracture, isn’t it?’ asked my son.

‘Yes’

‘Stethoscope is for checking heart, na?’

‘Yes’

‘Why ortho doctors carry a stethoscope, after all they don’t check the heart?’

I was suddenly stuck.

‘They carry stethoscopes for style;’ commented my college going daughter, who specialises in taunting young brothers.

‘Stupid chechi’

‘You stupid’

I knew that the dining room was quickly changing to a warfield and the trick was to retreat carefully without stepping on a mine.

‘Go, finish tomorrow’s homework;’ …my wife saved the day.

I was reminded of a prank during our postgraduate days when we had put a piece of chewing gum inside the tube of the stethoscope of one of our surgery colleagues, who went on with his daily business of checking patients’ heart, lungs and blood pressure till a general medicine resident borrowed his stethoscope and clarified its functional status and declared it dead.

Some 200 years ago, there was no stethoscope. To listen to the heart sounds the doctor had to place his ear directly on to the patient’s chest and listen. But then there was this ill young woman needing a medical examination; disturbing her modesty was out of question. Her physician, Dr. Rene Theophile Hyacinthe Laennec, was worried and wanted to find a way out. On a December morning in 1816, Dr. Laennec was taking a walk in the Louvre Park near Necker Hospital in Paris where he worked as a physician.

Two kids were playing on a seesaw; one was tapping one end of the wooden plank, while the other listened with his ear pressed firmly to the other end of it. Like most strollers he saw a seesaw, but his intelligent mind perceived it as a clue.

The mischievous deeds of those giggling kids unknowingly gave an answer to his medical needs. He rolled a paper tube, applied it to the woman’s chest, and listened. Over time the paper role evolved into a wooden tube, and later a latex tube attached to an earpiece. The modern day stethoscope was born.

Apart from stethoscope many medical conditions bear his legendary name but he was known for his down-to-earth humble behaviour.

By the way, in case you have a grudge against your doctor, loudly wish him ‘good morning’ after he places the stethoscope on your chest. He would hear it like a dozen of diwali crackers going off at close quarters. I can tell you there is nothing more irritating to a doctor. We have heard of stories of senior doctors pushing in a thermometer inside the patient’s mouth to keep talkative patients silent to get some peace of mind to concentrate.

When we entered our third year clinical class, sporting our gleaming stethoscopes around our neck like an Olympic silver medal, one of our professors asked us – ‘which is the most important part of the stethoscope?’ We pointed out all the different parts from the tubing to the chest piece to the earplug; to which he smiled and told us, ‘the area between the earpiece… your brain.’

The latest electronic stethoscopes can pick up the faintest of deviation of heart sounds, provided the physician is ready to listen. With handheld scanners becoming smaller and smaller, technically the stethoscope today might have become less essential than it was two decades ago. But over time it has transformed from an instrument to augment clinical information, to an icon of medical fraternity; the scope of stethoscope has gone much beyond its intended use, despite advances in medical technology.

If you are a user, remember how humble the originator was, and if you happen to be on the couch, keep silent when the chest piece is on your chest.

The bottom-line is, be humble, don’t mumble.

( The writer is Head, Department of Cardiology, PRS Hospital, Thiruvananthapuram. Email: tinynair@gmail.com )

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