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A soundless death

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Will the fear of misuse condemn ultrasound technology to its demise, a doctor asks.

It was just a word,

A ‘mantra’

To be uttered

when we got stuck

We hadn't seen it

hadn't read much about it

It was sparingly mentioned

in our textbooks.

But our seniors reiterated that

we could fit it in anywhere

If we ran out of our list of investigations

and the examiner wanted more

we could invoke it.

It was the king of all diagnostic tools.

X-rays to see bones and stones

Collapsed lungs and enlarged hearts

were routine,

Modalities we had grown up with,

But to assess the abdomen

the legendary Pandora's box

without cutting it open

seemed magical.

To evaluate soft tissues and solid organs

to see what is happening on the inside

from the outside ,

sounded unbelievable

It made diagnostic laparotomy

sound outdated

almost barbaric.

I saw it for the first time as a junior resident

A small TV with a grainy picture

I was surprised that the radiologist could make anything of it

To my untrained eyes it was like staring at the moon.

You could see what you wanted to see

A smiling face or an old woman at the spinning wheel.

But that was just the beginning.

Slowly I began to notice the different shades of grey.

The interplay of light and shadows

In cysts and tumours

An abscess ready to be drained

Or a benign lesion

requiring patient ‘wait and watch’'

Body functions in real time

urine filling the bladder,

food propelled in the gut

and the declaration of life

a tiny heartbeat.

As technology advanced

images became clearer

Making it possible to see

Blockage to blood flow

A malfunctioning heart valve

A ripped retina causing blindness

The reason of a numb limb

or a swollen joint

It was possible to ascertain the release of

an egg from the ovary

and predict whether the uterine lining

was primed to receive it.

With some expertise, it could be told

when a pregnancy

didn’t make it to the womb

and got embedded elsewhere.

Putting the mother at grave risk

In cases of trauma, in a flash

it could tell whether

there was internal bleeding necessitating surgery

A tendon rupture or a lacerated spleen

Air pressing on the lungs or blood around the heart

Used on the road side

It could save lives by saving time.

With perfect picture quality and the option of 3D images

It can show a baby yawning out of boredom

Or lustily sucking at its thumb

Getting entangled in loops of umbilical cord

Or sleeping soundly.

It is possible to check the baby's

eye movements

And heart valves

Count fingers and toes

Look for cleft lips and open spine defects

Diagnose conditions requiring expert neonatal care

So that a team is ready when the baby emerges

With colour Doppler we can predict

if the womb is inhospitable, foetal demise is eminent

and deliver the baby before it is too late,

It can diagnose defects incompatible with life

So that pregnancies can be terminated,

Curtailing the misery, lessening the heartache.

But just as it shows everything else

It can also show the genitalia of the unborn child,

which in our society is synonymous with female foeticide.

Because in a son-crazy nation,

a daughter will be killed ASAP,

The fear of misuse has condemned

the modality to disuse.

Buried in tons of paperwork

and tied in miles of red tape

It will never reach its full potential

An inexpensive, easily available, fairly accurate

diagnostic tool will die prematurely,

soundlessly.

As developed nations

exploit this technology

And make it available

not only in hospitals and clinics

but also in

ambulances and sports arenas

to hasten diagnosis

expedite treatment

and reduce mortality

We are curbing its reach.

The efforts to curtail its use

and limit the number of users

have had mixed results.

While the sex ratio at birth

has somewhat stabilised.

The child sex ratio continues to fall.

The fault is not in the machine

It is in the mindset

Till that changes

Nothing will change

because

A daughter can be eliminated

after she is born....

An ultrasound is not a

prerequisite to kill a girl child!

 

dr_manjugupta@icloud.com

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Printable version | Jan 28, 2020 4:16:48 PM | https://www.thehindu.com/opinion/open-page/a-soundless-death/article21381619.ece

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