Emedinews:Inspiration:The world is a wonderful place

 A true story, happened in 1892 at Stanford University:

 An 18-year-old student was struggling to pay his fees. He was an orphan, and not knowing where to turn for money, he came up with a bright idea. He and a friend decided to host a musical concert on campus to raise money for their education.

 They reached out to the great pianist Ignacy J. Paderewski. His manager demanded a guaranteed fee of $2000 for the piano recital. A deal was struck and the boys began to work to make the concert a success.

 The big day arrived. But unfortunately, they had not managed to sell enough tickets. The total collection was only $1600. Disappointed, they went to Paderewski and explained their plight. They gave him the entire $1600, plus a cheque for the balance $400. They promised to honour the cheque at the soonest possible.

 “No,” said Paderewski. “This is not acceptable.” He tore up the cheque, returned the $1600 and told the two boys: “Here’s the $1600. Please deduct whatever expenses you have incurred. Keep the money you need for your fees. And just give me whatever is left”. The boys were surprised, and thanked him profusely.

 It was a small act of kindness. But it clearly marked out Paderewski as a great human being.

 Why should he help two people he did not even know? We all come across situations like these in our lives. And most of us only think “If I help them, what would happen to me?” The truly great people think, “If I don’t help them, what will happen to them?” They don’t do it expecting something in return. They do it because they feel it’s the right thing to do.

 Paderewski later went on to become the Prime Minister of Poland. He was a great leader, but unfortunately when the World War began, Poland was ravaged. There were more than 1.5 million people starving in his country, and no money to feed them. Paderewski did not know where to turn for help. He reached out to the US Food and Relief Administration for help.

 The head there was a man called Herbert Hoover — who later went on to become the US President. Hoover agreed to help and quickly shipped tons of food grains to feed the starving Polish people.

 A calamity was averted. Paderewski was relieved. He decided to go across to meet Hoover and personally thank him. When Paderewski began to thank Hoover for his noble gesture, Hoover quickly interjected and said, “You shouldn’t be thanking me Mr. Prime Minister. You may not remember this, but several years ago, you helped two young students go through college. I was one of them.”

 The world is a wonderful place. What goes around comes around!

 Source: http://academictips.org/blogs/the-world-is-a-wonderful-place/

Emedinews:Insights on Medicolegal Issues:What is postmortem discoloration?

The bluish color of postmortem discoloration does not have the same connotation as cyanosis produced during life

• There is a gravitational pooling of blood in the veins and capillary beds of the dependent parts of the body occur since after death the body remains lying in a position and cessation of the circulation. The postmortem coloration helps a doctor to estimate the time since death.
• The skin of deceased may show dark purple discoloration due to accumulated blood. The process begins immediately after the circulation stops, and in a person dying slowly with circulatory failure, it may be pronounced very shortly after death. Lividity is present in all bodies, although it may be inconspicuous in some and thus escape notice.
• Postmortem lividity is first apparent about 20–30 minutes after death as dull red patches or blotches, which deepen in intensity and coalesce over the succeeding hours to form extensive areas.
• Postmortem lividity is usually well marked in the earlobes and in the fingernail beds. In a supine corpse, there may be isolated areas of lividity over the front and sides of the neck resulting from incomplete emptying of superficial veins. If the head is slightly flexed on the neck, then lividity may have a linear distribution corresponding to the skin folds.
• Fading of the primary pattern of lividity and development of a secondary pattern of lividity will be quicker and more complete if the body is moved.
• Cyanide poisoning results in lividity, which is described by different authors as pink, bright scarlet, and violet.

emdinews:Inspiration:The Circle of Joy

 And old story tells that one day, a countryman knocked hard on a monastery door. When the monk tending the gates opened up, he was given a magnificent bunch of grapes.

Brother, these are the finest my vineyard has produced. I’ve come to bear them as a gift.

Thank you! I will take them to the Abbot immediately; he’ll be delighted with this offering.

No! I brought them for you. For whenever I knock on the door, it is you who opens it. When I needed help because the crop was destroyed by drought, you gave me a piece of bread and a cup of wine every day.

 The monk held the grapes and spent the entire morning admiring it and decided to deliver the gift to the Abbot, who had always encouraged him with words of wisdom.

 The Abbot was very pleased with the grapes, but he recalled that there was a sick brother in the monastery, and thought:

 “I’ll give him the grapes. Who knows, they may bring some joy to his life.”

 And that is what he did. But the grapes didn’t stay in the sick monk’s room for long, for he reflected:

 “The cook has looked after me for so long, feeding me only the best meals. I’m sure he will enjoy these.”

 The cook was amazed at the beauty of the grapes. So perfect that no one would appreciate them more than the sexton; many at the monastery considered him a holy man, he would be best qualified to value this marvel of nature.

 The sexton, in turn, gave the grapes as a gift to the youngest novice, that he might understand that the work of God is in the smallest details of Creation. When the novice received them, he remembered the first time he came to the monastery, and of the person who had opened the gates for him; it was that gesture which allowed him to be among this community of people who knew how to value the wonders of life.

 And so, just before nightfall, he took the grapes to the monk at the gates.

Eat and enjoy them, he said. For you spend most of your time alone here, and these grapes will make you very happy.

 The monk understood that the gift had been truly destined for him, and relished each of the grapes, before falling into a pleasant sleep.

 Thus the circle was closed; the circle of happiness and joy, which always shines brightly around generous people.

Emedinews:Insights on Medicolegal Issues:What is Touch DNA?

Locard’s Exchange Principle states that with contact between two items, there will always be an exchange. So, when a crime is committed, if the perpetrator deposits a sufficient number of skin cells on an item at the scene, and that item is collected as possible evidence.

• It is the DNA in skin cells that is left at a crime scene and may be sampled from a variety of items including gun grips, steering wheels, eating utensils, luggage handles and clothing.
• Humans shed tens of thousands of skin cells each day, and these cells are transferred to every surface with which human skin comes into contact.
• Touch DNA is not Low Copy Number DNA (LCN DNA).
• LCN DNA profiling allows a very small amount of DNA to be analyzed, from as few as 10 to 30 cells.
• Touch DNA samples are processed exactly in the same way as blood, semen, saliva etc, and can stand up to scrutiny in court much better than LCN DNA.
• Touch DNA analysis may be able to link the perpetrator to the crime scene, by collecting the skin cells and analyzing them.

Emedinews:Inspiration:Teamwork Lesson

When you see geese flying along in "V" formation, you might consider what science has discovered as to why they fly that way. As each bird flaps its wings, it creates an uplift for the bird immediately following. By flying in "V" formation, the whole flock adds at least 71 percent greater flying range than if each bird flew on its own. People who share a common direction and sense of community can get where they are going more quickly and easily because they are traveling on the thrust of one another.

When a goose falls out of formation, it suddenly feels the drag and resistance of trying to go it alone – and quickly gets back into formation to take advantage of the lifting power of the bird in front. If we have as much sense as a goose, we will stay in formation with those people who are headed the same way we are.

When the head goose gets tired, it rotates back in the wing and another goose flies point. It is sensible to take turns doing demanding jobs, whether with people or with geese flying south. Geese honk from behind to encourage those up front to keep up their speed.

What messages do we give when we honk from behind? Finally – and this is important – when a goose gets sick or is wounded by gunshot, and falls out of formation, two other geese fall out with that goose and follow it down to lend help and protection. They stay with the fallen goose until it is able to fly or until it dies, and only then do they launch out on their own, or with another formation to catch up with their group.

If we have the sense of a goose, we will stand by each other like that.

Emedinews:Insights on Medicolegal Issues:What is a medicolegal case?

A medicolegal case is a case of injury, ailment, hurt or illness or death due to evident criminal cause or where the attending doctor, on examining the patient, concludes that criminal force/weapon has been used against human body and an inquiry/investigation by law agencies is required in accordance with the prevailing law of the land. It is a legal duty of the treating doctor to inform a medicolegal case to the nearest police station immediately after completing primary lifesaving medical care. In accordance with Section 39 of Criminal Procedure Code of India, the treating doctor is duty bound to inform the nearest police station as soon as he/she completes his primary medical care. Phones/mobile phones can be used for informing the police in this era of modern advancement in telecommunication. An acknowledgement of receipt of such a message should be taken for future reference. If the intimation is given orally or on phone, the diary number (DD or the Daily Docket number/name and designation of police officer) should be taken down as proof of intimation and should be properly documented in the patient’s records. The idea is to initiate legal proceeding at the earliest so that the maximum evidence can be collected by the police officer with minimum destruction of evidences, site of occurrence, knowingly or unknowingly by any party. There is a quote in Bernard Knight Text Book of Forensic Medicine, which says that ‘the doctor dealing with medico–legal cases should not act /behave like a detective; equally the doctor should never act like curtain between police and patient involved in crime.'

Emedinews:Inspiration: Just Listen

I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it's given from the heart. When people are talking, there's no need to do anything but receive them. Just take them in. Listen to what they're saying. Care about it. Most times caring about it is even more important than understanding it. Most of us don't value ourselves or our love enough to know this. It has taken me along time to believe in the power of simple saying, "I'm so sorry," when someone is in pain. And meaning it.

One of my patients told me that when she tried to tell her story, people often interrupted to tell her that they once had something just like that happen to them. Subtly her pain became a story about themselves. Eventually she stopped talking to most people. It was just too lonely. We connect through listening. When we interrupt what someone is saying to let them know that we understand, we move the focus of attention to ourselves. When we listen, they know we care. Many people with cancer can talk about the relief of having someone just listen.

I have even learned to respond to someone crying by just listening. In the old days I used to reach for the tissues, until I realized that passing a person a tissue may be just another way to shut them down, to take them out of their experience of sadness and grief. Now I just listen. When they have cried all they need to cry, they find me there with them.

This simple thing has not been that easy to learn. It certainly went against everything I had been taught since I was very young. I thought people listened only because they were too timid to speak or did not know the answer. A loving silence often has far more power to heal and to connect than the most well intentioned words.