Emedinews:Insights on Medicolegal Issues: What is conduct money for doctors?

In criminal cases, no fee is paid to any witness, including the doctor, at the time of serving the summons. The summoned doctor must attend the Court and give evidence because of the interest of the State in securing truth/justice; otherwise the doctor will be charged with contempt of Court. However, in criminal cases, conveyance charges and daily allowance can be claimed by the doctor according to Government rules.

Emedinews:Inspiration:The value of sincerity of purpose

A story is told of a man who approached three workers who were doing the same job. "What are you doing?" he asked each one of them separately and got different answers. "I am cutting the stones" replied the first. "I am earning my livelihood," replied the second. "I am building a mosque" replied the third. Each of the three workers saw himself linked to a different purpose.

Each one was to that extent, different from others, although all worked alike and were engaged in the same task. Our two hands with which we work are in no sense different from the hands of any other person.

The value of what we do depends upon the quality of the inner purpose in our heart with which we do our work.

Emedinews:Insights on Medicolegal Issues:What is the right to refuse medical intervention?

Theresa Marie "Terri" Schiavo case of the United States

The consistent refusal to intervene on behalf of Schiavo’s parents’ desire to continue nutrition and hydration is a reaffirmation of the right to refuse medical care even for mentally incapacitated patients and that artificial nutrition and hydration are medical treatments. In theory, the right of patients to refuse medical therapy can be limited by four state interests in: Preservation of life, prevention of suicide, protection of third parties such as children and preserving the integrity of the medical profession. In practice, these interests almost never override the right of competent patients and incompetent terminally ill patients who have left explicit advance directives.

Emedinews:Inspiration:Alexander The Great's Last 3 Wishes

Alexander, after conquering many kingdoms, was returning home. On the way, he fell ill and it took him to his death bed. With death staring him in his face, Alexander realized how his conquests, his great army, his sharp sword and all his wealth were of no consequence. 

He now longed to reach home to see his mother's face and bid her his last adieu. But, he had to accept the fact that his sinking health would not permit him to reach his distant homeland. So, the mighty conqueror lay prostrate and pale, helplessly waiting to breathe his last. He called his generals and said, "I will depart from this world soon, I have three wishes, please carry them out without fail."

With tears flowing down their cheeks, the generals agreed to abide by their king's last wishes.
1) "My first desire is that", said Alexander, "My physicians alone must carry my coffin."

2) After a pause, he continued, "Secondly, I desire that when my coffin is being carried to the grave, the path leading to the graveyard be strewn with gold, silver and precious stones which I have collected in my treasury".

3) The king felt exhausted after saying this. He took a minute's rest and continued. "My third and last wish is that both my hands be kept dangling out of my coffin".

The people who had gathered there wondered at the king's strange wishes. But no one dared bring the question to their lips. Alexander's favorite general kissed his hand and pressed them to his heart.

"O king, we assure you that all your wishes will be fulfilled. But tell us why do you make such strange wishes?"

At this Alexander took a deep breath and said:
"I would like the world to know of the three lessons I have just learnt.

Lessons to be learnt from last 3 wishes of King Alexander...

·         I want my physicians to carry my coffin because people should realize that no doctor on this earth can really cure any body. They are powerless and cannot save a person from the clutches of death.  So let not people take life for granted.

·         The second wish of strewing gold, silver and other riches on the path to the graveyard is to tell people that not even a fraction of gold will come with me. I spent all my life greed of power, earning riches but cannot take anything with me. Let people realize that it is a sheer waste of time to chase wealth.

·         And about my third wish of having my hands dangling out of the coffin, I wish people to know that I came empty handed into this world and empty handed I go out of this world".

With these words, the king closed his eyes.

Soon he let death conquer him and breathed his last. . . .

Lessons to learn: Remember, your Health is in your own hands, look after it. Wealth is only meaningful if you can share and also enjoy while you are still alive, kicking & healthy. What you do for yourself dies with you. But what you do for others will live for ever. Leave the “Legacy” behind.

Emedinews:Insights on Medicolegal Issues:Abrasion injury in medicolegal cases

Mechanical momentum means mass with velocity discharged into the human body by a moving object or weapon or itself due to impact of moving body against a surface produces injuries over the body. In the first case, the counter force is provided by the body and in the second case, by the rigidity of the object/weapon/surface/wall against which the victim falls by himself or is forced to fall by external reason. In most cases it is seen that the mechanical injuries produced over the body are due to a combination of above two forces. Abrasion is one of the most superficial injuries and involves destruction of the superficial layers of the skin, caused by fall on a rough surface, or being dragged by a vehicle. Abrasions are of different types based on the pattern of the causative force viz. scratches, grazes, pressure, impact or imprint abrasions. A doctor can help legal investigation by his evaluation and documentation of abrasions as below.

• They give an idea about the site of impact and direction of the force.
• They may be the only external signs of a serious internal injury.
• Patterned abrasions may help in relating the wound to the object which produced them.
• The age of the injury can be determined, which helps to corroborate with the alleged time of assault.
• Dirt, dust, grease, sand in the open wounds may connect the injuries to the scene of crime
• Character and manner of the injury may be known from its distribution.
• In throttling, crescent abrasions due to fingernails are found on the neck
• In smothering, abrasions may be seen around the mouth or nose.
• In sexual assaults, abrasions may be found on the breasts, genitals, inside of the thighs and around the anus.
• Abrasions on the face of the assailant indicate a struggle.
• Abrasions on the victim may show whether the fingernails of the assailant were long, irregular or even broken.

Emedinews:Inspiration: Determination

In 1883, a creative engineer named John Roebling was inspired by an idea to build a spectacular bridge connecting New York with the Long Island. However, bridge building experts throughout the world thought that this was an impossible feat and told Roebling to forget the idea. It just could not be done. It was not practical. It had never been done before.

Roebling could not ignore the vision he had in his mind of this bridge. He thought about it all the time and he knew deep in his heart that it could be done. He just had to share the dream with someone else. After much discussion and persuasion he managed to convince his son Washington, an up and coming engineer, that the bridge in fact could be built.

Working together for the first time, the father and son developed concepts of how it could be accomplished and how the obstacles could be overcome. With great excitement and inspiration, and the headiness of a wild challenge before them, they hired their crew and began to build their dream bridge.

The project started well, but when it was only a few months underway a tragic accident on the site took the life of John Roebling. Washington was injured and left with a certain amount of brain damage, which resulted in him not being able to walk or talk or even move.
 "We told them so."
"Crazy men and their crazy dreams."

"It`s foolish to chase wild visions."

Everyone had a negative comment to make and felt that the project should be scrapped since the Roeblings were the only ones who knew how the bridge could be built. In spite of his handicap Washington was never discouraged and still had a burning desire to complete the bridge and his mind was still as sharp as ever.

He tried to inspire and pass on his enthusiasm to some of his friends, but they were too daunted by the task. As he lay on his bed in his hospital room, with the sunlight streaming through the windows, a gentle breeze blew the flimsy white curtains apart and he was able to see the sky and the tops of the trees outside for just a moment.

It seemed that there was a message for him not to give up. Suddenly an idea hit him. All he could do was move one finger and he decided to make the best use of it. By moving this, he slowly developed a code of communication with his wife.

He touched his wife's arm with that finger, indicating to her that he wanted her to call the engineers again. Then he used the same method of tapping her arm to tell the engineers what to do. It seemed foolish but the project was under way again.

For 13 years Washington tapped out his instructions with his finger on his wife's arm, until the bridge was finally completed. Today the spectacular Brooklyn Bridge stands in all its glory as a tribute to the triumph of one man's indomitable spirit and his determination not to be defeated by circumstances. It is also a tribute to the engineers and their team work, and to their faith in a man who was considered mad by half the world. It stands too as a tangible monument to the love and devotion of his wife who for 13 long years patiently decoded the messages of her husband and told the engineers what to do.

Perhaps this is one of the best examples of a never-say-die attitude that overcomes a terrible physical handicap and achieves an impossible goal.

Often when we face obstacles in our day-to-day life, our hurdles seem very small in comparison to what many others have to face. The Brooklyn Bridge shows us that dreams that seem impossible can be realized with determination and persistence, no matter what the odds are.

Even the most distant dream can be realized with determination and persistence.

Emedinews:Insights on Medicolegal Isues:Medical negligence

The investigating police officer and the private complainant cannot always be supposed to have knowledge of medical science so as to determine whether the act of the alleged medical professional/doctor or hospital amounts to rash or negligent act within the domain of criminal law under Section 304–A of IPC said the Supreme Court of India. The Supreme Court states,

• “… As we have noticed hereinabove, that the cases of doctors being subjected to criminal prosecution are on an increase. Sometimes such prosecutions are filed by private complainants and sometimes by the police based on an FIR being lodged and cognizance taken.
• The criminal process, once initiated, subjects the medical professional to serious embarrassment and sometimes harassment. He has to seek bail to escape arrest, which may or may not be granted to him.
• At the end he may be exonerated by acquittal or discharge but the loss which he has suffered in his reputation cannot be compensated by any standards.
• We may not be understood as holding that doctors can never be prosecuted for an offence of which rashness or negligence is an essential ingredient.
• All that we are doing is to emphasize the need for care and caution in the interest of society; for, the service which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust prosecutions.
• Many a complaint prefers recourse to criminal process as a tool for pressurizing the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against.”

Emedinews:Inspiration:The woman in your life

 Tomorrow you may get a working woman, but you should marry her with these facts as well.

Here is a girl, who is as much educated as you are; who is earning almost as much as you do;

One, who has dreams and aspirations just as you have because she is as human as you are;

One, who has never entered the kitchen in her life just like you or your sister haven't, as she was busy with studies and competing in a system that gives no special concession to girls for their culinary achievements

One, who has lived and loved her parents & brothers & sisters, as much as you do for 20-25 years of her life…

One, who has bravely agreed to leave behind all that, her home, people who love her, to adopt your home, your family, your ways and even your family name…

One, who is somehow expected to be a master-chef from day 1, while you sleep oblivious to her predicament in her new circumstances, environment and that kitchen…

One, who is expected to make the tea, first thing in the morning and cook food at the end of the day, even if she is as tired as you are, maybe more, and yet never ever expected to complain; to be a servant, a cook, a mother, a wife, even if she doesn't want to; and is learning just like you are as to what you want from her; and is clumsy and sloppy at times and knows that you won't like it if she is too demanding, or if she learns faster than you…

One, who has her own set of friends, and that includes boys and even men at her workplace too, those, who she knows from school days and yet is willing to put all that on the back-burners to avoid your irrational jealousy, unnecessary competition and your inherent insecurities; Yes, she can drink and dance just as well as you can, but won't, simply because you won't like it, even though you say otherwise…

One, who can be late from work once in a while when deadlines, just like yours, are to be met…

One, who is doing her level best and wants to make this most important, relationship in her entire life a grand success, if you just help her some and trust her…

One, who just wants one thing from you, as you are the only one she knows in your entire house - your unstinted support, your sensitivities and most importantly - your understanding, or love, if you may call it…

But not many guys understand this…

Please appreciate "HER"

Emedinews:Insights on Medicolegal Issues:Lacerated wound

The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound as seen in MLC cases.

• Lacerations are tears or splits of skin, mucous membranes, muscle or internal organs produced by application of blunt force to a broad area of the body, which crushes or stretches the tissues beyond the limits of their elasticity.
• Crush injury from a direct blow may produce an irregular or stellate laceration with a variable degree of devitalized tissue, abrasion and visible contamination.
• Do not close a laceration if there is visible contamination, debris, non–viable tissue or signs of infection. Wounds may involve vascular areas of the face and scalp where the risk of infection is low or extremities where infection becomes a greater risk, along with the possibility of tendon and nerve damage. The elderly and patients on chronic steroid therapy may present with "wet tissue paper" skin tears following relatively minor trauma.
• When produced by a blunt weapon, such as club, crowbar, stone, brick etc., a lacerated wound is usually accompanied by a considerable amount of bruising of the surrounding and underlying tissues, and has inverted and irregular edges. The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound.
• When a heavy weight such as the wheel of a heavy cart or a truck passes over an extremity, by its shearing and grinding force, it tears the skin from the underlying tissue and crushes the muscles and soft part lying beneath it realizing considerable blood and fat in them.
• Crush injury syndrome or fat emboli may follow a lacerated wound. The tear, avulsion, split are types of laceration.

Emedinews:Inspiration:A harsh word

An Inspirational Story

A woman bought eggs and butter from a farmer who had a fine reputation not only for the quality of his products, but also for his promptness of delivery. Then one day, when she was expecting guests, he failed to come. On the next delivery, she spoke harshly to him. At the end of her tirade he said quietly, "I'm sorry if I caused you any inconvenience, but I had the misfortune of burying my mother yesterday."

Ashamed, the woman determined never to speak harshly to anyone again until she fully understood the cause of the delay.

Often we never care for other travails and traumas. Like a frog in the well, our feelings remain confined to our milieu. Even a farmer has his own priorities. Sometimes, we do not empathize with others. What if we had been stricken with some tragedy, and someone callously chastises us.

Emedinews:Insights on Medicolegal Issues:Forensic anatomy and importance of larynx in postmortem examination

Medicolegal Update
(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

• The larynx consists of a large ‘V’–shaped thyroid cartilage. Below the smaller cricoid cartilage, at the upper margin of the posterior wing of the thyroid on each side, are the superior horns or ‘cornuae’, which are connected by the thyrohyoid membrane to the greater horns of the hyoid bone, which lies immediately above.
• The hyoid bone lies at the root of the tongue. The hyoid calcifies at variable times; the body is usually calcified, but the horns may calcify irregularly, both in space and time. In teenagers and young adults, they are usually cartilaginous and the joints mobile.
• In middle and later life, the hyoid and thyroid horns calcify and become more brittle.
• The cricoid cartilage is a modified upper tracheal ring but can also become partly calcified as age increases.
• No meaningful ages can be placed on any calcification, but traumatic fractures can occur at any time except in children and most teenagers.
• The pressure is mainly bilateral, so that the sides of the larynx are squeezed. Particularly vulnerable structures are the four ‘cornuae’ or horns, which protect backwards to maintain the patency of the airway around the glottis
• Lateral pressure of the fingers can displace any of the four horns inwards, either by direct pressure or by pressure on the thyrohyoid membrane, which then drags the horns medially. In young persons, the horns are so pliable that they return to their normal position on release of the pressure but, variably beyond the third decade, they may be sufficiently calcified to fracture.
• Though the hyoid bone has received most attention in publications as being the marker of violence to the larynx, in fact the thyroid horns are far more vulnerable. Simpson (1985) found that, in 25 successive deaths from manual strangulation, there were 22 fractures of thyroid horns but only one fractured hyoid.

Emedinews:Inspiration:The Most Important Question

An Inspirational Story
(Dr GM Singh)

 During my second month of nursing school, our professor gave us a pop quiz. I was a conscientious student and had breezed through the questions, until I read the last one: "What is the first name of the woman who cleans the school?"

 Surely this was some kind of joke. I had seen the cleaning woman several times. She was tall, dark-haired and in her 50s, but how would I know her name? I handed in my paper, leaving the last question blank. Before class ended, one student asked if the last question would count toward our quiz grade.

 "Absolutely," said the professor. "In your careers you will meet many people. All are significant. They deserve your attention and care, even if all you do is smile and say hello".

 I've never forgotten that lesson. I also learned her name was Dorothy.

Emedinews:Insights on Medicolegal Issues:Exposure to a poison leads to illness

The very old, very young or those in poor health suffer greater damage

When people are in contact with a poison they are said to be exposed to it. The effect of exposure depends partly on how long the contact lasts and how much poison enters into the body, and partly on how much poison the body can get rid of during this time. Exposure may happen only once or many times.

• Acute exposure is a single contact that lasts for seconds, minutes or hours, or several exposures over about a day or less.
• Chronic exposure is contact that lasts for many days, months or years. It may be continuous or broken by periods when there is no contact. Exposure that happens only at work, for example, is not continuous. Chronic exposure to small amounts of poison may not cause any signs or symptoms of poisoning at first. It may be many days or months before there is enough chemical inside the body to cause poisoning. For example, a person may use pesticide every day. Each day the person is exposed to only a small amount of pesticide, but the amount of pesticide in the body gradually builds up, until eventually, after many days, it adds up to a poisonous dose. Only then does the person begin to feel unwell.

Emedinews:Inspiration:Grandmother's vase

An Inspirational Story

 One day I was lying on the bed, reading, when my mother came into the room. She held out a vase - a rather ugly vase.

 She asked, "Would you like to have this vase?" I replied quickly, "No, I don't want it."

 As she turned to walk away, I picked up something that said to me, Wait a minute, don't shut this off yet. So I asked, "Where did you get it?" She said, "Oh, I got it when I filled an order." Filled an order? I thought - no communication here. So I asked, "What do you mean, filled an order?"

 "Well," she said, "when I was a little girl, the Smith Company mailed catalogs to people. I would take the catalog around the neighborhood, and I'd get people to order from it. When I filled an order and sent it in, they gave me a prize. One time, I got a porch swing for my family."

 "Now you have to understand," said Hensley, "that my mother is 81 years old. She is one of six children in a family that her father deserted when she was quite young. Money was real hard to come by. My grandmother managed to keep the family together through the years, although I don't know how. For my mother to win a luxury like a porch swing was a significant accomplishment. Although she no longer had the swing, she had the vase - a vase full of meaning - which she offered to me. Instantly I said, "Mom, I want the vase." Now it sits in a prominent place in my living room. It symbolizes a precious meaning which my mother and I share: Unless you and I are sensitive to the other person and hear meaning, we may well have a communication problem."

 "Seek to be sensitive," said Hensley, "seek to get inside of the other person's frame of reference, seek to understand the meaning out of which that person receives and responds to your message, seek genuine interaction." - The Executive Speaker

Emedinews:Insights on Medicolegal Issues:Countercoup injury of brain

• Two types of impact occur on skull and the sound wave elicited by the impact. The first at the site where the force is applied, the second where the advancing segments of the accelerated brain are brought suddenly to rest by the forces that resist its forward motion.
• Counter coup lesions of the brain were once thought to be caused by the brain moving within the skull in a straight line with the force of the blow striking against its opposite side. But, experiments on mechanics of head injuries have demonstrated these lesions are chiefly due to local distortions of the skull and the sudden rotation of the head as result of a blow, which arouse shear strains or slide produced by the pulling apart of the constituent particles of the brain.
• Shear strains occur and pull apart the constituent particles of the brain. These are produced in all parts of the brain, but to a large extent at the base of the frontal lobe and the tip of the temporal lobe, as the skull gets a good grip on the brain in this region due to the projecting ridge of the sphenoid bone. Hence, severe and extensive injuries occur in this region with a blow on the occiput.
• On the other hand, countercoup injuries which are caused by rotation will not occur if the head is so well fixed that it cannot rotate at all when it receives a blow. Cerebral contusions and tears have been reported in autopsy as a result of trauma.

(Ref: Modi’s Medical Jurisprudence, 25^th Edition)

Emedinews:Inspiration:Christmas miracle – real story!

 This is a real Christmas miracle story, happened in December 1997 in Wisconsin, USA. A little girl named Sarah had leukemia and was not expected to live to see Christmas. Her brother and grandmother went to the mall to ask Mark Leonard who was a professional Santa Claus to visit the hospital to give Sarah the gift of hope through encouragement and prayer. A year later Sarah surprised Santa by showing up at the mall where he worked. Here goes the story. A little boy and his grandmother came to see Santa at The Mayfair Mall in Wisconsin. The child climbed up on Santa’s lap, holding a picture of a little girl. “Who is this?” – asked Santa, smiling. “Your friend? Your sister?”

 “Yes, Santa.” – He replied. “My sister, Sarah, who is very sick.” – he said sadly. Santa glanced over at the grandmother who was waiting nearby and saw her dabbing her eyes with a tissue. “She wanted to come with me to see you, oh, so very much, Santa!” – the child exclaimed.  “She misses you.” – he added softly.

 Santa tried to be cheerful and encouraged a smile to the boy’s face, asking him what he wanted Santa to bring him for Christmas. When they finished their visit, the grandmother came over to help the child off his lap, and started to say something to Santa, but halted.

 “What is it?” – Santa asked warmly. “Well, I know it’s really too much to ask you, Santa, but ..” – the old woman began, shooing her grandson over to one of Santa’s elves to collect the little gift which Santa gave all his young visitors.

 “The girl in the photograph… my granddaughter well, you see … she has leukemia and isn’t expected to make it even through the holidays.” – she said through tear-filled eyes. “Is there anyway, Santa, any possible way that you could come see Sarah? That’s all she’s asked for, for Christmas, is to see Santa.”

 Santa blinked and swallowed hard and told the woman to leave information with his elves as to where Sarah was, and he would see what he could do. Santa thought of little else the rest of that afternoon. He knew what he had to do. “What if it were MY child lying in that hospital bed, dying?” – he thought with a sinking heart, “This is the least I can do.” 

When Santa finished visiting with all the boys and girls that evening, he retrieved from his helper the name of the hospital where Sarah was staying. He asked Rick, the assistant location manager how to get to Children’s Hospital. “Why?” – Rick asked, with a puzzled look on his face. Santa relayed to him the conversation with Sarah’s grandmother earlier that day.

 “Common….I’ll take you there.” – Rick said softly. Rick drove them to the hospital and came inside with Santa. They found out which room Sarah was in. A pale Rick said he would wait out in the hall. Santa quietly peeked into the room through the half-closed door and saw little Sarah on the bed.

 The room was full of what appeared to be her family; there was the grandmother and the girl’s brother he had met earlier that day. A woman whom he guessed was Sarah’s mother stood by the bed, gently pushing Sarah’s thin hair off her forehead.

 And another woman who he discovered later was Sarah’s aunt, sat in a chair near the bed with a weary, sad look on her face. They were talking quietly, and Santa could sense the warmth and closeness of the family, and their love and concern for Sarah. Taking a deep breath, and forcing a smile on his face, Santa entered the room, bellowing a hearty, “Ho, ho, ho!”

 “Santa!” – shrieked little Sarah weakly, as she tried to escape her bed to run to him. Santa rushed to her side and gave her a warm hug. A child the tender age of his own son — 9 years old — gazed up at him with wonder and excitement.

 Her skin was pale and her short tresses bore telltale bald patches from the effects of chemotherapy. But all he saw when he looked at her was a pair of huge, blue eyes. His heart melted, and he had to force himself to choke back tears. Though his eyes were riveted upon Sarah’s face, he could hear the gasps and quiet sobbing of the women in the room.

 As he and Sarah began talking, the family crept quietly to the bedside one by one, squeezing Santa’s shoulder or his hand gratefully, and whispering “Thank you” as they gazed sincerely at him with shining eyes.

 Santa and Sarah talked and talked, and she told him excitedly all the toys she wanted for Christmas, assuring him she’d been a very good girl that year.

 As their time together dwindled, Santa felt led in his spirit to pray for Sarah, and asked for permission from the girl’s mother. She nodded in agreement and the entire family circled around Sarah’s bed, holding hands. Santa looked intensely at Sarah and asked her if she believed in angels, “Oh, yes, Santa… I do!” – she exclaimed.

 “Well, I’m going to ask that angels watch over you.” – he said. Laying one hand on the child’s head, Santa closed his eyes and prayed. He asked that God touch little Sarah, and heal her body from this disease. He asked that angels minister to her, watch and keep her. And when he finished praying, still with eyes closed, he started singing, softly, “Silent Night, Holy Night…. all is calm, all is bright…”

 The family joined in, still holding hands, smiling at Sarah, and crying tears of hope, tears of joy for this moment, as Sarah beamed at them all. When the song ended, Santa sat on the side of the bed again and held Sarah’s frail, small hands in his own.

 “Now, Sarah,” – he said authoritatively, “you have a job to do, and that is to concentrate on getting well. I want you to have fun playing with your friends this summer, and I expect to see you at my house at Mayfair Mall this time next year!” He knew it was risky proclaiming that to this little girl who had terminal cancer, but he ‘had’ to. He had to give her the greatest gift he could — not dolls or games or toys — but the gift of HOPE.

 “Yes, Santa!” – Sarah exclaimed, her eyes bright. He leaned down and kissed her on the forehead and left the room. Out in the hall, the minute Santa’s eyes met Rick’s, a look passed between them and they wept unashamed. Sarah’s mother and grandmother slipped out of the room quickly and rushed to Santa’s side to thank him.

 “My only child is the same age as Sarah.” – he explained quietly. “This is the least I could do.” They nodded with understanding and hugged him.

 One year later, Santa Mark was again back on the set in Milwaukee for his six-week, seasonal job which he so loves to do. Several weeks went by and then one day a child came up to sit on his lap. “Hi, Santa! Remember me?!”

 “Of course, I do.” – Santa proclaimed (as he always does), smiling down at her. After all, the secret to being a ‘good’ Santa is to always make each child feel as if they are the ‘only’ child in the world at that moment. “You came to see me in the hospital last year!”

 Santa’s jaw dropped. Tears immediately sprang in his eyes, and he grabbed this little miracle and held her to his chest. “Sarah!” – he exclaimed. He scarcely recognized her, for her hair was long and silky and her cheeks were rosy — much different from the little girl he had visited just a year before.

 He looked over and saw Sarah’s mother and grandmother in the sidelines smiling and waving and wiping their eyes. That was the best Christmas ever for Santa Claus.

 He had witnessed –and been blessed to be instrumental in bringing about — this miracle of hope. This precious little child was healed. Cancer-free. Alive and well. He silently looked up to Heaven and humbly whispered, “Thank you, Father. ‘Tis a very, Merry Christmas!”

 Source: http://academictips.org/blogs/christmas-miracle-real-story/

Emedinews:Insights on Medicolegal Issues:What is the patient autonomy?

The process of understanding the risks and benefits of treatment is known as informed consent however patient/legal heir must have the capacity to make the decision and understand the benefits and risks of medical care and voluntarily grant consent, without coercion or duress based on the moral and legal premise of patient autonomy.

• The patient has the right to make decisions about his/her own health and medical conditions and must give voluntary informed consent for treatment, medical tests and procedures.
• The doctor should give information about a particular treatment or test to the patient in order to decide whether or not he wishes to undergo such treatment or test. This is based on the moral and legal premise of patient autonomy.
• The legal term for failing to obtain informed consent before performing a test or procedure on a patient is a form of assault a criminal offence in India.
• For many interactions like a physical exam with the doctor, implied consent is assumed. For more invasive tests or for those tests or treatments with significant risks or alternatives, you will be asked to give explicit written consent.
• Under certain circumstances there are exceptions to the informed consent rule. The most common exceptions are an emergency in which medical care is needed immediately to prevent serious or irreversible harm and incompetence in which someone is unable to give or refuse permission for testing or treatment.

Emedinews:Inspiration:Smoke signal

An Inspirational Story

The only survivor of a shipwreck was washed up on a small uninhabited island. He prayed feverishly for God to rescue him. Every day he scanned the horizon for help, but none seemed forthcoming.

Exhausted, he eventually managed to build a little hut out of driftwood to protect himself from the elements, and to store his few possessions. One day, after scavenging for food, he arrived home to find his little hut in flames, with smoke rolling up to the sky. He felt the worst had happened, and everything was lost. He was stunned with disbelief, grief, and anger. He cried out, ‘God! How could you do this to me?’

Early the next day, he was awakened by the sound of a ship approaching the island! It had come to rescue him!

‘How did you know I was here?’ asked the weary man of his rescuers. ‘We saw your smoke signal,’ they replied.

Moral of the story: It’s easy to get discouraged when things are going bad, but we shouldn’t lose heart, because God is at work in our lives, even in the midst of our pain and suffering.

Remember this the next time your little hut seems to be burning to the ground… it just may be a smoke signal that summons the Grace of God.

Emedinews:Insights on MEdicolegal Issues:Abrasion injury in medicolegal cases

Mechanical momentum means mass with velocity discharged into the human body by a moving object or weapon or itself due to impact of moving body against a surface produces injuries over the body. In the first case, the counter force is provided by the body and in the second case, by the rigidity of the object/weapon/surface/wall against which the victim falls by himself or is forced to fall by external reason. In most cases it is seen that the mechanical injuries produced over the body are due to a combination of above two forces. Abrasion is one of the most superficial injuries and involves destruction of the superficial layers of the skin, caused by fall on a rough surface, or being dragged by a vehicle. Abrasions are of different types based on the pattern of the causative force viz. scratches, grazes, pressure, impact or imprint abrasions. A doctor can help legal investigation by his evaluation and documentation of abrasions as below.

• They give an idea about the site of impact and direction of the force.
• They may be the only external signs of a serious internal injury.
• Patterned abrasions may help in relating the wound to the object which produced them.
• The age of the injury can be determined, which helps to corroborate with the alleged time of assault.
• Dirt, dust, grease, sand in the open wounds may connect the injuries to the scene of crime
• Character and manner of the injury may be known from its distribution.
• In throttling, crescent abrasions due to fingernails are found in the neck
• In smothering, abrasions may be seen around the mouth or nose.
• In sexual assaults, abrasions may be found on the breasts, genitals, inside of the thighs, and around the anus.
• Abrasions on the face of the assailant indicate a struggle.
• Abrasions on the victim may show whether the fingernails of the assailant were long, irregular or even broken.

Emedinews:Inspiration:A Dream cannot be sold

An Inspirational Story

Jehdi and Hassan were two merchants who were very close friends. Jehdi was a cheerful person, almost frivolous, whereas Hassan was very serious, perhaps too cautious and careful. But an unbreakable bond of friendship tied them together and this made their journey for business happy, for they never had any dispute.

One time they started together toward the city of Touria. They arrived at the outskirts of a forest where the big trees, moist rocks and cool shade invited them to take a well–deserved rest. Within a minute Jehdi fell asleep. Hassan looked at his friend with a sigh and told himself, "He sleeps peacefully in nature, as if he were in his own house. I am afraid of someone robbing me. Even though the thief might get very little, I am too apprehensive and I prefer to be cautious. After all, one never knows what might happen".

Hassan was ruminating over his anxiety when suddenly he saw a wasp coming out of Jehdi’s left nostril. Its enigmatic dance surprised him. It flew toward a single pine tree standing on a rock, circled the tree 3 times, and then returned to the sleeping Jehdi and disappeared into his right nostril.

Just at that moment Jehdi woke up, sat up laughing and said, "Hassan, you will never believe me. I just had a marvelous dream. Just imagine that there is big pine tree standing on a high rock, exactly like the one you see there. A wasp droned around the trunk and its wings buzzed as if to say, "You must dig in this place, you must dig in this place!" I started digging and I found a big pot full of gold coins. I have never in my life seen so much money…!"

"Yes, truly it is a strange dream," replied Hassan. "If I were in your place, I would have dug around the pine tree there." "My poor friend, how naive you are. I would never take a dream seriously. It is so hot here, to dig would be torture! Please, let us continue our journey."

But Hassan insisted, "Jehdi, a dream like this surely has a meaning. If you do not want to dig, I will try instead. Do you know what I propose to you? Sell your dream to me."

Jehdi began laughing loudly. "This is a good piece of business for me! How much will you pay?" "You have said that there is a big pile of gold coins. I am your friend and I do not want to wrong you. You tell me how much you estimate to be the price of your dream."

After a brief discussion, they agreed to the sum of 300 coins. "Never have I made such a business deal. So much money for a simple dream of no value. How gullible you are, Hassan!"

The 2 friends then went under the pine tree which the wasp had shown in the dream. Jehdi was amused to see Hassan perspiring profusely and breaking his back with the shovel. He continued on until the shovel made a dull sound as if it had struck something hard.

What a surprise for the 2 merchants when they uncovered an earthen pot full of gold coins! Before breaking it, Hassan noted an inscription near the handle: "the first of seven." "The first of 7. That means there should be 6 more pots buried," Jehdi understood, starting to regret the deal he had concluded too quickly.

This time both of them dug with energy and, sure enough, they found the 6 pots, one after another, each one filled to the brim with gold coins. Hassan built a huge inn in the city and named it The Bulging Pot. He lived as a rich and satisfied man until his death.

Jehdi often came to visit him and greeted his friend with the words, "Well, Hassan, how are you? I have come to see what has happened to my dream." And the 2 comrades patted each other on the back laughing. But every time Jehdi returned home sadder, for he knew that he could never buy back his dream.

eMedinewS:Insights on Medicolegal Issues:Accidental suffocation

• There have been numerous accidental deaths as a result of children putting things into their mouths and swallowing them, which in turn block the airways. This is why it is imperative that small children are never left unattended and are not allowed to put anything in their mouths, which may result in their choking.
• People also die of suffocation in the instance of a house fire where there is a lack of oxygen and they cannot breathe. The postmortem examination in such cases provides information whether or not the victim was conscious at the time of the fire starting or if indeed they had already been deceased. This process is measured by the amount of carbon dioxide in the deceased’s system at the autopsy stage.
• Murder is comparatively rare however in some cases the assailant has tried to cover his or her tracks by setting fire to the location at which the deceased is finally found. This could be a house, an office, a workshop, anywhere.
• The autopsy surgeon must look for the telltale signs: the bloodshot eyes, the high levels of carbon dioxide in the blood and bruising around the nose and mouth and may even collect trace evidence such as hairs and fibers from around the nose and mouth of the deceased.
• As accidental suffocation or smothering is relatively common, therefore until proven otherwise by a forensic surgeon/doctor and subsequent inquest, all cases of suffocation or smothering should be treated as potentially suspicious.

Emedinews:Inspiration: What ever happens is for Good

An Inspirational Story
(Dr GM Singh)

 What ever happens is for Good! We may not however, understand it particularly if it is not to our liking. The following story tells us the same very nicely.

Me: God, can I ask you a question?

 God: Sure.

 Me: Promise you won't get mad.

 God: I promise.

 Me: Why did you let so much stuff happen to me today?

 God: What do you mean?

 Me: Well, I woke up late.

 God: Yes.

 Me: My car took forever to start.

 God: Okay.

 Me: At lunch they made my sandwich wrong and I had to wait.

 God: Hmmm…

 Me: On the way home, my phone went dead, just as I picked up a call.

 God: All right.

 Me: And on top of it all, when I got home I just wanted to soak my feet in my new foot massager and relax, but it wouldn't work!!!Nothing went right today! Why did you do that?

 God: Let me see, the Death Angel was at your bed this morning and I had to send one of the other angels to battle him for your life. I let you sleep through that.

 Me: (humbled): OH...

 GOD: I didn't let your car start because there was a drunk driver on your route that would have hit you if you were on the road.

 Me: (ashamed)

 God: The first person who made your sandwich today was sick and I didn't want you to catch what they have, I knew you couldn't afford to miss work.

 Me: (embarrassed): Ok...

God: Your phone went dead because the person that was calling was going to give false information; I didn't even let you talk to them so you would be covered.

 Me: (softly) I see God.

 God: Oh and that foot massager, it had a shortage that was going to throw out all of the power in your house tonight. I didn't think you wanted to be in the dark.

 Me: I'm sorry God.

 God: Don't be sorry; just learn to trust me.....in all things, the good and the bad.

 Me: I will trust you.

 God: And don't doubt that my plan for your day is always better than your plan.

 Me: I won't God. And let me just tell you God, thank you for everything today.

 God: You're welcome child. It was just another day being your God, and I love looking after my children.

Emedinews:Insights on Medicolegal Issues:Medicine and law have been interrelated from the earliest times as per Gradwohl’s Legal Medicine.

Medicine and law have been interrelated from the earliest times as per Gradwohl’s Legal Medicine. The role of the doctor and the police is nothing but like a solitary person, sage, Qazi and priest. They are an intermediary between God and man. The purpose of medicine is to maintain the patient in the best health, to overcome his diseases, injury and to lengthen his healthy life. The purpose of law is to maintain peace and order in the society, respect of humans through human rights and to provide equality of opportunity. To achieve these purposes medicine emerges from the laboratory by the scientific process and law emerges from the society by the process of experience.

"People follow medicine and Law follows people".

Emedinews:Inspiration:The Here and Now

The critical time for accomplishing anything is in the here and now. Every day is a day to dare to do my best. Each day provides opportunity for self–improvement/self–renewal. Today’s accomplishments, not yesterday’s or tomorrows, produce the most satisfaction as what I accomplish today can give me an immediate feeling of self confidence and direction.

The critical time for accomplishing anything is in the here and now, today. The most important ingredient in future performance is present performance. The most difficult tasks are consummated, not by a single explosive burst of energy or effort, but by consistent daily application of the best I have within me.

Practice is an opportunity to improve my skills. Approach each practice with enthusiasm, as nothing great has ever been accomplished without it. Challenge myself mentally as well as physically and I will start to enjoy the price of success rather than pay for it. Desire… the "want to" is the extra which enables an athlete to take whatever ability he/she has and utilize it to the maximum. Total effort gives an athlete a special kind of victory… victory over himself/herself. I will make this the best day and the best practice ever.

Emedinews:Insights on Medicolegal Issues:What is the vegetative state?

Complete absence of behavioral evidence for self or environmental awareness

• There is preserved capacity for spontaneous or stimulus–induced arousal, evidenced by sleep–wake cycles i.e. patients are awake, but have no awareness. This means that the patients appear awake. They have normal heart beat and breathing, and do not require advanced life support to preserve life and cannot produce a purposeful, co–coordinated, voluntary response in a sustained manner, although they may have primitive reflexive responses to light, sound, touch or pain.
• Patients cannot understand, communicate, speak, or have emotions and unaware of self and environment and have no interaction with voluntarily control passing of urine or stools. They sleep and awaken. As the centers in the brain controlling the heart and breathing are intact, there is no threat to life, and patients can survive for many years with expert nursing care.
• The following behaviors may be seen in the vegetative state:
• Sleep–wake cycles with eyes closed, then opened. Patient breathes on her own; Spontaneous blinking and roving eye movements; Produce sounds but no words; Visual pursuit following an object with her eyes; Grimacing to pain; changing facial expression; Yawning; chewing jaw movements; swallowing of own spit; no purposeful limb movements; arching of back; reflex withdrawal from painful stimuli; brief movements of head or eyes toward sound or movement without apparent localization or fixation; startled reaction on a loud sound.

Almost all of these features consistent with the diagnosis of permanent vegetative state were present during the medical examination of Aruna Shaunbag; behavior suggestive of a minimally conscious not vegetative state observed during the examination.

Emedinews:Inspiration:The goose story – teamwork lesson

An Inspirational Story

 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 are resuscitative injuries?

Doctor should always document resuscitative injuries in detail in case of death

The injuries produced in human body during resuscitation pose difficulty in interpretation of injuries noted at postmortem examination or in inquest paper by the investigating law enforcement agency. Before proceeding to make an interpretation, the doctor conducting the autopsy should know if there has been an attempt for resuscitation and who did it and for how long. He should also know about the methods used in a particular case and whether all these have been documented in the clinical sheets or not. Resuscitative attempts may lead to skeletal, cardiac and abdominal viscera injuries. The investigating police officer should make a note on the basis of statements taken from the relative and doctors who attended the deceased and the same should be enclosed in inquest paper before handing them over to the autopsy surgeons.

• The method generally used for life saving attempts by non–medical persons who are near the critical patient is mouth–to–mouth respiration and manual chest massage may causes contusions.
• Resuscitation in hospitals includes bag and mask intubations, endotracheal tube, obdurate airways used for respiratory ventilation.
• Mechanical methods like Thumper, active compression–decompression device and defibrillators are used in resuscitation. Closed chest cardiac massage along or with interspersed abdominal compression is also used for resuscitation.
• The injections and closed–chest cardiac massage and other resuscitation procedures may result in the fracture of a chest vertebra, serial fractures of ribs resulting in an unstable thorax, bilateral hemothorax, tension pneumothorax, rupture of kidney and of spleen.
• Fractures of ribs and/or sternum were found in 40% of cases, the frequency increasing with age. The number of fractured ribs ranged up to 16, mainly 3–8 ribs was fractured. Fractures of the 1st and 8th to 12th ribs were very rare.
• The common site of rib fractures after heavy blunt thoracic injuries was found in the dorsal region.
• The injuries which are received or inflicted on body prior to death are called antemortem injuries and may or may not be contributing factors in causing death or they may have occurred due to other reasons such as resuscitation/transport of sick/ill person for medical care called artifacts.

Emedinews:Inspiration:Unique human flaws

An Inspirational Story

An elderly Asian woman had two large pots, each hung on the end of a pole, which she carried across her neck.

One of the pots had a crack in it while the other pot was perfect and always delivered a full portion of water. At the end of the long walk from the stream to the house, the cracked pot arrived only half full.

For two years, this went on daily with the woman bringing home only one and a half pots of water. The perfect pot was proud of its accomplishments. The poor cracked pot was ashamed of its own imperfection and miserable that it could only do half of what it had been made to do.

After 2 years of what it perceived to be bitter failure, it spoke to the woman: “I am ashamed of myself because this crack in my side causes water to leak out all the way to your house.”

The old woman smiled, “Did you notice that there are flowers on your side of the path, but not on the other pot’s side?”

“That’s because I have always known about your flaw so I planted flower seeds on your side of the path, and every day while we walk back, you water them. For two years I have been able to pick these beautiful flowers to decorate the table. Without you being just the way you are, there would not be this beauty to grace the house.”

Moral: Like the pots, we all have our own unique flaws. But it’s the cracks and flaws we each have that make our lives together so very interesting and rewarding.

Emedinews:Insights on Medicolegal Issues:What is panic disorder?

• It is a condition of vulnerability to stress with repeated sudden attacks of panic with sustained anxiety and recurrence of panic. It is a period of distress and apprehension, with somatic symptoms of feeling of choking, breathing trouble, trembling with a fearful feeling that he may go insane or may even die.
• The attack may last for a few seconds to a few hours; usually the peak of distress is felt by about 10 minutes after starting.
• Recurrence is also sudden; it can be said to be a part of anxiety, phobia and stress disorder syndrome.
• It is treated by psychotherapy, benzodiazepine group of drugs, encouraging thoughts to be free from anxiety.

Emedinews:Inspiration:The story of an ant

One morning I wasted nearly an hour watching a tiny ant carry a huge feather across my back terrace. Several times it was confronted by obstacles in its path and after a momentary pause it would make the necessary detour. At one point the ant had to negotiate a crack in the concrete about 10mm wide. After brief contemplation the ant laid the feather over the crack, walked across it and picked up the feather on the other side then continued on its way.

 I was fascinated by the ingenuity of this ant, one of God’s smallest creatures. It served to reinforce the miracle of creation. Here was a minute insect, lacking in size yet equipped with a brain to reason, explore, discover and overcome. But this ant, like the two-legged co-residents of this planet, also shares human failings. After some time the ant finally reached its destination – a flower bed at the end of the terrace and a small hole that was the entrance to its underground home. And it was here that the ant finally met its match. How could that large feather possibly fit down that small hole? Of course it couldn’t. So the ant, after all this trouble and exercising great ingenuity, overcoming problems all along the way, just abandoned the feather and went home.

The ant had not thought the problem through before it began its epic journey and in the end the feather was nothing more than a burden. Isn’t life like that! We worry about our family, we worry about money or the lack of it, we worry about work, about where we live, about all sorts of things. These are all burdens – the things we pick up along life’s path and lug them around the obstacles and over the crevasses that life will bring, only to find that at the destination they are useless and we can’t take them with us.

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, 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 little as 10 to 30 cells.
• Touch DNA samples are processed exactly 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:Words to live by…

Accept that some days you’re the pigeon, and some days you’re the statue. Always keep your words soft and sweet, just in case you have to eat them. Always read stuff that will make you look good if you die in the middle of it. Drive carefully. It’s not only cars that can be recalled by their maker. Eat a live toad in the morning and nothing worse will happen to you for the rest of the day. If you can’t be kind, at least have the decency to be vague. If you lend someone $20, and never see that person again, it was probably worth it. It may be that your sole purpose in life is simply to serve as a warning to others. Never buy a car you can't push.

Never put both feet in your mouth at the same time, because then you don’t have a leg to stand on. Nobody cares if you can’t dance well. Just get up and dance. The early worm gets eaten by the bird, so sleep late. When everything’s coming your way, you're in the wrong lane. Birthdays are good for you; the more you have, the longer you live. Ever notice that the people who are late are often much jollier than the people who have to wait for them? If ignorance is bliss, why aren't more people happy? You may be only one person in the world, but you may also be the world to one person. Some mistakes are too much fun to only make once. Don’t cry because it’s over; smile because it happened. We could learn a lot from crayons: Some are sharp, some are pretty, some are dull, some have weird names, and all are different colors but they all have to learn to live in the same box.

A truly happy person is one who can enjoy the scenery on a detour. Happiness comes through doors you didn’t even know you left open. Have an awesome day, and know that someone has thought about you today…

Emedinews:Insights on MEdicolegal Update:Facilitate cadaver organ retrieval for transplantation

In India, certain amendments to the Human Organ Transplant Act 1994 are required to enhance cadaver organ retrieval and transplantation to bridge the huge demand–supply gap. The pool of donors, including increasing the supply of organs by widening the definition of ‘near relatives’ by allowing organ swaps among needy families, as well as, simplifying cadaver transplant procedures. The paired matching should be permitted i.e. if patient A’s donor does not match A, and likewise for patient B, then donor switch should be allowed, if it results in a match. Swaps or exchanges between families unable to fulfill the need of their family member in need of a transplant.

Emedinews:Inspiration:The last game

An Inspirational Story

Wow! What a ride! I feel like I just got off the worlds biggest rollercoaster and I am still woozy! I don’t know to laugh or cry. I feel a sense of relief, yet disappointment. I even dream to jump back on. I dare not for my heart may not take another ride!

My son started football as a freshmen boy, and now four years later, a senior, played his last game. He has learned a lot about life; the ups and downs that come without warning. He’s learned life isn’t always fair. Sometimes you watch life "happen" for others, while on the sidelines wondering what’s wrong with me. The sweat and tears. Oh the tears…if I had a bottle to catch them all! Tears of joy, disappointments, dropped balls, what ifs, only ifs, the injuries. The list goes on and on.

My mind wanders back over the years to my own tears and emotions.

In two hours time I was capable of love, hatred, excitement, disappointment and great anxiety! I was a mom all week packing lunches, carpooling, cooking and breaking up fights before school, after school and at the dinner table! Trying to make the home a safe haven for our kids!! On Friday nights I turned into a screaming, poor sported fan, full of pride.

The first time I sat at a game and screamed I looked around to see who it was, I couldn’t believe that noise came out of my mouth. And so it was my glorious life for four years. Cool aid mom during the week and crazy, screaming fan on Friday nights! A couple times I even thought I’d make a great coach! I always knew what the coach should have done after the play was over!

I ask myself, "Would I do it again?" The answer is most assuredly a YES. I’d do it again and again and again and again! I will never forget the last game. The kids all squished together in a circle of unity, chanting, swaying back and forth holding their helmets up high into the sky. ON this night it came clear to me it wasn’t about any one player or position. It didn’t matter who started or ended or just watched from the sidelines. This was a family. Sometime, somewhere and somehow, along the way, they became ONE.

What is any hurt which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days?

A grievous injury

The 8th clause of Indian Penal Code 320 defines such hurts, which cause the victim to be in severe bodily pain for a period of 20 days as

• Any hurt which prevents the victim from following his ordinary pursuits for a period of 20 days
• Ordinary pursuits means the patient is not able to go to the toilet, to brush the mouth, bathe, cannot eat himself, cannot walk and to carry on such daily pursuits require mandatory help of other person for 20 days
• The length of time during which an injured person is in pain, disease or is not able to pursue his ordinary daily routine work must be meticulously and satisfactorily observed by the doctor himself before certifying the injury as a grievous injury.
• It is employed not only in cases where violence has been used but also in cases where hurt has been caused without any assault, e.g., by administration of drugs, the digging of pitfalls. The setting of traps etc. the extent of hurt and the intention of the offender are considered for giving punishment.
• It is difficult for a doctor to prove that an injured person was in severe bodily pain for 20 days but it is easier to prove that he was unable to follow his ordinary profession/pursuits due to the hurt.
• A mere stay of 20 days in the hospital doesn’t make an injury grievous unless the person was in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days. Certifying doctor must rule out and document the feigned illness in medicolegal report.

Emedinews:Inspiration:A place to stand

If you have ever gone through a toll booth, you know that your relationship to the person in the booth is not the most intimate you’ll ever have. It is one of  life’s frequent non–encounters: You hand over some money; you might get change; you drive off. I have been through every one of the 17 toll booths on the Oakland–San Francisco Bay Bridge on thousands of occasions, and never had an exchange worth remembering with anybody.

Late one morning in 1984, headed for lunch in San Francisco, I drove toward one of the booths. I heard loud music. It sounded like a party, or a Michael Jackson concert. I looked around. No other cars with their windows open. No sound trucks. I looked at the toll booth. Inside it, the man was dancing.

"What are you doing?" I asked. "I’m having a party," he said. "What about the rest of these people?" I looked over at other booths; nothing moving there. "They’re not invited."

I had a dozen other questions for him, but somebody in a big hurry to get somewhere started punching his horn behind me and I drove off. But I made a note to myself: Find this guy again. There’s something in his eye that says there’s magic in his toll booth. Months later I did find him again, still with the loud music, still having a party.

Again I asked, "What are you doing?" He said, "I remember you from the last time. I’m still dancing. I’m having the same party." I said, "Look. What about the rest of the people." He said. "Stop. What do those look like to you?" He pointed down the row of toll booths. "They look like toll booths." "Noooo imagination!"

I said, "Okay, I give up. What do they look like to you?" He said, "Vertical coffins." "What are you talking about?"

"I can prove it. At 8:30 every morning, live people get in. Then they die for eight hours. At 4:30, like Lazarus from the dead, they reemerge and go home. For eight hours, brain is on hold, dead on the job. Going through the motions."

I was amazed. This guy had developed a philosophy, a mythology about his job. I could not help asking the next question: "Why is it different for you? You're having a good time."

He looked at me. "I knew you were going to ask that," he said. "I’m going to be a dancer someday." He pointed to the administration building. "My bosses are in there, and they're paying for my training."

Sixteen people dead on the job, and the seventeenth, in precisely the same situation, figures out a way to live. That man was having a party where you and I would probably not last three days. The boredom! He and I did have lunch later, and he said, "I don’t understand why anybody would think my job is boring. I have a corner office, glass on all sides. I can see the Golden Gate, San Francisco, the Berkeley hills; half the Western world vacations here and I just stroll in every day and practice dancing.

Abraham Lincoln said, "Most people are about as happy as they make up their minds to be." I would tend to agree.

Emedinews:Insights on Medicolegal Issues:Facilitate cadaver organ retrieval for transplantation

In India, certain amendments to the Human Organ Transplant Act 1994 are required to enhance cadaver organ retrieval and transplantation to bridge the huge demand–supply gap. The pool of donors, including increasing the supply of organs by widening the definition of ‘near relatives’ by allowing organ swaps among needy families, as well as, simplifying cadaver transplant procedures. The paired matching should be permitted i.e. if patient A’s donor does not match A, and likewise for patient B, then donor switch should be allowed, if it results in a match. Swaps or exchanges between families unable to fulfill the need of their family member in need of a transplant.

Emedinews:Inspiration:A bowl of noodles from a stranger

That night, Sue quarreled with her mother, and then stormed out of the house. En route, she remembered that she did not have any money in her pocket; she did not even have enough coins to make a phone call home. At the same time, she went through a noodle shop, picking up sweet fragrance, she suddenly felt very hungry. She wished for a bowl of noodles, but she had no money!

The seller saw her standing before the counter and asked: - Hey little girl, you want to eat a bowl? But … but I do not carry money … she shyly replied.

Okay, I’ll treat you – the seller said – come in; I will cook you a bowl. A few minutes later the owner brought her  a steaming bowl of noodles. Sue cried as she ate some pieces

What is it? – He asked. Nothing. I am just touched by your kindness! – Sue said as she wiped her tears. Even a stranger on the street gives me a bowl of noodles, and my mother, after a quarrel, chased me out of the house. She is cruel!!

The seller sighed: Girl, why did you think so? Think again. I only gave you a bowl of noodles and you felt that way. Your mother has raised you since you were little, why were you not grateful and disobeyed your mom? Sue was really surprised after hearing that.

“Why did I not think of that? A bowl of noodles from a stranger made me feel indebted, and my mother has raised me since I was little and I have never felt so, even a little.”

On the way home, Sue thought in her head what she would say to her mother when she arrives home: “Mom, I’m sorry. I know it is my fault, please forgive me …”

Once up the steps, Sue saw her mother worried and tired of looking for her everywhere. Upon seeing Sue, her mother gently said: “Sue, come inside honey. You are probably very hungry? I cooked rice and prepared the meal already, come eat while it is still hot …” Unable to control any longer, Sue cried in her mom’s hands.

In life, we sometimes easy to appreciate the small actions of some people around us, but for the relatives, especially parents, we see their sacrifices as a matter of natural …

Parental love and concern are the most precious gifts we have been given since birth. Parents do not expect us to pay back for nurturing us …… but have we ever appreciated or treasure the unconditional sacrifice of our parents?

Source: http://academictips.org/blogs/a-bowl-of-noodles-from-a-stranger/

Emedinews:Insights on Medicolegal Issues:Facilitate cadaver organ retrieval for transplantation

In India, certain amendments to the Human Organ Transplant Act 1994 are required to enhance cadaver organ retrieval and transplantation to bridge the huge demand–supply gap. The pool of donors, including increasing the supply of organs by widening the definition of ‘near relatives’ by allowing organ swaps among needy families, as well as, simplifying cadaver transplant procedures. The paired matching should be permitted i.e. if patient A’s donor does not match A, and likewise for patient B, then donor switch should be allowed, if it results in a match. Swaps or exchanges between families unable to fulfill the need of their family member in need of a transplant.

Emedinews:Inspiration:Why is there war?

 It was my first day at school. I felt nervous and scared. I went to all my classes with no friends. It felt like no one cared.

I listened anxiously to all the lessons and waited for lunch break at one. Then finally the bell rang. It was time to talk and have fun.

In the lunch line I met a new friend who wore a hijab on her head, and though I am Jewish, we got along fine, and I was so relieved when she said, “Sit with us, at our table.” She pointed to the one next to the door.

So I agreed, and took my tray and was about to walk with her across the floor, when suddenly I felt a nudge. “Hey, I saw you on the bus,” said a tall girl in a long skirt. “I see your Jewish star necklace. You should sit with us.”

At that moment I looked around, and that’s when I noticed, to my surprise, the nations of the world, isolating themselves. That’s what I saw through my own eyes.

The Spanish only sat with Spanish, the Russians always with the Russians, and never the Arabs with the Jews. I saw the reason why war gets started. Everyone sticks to their own kind. The lunchroom was a map of the world. Why was everyone so blind?

And so I turned down this girl, and went with the first, and there was no enmity. I built a bridge between two worlds when I sat with those different from me. Hope you will do the same.

Source: http://academictips.org/blogs/why-is-there-war/

Emedinews:Insights on MEdicolegal Issues:Collection of biological samples and medical evidences in a medicolegal case

The analyst/doctor has a legal responsibility to retain untested biological specimens in legal cases so that another person can test them and come to an independent conclusion as to their origin.

The observation of scenes of crime, collection of human body fluids, weapons of the offence and medical examination of victim, accused, or both is required in any investigation of crime against human body such as injury, rape, murder.

The medical examination is carried out in emergency ward of hospitals and treatment of injured and dying patient remains the major focus of the treating doctor. But, in cases of crime against the human body, the medical examination and collection of biological sample/s, its documentation, packaging, and analysis have an important role and should be done by the doctor very meticulously with the high standards of science and the law in mind. These biological materials include: Blood, seminal stains, vaginal smears/slides gastric lavage, chemical substances, poison, hair, fiber, broken glasses, knives, blunt instruments/objects, fire arms, bullet, live and empty cartridge cases, wads, clothing etc. This scientific biological evidence becomes legal evidence in prosecution/acquittal of case if collected correctly.

Emedinews:Inspiration: Stop waiting

We convince ourselves that life will be better after we get married, have a baby, then another. Then we are frustrated that the kids aren’t old enough and we’ll be more content when they are.

After that, we’re frustrated that we have teenagers to deal with. We will certainly be happy when they are out of that stage. We tell ourselves that our life will be complete when our spouse gets his or her act together, when we get a nicer car, are able to go on a nice vacation, when we retire. The truth is, there’s no better time to be happy than right now. If not now, when?

Your life will always be filled with challenges. It’s best to admit this to yourself and decide to be happy anyway.

One of my favorite quotes comes from Alfred D. Souse. He said, “For a long time it had seemed to me that life was about to begin – real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, or a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life”.

This perspective has helped me to see that there is no way to happiness.

Happiness is the way. So, treasure every moment that you have and treasure it more because you shared it with someone special, special enough to spend your time… and remember that time waits for no one.

Happiness is a journey, not a destination.

So… “Work like you don’t need money, love like you’ve never been hurt and dance like no one is watching.”