LACK OF MERITOCRACY CROWNED THE STUPID CLOWNS IN THE MYANMAR MEDICAL GROUND

Yes, if there is no meritocracy, clowns could be definitely crowned.

Let’s look at the following act of clowns in the Myanmar Medical Circus.

Once a patient who has a myxoedema or hypothyroidism, a disease caused by decreased activity of the thyroid gland, causing a subnormal basal metabolic rate of the whole body, went to consult a Physician and complaint about her constipation and abdominal discomfort.

The Physician just rush through the physical examination and ordered a CT Scan of abdomen. (May be a scam, wishing for a kickback from the radiologist for that expensive investigation or just a mere laziness to check thoroughly or may be in a rush to see another patient or just wish to finish the consultation in order to go back home and watch the popular Korean soap opera.).

The Radiologist done the CT Scan and reported that there was a Cancer of the Rectum, the terminal portion of the large intestine, just above the anal canal which ends at the anus.

 

So the patient was referred again to the Colonoscopist to examine the colon with the fibreoptic flexible colonoscope. The Colonoscopist is using the state of art latest equipment. He used the robotic arm and controls the whole procedure with the remote control by watching at the monitor screen.

He recorded his procedure in detail. The following is the excerpts of his records_

“The scope enters the anus. And then after going for about two to three inches, I saw the annular rounded, well defined constricting mass obstructing the lumen. I could not go around that mass. I saw a small hole at the centre that was like a slit. I managed to enter the scope through that narrow opening but caught in a blind end, cul-de-sac. At last I give up proceeding, retreat and decided to take biopsies from the mass. I took biopsies from three different positions. And then the biopsies were sent to the Pathologist.”

The Pathologist read the request form thoroughly, esp. the history of the present illness, procedure etc. After that only, he examined the biopsies and reported back as Adenocarcinoma, A malignant tumour originating in glandular tissue.

So at last the poor patient was referred to the Surgeon. But that night the patient suffered from “Acute abdomen”, sudden severe abdominal pain.

The Surgeon ordered the plain X-ray abdomen, erect and lateral. He found the GUD or Gas under the Diaphragm, which indicates that there is free air in the abdomen. Normally the gas always stays in the stomach and intestines only. There are some rare causes of GUD but usually the gas came out when there is a hole or perforation of stomach or intestine. So the Surgeon decided to do the urgent laprotomy that is open up the abdomen, search the cause and proceed as necessary.

To the Surgeon’s surprise he could not find any disease in the abdomen and so decided to close back.

Now let’s do a post-mortem. Pardon me; I should not use this word as our patient is lucky and still alive. I don’t mean the real post-mortem but a retrograde analysis in detail what went wrong.

Although I had no chance to read back our gold standard, prescribed Surgery tax book, Bailey and Love for few decades, I still remember the words at the start of the Abdomen section.

“Abdomen is a magic box.” 

And I still remember a footnote also, “If you do not put your finger, you have to put your foot in it”, reminding the doctors, especially the Surgeons to examine the P.R. or Per Rectal digital examination. In laymen terms, to put the finger into the anus to examine and after all, more than 90% of the said suspected  Cancer of Rectum is within the reach of the doctor’s examining finger.

The Physician missed that the myxoedema is the cause of the patient’s constipation. Even if a first year clinical student missed that, he could be failed.

The Radiologist had given the wrong diagnosis of Ca Rectum on the normal CT Scan.

Colonoscopist entered the wrong hole, vagina, mistaken the normal cervix of the uterus as a tumour. Even he entered the uterus unknowingly. During the colonoscopy, it is a normal procedure to pump a lot of air through the scope. So the pumped air passed through normal uterine appendages and entered abdomen, bloated, distended and showed the positive GUD.

The Pathologist looked at the normal cervix cells and diagnosed wrongly as an Adenocarcinoma.

So this is the result of ignoring MERITOCRACY leading to choose the relatives and friends of Tatmadaw, to become specialists in different fields of Medicine. Now Myanmar Medical Circus is using the first class or state of the art medical facilities with the stone aged mentality under the stupid, racist, xenophobic, religious fanatic military dictator SPDC.

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