FRESH OUTLOOK!!!- A CLINICAL EXPERIENCE

This was during my years in Telco(now known as Tata Motors)Hospital in the 80s.I was a Consultant Surgeon there then.I had just returned from a long vacation and I had gone to the Surgical Male ward for my rounds.As I was about to finish,my boss then,Dr.R.V.Singh asked me to see a patient which was foxing all the other Consultants in our Surgical department.Incidentally we had joint rounds in the mornings at 8AM though we had 2 units in place,before each unit went their separate ways to OPD and OT(Operation Theatre) alternately,so that collective minds was made to bear on the surgical problematic cases.
Well,this was a young man about 28 years old who had met with a serious RTA(Road Traffic Accident)about 7-10 days back.Initially he was transiently unconscious for about 48 hours with improving levels gradually.When I saw him,it was probably after 10 days or so.I found him lying in bed,fully conscious,and as they say in Medical parlance-well oriented in time and space.What was labelled initially as a "Head Injury",here he was lying fully conscious,talking,crying and laughing which no head injury patient could do but what he had was complete paralysis of all his limbs from neck downwards.
I reasoned that with a full sensorium and LOC(Level of Consciousness)it could never be "Head Injury".The lesion had to be below the level of Brain Stem and probably in the Cervical Spine.When I gave my verdict,the other Specialists pointed out that the Xray of the Cervical Spine which had been taken did not show any fracture.
I examined the Cervical Spine X-rays but I saw all the 7 Cervical Vertebrae were not visualised in the Xrays taken.My Surgical Guru,Dr.T.K.Lahiri,M.Ch.FRCS at BHU had taught me that for a study of Cervical Spine,all 7 vertebrae should be displayed.This is difficult as the 2 shoulders come in the way when taking a lateral view or an oblique of the Cervical Spine.Proper precaution and a manouvere is required to display all 7 vertebrae.A fresh xray was taken with the correct manoueuver and lo! and behold there was an oblique spiral fracture of a cervical vertebra,exact number of the verebra,I am not able to remember.A correct diagnosi altered the complete complexion of his management.
The moral of the story is that in our everyday lives we get mired down in our individual viewpoints or of the group or caste or religion-some thing we call"Tubular Vision".When we reach a deadend,if a person from outside comes,he brings a fresh viewpoint possibly with excellent esults as in this case.