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8
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58

EXPERIENCE OF A MALE OB & GYN IN A MUSLIM CULTURE IN PAKISTAN.

As part of my post retirement ob & gyn activities, I spent two years in the early nineties, working at the Aga Kahn Medical School in Karachi, Pakistan. That is a most modern facility with excellent staff and resources and great medical students. One can imagine that the majority of obstetricians and gynecologists in a muslim country, like Pakistan, are female and that male ob & gyn might encounter some difficulties It was my distinct impression that often it is not the woman herself who objects to being examined and treated by a male, but rather the husband. An anecdote of a real situation which I encountered will illustrate this. One day I was sitting in my office next to the labor and delivery suite as one of the more junior female residents came running into my office, quite excited. “Doctor Le Maire, could you please come quickly? One of the laboring patients has some very major drop in the baby’s heartbeat. I am worried but cannot reach her private doctor and the doctor on call is in the operating room.” I ran over to the delivery suite with the resident and into the patient’s room. She was obviously in much discomfort and her husband was at her side. One of the first things an obstetrician may do when a woman in labor shows signs of some problem with the undelivered baby as evidenced by a drop in the baby’s heart rate, is to examine the woman vaginally. In doing so, the he or she can determine if the baby can be quickly delivered or if there is a reason for the drop in the baby’s heart rate, such as a loop of the umbilical cord being compressed by the head, in which case an immediate C- Section might be necessary. So I immediately put on a pair of sterile gloves and got ready to examine the woman. She herself was perfectly ready to let me do this, but her husband stopped me and told me that he objected to his wife being examined by a male. This was even in the face of a serious situation with potential for harm to his unborn baby. There was no time to be lost trying to reach one of the female attendings, so I did the next best thing and told the very junior resident to take the patient into the operating room and examine her there and let me know the findings, while I was getting the operating room organized to do a C-Section, if called for. The strange thing is that the husband would have let me do a C- Section on his wife, but not a vaginal exam. As it turned out, by the time the patient ended up in the operating room, her private doctor had been located and was in attendance. The outcome was good and a healthy baby was delivered soon after. However the situation could have been quite different and catastrophic. Even stranger to me was that the woman’s husband was not a lay person but actually a chief resident in anesthesiology in the same hospital, with whom I had worked together in the operating room on a number of occasions. I would never have thought that an educated person and a medically educated person at that, would jeopardize the well being of his unborn child and wife, based on cultural and religious beliefs. Later on in the year this same anesthesiology resident came to ask me for a letter of recommendation as he wanted to apply for a specialized fellowship in the USA. I hope that the reader can understand why I politely (perhaps not so politely) refused. Those interested can read more about my experiences in an e book, entitled "Crosscultural Doctoring. On and Off the Beaten Path." One can down load it for free to the reader device of your choice from Smashwords at: http://smashwords.com/books/view/161522. Or just Google Crooscultural Doctoring.  
DR William LeMaire
over 3 years ago
12
1
74

Focus On: Ultrasound-Guided Lumbar Puncture

In the emergency department, lumbar punctures are most commonly performed to determine the presence of an infectious process (meningitis, encephalitis, sepsis, etc.) or subarachnoid hemorrhage  
American College Of Emergency Medicine
over 9 years ago
8
1
73

Pancreatitis - Surgical Indications and Procedures

<p>This is the third in the series on severe pancreatitis and necrotizing pancreatitis. &nbsp;This episode reviews the indications for surgery, morbidity and mortality of surgery, and what are the surgical options. &nbsp;</p>  
Jeffrey S. Guy, MD, FACS
over 9 years ago
7
1
60

Cardiovascular Risk Reduction for Surgery

This episode explores what is needed to make surgery safer for the patient with cardiovascular disease.&nbsp;  
Jeffrey S. Guy, MD, FACS
over 9 years ago
9
1
68

Q&A on Radiation for Head and Neck Cancer: Introduction and Role after Surgery, by Dr. Alex Lin (audio)

<p <p>Q&amp;A session following presentation on history &amp; general approaches for radiation, with focus on head/neck cancer, by Dr. Alex Lin, Assistant Professor of Radiation Oncology at the Univ. of Pennsylvania.</p </p>  
Howard (Jack) West, MD
over 9 years ago
10
1
66

Q&A on Radiation for Head and Neck Cancer: Introduction and Role after Surgery, by Dr. Alex Lin (video)

<p <p>Q&amp;A session following presentation on history &amp; general approaches for radiation, with focus on head/neck cancer, by Dr. Alex Lin, Assistant Professor of Radiation Oncology at the Univ. of Pennsylvania.</p </p>  
Howard (Jack) West, MD
over 9 years ago
13
1
65

Radiation for Head and Neck Cancer: Introduction and Role after Surgery, by Dr. Alex Lin (Audio)

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Lecture on history and general approaches for radiation, with specific attention to its role in post-operative treatment of head/neck cancer, by Dr. Alex Lin, Assistant Professor of Radiation Oncology at the Univ. of Pennsylvania.</span></p>  
Howard (Jack) West, MD
over 9 years ago
0
1
70

Radiation for Head and Neck Cancer: Introduction and Role after Surgery, by Dr. Alex Lin (Video)

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Lecture on history and general approaches for radiation, with specific attention to its role in post-operative treatment of head/neck cancer, by Dr. Alex Lin, Assistant Professor of Radiation Oncology at the Univ. of Pennsylvania.</span></p>  
Howard (Jack) West, MD
over 9 years ago
1
1
61

Should Surgery be Considered for Very Limited Small Cell Lung Cancer? (audio)

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Howard (Jack) West, medical oncologist, President &amp; CEO of GRACE, reviews the debate about whether surgery should have a role in managing early small cell lung cancer (SCLC).</span></p>  
Howard (Jack) West, MD
over 9 years ago
2
1
57

Should Surgery be Considered for Very Limited Small Cell Lung Cancer? (video)

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Howard (Jack) West, medical oncologist, President &amp; CEO of GRACE, reviews the debate about whether surgery should have a role in managing early small cell lung cancer (SCLC).</span></p>  
Howard (Jack) West, MD
over 9 years ago
9
1
56

The Role of Surgery in Management of NSCLC (Audio)

This slide presentation by Dr. Ralph Aye, thoracic surgeon and Chief of the Thoracic Oncology Division at Swedish Cancer Institute in Seattle, provides a general introduction to surgical management options for early stage non-small cell lung cancer.  
Howard (Jack) West, MD
over 9 years ago
10
1
47

The Role of Surgery in Management of NSCLC (Video)

This slide presentation by Dr. Ralph Aye, thoracic surgeon and Chief of the Thoracic Oncology Division at Swedish Cancer Institute in Seattle, provides a general introduction to surgical management options for early stage non-small cell lung cancer.  
Howard (Jack) West, MD
over 9 years ago
7
1
25

Management Options for Stage IIIA NSCLC: The Outer Limits of Resectability (Audio)

This slide presentation by medical oncologist and lung cancer expert Dr. Jack West covers the most common management strategies for stage IIIA N2 node-positive NSCLC, with a particular focus on a comparison of preoperative treatment followed by surgery vs. chemo and radiation without surgery.  
Howard (Jack) West, MD
over 9 years ago
8
1
30

Management Options for Stage IIIA NSCLC: The Outer Limits of Resectability (Video)

This slide presentation by medical oncologist and lung cancer expert Dr. Jack West covers the most common management strategies for stage IIIA N2 node-positive NSCLC, with a particular focus on a comparison of preoperative treatment followed by surgery vs. chemo and radiation without surgery.  
Howard (Jack) West, MD
over 9 years ago
11
1
39

Trauma and Surgery During Pregnancy

Topics Today, I&#8217;ll discuss Trauma and Surgery during Pregnancy. Trauma during Pregnancy&#8230; OBGYN 10 Trauma and Surgery During Pregnancy Video&#8230; View Free Video Here Free Links: OBGYN-10 OBGYN-101 Gray Haired Note Brookside Associates Medical Education Division  
Mike Hughey, MD
over 9 years ago
7
1
28

Non-Dysplastic Abnormal Pap Smear Results

Topics Today I&#8217;ll discuss the clinical management of abnormal Pap smears that do not involve obvious dysplasia or cancer of the cervix. Pap Smear Interpretation and Management of Abnormals&#8230; View Text Here Pap Smear Video&#8230; View Free Video Here Commercial Links: Dysplasia Vide Colposcopy Vide 5-Minute Pap Smear Video Free Links: OBGYN-10 OBGYN-101 Gray Haired Note Cervical Intraepithelial Neoplasia: History and Detection, in [...]  
Mike Hughey, MD
over 9 years ago
7
1
40

Episode 7. Upper GI Surgery (Part 3 of 3)

Podcast on small bowel conditions. Final part of 3 covering upper GI surgery.  
Saran Shantikumar
over 9 years ago
Preview
1
33

Refractive Cataract Surgery Pearls-Education

“less dependent on glasses”<br/><br/>Education is discussed in 3 Categories:<br/> 1. What is a Cataract?<br/> 2. What is Cataract Surgery?<br/> 3. What are your lens options? Standard or Premium IOL  
Rob Melendez, MD, MBA
over 9 years ago
Preview
1
29

Glaucoma-Laser Trabeculoplasty

Sample audio file from <a href="../Products.html">Ophthalmology Buzzwords™</a> Audio Book.  
Rob Melendez, MD, MBA
over 9 years ago
3
1
66

Surgery for aspergilloma and invasive aspergillosis by Gilbert Massard (43.29min)

Dr Massard discusses the options for surgery in aspergilloma and invasive aspergillosis.  
Aspergillus Website
over 9 years ago