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Indian Journal of Plastic Surgery, Vol. 36, No. 1, Jan-June, 2003, pp. 53-54 Letter to Editor We need to think and act Dr. Ajay Singh Consultant Plastic Surgeon, Ranchi, Lucknow. Code Number: pl03015 Sir, During the Annual conference of APSI (Bihar-Jharkhand) on 15-16th Feb 2003, the honourable Health minister of Jharkhand, Dr. Dinesh Kumar Sarangi, in his Inaugural address raised few very sensitive points, which though sounded bit crude but was very thought provoking I am quoting (highlighted) few important parts of that speech which is very much true in our part of the country. My purpose of sending this is to take opinion of our other Plastic Surgeon colleagues senior, contemporary and juniors, what do they feel about this. Sir recently I was in Delhi and I was surprised to see that simple MBBS were doing Plastic surgery practice saying them self as cosmetic surgeon. Why to go far a relative of mine is doing that in Delhi and is getting services of our regular plastic surgeon as his assistant. Are we not doing injustice to this speciality, can't we do some thing to stop such act through our association. If needed for the political and MCI support my services will always be there. Dr. Ajay Singh Consultant Plastic Surgeon, Ranchi, Lucknow. Dear friends, I am honoured, as today I am amongst a surgical super speciality group. I my self wished to be here the day I knew about this conference, just to know something new. The plastic surgery is now passing the era of microsurgery, LASER surgery and endoscopes surgery. Robotics is in pipeline too. We are importing the latest from abroad the same, which we had long back. I feel it worth mentioning here that, In 600 B.C in the city of Varanasi the father of modern surgery SUSHRUTA was regularly doing reconstructive plastic surgery of nose, for those who had under gone the punishment of adultery. That time the nose chopping was the punishment for this sexual misconduct. The Rhinoplasty done by him is named "Indian Rhinoplasty " in which he used forehead flap for nose reconstruction. The use of honey paste on wounds was his method of burn treatment. Mention of skin grafting and genital deformity correction method too are mentioned in SUSRUTA SANHITA [16,32,fpc pa.297]. The Kangra valley was world famous place for EAR reconstruction. The patients who use to undergo punishment of ear amputation in Middle East mainly Persia were regularly treated at these centres in pre mughal and mughal era. But we could not retain our skill due to regular invasions linked problems in the nation. I said this on to impress that it was we who started this surgical craftsmanship, and we are proud of it. Because the father of modern Plastic SURGERY Sir. Harold Gillies too on a later date acknowledged Sushruta's method of plastic surgical process. The word PLASTICOS it self means remodelling or reconstruction so he concentrated him self on reconstruction. Thus basically plastic surgery to the best of my knowledge is reconstructive surgery and it is the surgery for those who have been deprived of any part of their body, which either the nature denied then of accident deprived them. The congenital deformities from lip, palate. Other parts of the face, hand, foot and the genitals. Or the part or parts lost in accidents or body part got deformed due to burns. Thus it was a boon for the poor ailing masses. I said "was" as Gradually the reconstruction expanded to the reconstruction according to desire, and desire crossed the limits of possibilities. I think here we got detracted. The plastic surgery started getting status of five star surgery and we missed the masses for which this super speciality was evolved. I may not be correct in my statement, but with all due regards to my seniors, friends and others, till date plastic surgery has not reached to the real needy. Till date plastic surgery is considered as surgery of stars be of film, fame or politics. The failure was improper communication and lack of awareness. The films, magazines made some false notion and till date no one ever tried to remove the myths from the masses regarding the process and cost of surgery. So ultimately the subject got lost. Result, that it remained confined to one and half medical colleges in unified Bihar in last 40 years and after Jharkhand we have non. Not because the need is not there, but whenever it was proposed every body gave a sarcastic smile as if what rubbish you are taking. Why government will open a department of affluent in its medical college? This is the question they put to us. It is due to non-aware ness of the masses for this wing of medical science and public representatives come from them only. To start with medical therapy was a mission, then it became profession then business and now finally commercialisation by few. The worst influence of business came on super speciality branches, be it renal transplant or by pass surgery. These vices too influenced plastic surgery in the name of cosmetic surgery. The surgical beautification has become a medical industry. The black ships of profession defined plastic surgery as only cosmetic surgery and in the mad rush of money the basic were left the actual and real roots were forgotten. The result being genital deformities went to genital-urinary surgeons and lip palate went to oral [dental] surgeons, hand surgery went to orthopaedics, facial injury to ENT specialist, neck surgery to oncologist and the plastic surgeons are left with burns, grafting and flap surgery. It is pain full to note that a super speciality became dependent speciality of orthopaedics and general surgery, who did it? IT IS YOU TO ANSWER (SIC). Looking good is desire of all, it is not wrong But the givers should know his limit and, the recipient should know what they are getting. There should be full transparency in our approach, I am sorry to say it not there today. We give hopes of impossible result IN plastic surgery and out come is bad name to the profession and speciality. It may be practice of few, but as you work on skin surface the result is to be audited by the society not you. So please ask your fellows to restrain your self from these petty temptations as temptation of few millimetres may result into disaster. My deliberation is not to discourage you but to caution you what masses feel for this speciality. When I was coming for this meeting, my own men said to me, "you are going to these surgical sculpters at the right age, as very soon you may need them". The comment sounds innocent but not the feeling. It is not good for this supreme speciality for which I had the fascination since my student days in medical college. Destiny took me to political side. I may be of some help in getting this department in our medical colleges in Jharkhand, but I am bit shaky in this statement of mine as I am fully aware of this fact that patron of this Plastic surgeon's association himself is a Plastic surgeon and cabinet minister Dr. Ashok Kumar, the other plastic surgeons too are equally influential, if they couldn't do any thing then where do I stand. The Association of Plastic surgeons of India, Bihar -Jharkhand branch is still united like sesames twins, it is a healthy trend for this subject. The effort too should be united if we really want to have this branch which started in Patna Medical College in 1963 and could not cross even river Ganges till date. But a ray of hope is always there I know a few who are trying to propagate the basics of plastic surgery, this silver lining is giving me impetus to try once for creation of this important unit in at least each medical college of Jharkhand, But at least demand should come from your end. I need this department in Jharkhand for my poor burn victims, for have-nots having congenital deformities and victims of industrial accidents. We need microsurgical units, we have industries and mines how can they afford private treatment we need it not as luxury but as necessity. We need this department for what it was meant. Wishing you all a very comfortable, hospitable, and productive stay at Jamshedpur, during the conference, the first after formation of Jharkhand. Hope this conference will give awareness to the masses regarding the actual scope of this subject. In this post valentine day a message of love to all our guest and good wishes to my colleague of Jharkhand who always stood by me when and where I needed them." Dr. Dinesh Kumar Sarangi Hon. Health Minister, Jharkhand. Copyright 2003 - Indian Journal of Plastic Surgery. |
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