For the doctor who has everything

Surgery

CHRISTMAS PRESENTS are an awkward problem for the wives and friends of earnest doctors. Not for them are the elephants or aeroplanes marked "his" and "hers" or a gold-plated golf club available from the famous store in Dallas , Texas . The very avoidance of this type of conspicuous extravagance, however, blocks fulfilment of the desire to express a thought appropriately. The following list may serve as a guide to the perplexed in this situation.

The cheapest present in this list, at about 20 cents, is a nylon bristle toothbrush. It is used for scrubbing dirt out of anaesthetized wounds of the face, hand or leg. Between uses, it is stored in a suitable antiseptic. It will be especially welcome for a doctor doing his own casualty work in an area remote from a large metropolitan hospital.

For a little over $4 (excluding batteries) a doctor may be bought a rabbit-shooter's head-lamp. Its light is as bright as that of many types of operating theatre lamp, and it is very-handy for suture of an episiotomy, or some other surgical procedure where visual acuity is important and roughly proportional to the lighting intensity. A good quality brand is important, as some types can be bought which would not be satisfactory.

Just a little more expensive is membership of the Australian Consumers' Association and a year's subscription to Choice magazine. Many doctors are already aware of its virtues without actually having subscribed. if it can be placed in a waiting room and is being paid for from his own account, it is then likely to be a tax-deductible item.

In almost the same price range is a tilt-top plastic waste-bin. Its capacity for printed matter is many times that of a pedal bin while occupying no more floor space. Its appearance is quite smart; it is very easily emptied by a cleaner, and there is no pedal mechanism to succumb to gradual bending forces over some months or years. The larger model is recommended.

For doctors who are often stitching hand or face wounds, the present of a Zeiss binocular loupe will provide a revelation. At just over $37 from an optical instrument firm, on approval, it opens up a new world of sight comparable to that met underwater with one's first adventure with a mask and snorkel tube. Wounds that are otherwise simply dull and dirty suddenly reveal an individual museum of foreign matter, and anatomy that has hitherto lain mostly in the imagination. It taker about a fortnight's practice to become used to the sudden increase in visual acuity, which is much greater than that of the one-lens systems. Once a doctor if addicted to the use of this device, the condition is likely to be permanent.

A small cassette tape recorder is an excellent present, There are two quite good makes, a little over six inches long, and one at half the cost of the other. They will record and play back music on standard cassettes. More important, they will do the same for lectures and for papers in ,preparation. With the addition of a foot switch, they save time in the final stage of preparation before typing a first draft of a paper.

Although it may not yet be evident to organizations interested in postgraduate education, by 1972 they may well be stocking a large range of these cassettes, recording the talks of local and overseas speakers with the minimum of fuss and effort using high-quality unobtrusive portable instruments. The cassettes will be posted in standard little cardboard packets with equally little fuss.

Rather more expensive, but likely to be much appreciated by those who record some of their clinical or laboratory work for medical journals, is a best-quality "Polaroid" camera, with close-up accessories and a carrying bag. For medical work its main advantage is that the completed print is available in a few seconds, rather than in a few days taken by professional photographers and conventional cameras. Prints from "Polaroid" cameras can be quite acceptable to medical editors, even if their standard is not as high as that of prints from properly trained photographers. Having the illustration available so quickly, however, is a great help during the preparation of a manuscript "bis dat cui cito dat *", as Hamilton Bailey said in relation to emergency surgery. For those with an aggressive accountant, a leasing arrangement for the acquisition of this item might be an advantage.

At the top of this brief list, for presentation by a wife who has just won a lottery or submitted the best advertising-competition jingle of them all, is the purchase of a video-tape camera, recorder, monitor and tape. Two thousand dollars over the counter, and you can have the lot gift-wrapped and carried to your waiting car, for black and white anyway. Colour video is a little dearer. For the keen student of those manual procedures which loom so large in medical work, there can be no better equipment to act as the magic mirror for which the Scots poet Robert Burns yearned. One waits patiently, but hopefully.

"He gives in double measure who gives quickly"

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This was yet another uninvited editorial written over an evening or two for the Medical Journal of Australia December 20, 1969 p122-3

I'm no good at buying presents for birthdays, Christmas or other occasions except for myself. This time of my life was one of extended childhood, when I would walk through hardware shops wondering what devices for the kitchen or workshop might be useful in the operating theatre or medical practice elsewhere.

Any devices with a medical label were automatically more expensive, partly for good reasons such as documentation, higher built-in reliability and safety, and much smaller turnover, as well as a heavy up-market image.

Interesting, a Zeiss 2.2 dioptre loupe cost $38 then. Ten or 15 years later a custom loupe from Designs for Vision of New York cost over $1000.

By contrast a very basic video system cost $2000 then, and today far less for a hugely more powerful system. Moore 's Law is at work. Moore was the founder of Intel, the world's biggest maker of integrated circuits for memory and other computer components. The popular version of his law – not the way he remembers stating it – says the cost of chips halve and their power doubles every year. That means a factor of 1024 every ten years and over a million in 20 years, which is what has roughly been happening.

This is why there is the remorseless technical development of computing devices in medicine, partly because it can be done and therefore must be done and partly because of accelerating growth of expectations both by doctors and society even if this means massive 'overkill' (a better word please?) and waste at times.

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