Times of India
26 March 2010
By Lata Mishra

The department has 9 vacancies as doctors refuse to operate without microscope; department head prefers human skill to technology
About 40 years ago, Nair Hospital’s neurosurgery department was the first state–of–the–art ‘super speciality’ division in the city’s civic hospitals. Now, caught in the crossfire between the time–tested and the modern way of conducting brain surgery, the department is left with nine vacancies and only three doctors.

Neurosurgeons transferred here turn down the posting because they prefer conducting surgeries with the microscope, which magnifies an image by 20 times. However, the department still uses the loupe, which offers a magnification of a mere three times.

The head of the department Dr H V Savant, on the other hand, lays more stock on human skill than on technology. “‘A machine cannot do what the hand can. These new doctors rely too much on technology and have little faith in their own skill,” he says.

Doctors, who refuse to take the promotions that bring them to this department, say that the 40–year–old loupe is used even by watchmakers. Other civic neurosurgery departments are about to upgrade to microscopes that magnify an image by 60 times, they say. Sources say the Nair’s neurosurgery section has not bought any equipment in almost two decades. KEM hospital’s neurosurgery department, for instance, has 17 doctors and two microscopes.

Some neurosurgeons, when transferred by the Brihanmumbai Municipal Corporation to Nair, have preferred to leave the civic set up altogether rather than to work here. One such doctor, on the condition of anonymity, says, “The department did not fit with my academic goals. No modern neurosurgical operation is possible without a microscope. Even village hospitals use it. Despite several requests and adequate funds, the microscope has not been purchased by the department in the past 10 years.”

Another surgeon, who has recently been made an offer by Nair, said, “Doctors come to public hospitals to learn. Nair hospital does not have even basic equipment. Very few patients come to the department. This results in very low patient exposure for us. So why should I join them?

The department had bought a microscope way back in 1985. This instrument is now defunct. Sources in the department say that the Nair neurosurgeons are unable to perform major operations because of the lack of technology. This leads to a larger inflow of patients at KEM and Sion hospitals.

Dr Savant, when asked about the meagre number of surgeries in his department, said, “We have only three doctors. This makes it hard for us to handle major operations.” He also alleged that BMC was not filling the vacant posts.

Asked about why the department had not bought a microscope, he said, “All major surgeries can be performed using the loupe.” Hospital sources said that using the loupe increased the incidence of error in brain surgeries.

When contacted, Dean of Nair Hospital Dr Ravi Ranaware said he did not want to comment on the issue.