Lithotomy PositionThe lithotomy position is well known to medical students, especially in Obs and Gyn. It is characterized by the patient lying supine (on her back) with hips and knees flexed and thighs separated as shown above. This position is ideal for vaginal examinations and is the usual position for childbirth.

But where does it get its name? Is it like many other medical terms eponymously derived from the name of a famous doctor in history? Actually no (although there was an ancient surgeon who was named after it- we’ll come to this later). It comes from the Greek word lithos meaning stone (+ tomos=cut). But what does this have to do with the position? Actually, this is the position used in ancient times for surgical procedures to remove stones (kidney stones, bladder stones, gallstones) via the perineum.

In those days, the lithotomy operation was done without anaesthesia and was intensely painful! Death rates were very high, so much so that the Hippocratic oath stipulated that “I will not cut for stone, even for the patients in whom the disease is manifest; I will leave this operation to be performed by practitioners.” The “practitioners” referred to were surgeons (who were different to physicians at that time). At that time a few specialists practiced perineal lithotomy, notably Ammonius Lithotomos of the 3rd century B.C.E. The muslim surgeon Alzahrawi (Albucasis) (1000 C.E.) improved the procedure with a new technique using a special instrument he invented, thereby reducing death rates. It is described in great detail here: http://rabieabdelhalim.com/zahrawiBladderStoneExtraction.pdf An interesting read for budding urologists!

Spain flag

After 90 minutes of gruelling football, the final whistle finally blew, with Germany unable to secure an answer to Puyol’s second half header. Who said short players can’t score from headers? This secured Spain’s spot in Sunday’s final against the Netherlands. It would be a historic final with neither team having won a World Cup before.

I was quite pleased with the result, as I have supported Spain throughout the World Cup, but I must admit I had some initial trepidation, in light of Germany’s recent magnificent victories. However, today Germany was simply outplayed, with Spain establishing its dominance from the get-go.

Spain created more chances at goal than Germany, and it is a wonder how more balls didn’t find the back of the net. However, as Germany realized today, in a World Cup semi it doesn’t matter if you win by 1 goal or 10, a win is a win. Memorable was the chance David Villa had as he slid in to meet a cross, only missing it by mere inches.

I have one bone of contention: In the twilight of the game, Pablo was given a marvellous opportunity to help Spain increase their lead and seal the deal. He and Torres were directly in front of goal, and Pablo was in possession of the ball, but was being heavily attacked by a German defender. All he had to do was pass the ball to Torres who was unmarked, but Pablo chose instead to seek personal glory and refused to pass, eventually losing the ball. What was he thinking? I have seen this happen in school-yard football, but would not expect it to happen at the international level. Quite disappointing indeed. However, hats off to coach Vincent del Bosque who promptly brought Pablo off the field in the waning minutes.

All in all, it was a job well done. I’m looking forward to the final on Sunday, supporting Spain to the very end.

Surfing the web, I came across this account of studying medicine in Trinidad written apparently by a foreign medical student .

http://archive.student.bmj.com/issues/99/12/life/465.php

First Post!!!

Posted: July 2, 2009 in Uncategorized

I have been wanting to blog for years now. I started a “Blogger” account before I was in med school, but I never posted anything. I have had a recent return of interest in blogging, so I started this blog. 

I want to blog about medical school, but also about my interests- especially technology and gadgets, my opinions on what is going on in the world and cool stuff that I discovered while surfing the web. I have unanswered questions though; should I use separate blogs for all of these or should I blog about all of these topics on this blog?