Posted by: Tony Copperfield13 February 2014
The Daily Mail reckons that the stethoscope is under threat. Nonsense. I’ll bet you remember the day you bought your first. I still have mine. Now retired, it’s a well worn Littman with grey tubing that was my constant companion through medical school and house jobs.
Students kept theirs neatly tucked away in their white coat pockets or allowed them to hang off their necks like pendulums. Doctors adopted the American “draped around the collar” approach with diaphragm below one clavicle and earpieces below the other.
This is how I learned one of medicine’s most important lessons, that a stethoscope is a badge of office, not a diagnostic instrument. Before the weekly cardiology ward round we managed to stuff the earpieces of the professor’s stethoscope with cotton wool.
He led us up and down the ward as usual, resting the bell and diaphragm on the chest of every patient in the place. He got some of them to breathe in, breathe out and say “99” and afterwards he left the ward as though nothing untoward had happened, probably to buy some “Otex” from Boots.
A stethoscope is not a device for listening to patients’ hearts and lungs, it’s a device used to shut the bastards up. It says, “Me doctor, you numbskull.” If you have a stethoscope - a proper one, not one of those weightless diaphragm-only pieces of crap that nurses get out of Xmas crackers – then you’ve got credibility.
You might say I’ve over-reacted as I’ve somehow acquired four. A teeny weeny one for the teeny weeny baby clinic, a paediatric one for no particular reason, a standard adult version to use when I want to make standard adults think that I’ve really listened to their chest before telling them they don’t need an antibiotic and my favourite, a really big, heavy “Cardiology Special”.
This weighs in at about half a pound at the business end. I keep it on hand in case any trouble kicks off on a home visit. The impact generated by a sizeable chunk of metal swinging at the end of a three foot length of sturdy plastic tubing is enough to persuade the meanest looking crossbred yard dog – or his owner - not to have a second go when it hits between the eyes.
And that is why, Mr or Miss ‘Daily Mail Reporter’, I don’t believe that doctors’ love affair with the stethoscope is coming to an end. Who cares if you can record a patient’s heart sounds using an app on a smartphone? That’s missing the point. If I want to know what someone’s heart really sounds like I have a bunch of request forms labelled “Echocardiogram”.
Even the CQC have stuck their oar in, complaining that our beloved tubes teem with billions of pathogens. Not satisfied with confiscating our long sleeves, college ties and wristwatches, now they want our Littmans too.
Enough is enough. They’ll get my trusty stethoscope when they prise my cold dead hand off of it and not a moment sooner.