Tuesday, December 22, 2015


MY FIRST stethoscope was a Caribbean blue Littmann Classic II (3M), bought in 2009 at a sale of a local sorority. That special day in 2009 was a milestone: me, a would-be doctor, donning my first stethoscope on my way to the Neurology Ward, where I was to have my first preceptorial with Dr. Leonor Cabral-Lim. With bated breaths, my classmates and I waited for her to arrive; save for what we had read in DeMyer, we hadn’t had any idea what to expect. We were to demonstrate what we learned on the art and science of the physical examination. Yet we carried our steths—as we liked to call them—proudly, like a thick necklace. I remember trying mine out with my seatmates, the Catangui twins. I asked them to breathe deeply—ah, bronchovesicular sounds, no crackles, no wheezing. They, in turn, listened to my heart beat, alternating between a bell and a diaphragm to make sense of the S1 and S2.

Those days were special moments for me—the beginnings of what would be the bread and butter of my vocation as a physician. I have used my Littmann II since then: when I forayed into the clinical wards as a clerk, when I became an intern, when I entered pre-residency, and for much of my first year residency in Internal Medicine. I haven’t paid much attention to it—familiarity does breed contempt—because it has been a part of my every day get-up, like my eyeglasses, that I almost never went out without it near my person.

Towards the second week of December, I discovered that I could no longer hear breath sounds through my steth. I was at the Pay Ward, receiving a referral for an Infectious Disease consultant, and I panicked because I was certain, so certain, that the breath sounds were absent. Was this pneumothorax? But the patient looked comfortable, as if nothing was wrong. There I saw it: a break on my stethoscope’s stem; the sounds leaked through it. I figured I could make do with it if I sealed it with a tape, but the seal wouldn’t last long. It was time to get a new one.

After my 24-hour ER shift, I headed to a local store, following my roommate’s advice. I took the train, looked for the store he had told me to find, and thought of Everly Ramos’s advice to get a Littmann Classic III (3M), olive green, with a smoke finish. She has impeccable taste. I found it—a rare piece—and bought it without fanfare. I’m so thankful for God for giving me money to buy it. Tomorrow I can go to the ER, more confident of my chest physical examination, so much so that now I can lovingly convince my friend Racquel Bruno when I tell her that the patient no longer has pneumonia.

OVER DINNER, my friends Kenneth Ong and JC Malabad told me why my first stethoscope was damaged. "It must have been in contact with your body oil, Kuya," they said. Apparently, the tubing's exposure to oil makes it stiff—precisely what happened to my steth. I quote from the Littmann website:
If you like to wear your stethoscope around your neck, wear it over a collar to keep the tubing flexible.

A few tips, reworded by yours truly, to care for one's stethoscope:

  • Don't wear it during a parade; sunlight will damage it.
  • Use soapy water or alcohol to clean it. 
  • Don't store it inside the fridge or throw it in snow.



Blogger Unknown said...

My uncle told me if I became a doctor my stethoscope would be on him. Hehe. Apparently, he wanted to be one but financial constraints caused him to go to cadet training instead.

Tue Dec 22, 10:43:00 PM GMT+8  

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