OB-GYN With Dog-Nose

Veeraswamy Krishnaraj


Dog nose sensitive to faint smells we cannot perceive.

 August 2016

The OB-GYN is a fictional character.

I am an obstetrician in a multispecialty clinic run by the hospital. Yes, the hospital pays me a handsome salary. I have three OB-GYN associates with me. Four of us take calls and attend emergencies every fourth day and every fourth weekend. I consider I am lucky. I know of OB-GYNs on call every day, every night, every weekend… When you don’t show up to attend the patient in the hospital ER, you invariably lose that patient to the newly minted OB-GYN, who camps outside the hospital and just hangs around in the hospital, when he or she is not in the office.

Though the patients register with the individual doctor as private patients, it is invariable they get seen by the other doctors on off-days.  Three of us are available in the clinic during day time for four weekdays. In an emergency, one of us take a walk to the ER to attend the emergency case knowing well that the patients in the clinic waiting room will be attended to by the other two. We take turns for delivery and Gyn surgery. We try to attend to our own patients.

We serve indigent patients in a high crime neighborhood.  Safety is a concern. We have retired or off-duty police officers serving as security guards. They don’t carry guns in the premises. They have good idea of who is who entering the premises. A retired war dog serves as a sniffer for contrabands like guns, narcotics… We developed a special relationship with the dog. It always gives each of us a welcome bark, when we enter the building. We reward the dog special treats.

When the dog barks, we hear it in the examination room.  He was a sergeant in the military. It raises the paw and we always salute the dog at the entrance.

I saw a patient one day the wife of a colleague of mine, a gastroenterologist.  As she walked into the examination room, I congratulated her on her first pregnancy.

Patient: What do you mean, I am pregnant?

Me: Believe me dear, you are.

Patient: I had been to the internist. My husband does not think I am pregnant.

Me: Yes, you are. You can wait until the baby bump shows up or we can diagnose your pregnancy with a test.

Patient: You did not even examine me. How do you know? Are you clairvoyant?

I know her personally and professionally. A test was done and it was positive for pregnancy.

Me: Dear, the test shows you are pregnant.

I gave her a quick examination and sent her on her way to the nurse practitioner to receive prenatal instructions…

How did I know she was pregnant?

We trained the war dog to sniff the patient from a safe distance, so that the patient is not offended. The dog lies beside the security guard. We trained the dog to raise the tail and keep it upright for a few seconds, when it smells pregnancy.  Other elaborate dog gestures were taught to the dog to diagnose cancer in various parts of the body.

Once a urologist diagnosed bladder cancer with the help of the dog.  Many other cancers were diagnosed by the war dog. With such diagnostic skills, he was part of the team. We appended M.D. at the end of his name.

I was hit with an epiphany. Why not inject myself with the stem cells from the nose of the dog? That should do it. My olfactory sense will be up to snuff and rival the dog.

Now a switch to the third person. I become he.

 In a reckless experimental abandon, the doctor injected himself with the stem cells from the nose of the dog. Over several months, the doctor trained himself by the nose to diagnose pregnancy, uterine cancer, ovarian cancer… by secretly and discreetly smelling the patients at a professional distance. He knows one condition from the other distinctly. He never told his secret to anyone else.

One day a woman walked in with the presenting complaint of sterility.  He consulted with his gnostic nose on the diagnosis. The beak spoke to him. Several OB-GYNs were at their wit’s end to make a diagnosis. He never looked down his nose on other doctors. There was no whiff of female hormones emanating from her. She had widely separated eyes with otherwise normal female habitus. He put his nose to the grindstone and came up with the diagnosis: 46,XX/47,XXX mosaic. The lab test clinched the diagnosis. Genetic counselling was offered to the young patient. That patient brought and personally offered her thanks to the doctor with a nosegay.

He does not jump the gun and tell the patient the diagnosis, as she steps into his office. Yes, he follows the omniscient nose first. Sudden revelation of diagnosis upsets patients. Patients expect rightly a look of professionalism, delebration and concern from the doctor.  He takes history, examines the patient and offers diagnosis and treatment like any OB-GYN. It is Rhinodiagnosis. He goes through the motions, expected of the OB-GYN. He never failed once to make the diagnosis correctly. His fame grew and no one knew his rhino-skills. No one knew it was the nose talking, the mouth just moving perfunctorily. He was declared the OB-GYN of the year and the decade. He did not turn up his nose at other doctors. The fame did not go to his head. And yet other doctors called him Nozzle Dazzle.

The nose was his asset. He did not insure his nose because he feared people, particularly the jealous colleagues will find out his secret. He kept his collunarium (fancy name for nose drops) in his pocket to keep his olfactory sense in shipshape.

Some wags among the doctors called him the Gold Finger. No one knew of his golden nose. His fame grew. Patients poured into his office in torrents. What is he going to do? How was he going to handle the extra load?

The hospital employed additional Physician Assistants to service (history and physical) the patients before the doctor himself examines them. The PA gives the history and relevant physical exam findings to the doctor. The doctor does a quick review and relevant exam and offers the diagnosis and treatment in a few minutes. The wags appended the name 'Minuteman Doctor.' No one knew he smelt the case at the doorstep.

The hospital expanded the OB-GYN services, built a separate wing for maternity and gynecological services and named it after the doctor.  The wags were at it again. Now they call the doctor Gold Digger.

ENT doctors had a clue as to his ability and named him Concha-Wonka.  Concha = turbinate bone, esp. in the nose. Wonk  = a person who studies a subject or issue in an excessively assiduous and thorough manner.

Science Section NYT. October 11, 2016

We have about six million olfactory receptors; dogs have 300 million. Humans sniff once per second-and-a-half; dogs, five to 10 times a second.
Dogs and many other animals have a second smell system called the vomeronasal organ (VNO) above the roof of their mouth and below the septum dividing the sides of the nose.
“There’s no ‘noxious scent’ receptor in the dog’s brain,” she added. “But they do seem particularly interested in rolling in smells that we find somewhere between off-putting and disgusting.”
Yes. Many of a dog’s identifying smells are in the anal glands. ...“dogs wag, basically dispensing their personal odors from their rumps.”
Researchers have found that dogs have 300 million olfactory receptors, compared with about six million for humans.
“They’re taught that it’s impolite to smell a rump because it’s impolite for people to do it. We put those kind of mores on our dogs.”
“Take a cue from the dog,” she said. “Put your nose in things and take dedicated sniffs. Name the smells. Every expert smeller I met practiced it thousands of times. Pick up a bottle of perfume. Crush leaves between your fingers.