Meandering Mindscape

One week's worth: Mexican Bean Casserole

2011-11-13T22:40:00.001-05:00

Is there anything worse than the Sunday-evening Funk? Weekend's almost over and not half the items on the to-do list are crossed off. I'm trying a new solution to combat Sunday gloom-and-doom. Cooking. Ever since my lunch money from the residency program stopped (i.e. beginning of this academic year), I've had to figure out lunch options so I can avoid yucky, unhealthy and expensive cafeteria mush passed off as food. So, Sunday evening has turned into the night to cook a week's worth of lunches and dinners.

The problem though, is that I'll hit upon an amazing recipe and it'll taste wonderful when I cook it for myself, but in a month or so a) I'd have forgotten all about the recipe and/or b) it'll just not taste as good as the first time (the later will unfailingly happen if I've raved about it to S and try to recreate it for him). Also, being trained in the mom-and-grandma 'a handful of this and a dash of that' school of cooking, recipes never do turn out the same twice in a row. So, here's an attempt to keep an ongoing recipe journal so that 3 months from now, when I fall into a rut of eating moong dal and cereal on alternate days, or when I just can't remember the key ingredient I added to make that curry hit the spot, I have something to refer to (ahem, as if the internet is short on food blogs and cooking websites...).

The great thing about having to cook only for myself is that I have awesome flexibility in playing with weird ingredients, fine tuning fat content (less!) and salt content (unfortunately, more). This week's meal, however has nothing unusual in it. It does have something in it that I've bought for the first time: a can of chipotle peppers in Adobo sauce. Smoky, spicy, vinegery and delicious! The whole Mexican meal idea was an excuse to use up most of this stuff. The reason I bought the chipotle pepper in the first place was to make homemade 'chipotle-mayo', a great dipping sauce to put into and on everything. But since I couldn't use up the whole can with just the mayo, the rest of this week's cooking was born. Recipe below.

Mexican Bean Casserole

Ingredients:

- 1 pack of yellow corn tortilla

- 1 can of enchilada sauce

- 1 red bell pepper

- 1 green bell pepper

- 1 red onion

- 2 tomatoes

- 2 cloves of garlic

- 1 cup chopped broccoli (used frozen)

- 1 can of black beans (drained the frothy gas-inducing liquid it comes in)

- 3 chipotle peppers (from a can of chipotle peppers in adobo sauce), chopped fine

- ~ 1 Tbsp olive oil

- Some type of Mexican seasoning (used Chipotle flavored Taco seasoning)

- Cheese (Mexican four-cheese blend)

- 1 small can of sliced black olives

Method:

- Dice onion, red and green bell peppers, tomatoes into large (roughly 1") cubes. Mince the garlic cloves.

- Preheat the oven to 375 C. Grease a 13" X 9" baking tray with a drop or two of olive oil.

- Heat the olive oil a large pan. Add onions and garlic and cook till onions are translucent but still firm. Then add the frozen broccoli and cook for a minute. Next add the red and green bell peppers. Cook for about 2- 3 minutes. Add the tomatoes. Cook for another 3-4 minutes. We want the bell peppers to have a crunch, so don't overcook them.

- Add the chopped chipotle peppers. Add the drained can of black beans.

- Add Mexican seasoning, and after tasting, add salt as needed (the seasoning and beans both have some salt. Also we will be using cheese and enchilada sauce eventually, both containing salt)

- Turn up the cooking flame so the some of the liquid (which the tomatoes release) evaporates. We don't want too much runny liquid, a little sauce is fine.

- Coat the bottom of the greased 13" X 9" pan with about 3 Tbsp of enchilada sauce. Layer it with corn tortillas, in one single flat layer. We'll need to tear some of the tortillas into halves, quarters and random shapes so that the pan is completely covered with only one layer. (highly doubt one needs to be careful with this; I just wanted to avoid overlapping thick layers).

- Layer about half the bean-vegetable mixture on this. Put a thin (or thick) layer of cheese. Put a second layer of tortillas. Spoon about 3-4 Tbsp of enchilada sauce on the tortillas. Layer the remaining bean-veggie mix. Layer more cheese. Put last and final layer of tortillas. Coat it with enchilada sauce, and more cheese. Spread the sliced black olives.

- Bake in the oven for about 15 minutes, till the cheese layer has melted

- Done (if you spread it over a week and eat, one feels less guilty about the cheese. Hey, it's better than the greasy slice of cafeteria pizza, right?)

Chipotle Mayo 'Recipe' (if we can call it that). Open can of chipotle-mayo-in-adobo-sauce. Chop up about 3-4 peppers. Lick you fingers and then please wash your hands. Put the peppers into a container that you're going to use to store it in. Dump in some mayo. Add a teaspoon of Adobo sauce from the can. Mix. Titrate by preferred spice level and degree of orangeness you are comfortable eating. Enjoy! Save the rest for a cold week's worth of spicy evening-snack goodness.

Okay then, until next week's recipe. (Or a mid-week one if I eat this up too fast!)

Mexican Bean Casserole

I'm in AWE

2009-05-07T11:25:00.001-04:00

I was listening to a really cool podcast this morning. (Let me recommend at this point the “how stuff works” podcast. It makes for hours of informative and very entertaining listening). I’ve had quite a few embarrassing “laugh-out-loud” moments on the subway and streets listening to this. Anyway, getting back to the podcast. It was a podcast about face transplants. And that’s when it happened. A sudden “kicked-in-the-stomach” feeling. A racing of the heart. A restless energy filling me. And I knew I was in AWE. Completely and irrevocably, head-over-heels. In awe with what humans have accomplished and continue to accomplish.

It started with hearing about the first kidney transplant in the 1950s. How one man or maybe a group of men thought of and executed something so radical. What a combination of imagination, intelligence, creativity and skill that requires. And how generations of researchers, scientists and surgeons have run with that idea and brought us to a point when a person’s FACE can be replaced. What skill there is in the hands of a surgeon, who can transplant a tiny heart in a child, can separate twins joined together at the skull, who can STITCH together a face for someone, can dig into a brain and remove a tumor, can remove a gall bladder through 2cm holes in the belly! Let the surgeons have their egos… they deserve that and more. If I could do what they do as a routine, each day I would have good cause for an inflated ego!

The list of man’s stupendous achievements is long. Computers, pharmacology, engineering, robots, space travel, music. Genetic, chemotherapy, surgery. Ballet, rock, piano. Literature and art. Architecture, glass making. We take it all for granted. We look for reasons to not be awed. We look for ways to give less credit than due, finding something wrong in the person who achieved something, a way to “humanize” them. Maybe we do it because our ordinary lives would seem even drabber if we compared it to the lives of people who achieve something. We need to pull them down because otherwise, how do we live with our own mediocrity? We spend much too much time being cynical when truly there is magic around us. And sometimes we should just appreciate and give credit to that talent, be awed and inspired and try to make something of our own lives so that it leaves a mark.

Coming back to this big crush that I have on mankind this morning… I realize that nothing, absolutely nothing is as attractive as an intelligent mind. I say this because the general perception in the media and a whole bunch of subliminal messages sent out to us give credit to looks and bodies. Early in life, through school and college, kids suffer insecurities based on their looks. Someone ought to tell them, that through life, it is not looks but only brains and hard work that will only ever mean anything. So here’s to being in AWE. Here’s to trying to make the best of our opportunities and to making a difference!

Mother

2009-02-18T20:52:00.000-05:00

I got back home from work today and, to quote a phrase that could stand to be abused more often, had a 'renewed respect for my mother'. I wonder how she came home each day after 8 long hours of going half-blind in front of a computer screen, traveling by train from Churchgate to Santacruz, shopping for groceries, cooking dinner in a hot kitchen, checking on my home-work, hearing every single detail of my day, watching the news and having a rousing debate with my dad about the state of the nation's politics, getting stuff ready for the next day... only to wake up the next morning and go through the same routine again. I've only had a 9 hour work day and my mind, right now, is swirling with so many thoughts that I can't seem seem to put a finger on a single one. It amazes me to think of all the things that she planned and accomplished in the same 24-hour day. Not just my mom, but several mothers of that generation are absolute “super-women”. Most of them had to straddle the demands of a generation of mother-in-laws and mothers who expected them to be perfect “bahu-betis” while proving that they are as competent as any other at work. No excuses worked on either front. I cannot imagine my mom coming home from work and saying, “I'm too tired today, maybe I'll not cook, but blog.” I think many, in our generation of middle-class educated women, have it easy. We seldom have to make any compromises, we are not just free to but EXPECTED to follow our dreams and reach our potential. We usually have the solid security of our family behind us. We are so unaccustomed to hearing a “no”. Does that make us unhappier when life sometimes declines us? Does the fact that we have only ourselves to blame if we fail make it that much harder to face ourselves when we do? Are we spoilt children who don't know how to cope when things don't go our way? I don't know the answer to these questions but I sure hope that we don't buckle. If we do, I think we may go back to our mothers, queens at “dealing with it”, for solace and advice.

How's it goin'

2008-12-19T14:19:00.001-05:00

Eight months into my first trip to the United States and I still pinch myself sometimes. Am I really awaiting a snow storm? Do I really own a 60% down-filled jacket and boots with tires for soles? Do I live in a place so quiet that I can hear my own stomach ALL THE TIME? Do I step out on a day when the temperature is 2 degree centigrade and think it is such a nice day? Some things are easy to adjust too. But here are a few quirky details of the Amreeki way of life that I still need to get used too.

I think the thing that fazes me most is the abundance of choice available. The availability of choice only brings home the fact that now, there are so many things you CAN'T have. I really was much better off not knowing about the Chanel perfumes and Louis Vuitton bags that I can't buy. But, before this post becomes a rehashed statement on the cons of capitalism, the power of advertisement, media and materialism, I'll move on to other troubles I have settling in. If abundance of choices was my only problem, I'd be able to deal with it. But, combine too many choices and too little time to make those choices, and there's a neat trick the Gods played on us. Ha, ha. Now you know there may have been something better, but you didn't have the time to look. And, if you looked, you couldn't compare. And if you looked and compared, you know you can't afford it. So you're still miserable. Here's an example that typifies the problem.

How can it possibly be so hard to order yourself a cup of coffee? I'm better at this now, but I still don't always get what I want. So, I'm waiting in the queue at the hospital's coffee shop. First, crane neck to look at menu. Then, read a list of at least ten coffee flavors (with names like Jamaican me crazy) only to realize that only the 'flavor of the day' is available. Okay, now just to make things interesting, one of the coffee flavors is also available everyday, and this is scribbled into the corner of the menu board in white chalk. Flavor decided, you're just about looking at the mouthwatering display of muffins and cookies and for the life of you, you can't see them listed on the menu. So you don't know what they cost and worry about ordering them and getting hit by a hefty breakfast bill. You then read on the menu board that bagels are available, but you can't see any displayed and want to know what kinds they've got. Do they have flavored cream cheese? What does it cost? Do they toast the bagels? Questions, questions... And even as you stand there undecided, you get the sense of being on an escalator or conveyor belt; and you just have to keep up. Your hands are clammy, your heart beats faster, now it's your turn and you have no clue what to order. “Umm. May I have one coffee please?” you timidly whisper. “Small, medium or large? Cream or milk? Sugar or splenda? How many?”, the brisk woman behind the counter shoots. Okay... Small. Maybe with milk. I wonder will two sugars suffice? You just babble the first things that come to your mind, knowing well that you might be ruining you cup. She takes off to make your coffee faster than you can say Starbucks. Hesitantly, you call behind her, “And could you make it caramel flavored?” The dirty look you get could turn that caramel bitter! And what about the food? What? Ask all those questions about flavored cream cheese and toasted bagels while the person behind you fries you to crisp with their angry gaze? No, thank you. Don't you know I'm on a new diet? It's called the “too afraid to ask and order diet”. And it works like a charm. You finally juggle the coffee cup, your extra sugars, a stirrer and tissues with nervously shaking hands and barely make it outside without sloshing it. By the time you're done ordering and getting your coffee, you NEED that coffee!

The other thing that bothers me is the constant sense of movement and urgency around. Everyone knows where they want to go and is in an almighty hurry to get there. Rapidly moving coffee shop lines. Revolving doors that you had better time yourselves properly to get into. Escalators. Knowing the correct freeway exits. No wonder people here are so “prepared” for things. Decorating for Christmas begins on Thanksgiving. You go at least half an hour early for the movie so you can get good seats. You plan to get to the banks of the Charles early in the morning to catch the July 4^th fireworks which begin at 9:00pm! You start your retirement fund in your first year on the job and your child's college fund just about the time he is born. You feel like like you're on a treadmill all the time. In fact, things are so much in fast-forward mode that you don't have time to even say a proper hello. Which brings up my next pet peeve: the American greeting.

You are walking down the corridor and you see someone walking from the other end who you know “by face”. Now, of course you're going to wish them. So, as you near and are just about to cross each other, he/she says “How's it goin'” Here, I am prepared to say my standard Indian greeting of good morning or good afternoon and I have to respond to the “How's it goin'”. Note the lack of a question mark after that statement. It isn't really a question. No one wants to know how anything is going. To borrow from the Foster's advertisement, “How's it goin'” is American for hello. So, I'm trying to figure out what to say to this question/statement. After all when you say “How's it goin'” and I say “Good morning”, it just doesn't ring right. Do I say “It's going great” (too exuberant)? “It's going well” (sounds like incorrect English)? “It's going okay.” (sounds too cool)? “It's going badly and I want to take the next flight back home” (too much information)? Not only do I have to respond to the statement but courtesy demands that I also thank you for asking and ask you the same question. And with my unblemished Indian accent “How's it goin'” sounds awful. All this has to accomplished in the time it takes for us to pass each other in the corridor. No wonder it comes out sounding “Huh.. itsfineyou?”. And no, the other person does not respond to your question. Maybe because he's out of earshot by then. Or maybe this is the daily-use cousin of the more formal “How do you do?”. I almost think that the other American greeting of the eyebrow raise to acknowledge a person is much better than this 5 second nerve-wracking encounter. The eyebrow raise and half smile is so much easier to respond to. Just smile back. Now questions, answers and accents to deal with.

Of course there is never any trouble in saying a goodbye to anyone. There's a nice general all inclusive way of doing it. No need to look around you, of being aware of the world around, or stressing about saying the right thing. Just say “have a good one.” A good morning or good afternoon or good day, your choice. So, if you lasted this far in reading this post, I hope it's goin' well and that you had a good one.

Siachen, Mumbai and the country in between

2007-09-28T05:02:00.001-04:00

Recently, I took a trip to Leh in Ladakh. It wasn’t a trek or a vacation, but, in fact, a course in mountain medicine. Ladakh is beautiful. Not the blooming, rosy, fresh, young beauty one finds in the garden-strewn Srinagar. Not the flashy, breathless, twinkling gaiety of Mumbai’s nightlife, or the too-perfect, postcard quality prettiness of Manali. Not the lush and craggy imperfection of a Sahyadri hill. Leh is beautiful in a stark, lonely, wistful sort of way. It is a beauty that tempts you to discover the solemn secrets of a time past, which it holds close to its bosom… a beauty that haunts you. It is the beauty which one associates with graceful aging, with scars - with dust and history.

Well, the whole trip was a wonderful experience from start to end. Since we were attending the course conducted by the Indian army, we were living in the army transit camp at Leh. With me in the course were seven more civilians and sixteen participants from the armed and para-military forces. There was just one other Bombayite. These people with us had all seen a lot more of the world than me… many had taken part in expeditions, most had defended the country's borders at some point of time, some had dealt with Bangladeshi militants, some had done time on Siachen and one had even eaten leeches in early morning patrols in Sikkim! But most of these very interesting people had a little awe for the two Bombay kids. ‘Awe’ sounds very pompous and I know that we don’t deserve it. Just because Mumbai happens to have the film industry, a plethora of nightclubs, the famed nightlife and busy trains and a pulsating never-asleep work culture, I think there is a feeling that Mumbaiites must be confident, bold and fun. I’m sure nobody consciously thinks this of us. It is an assumption that we must be slightly street-smart, confident, and brazen and bindaas. Well, this generalization is (like most) largely incorrect.

I’m not a very patriotic person. I don’t think that drunken renditions of the national anthem when we win the cricket world-cup or watching the tax-free “Chak De” and suddenly developing a love for the national sport are signs of patriotism. The concept of both watan and war are alien to me. In fact, the very usage of the word watan irritates the Tamilian in me… it is as though the North is the sole representative of India, and let’s just use the Bangalore example when it’s convenient to say that we are “world-leaders” in software technology. I also have little patience with North-Indians who lump everyone South of the Vindhiyas as “Madrasis”. (Notice the irony in that previous statement.) In fact, the entire “North-East Indian Idol” fiasco is a scary reminder of widespread ignorance, double-standards and inability to see the country as one. It is amusing how newspapers suddenly report the inability of politicians in the North-Eastern parts of the country to provide the basic civic amenities. All of a sudden, they focus interest on how politicians are using a singing contest to resurrect pride in the more neglected regions of the nation. Somehow, the timing of such reports itself adds to the irony.

At most times, I really cannot grasp the concept of “nation”. But, in Leh, we went to have a look at the “Hall of Fame” museum. The museum has, among its many informative displays related to all the wars of independent India, a little wall dedicated to Siachen. It tells us why we need to keep fighting off an enemy army in the bitterly cold, inhuman terrain. They are after our land, nibbling into it; piece by tiny piece. It is then, that it strikes one that the distance between Siachen and Mumbai isn’t that far after all. The freedom that we don’t even realize we have, that we take so much for granted is definitely bought at a price. And suddenly I feel selfish and scared. Selfish because I, who cannot understand what the word “nation” really means, desperately want to belong to a country that gives me my freedom. Scared, because, I suddenly realize how much I have and how much I might lose. Out of this fear and self-interest is born the notion of “freedom and nation”. It is pathetic. I think we should all be made to serve in the army for a while so that it gets through to our thick heads what it means to be the member of a free nation and how grateful we ought to feel. And I wonder what the soldier standing at his post in Siachen, reading his copy of yesterday’s newspaper today (it’s the earliest that the paper will reach there) thought about the boys in blue who received the “hero’s welcome” for winning the Cricket War.

Trials and Travels in Mumbai

2007-09-14T10:26:00.002-04:00

Mumbai has one of the best public transport systems in India. It also has one the most overused public transport systems in the country. Those of us who use these systems everyday are either desperate or masochistic or trying to cleanse off our bad karma. On the plus side, we always have stories to regale an audience of saucer-eyed listeners about the trials and travails of the experience.

Much has been said and written about travel in Mumbai’s local trains. One particularly curious experience must be added. This particular ‘event’ occurs only at large terminal stations like Borivali or Churchgate from where trains start. To get into the train at these stations, it is not enough that you reach the platform before the train leaves, but in fact, before it even arrives on the platform. Once you reach at least two whole minutes before the train, you must plot your exact co-ordinates on the platform from where you are closest to the compartment door. It is important to know whether the train is 9 or 12 coaches long, whether you will travel by first class or second and how far ahead on the platform the train usually stops. This last detail can make the difference of only one compartment door but it is enough to throw one’s plans for a seat completely awry. If you are the kind that excelled at long jump in school or the sort who has done fielding for the South African cricket team, then you should stand in the first row where you can execute a perfectly timed flying leap into the not-yet-slow train. Of course, this must be accounted for when you plotted your waiting position on the platform. For athletically challenged ones like me, I have found that it is a better strategy to stand in the second row. You won’t earn the wrath of people behind you if you didn’t leap in, and you can move towards the compartment door quicker than the women in the first row if you didn’t stand exactly in front of it.

Some agile and intelligent men of the species stand where the ladies compartment is supposed to arrive. To do this, they beg for a little elbow space from the rightful owners of that spot. As the train approaches, they begin to wave wildly at the people who are leaning out of the train. Even as you wonder how they seem to know all these people you realize that this is a signal for them to get out of the way. In most places in the world, the rule is to allow passengers to alight first. Not so here. Here, you stay well out of the way of the jumpers lest you find a human projectile landing on you. But, since the Mumbai sign language is understood by all those who regularly commute by trains, the passengers dutifully move out.

Every time I go through this experience, the scene from Braveheart comes to mind. The women brace themselves for the onslaught. The college girls reposition their bags; the women tie their dupattas in front of themselves, the first row of people inches back in anticipation, just as the rows at the back move forward in eagerness. We can all hear William Wallace, the great Scottish hero, commanding his troops to “Hold, hold, hold…”, and, when the train does arrive, to throw caution to the winds and “CHARGE!”

And after all this planning and strategizing you finally receive the fruits of your labour… the coveted window seat in the ‘right’ direction*. Of course, if you had some poor luck and were stranded behind a Mumbai newbie (a.k.a. moron) who doesn’t know to work the system, then all you get is the meagre fourth seat.

Bus travel is not too easy either. First, there is the endless wait for the once-an-hour bus. Then you wade through the mass of bodies (in the predictably overflowing bus) to evict the young men sitting on the seats reserved for ladies or the one marked for pregnant women. Of course, it is hard to ignore the (Santoor soap) looks you get from people for sitting on the pregnant women seat! If you’re not lucky, you are standing on tip-toes and watching 2 people (one of whom is the driver) in the huge Innova next to this bus adding to the inch-by-creeping-inch traffic jam, which was created in the first place by the kind of people who need an entire multi-utility 8-seater vehicle to haul their (only) arse. All the while you stand there and plot all manner of evil on the owner of the vehicle, or think of ways to improve Mumbai’s roads/traffic/car pooling systems, or think of how you need to blog about this, or engage in other fruitful thinking. Who says Mumbaikars don’t have leisure to “stand and stare”? And I have little patience with people who think that we don’t have any patience.

I am convinced that all travel in Mumbai is a means of strengthening one’s character. If you can head out each morning into monstrous traffic jams, bad roads infested with selfish road hogs, crushing crowds in trains and buses and emerge with sweat-soaked shirts but smiling faces to face the day (and the journey back home at the end of it) then you are truly an evolved being. Give yourselves a pat on your back Mumbai!

*Right direction: In the winter, this is opposite the direction the train moves, while in the summers, it would be with the direction of the train. In the monsoon, usually people try to avoid the window seats!

Our take on Rural Medical Officership

2006-09-15T09:41:00.000-04:00

The Times of India of September 14, 2006 carried a story about rural MO-ship after MBBS, in which several parts of the situation were neglected/wrongly represented. Sumedh and I wrote this to set the record straight.

The Government Resolution (GR) issued by the state Government in the month of July this year dictates that medical graduates of Government and Municipal colleges must serve for a year (possibly two) in a rural area, as per the bond signed by them while joining the course. The timing of such a GR follows close on the heels of the chikungunya epidemic in interior Maharashtra and, more importantly, the intense media coverage of the same. Suddenly, questions are being asked as to why the healthcare machinery isn’t functioning well enough in the villages. So, arbitrarily, it was decided to do a patch up job (akin to the pre-monsoon road strengthening frenzy, which we know too well, doesn’t last long). The Government finds the softest targets possible – the fresh, just out of college, medical graduate.

Now, to clear a little history. The Government of Maharashtra and the Municipal Corporation of Mumbai take a bond from the medical students at the time of admission that the students will serve the respective bodies for a period of two years if required; else they are liable to pay Rs. 1 lakh. Under the bond, medical graduates were posted in rural health centres. But this was arbitrarily scrapped in 2001. Has anyone examined why this happened? Were any interviews conducted for the same since 2001? And, why not? Why was this situation allowed to develop in the first place? Will these postings also arbitrarily be stopped sometime in the future? And, yes, who will man the rural health centres then?

The underlying problem is the unwillingness of successive Governments to tackle the root of the matter. A doctor is not synonymous with health. Reaching a doctor to the village doesn’t mean that health has reached the village. To cite the most pertinent example, chikungunya is a disease caused by a virus carried by mosquitoes. Is it the doctor’s responsibility to spray pesticide? Is it the doctor’s responsibility to give mosquito-nets? Is it the doctor’s responsibility to eliminate stagnant water and other breeding sites? As a doctor, the only management at a primary level would be to dole out anti-fever and painkiller drugs. This is the Government’s ‘healthcare plan’ to curb the epidemic. Where the focus and thrust should be prevention, the employed strategy seems to be ‘treatment’, which, as you read above, isn’t even curing the disease!

Okay, so the Government didn’t do its job in preventing this epidemic well enough; but that’s not where their shortcomings end. Nothing has ever been done to attract doctors to the rural set-up! If a young doctor decides to work as an MO in a village, he faces several hurdles along the way. He cannot send his kids to a good school, lives with the anxiety of being transferred and, of course, there’s the remuneration package. Are these too much to expect? That’s not all; there are more immediate concerns. Some of us will be posted in tribal/Naxal areas. Can the Government even assure us personal safety? The simple fact is that they can’t. A good system can sustain itself only if it is win-win for all concerned parties. Doctors are normal people with normal aspirations. It isn’t possible to live on ‘respect for being in a noble profession’ in these times. This is where public perception needs to change.

People must decide exactly how they view a doctor. On one-hand we can be tried under laws such as the Consumer Protection Act, which effectively makes us your baniya of Healthcare General Stores. On the other hand, altruism is expected of (even forced upon) us. So it’s only too easy for non-medicos to sit in the comforts of their homes in Mumbai and berate the ‘selfish young doctors’. It’s socially convenient to blame a variegated group that goes by the name of ‘the young generation’. We are seen as being too spoilt to give anything back to the nation and are a favourite target to flog. It doesn’t matter if anything is being done to really change the healthcare (or any other) facilities in rural areas, or not.

There exists another twist to this tale. The GR also prevents students of Government and Municipal hospitals from appearing for the post-graduate entrances if the year of service is not completed. Even if they pay the bond, they are expected to sit idle at home for a year and can only take the next CET. Students of private medical colleges have no such problems, they can take the entrance right after getting their degree. So how can the same entrance exam have different eligibility criteria for students of different institutions? Is it just a coincidence that several private medical colleges are owned by politicians? The text of the bond we signed includes no clause about eligibility for post-graduate entrance examinations. By making MOship a criterion for eligibility to take these exams, the Government is adopting a strategy better known to most as blackmail.

Whether or not the public may understand the finer nuances of this matter, we are fairly certain that there are numerous political vested interests behind this move. If there are motives to be questioned, they are solely those of the Government!

Prey!

2006-09-11T14:13:00.000-04:00

This afternoon I had my own little walk on the wild side. I walked into a scene straight from the African jungles, replete with the yellow glades of dry grass and the incessant drone of the dragon-fly. (Do dragon-flies drone? Or maybe bees drone… male bees: drone. :D)

So the jungle in question here is Thakur Complex. The scorching sun was truly baking the leaves on the few trees there and if you listen hard enough, the noise of traffic can be equated to the drone of insects. All is calm. The deer gather about the pond for their refreshing drink of the life-giving elixir… something to quell the oppressing heat. Well, if we can accomplish the slightly difficult task of equating the vegetable and fruit bhaiyas to the deer and the main Thakur market road to my placid pond, then the analogy will work. For the sake of variety, some elephants (tea-stalls) and buffaloes (pirated DVD sellers) also gathered at our pond. A couple of old Gujju aunties and some young track-pant wearing housewives are bargaining at the various shops. (Well, no analogy for that one). Everybody is going about their business peacefully.

Suddenly, in the distance a bird shrieks out. What’s that?! The animals stare at each other, stunned and scared. They hear the swish in the trees overhead as the faithful monkey rushes in to warn them…”He’s coming! He’s coming! The cheetah is here.” In our modern-day jungle this is actually the pitter-patter of a keen vendor’s feet as he comes to warn the others about the rapidly approaching BMC van. The van of destruction is here, mauling all it sees, anyone who lies in its vicinity.

Just as suddenly the stampede begins… deer and buffalo, horn and trunk… they all run. And as I was walking through the jungle, God help me, but the stampede is running straight towards me. The tea-stalls fold up; the DVDs disappear without a trace. Help! The elephant is running straight at me! Oh! It’s the vegetable cart being pushed at breakneck speed into the nearest building, out of sight. The banana seller runs with the tokri on his head, as fast as his legs will carry him. The ‘fineapple wala’ bundles his pineapples shabbily in a sack and runs, once again into the nearby building. No more bargaining for the coriander and nimbu seller as he takes the price the mean aunty pays and vanishes into a nearby nana-nani park.

And then I see him, the splendid cheetah with his coat a shiny golden, his dark, gleaming eyes alert to every movement, with the blood of an innocent deer dripping off his saber-toothed jaw. The van quietly snakes its way down the market. Three young boys are seated atop the van, their beady eyes darting from side to side undoubtedly spotting every laggard bhajiwala. Inside the van the real villain sits; two plump BMC employees. One of them has an expressionless face and the other is chewing pan and smiling a sadistic smile. In the back of the truck are tokris of Dudhi, carrots and tomatoes, rudely strewn about along with a few mangled carts. But the hunter isn’t satiated. The cheetah spots a deer trying to help his young one and leaps towards him with a single jump. The three boys slither down the van in a blink and swoop down on the bhajiwala’s cart, dragging it mercilessly towards the truck. With a rude jerk they hoist it into the van, not caring for the permanent damage they cause the thela. The cheetah goes for the tender neck of the fawn and it snaps as the teeth close in on it. The deer and the bhajiwala stand in mute shock as the hunter returns; he can eat no more.

Offering silent sympathy with the unshed tears in their eyes the creatures of the jungle slowly return to their pond and life goes on in the market.

PS: While I didn’t witness any thela being broken before my eyes, there was enough evidence of the destruction in the back of the BMC van. With the hafta they have to pay pandus , the wage war (pun unintended) with the aunties and the constant vigil against Municipality trucks, it is amazing how well these vendors cope and even manage to be cheerful on most days. Nonetheless, it's truly a jungle out there.

An Impulse to Help

2006-09-08T04:44:00.000-04:00

I’ve noticed this thing about myself. When I have a desire to reach out to someone for something that’ll make them feel better, I stop and consider it a hundred times before I act upon it. Why?

Be it a stranger on the street or a close friend, I have different excuses to stop myself from doing good.

I little while ago, a friend of mine really needed me to be there for her. And I knew a listening ear was needed. But all the while, I felt that another close person would be that listener. She couldn’t possibly need me, when she had that support. I’m not going to be good enough to help her… she might not really want to tell me about it… Low self-confidence is still a poor reason to not help someone. How often have we said, “But what could I possibly do to help?” The strangest thing about what I’ve written here is that any decent person ought to be asking, “How could you not help your friend?!” But I can think of umpteen examples when we thwart this very impulse. In each of those instances, if you view them in hindsight, you’ll repeatedly face the same question… how could I not help?

Imagine you see a beggar boy on the road. Your emotions are a unique mix of indifference, pity, anger, frustration. Some impulse in you wants to give him that one rupee, maybe the half packet of biscuits in you bag… but you stop… what will he do with the money? Use it to buy drugs, you think, not really too sure as to when you formulated that idea. We mustn’t be encouraging begging, you’ll think... A whole gamut of thoughts and emotions flood your brain and swamp out that tiny flickering impulse to just give that lean hand a biscuit and that wan face a smile. Even as I’m writing this, my mind is scoffing at me…A smile! What good can a smile do for a wretched existence?! Why, why have we become so cynical?

Another situation. You enter the train and hear screams and cries from the compartment. Someone has injured themselves… you could help her get to a nearby hospital or you assume someone else will do it. Someone is lying unconscious on the road… someone else will pick him up…police ka locha ho jayega. Same pattern. The tsunami of cynicism drowns out your poor little fishing boat of the mere thought to help even before it touched the waters.

The Mumbai blasts. Now here is a situation where everybody helped and everybody wanted to help. But that’s what the newspapers will say. No one covers the stories of the many, many people who sat at home, or sat at Café Coffee Day and asked “But what could I possibly do?” I was one who asked myself that, even I sat a stones throw from KEM hospital. What did I tell myself? Oh! the entire residents’ hostel is there, I’m not really needed. I need to find out how my family is… I’m safe here let me stay, it might be dangerous to venture out… Well all these maybe reasonable excuses. But that’s what they are; excuses. Someday very soon I’m going to ask myself, “How could you not have gone?”

Well, I can think of example after example of similar situations. There is a tiny spark which says to you, go and do something good. But even as you hear it, the ‘intellect’ takes over. Sometimes it is cynicism (Hah! Like that would really matter!). Sometimes it is low self-esteem (I can’t possibly be the one who’ll make the difference). Sometimes it is indifference and sometimes it is just our old friend, ego (they don’t really need my help, it’ll be turned down). Very often these things happen in our heads over split seconds. Only much later, if we happen to think over it, the voice inside will say, how could you not help. But by then, the signal is already green. The joy that can be experienced by doing a good turn is very sweet but, in spite of that, of the fifteen do-good impulses we’ll have, we’ll act on one! It’s almost surprising how we allow ourselves to function with such frustration of not having done right, especially since acting on the impulse would not only have been ‘right’, it would also have felt good! How do we so often and consistently stop ourselves and others from feeling good? It boggles the mind.

I’m making a mistake by writing this piece using the pronoun ‘we’. It is wrong to assume that all people are this way. My apologies to them. And if one such is reading this then, you must know that you are quite exceptional and I wish I was like you.

What is the big deal?

2006-06-21T10:18:00.000-04:00

During the times when Football World Cups or Indo-Pak cricket matches are played, a spirit of universal hullabaloo is palpable all around. It seems to mingle in the air we breathe and fills us with excitement about the event, however poor our knowledge of the sport is. We are simply excited because something so ‘big’ is happening around us (cable TV now having shrunk the world), and all of us want to be a part of the world event, no matter if the game does nothing for us.

Football and I haven’t been introduced nicely. My only experience of watching the game was to look out of my balcony on Sunday evenings and watch all the building boys and uncles play a loud, boisterous game. Edwin uncle as the stern, no-nonsense referee bringing control over a bunch of eccentric Bengali boys (and uncles) was as entertaining as any soap on TV. In the rains, the whole lot of them would play in the slippery ground and fall and yell and fracture bones and have a blast doing it. Those were the times I wished I was a boy, so I could join them and get splattered by muck. But, beyond ‘colony’ football, I knew almost nothing.

England and Brazil are the only teams where I know the names of more than one player and the Shevchenkos and Ruud van Nistelrooys are just a bunch of funky names which seem to be studded with consonants and are fun to say out aloud! In fact, blame my geography from school but what and where the hell is ‘Ivory Coast’? Of rules I know little, so technique would be a far, laughing cry. But still, caught up in the aforementioned football fervour I too switched on my TV to catch the game between England and, I guess, one of those blink-and-you’ll-miss-it-in-the-atlas islands from the Caribbean archipelago. Okay, so I sat through the one and half hours. Two or three goals were scored. Great, joy be with the world. ‘So what?’ I asked myself. I didn’t think sitting through the ninety minutes was compensated by those goals. I was amazed as to how a reasonably slow-paced game like this (compared to, say, basketball or hockey) could possibly be the most watched sport in the world. Tennis has constant rallies and points, one-day cricket is definitely faster, and even snooker is fun to watch. While it is blasphemous to say this in these times, I didn’t see where the excitement came in football.

Then I saw the Argentina versus Serbia-Montenegro match that Argentina won 6-0. What can I say, except that now, I’m a believer. I didn’t even see all of it, just the last half-hour where 3 of the 6 goals were scored. I don’t have the technical words to describe what I saw, but I was, for the first time touched by the excitement of the game. The beauty and precision of the 24 passes that lead to a record-making goal was breathtaking (that was the second goal of the match which I saw in innumerable replays, none of which got boring). If anybody must be initiated to the game, that is the match. Of course it was one-sided but that one side played the game like an orchestra plays the symphony (Gosh, that almost sounds like Siddhu!) .

Since that day, I have definitely been following the games with a lot more zeal. I’m far from being a typical football ‘fan’ and I still don’t understand rules and no, I do not know where Serbia and Montenegro lie. But, I’ve stopped asking what the whole deal is. Time to wrap up this post and catch the 7:30 pm match, whoever is playing it.

The joy of ABG

2006-06-21T07:55:00.000-04:00

Recently, I completed the posting which is known to be the best in the twelve months of internship; my stint in the emergency medical services (EMS). The EMS, as will be obvious at first glance of the queue of trolleys and throng of patients who are there perennially, 24x7x365, can be termed as the most pulsating place in all of KEM. To be working here, to actually be a part of running this ordered pandemonium is the stuff that our ER-fuelled dreams are made of. To say that every intern waits for his days in the EMS would be an exaggeration but, it is the one time that you are working so hard that you don’t know when morning ended and evening began. Although, most interns (me included) who look zonked will tell you ‘EMS night maara’, with a pained expression, their expressions belie their inner joy, of being there, in the heat of the moment, on their toes, ‘doing‘ something. Maybe I’m getting carried away. Most times, you are doing the same old ‘collection’ of blood to be sent for various tests. But there is learning by seeing that is always happening, simply because of the sumptuous volume of patients and variety of diseases that are there.

And then there is ‘learning by doing’. Now, in the beginning of my posting, most things were fun to do but the words that filled me with dread were “Veena, is patient ka ABG maar.” Now, an ABG stands for Arterial Blood Gas analysis. For this blood needs to be collected from an artery and sent to a laboratory where someone will then put two drops into a nifty machine which tells you the acidity of the blood, the amount of oxygen, carbon dioxide et cetera in it. Sounds pretty straightforward. So, what’s my job? Only the blood collection bit. See, for most patients we have to send blood for a few routine tests and additionally an ABG. For the routine tests we collect blood from veins, a job which is simple enough. Just ask the patient to make a tight fist, ask the relative to hold his (the patient’s, I mean) upper arm and squeeze like crazy. A shy little vein will soon get engorged with blood and become nice and fat. Slip the needle into this vein; pull the syringe and a jet of dark venous blood rushes in. Smooth, clean, over in an instant.

But, an Arterial blood gas analysis, as I mentioned earlier, obviously needs blood from an artery. Now here’s where the trouble begins. First, we have to explain to the patient that this ‘tapas’ (that is the word for investigation in Marathi and not some funky Mexican food dish!) is different so I need to collect blood again. Most patients are already a little grumpy but they relent and extend their arm out again and make a fist, prepared for the second needle prick. That’s when you tell them that this blood is to be collected from a different place and they don’t need to make a fist. The blood is mostly collected from the radial artery in the wrist. (This is the same thing that all the doctors in Hindi movies feel before they declare a person dead on screen). Herein lays the trouble. The artery, unlike the much more co-operative vein, cannot be seen, its pulsations must be felt and the needle inserted where you feel the pulse best. It takes quite a while to master this. And the sufferer is the unsuspecting patient. When he gave you his hand for the second time he had no idea that this prick would be so much more painful because sometimes you hit the bone that lies underneath and at that moment I’m sure every patient wishes he was dead rather than go through such horror. Also, since interns are learners, one prick is almost never enough to draw out the blood and we, on an average, prick twice before the bright red colour of arterial blood fills the syringe and suffuses our faces with bright smiles.

Now, in the first few days in the EMS, I had a tough time getting the artery (or, should I say, my patients had a tough time). It got so bad that one of my hapless victims had to be rescued by the ABG mama, who, miraculously, hit pay dirt at first prick in a patient I had pricked at least four times without success. Then, I asked my co-intern who seemed to be getting arterial blood quite often what I was doing wrong. So, for the next ABG she came along and pointed out my mistake. I was inserting the needle perpendicular to the direction of the artery (in the same plane, though) which did seem like quite a foolish error. So the trick was to enter parallel to the direction of the artery which happens to run up the arm. That little word of advice just seemed to wipe away a lot of problems. That particular ABG I got instantaneously. One prick and zwoop, the blood rushed into the syringe. Such an acute thrill as I felt! Few things can feel as great as getting a procedure right. You get this rush of joy at having succeeded at something which is slightly difficult. And the feeling of complete bliss is very different from anything I’ve experienced before. This is close to how a sculptor must feel on appraising an idol built by his hands, this is how a master chef feels looking at his three-tier wedding cake, and this is how the surgeon feels after performing a difficult Whipple’s surgery meticulously. While my task may not be anywhere near the difficulty level of these, the sense of accomplishment I felt is probably the same. After that there have been innumerable ABGs. Many have taken a little digging and prodding for the artery and some have taken several pricks. But I’ve definitely improved and each time that I have succeeded the delight has remained unchanged.

So, the moral of the story, when you’re feeling blue, go out there and “do something” with your two hands. Don’t sit and read a book or watch TV or check your e-mail; do something. Oh, but don’t maaro ABGs for kicks, it’s still extremely painful for patients. Moral number 2: If you don’t get the ABG after three to four pricks and the registrars are too busy to help, ladies and gentlemen, its time to call ‘ABG mama’. This guy is a class 4 worker (a mama) in the emergency department who can get most people’s ABGs in one prick. And surprisingly, he doesn’t look too old, so it’s not as though he’s picked it up by hanging around the place for twenty-five odd years. Well, some people are gifted. The others just have to learn. Unfortunately, the poor patient who comes to KEM becomes the pin-cushion and laboratory mouse in our learning curve. Is this the price that he pays for very cheap treatment? I suppose that’s a complex ethical poser that has no right and wrong answers. So we shall leave it be.

As for the ABGs, maybe it’s a sad statement of how my life is right now, but getting it right is the high-point of each day.

The things that we do

2006-05-22T11:34:00.000-04:00

During the last week of April, I was living just another intern’s life – getting to work by 8, blood collections, signing musters, getting bored, casualties, movies… the works. And then, one fateful afternoon, some seniors of mine were discussing the injustice that Mr. Arjun Singh is trying to perpetuate in the name of social justice. And this is how it begins: how I start to do things that are no longer normal for an intern. But, the strange thing is that most interns are now doing what I’m doing; and so we’re all doing the normal thing.

Letter to the First Citizen
It was yet another sweltering afternoon and I was trying to escape the oppressive heat by running off home. Little did I know that I would soon be thrown into the frying pan. A couple of seniors ask Sumedh and I to help in framing a letter with our grievances. And to whom was this letter addressed? None less than the President of the sovereign democratic republic of India. Somehow, I felt very dwarfed by the whole notion of actually writing a letter to the president as if it were a complaint to the school principal. In fact, all of us weren’t too convinced that the man himself would read the letter and were giggling at our naïve presumptuousness of advising the President as to how the Government is going wrong.

Calling the Media
When we realized that mere letters to presidents weren’t going to make the slightest of dents in the Government’s plans, all of us decided that a more vociferous form of protest was required. So, what work was I stuck with? Nothing more important than calling the media to cover the event. This included getting journos from Maharashtra Times and Loksatta to NDTV 24x7. Suddenly I am on first-name basis with the omnipresent reporter of Sahara Mumbai. This did not happen just to me; but, as far as I know, half of the intern-batch of KEM now regularly finds itself on TV or being quoted in the papers. Just another day, just another journalist, just another request, “could we get 3 speakers for the RKB Show tonight on Sahara?”

Rallies
I never, ever imagined that one day I would sit in the dusty, sprawling grounds of Azad Maidan. I never thought I would scream “Ek, do, ek, do, Arjun Singh ko fek do”. In fact, the first time I did it, I laughed at myself. But, during the second rally, when 300 of us sat outside the Governor’s bungalow and rokoed-the-rasta, suddenly I was in the moment and the words “Ek, do, teen, chaar, bandh karo yeh atyachaar” rolled off much easier. When the cops came, my uneasy premonition of the afternoon was being played out alive. The crowds, stubbornly seated with crossed-legs and locked hands, chanted “Sarfaroshi ki tamanna ab hamare dil mein hai; dekhna hai zor kitna bazu-e-qatil mein hai” and meant every word of it. During the last candle-light protest at Shivaji Park, the IITians came up with a bunch of innovative slogans, of which “Shikshan ke dalaalon ko, joote maaro saalon ko” kicked ass! (pun intended)

Courting the court
Thanks to our impromptu protest outside none less than the Raj Bhavan, the police were flummoxed as to how 300 students materialized out of thin air in such a high-security zone. To hide their discomfiture at being made a pandu, they found two scapegoats in our YFE group. Obviously, none of us could tolerate these people being made the fall guys for that which was our common plan and, so, 65 people showed up in the Sessions Court to attend the hearing of their plea for anticipatory bail. I had never thought that as early as 23 I would see the insides of a criminal court. For those who haven’t been there and don’t think they will have the opportunity either, it’s just another high-ceilinged, dusty old building, which is, strangely, very, very quiet.

Almost on Air
When Sahara Samay gave us our first full hour of airtime on the RKB Show, I was to go on air but chickened out and just accompanied the guys who spoke. Well, in the bargain, I have now visited the recording studio of a news channel and it’s much smaller than I imagined it to be. Also, it seemed like just another office where a couple rooms had cameras. In fact, we got to know of the office hierarchy firsthand when one of us was lounging on the boss’ chair and was unceremoniously ousted forthwith.

In these two and a half weeks, I have not lived my own life but that of an activist. The sad part is that all my peers have similar stories. The Government’s populist measures are having an immediate impact on our lives and hard-working, happy students are suddenly going on hunger strikes and are at the wrong ends of the police’s lathis. Who knows what the weeks ahead hold for us? In fact, just today, I met women from an NGO who have instant access to the CM and Mahesh Bhatt (!). All I can say is that whatever be the results of our protests (and the picture is bleak very often), what must be done must be done.

For those who don’t yet know what I am talking about, check out http://yfemumbai.blogspot.com/ and mail us with your info at yfemumbai@gmail.com . Don’t fail your future generations.

Abominable Moocha

2006-04-12T13:49:00.000-04:00

Last week, I was on my way to college one morning, just like every other morning. The one hour train journey is perfect time to catch up on the eighth hour of sleep and I go so far as to take an early train so I can go seated comfortably and peacefully doze away. So there I am, nodding away like it’s no one’s business, when a slightly plump personage seats herself down beside me and I am awakened. She has a very, very familiar side-profile… in a jiff I recognize her. She used to teach me English in my school in Madras (!!) in standard seven. After all these years, imagine stumbling onto Mrs. Chitra Pandey, CP as we called her (we would privately refer to all teachers by their initials in our school). Wow.

Now the typical turn that the story is expected to take at this point is that CP was our favorite teacher and all us kids loved her. It’s quite the contrary actually. CP had joined the school that year and had replaced a well-beloved English teacher. Not a great place to start. And to add to that she had a North-Indian scorn for us. So, naturally, we found all possible faults with her. We didn’t like the way she taught, or her diction (seventh standard kids can be quite opinionated and unforgiving at that) or even the way she dressed! And, yes, we were a naughty class who showed our dislike in our own little ways.

She had to teach us a book by Ruskin Bond called ‘The Hidden Pool’. This is an endearing story of three young boys and their friendly capers, and how they grow to become great friends. One of the chapters describes a game that the boys play where they hold a race among cockroaches they have adopted and trained for that very purpose (did I forget to mention that the protagonists were a little strange?). Now, one of the cockroaches was named ‘Moocha’ (meaning moustache in Hindi) because of his long whiskers. In Tamil, however, the word ‘Moocha’ has an altogether different meaning. It means urine. So imagine a class of Tamil kids who are out to harass their poor Uttar Pradeshi English teacher who knows zero Tamil. She is bewildered as to why her class breaks out into an uncontrolled epidemic of guffaws each time she utters the name of the confounded cockroach. The first few times she thought it was because the word Moocha was funny-sounding and joined in the laughter. But the laughter wouldn’t stop (the cockroach happened to be the winner in the race and therefore repeatedly appeared in the text). Soon she started getting suspicious if we were playing some Enid Blytonesque prank on her and were just laughing to spite her. When she mentioned this to us, it sent us into another spree of choking laughter… we were being wrongly credited for what sounded like an ingenious plan. Unfortunately, we were innocent. It was just Moocha’s fault! The class ended with just a couple of pages having been read, a very suspicious teacher and a much amused class of rascals who had had their fill of toilet humor. We laughed so much that day, we almost peed in our pants (that just HAD to come).

Another time she was taking our class and we were still thrashing about in ‘the hidden pool’ (it’s quite obvious why the going was so slow in a class such as ours). This time the chapter dealt with the Abominable Snowman, the Yeti. Now Mrs. CP had a slight problem pronouncing the word ‘abominable’, which we precocious things thought was unacceptable in an English teacher. So as she gave us several variations like ‘abonimable’ and ‘abonomimable’, we snickered among ourselves. Quite a bunch of monkeys we were.

But all that was years ago. That day in the train I introduced myself to her and we exchanged phone numbers and stories about how we landed in Bombay. Bandra came and she alighted, leaving me in the sepia toned world of the past. Memories just kept crashing into me, wave upon wave of incidents from the best year of my school-life, standard seven.

We did everything that year. Took part in the school play, went for umpteen elocutions, and won the first prize in a fashion show! We also had extra-curricular coaching in English where we were made to adapt famous Shakespearian passages to modern day personalities. I remember I was Dawood Ibrahim and I had to say Lady Macbeth’s lines…'all the perfumes of Arabia will not sweeten these hands’. In the midst of all this we managed to study and do well in class. It was also the beginning of a mixed friends circle with boys and girls. (Yes, Madras was a slightly conservative society and slow to catch up with such things). What fun it was organizing that first pot-party at a friends place. Such silly games we used to played, such silly names for each other we had. We laughed, gossiped, helped each other, had ‘best friends for life’ and first crushes. Those were days when we were completely ourselves, saying what we felt and doing what we pleased. We didn’t weigh our words so that what we said would be ‘correct’. We went right ahead and gossiped and bitched without analyzing the propriety of our actions. I’m glad I’ve changed and grown from that phase today, but something of that precious carefree spirit is lost forever. As are all my friends. I have lost contact with each one of them and they have all just dropped into a crevice in time. If it weren’t for my very powerful memories, I’d easily say I dreamt all these people up. I have no addresses, no phone numbers, not even a photograph. At one time these people completely ruled my waking thoughts. It is almost bizarre and, as I’m realizing for a few years now, a very profound loss.

Well, anyway, later that day I went to meet Dr. Keyur, a professor who taught me in standard 12. I was meeting him after four and a half years and everything seemed the same in that leafy Kalra-Shukla road in Parle east. Three things that Dr.Keyur told me back in twelfth standard have stuck with me and are very useful pieces of advice. Number 1; don’t write too fast, give time for hand and brain to move in concordance so that you make fewer mistakes. Number 2; compete only with yourself, there are too many people in the world you'll need to beat if you look outside. And number 3; use the tic-tic pen-pencil not the sada Natraj ones for neater diagrams. All these are very important words which have helped me immensely in these four and a half years. Anyway, it felt nice to meet the man who had a large contribution to my liking Biology and eventually ending up in Medicine.

So, although the day started like any other I ended up being a long, long trip down memory lane.

Blast Barista

2006-04-01T13:55:00.000-05:00

Today I went to catch a movie after several months. Being in what we thought was good enough time for a movie like Being Cyrus i.e., fifteen minutes early, my friend and I were surprised to find the show full and bought tickets for the next show. This left us with two hours to kill and it being a scorching twelve thirty in the afternoon, our only demand of the place where we’d spend the time was that it be air-conditioned.

So we walked into a nearby Barista. I scanned the menu for options which fit the wallet considering that this was an unexpected expense. (We must not forget that we are lowly interns who are a week away from our first pay). I found several options within my price ceiling of Rs.45. Oh what luck! They also had low-cal options on their menu. So there we are, placing our order when the coffee-maker-order-taker says he’s sorry but he doesn’t have the low-cal drink I want. With a small frown I ask for option No.2; a barista toffee frappe. “Sorry ma’am, I don’t have this but can I make you a ‘barista toffee something else’. Will that be okay?” Okay, I thought, what difference will it make? Some other toffee flavoured coffee. So I told him to go ahead and added, before he could ask, “No cream, chocolate sauce or other stuff with it.” “No ice-cream?” he almost pleaded. Stupid question to ask someone who was just refused a low-cal drink I’d say. So after making it clear that I want only coffee, I go back to my seat. As my friend places his order, I can see our counter guy tell him something which looks like ‘seventy-seven’, if I lip-read correctly. Great, I thought, both coffees in seventy-seven, perfect.

How wrong I was. Just my coffee cost Rs.77. Rs.77!! For a coffee?! And the original frappe thing I had ordered was only Rs.45. So what had he ‘made me’ that was suddenly this expensive, sans chocolate sauce, sans ice-cream, sans cream? At the risk of sounding like my dad, in seventy-seven rupees I can buy 2 packets of Sunrise coffee powder and drink frappes for two months. As for the coffee, give me Mysore Café’s filter kapi, any day. Or the meticulously measured out tall glass of cold coffee that Sumedh makes when we go to his place which no Barista can ever match upto. Or my mom’s early morning ‘alarm for the brain’ brew. Stupid snobbish glass of barista coffee that, I must add, had the ‘toffee’ flavor stuck to the sides of the glass only, which I, nevertheless, polished off in quite an undignified manner.

And this isn’t the first time that any of these coffee shops have let me down in the value-for-money department. A similar experience occurred when a friend once ordered a ‘Barista Blast’. At a whooping price of Rs.80, I’m sure it blasted a hole in his pocket. Another time, at Café Coffee Day, I ordered an iced café mocha which was more ice, less mocha. Sumedh and I waited for the ice to melt, (yes, sometimes you are that jobless). And we must publish our significant finding, that water filled a third of the glass. These people are only out to cheat us.

The fundamental thing is that no one goes to these coffee shops for the coffee. We go there for the lack of a better hang-out in Bombay. Not too many parks and walking tracks for us. The latest Supreme Court ruling in favour of the mill lands being the property of the owners only, to pretty much do what they please, means that there will be more Phoenix mills malls and fewer Joggers' Parks. And these malls will definitely have a Barista, won’t they? But, I’m drifting. The other reason why people go to Barista is to kill two hours in AC bliss. Well, under the circumstances, my original suggestion of window shopping at Shopper’s Stop would have been easier on the pocket. But I should keep that in mind the next time I want to meet up with someone.

PS: The movie ticket cost only Rs.65. The coffee on the other hand…

A lament

2006-03-28T13:11:00.000-05:00

I have one crib with the field of medicine. It gives one very little scope for creativity. I mean that from the point of view of the everyday, average student of the science. Medicine is all about absorbing facts, facts and some more facts. Or, it is about understanding bodily processes which is indeed very fascinating. But in medicine there is no place for the abstract.

A student who studies fashion designing, must, as a part of what he does, come up with a new design each day. Can you see how tough that can be? A mehendi-wali must think up of attractive ways to fill up the palm and nowadays designs stretch all the way up to the elbow, not to mention the feet. An artist can make blank paper and mute canvas into a picture that conveys a thousand emotions. A make-up artist must know exactly how to enhance each face, each bone-structure. Most music directors are geniuses. How do they create melodies and tunes from nothingness? I tried it the other day… to come up with a tune; beyond the first few notes I hit a roadblock. And it was extremely forgettable… I’ve forgotten it myself. Oh, I forgot to mention jewelry designers… shining rock turned into such exquisitely beautiful treasures. People who conceptualize advertisements, movie directors, authors, poets… All these people’s work may seem frivolous to some. But thank God not everyone is out there saving the world! All these jobs require talent. Something works inside the head of that person alone and comes out in the form of art, a lasting legacy for the world to enjoy and sometimes even revere.

The next lower rung on the creativity ladder is made up of people who know certain facts and apply them in ingenious ways. A civil engineer who builds a brilliant sea-link, an electronics guy who engineers a new technology for the mobile phone, a surgeon who opens up the patient and figures out new ways to deal with anomalies, a scientist who comes up with better fuels, a chemical engineer who develops a new drug molecule. These people actually bring the civilization forward in their own small ways. Is that why these people are looked upon in society with great respect?

The people who are way down this ‘smartness order’, I believe are us junior medicos. We are (and will be for some years to come) so lost in absorbing facts that we don’t ever really apply our heads or think. What we do, when we are not learning skills is, retrieve facts from memory. And as we move into the era of ‘evidence-based medicine’ we will use innovativeness to a lesser degree. There will be studies and guidelines for everything! This may be excellent for the patient and therefore it is the right thing to do. After all, no doctor is above the patient. But, it leaves very little scope for originality. That is my lament with this field.

So before our noses inadvertently go up a little higher, before we say ‘I’m a doctor’ with too much pride, maybe we should try composing a tune.

On a lighter note, I have several other laments for the day. The following evoke the emotion called Aaargh :-

Teenage girls who come to the gym with cell phones growing out of their ears and who only stand in the passage and have loud fights with their boyfriends.
Rickshaw walas who don’t give your one buck back.
Aunties in first class ladies compartment. They ‘adjust’ to give you only so much place to park your butt on the ‘fourth seat’ such that it is more uncomfortable than standing.
Thin women who come to the canteen and eat cheese pau bhaji! Here I eat a single chappati and sweat my life’s blood out on a treadmill to lose 50gms. And these women look as svelte as ever.

Metabolism can be so unfair. Well, but so is life sometimes.

I must end with a PJ which I'm quite proud I came up with.
Q: What is a beggar’s favorite music genre?

A: Metal. Ha, ha.

PS: The unused creative energy must come out in some way, sadly, for those who read up to this point.

Highlights in her hair and other scary stories

2006-03-21T04:07:00.000-05:00

A few days back I mustered my courage and subjected myself to a hairdresser’s unpredictable colouring paraphernalia… I was finally making good on my long-standing threat to colleagues of highlighting my hair. So there I am getting strands of hair painted with a coffee brown vile looking mixture which doesn’t closely resemble the eventual colour I want for my tresses. Now the proceedings were being observed by a trainee hairdresser as the ‘expert’ worked away on my hair. I wouldn’t really mind that if it wasn’t for their frequent remarks and comments regarding the procedure. “Oh, so that’s how thick each highlight should be”. “I think you’ve missed this section of hair.” “Arre…will this colour develop properly since her strands are a little coarse, na?” Not exactly the most comfortable banter buzzing over you as you hang your head down and submit yourself meekly to your fate. As I sat there with the coloured strands wrapped in aluminium foil, looking like I’d walked from the sets of some alien movie, and worried that I’d look like I’d come from a horror movie once the foil came off, an interesting analogy struck me.

The other day, I had assisted…how should I put it…a brilliant but slightly whacko surgeon during an appendicectomy operation. The patient, a frightened lady, had come with severe tummy ache the previous day and had been packed off home after an injected pain-killer and some ‘reassurance’. Now here she was this morning, a little worse than yesterday… reassurance obviously can’t take care of an angry, red, bursting appendix that needs must be heard! So an emergency operation is planned and the abovementioned Dr. Sameer, rubs his hands in glee in anticipation of the ‘cutting’ he’s going to get to do. I can see him almost salivating!

Removing an inflamed appendix is bread and butter, routine stuff for most general surgeons, so it was expected to be cake walk. Zero stress for the surgeon. The patient’s story is a little different. And it dosen’t help that, as she enters the Operation Theatre (OT), the doctor asks for the radio to be turned on. Out pour the strains of the latest rapchik itam number - “Chhore ki baatein meethi churi hai...” (OST: Fight Club). Dr. Sameer is just getting warmed up with a little jig beside the OT table. Now to give you a clear picture… the patient is on that table and the anaesthetist is just starting to ‘induce’ her and, as it often happens, the operating surgeon, Dr. Sameer, has not yet washed up for the surgery. So the patient lying there quietly watches the man in whose hands her fate (or at least her appendix) lies giving himself up to the rhythm. The music picks up pace and the anaesthetist makes the patient sit up. This operation will be under ‘spinal anaesthesia’ which basically means that only a certain level of the trunk will be numb…and God help her for the poor lady will stay conscious through the ordeal. The needle enters her spinal canal and, by now, Dr. Sameer is in full and graceful flow; he actually skips in a little circle around the table. The hapless woman must have felt like the holy offering of a tribe in some ancient African sacrificial ritual with the tribe chief jumping around her with spears in both hands. (Come to think of it, we can compare the lumbar needle used for anaesthetizing with a spear).

Well, the operation gets underway. As he opens the layers of her abdomen and reaches deep down to find the offending appendix he exclaims about the friable and inflammed state of the organ and also curses the doctors who sent her home on the previous day. Then he figures that it is partly the patient’s fault. Why did she say she felt better after the injection yesterday? All this in Hindi, in a voice loud enough to be heard by the patient, whose eyes were covered but whose ears must’ve been a hundred percent perked up. As we go about the job, flakes of pus swim up from the abdominal cavity and we hear him curse some more about how this is a gandha appendix. A little later, as I’m assisting him remove clamps on many of the bleeding veesels, one clamp slips from my hand before the bleeder has been tied with a thread. To this he loudly says, “Arre…sambhal… waise hi yeh operation normal nahin hai.” Imagine lying there, with sleeping feet and an awake brain, knowing that your insides were being scrutinized, appraised and tampered by a grumbling dude who, until twenty minutes back, thought he was a member of some ganesh visarjan group. A little scary I’d say. Oh! And the radio was still playing.

As this incident played itself out in my head, the ‘colour developer’ had completed its job on my hair as was announced by the shrill timer. As the hairdresser washed the excess colour off and the dried my hair, I was thrilled to see the most beautiful and shiny shade of copper emerge… Wow! This hair thing had worked just fine. My thoughts went back to the patient who, thankfully, also went home just fine. Having traded one slightly messy vestigial organ for the lyrics of the latest catchy tune, my guess is she came off better…

So, what's changed?

2006-03-20T08:31:00.000-05:00

This blog comes up more than a week after the famous resident doctors’ strike has been called off, and its crippling effect is becoming a mere tale we’ll tell at family gatherings. But one thought has been tickling my brain and refuses to die its natural death and must pour itself out on e-paper.

I had to do the night shift in the surgical emergency department one night after the strike was called off. Walking in for work that night, there was a marked change from the now usual sight of the large, empty emergency floor with a countable number of patients rattling between the pathology labs, x-ray sections and surgery/medicine sections. There was a respectable throng of patients everywhere and the incessant whisper was slowly growing into a loud buzz. On entering the Emergency Surgical Room (ESR) another new sight greets me… a registrar!

Immediately I’m pressed into action - “Intern, put IV lines into those two patients, fast.” Through the night the instructions flow thick and strong. The patients’ relatives, sick with worry themselves, entering in groups of twos and threes are loudly chided to not crowd up the ESR. “Sirf ek jan ruko andar.” People are sent all over the place without being given instructions clearly. Scolding a poor patient who kicks up a fuss about being pricked by a thick-bored needle, threatening another lady who finds it uncomfortable that a tube is being shoved down her nose… and so we go through the night. Through it all, not one expression on the face of the houseman; and worse, only a scowl on the registrar’s face.

You would think that people, who had returned to work because their demands had been met, would be a happy lot. You would think that they had missed their work, at least a little, and were glad to be ‘back in action’. Maybe I’m being too naïve… the changes that the government, promised won’t be here for a while and no one likes being dragged out of an impromptu vacation… but there can be at least one smile.

As doctors, we have a responsibility to communicate well. We see people at their most vulnerable moments and what we say and how we act is the sole determining factor for our patients’ sense of security. It doesn’t take a genius to know that every act of ours is being noted; every utterance weighed for its tone… anything to betray our true idea of the patients’ prognosis is being bleeped on the radar of their subconscious. These residents were, not too long ago, students who spoke nicely to the patient in the ward. Tomorrow they will be lecturers and will suddenly be comforting, patient and pleasant to patients again. So what happens to them in those three years? I can see that they are a frustrated lot; what with long hours, too little pay, shocking living conditions… but do they completely stop enjoying the high of accurate diagnosis, patient interaction and successful treatment? Why must the patient bear the brunt of their anger against the system just because he can’t afford a private doctor? Why will they smile and explain prognosis to the same guy tomorrow at their private consulting? The joy of interacting with people has got to be one of the reasons for taking up clinical fields; else they are in the wrong line. In fact, in a study done in the US they found that doctors who got sued most often weren’t making more mistakes than their colleagues; they were just arrogant. Does it take lure of money or the fear of a lawsuit to treat the ailing better? Isn’t it shameful to ask that question?

The hospital is, as such, a depressing place… no one wants to be here. To add to that, if sick people are treated like a nuisance, I don’t think that helps any. And the resident doctor, the one who is around most often, can make the difference between the negative vibes and the sunshine in the ward. I too know that many patients who throng a municipal hospital are not educated well enough to follow prognosis, many of them are stubborn about their idea of what ought to be done, many don’t follow rules. An occasional raise of the voice is not just a reaction, sometimes it is the only thing that works. But you can’t stay angry with all people at all times!

One incident comes to my mind when I think of rude doctors. A few years back my grandmother was admitted to Nanavati hospital for fractured vertebrae. Now, one day when I was sitting with her and she was complaining about exceptionally severe pain, a bunch of trainee doctors walked in. My grandmother almost begged them to do something to alleviate the ache. I don’t remember what they said; I only remember their arrogant, why-is-she-bothering-us attitude. I also remember being livid that evening and thinking to myself that when I become a doctor, I won’t treat any patient like that. Sometimes, watching my seniors shout at patients I find myself absorbing their unpleasantness. Being just a toddler intern, I still talk nicely to patients but I’m beginning to think its okay to be rude. God forbid, I don’t want to turn into a nasty snarling thing that people are too afraid to approach… I have to guard against that arrogant, dismissive, sharp tone that I think can pass off.

Well, let me come back to the strike which, let’s not forget, began because a doctor was struck by a patient’s relative. I’m not justifying the assault, but I can still feel anger at the way my grandmother was treated and I know that no reasonable person will hit someone who spoke to them decently. Somewhere, all the unpleasantness of the days spent in KEM got too much to bear and just boiled over in the form of a slap that resounded across Maharashtra in the form of a paralyzing strike. Well, but that’s over now, isn’t it? We’ve got our “written promise” for new hostels, our pay hike… we are back to yelling at patients and cribbing about ‘double emergency’… So, what has changed?