I'm in AWE

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

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'

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

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

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

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!

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.