Tuesday, December 20, 2011

The women (in music) are here!

Since a long time now there has been a dearth of good female musicians, the key word here being good, across various genres of music. International pop music was dominated by female artists who seemed to be in the business solely to sing along on auto-tune and make videos in skimpy clothes (or so a friend has told me many times).

I mean, of course there are good female voices out there, but most of the time they're just turned into and/or drowned out by the cacophony of manufactured pop acts out there, with plastic faces, singing meaningless party lyrics and grooving obscenely in videos, while repeating variations what is known as 'the pop chorus' - which basically includes some random rhyming words. (Katy perry, Britney Spears, Rihanna, Miley Cyrus, Nicki Minaj....and well many more I don't care to find out about).

And now, well finally, finally, this past year, I have found female musicians I truly admire. With real talent, powerful vocals, meaningful lyrics, and looks that no one cares about, these women have broken into the music scene and changed the current scenario, and won many hearts and ears.

To start off the list, there is only one woman I must talk about, Adele. I mean, her voice has to be heard to be believed. And such powerful lyrics to go. Wiki tells me her latest album 21 has spent 11 consecutive weeks at number one in the UK, the longest ever by a female solo artist on the UK albums chart.

With 'Someone like you' I think she just outdid herself. I don't think heartbreak and vulnerability has ever been described better in a song. Don't let her vocal range put you off though, some may say she screams a lot. I happen to like the screaming. But this particular song has a couple of versions where she has varied pitches. I doubt there are many artists who can do that kind of a thing.

She hasn't even come up with that many videos for her songs, most of them are just live recordings of her singing in that magnificent voice. Other songs I would recommend are 'Rolling in the deep', 'Set fire to the rain', and 'Daydreamer'. This lady is made for great things, is already a legend in her own right, and I cannot wait to hear more of her music, while of course, listening to her older songs every single day.

Florence + The Machine
Then we have yet another English artist, Florence and the machine. She first shot to fame last year with their song 'Dog days are over' and to be honest, I didn't like her too much then. But now, with 'Shake it out' she has my full attention. With fantabulous lyrics like 'I am done with my graceless heart/ So tonight I'm gonna cut it out and then restart' I don't know why I should listen to any of the other pop trash out there. Her music has been variously classified as 'mystical pop' or 'rock' and well I don't care much about the classifications.

I have been exploring more of her music, and I realize all the critical acclaim she is receiving isn't unwarranted. 'No light, no light', and 'Leave my body' are other songs by her you should check out. Though all her music may not appeal to me, there is undeniable talent here.

Lana Del Rey
Another singer I have discovered just a couple of days back is Lana Del Rey. So far, the only thing I know about her is that her music is ethereal and addictive. Listen to 'Video Games'. I haven't been able to stop listening since a week now. Don't get distracted by how she looks. She is the only good looking singer on this list. That track however may not appeal to everyone with its lazy meandering pace. Other tracks you should check out are 'Born to die' and 'Blue jeans'. This singer is just starting off, but there is something special here, no doubt about that.

Last on this list is the very (in)famous Lady Gaga. She has single-handedly transformed the International Pop scene, bringing in good quality music, infusing a new lease of life into music videos, and changing concepts of fashion forever. High time you stopped making fun of her and started respecting her. Have any doubts about her vocal prowess and let the song 'You and I' dispel them. I don't think I will ever be able to get over that song. Her music, in general is very get-stuck-in-your-head type and very danceable-to. And who doesn't love a great dance track? Her other songs I would recommend are 'Bad Romance''Telephone' and 'The edge of glory'.

Lady Gaga
Her lyrics may be obscene at times, but I assure you they are never dumb. Sample this: 'I don't wanna think anymore/ I left my head and my heart on the dance floor' (on Telephone). She doesn't look that good but hides the fact extremely well with her various get-ups. She has created an identity and an image for herself, which helps a lot to set herself apart and succeed in the otherwise sick frenzy of female pop artists out there. For that, I admire her. And well, as she herself proclaimed in one of her songs: 'I'm a freak, baby' (on Bad Romance), maybe we should just accept that and move on. Her videos are always such brilliant works of art, though often bordering on unwatchable. But listening to her music always feels good. In a bad way. Yeah.

Do let me know if there are any female artists currently making music that you really admire. Here's to hoping more of good music and more of female dominance over this world. Hah. Ladies and gentlemen, sit up, and listen. The women are here.

Wednesday, December 7, 2011

Conversations from Psychiatry

I have only a short post for you, since I only attended parts of my already short Psychiatry rotation.Other than that, do let me know what you all have been up to, how are your rotations going, and for my co-interns, how bad is the exam fever?

An ongoing discussion about various ways in which funds can be used by the department.

J: Sir, we can get carrom boards in the wards for indoor patients, some entertainment for them. Both the side rooms are empty only most of the time. We can keep it there.
Y: Yes, that's a good idea, but who will take responsibility for taking care of the carrom boards, that is the question.
P: Oh yes, always good to entertain the patients. Tell me, is the TV in our ward working?
J: Yes sir, the one in the male ward is working, the one in the female ward isn't.
P: Okay, don't you people want to install a treadmill in the ward? Let's get a treadmill. All you junior doctors can work out on it, patients can work out on it, good for everyone.
J: <Says nothing>
J: (trying again) We should get some games for the patients to play and pass time. We can get something like playing cards.
P: Yes, let's get them Tarot cards.
Me: <mouth hanging open>
J: Sir, the psychotic patients will make predictions with the Tarot cards and become even more psychotic.
P: Yes, that should be great.
J: (looks at where I am sitting) All you interns, please go sit in the next room.

{J=Junior Doc
Y=Unknown in pyramid
P=Senior doc
Me=Bottom of pyramid}

Intern: (Shouting in the ward for a patient) ABC, ABC... ABC kaun hai?
X: Haan ji, yahaan hoon.
Intern: Aapka khoon nikalna hai, chalo so jao.
<proceeds to collect blood>
Intern: <handing over a bulb> Issme Urine collect karke table pe rakh dena.
X: Theek hai Doctor sahab.

<Intern goes and starts studying>

<After some time>


<Everyone gets scared and looks at each other>

Intern: <bravely gets up and goes out> Yes, sister. Kya hua?
Sister: <gives murderous look>Why did you collect the patient's relative's blood? And Urine also!!!
Intern: But, but, I was calling for the patient, and he came!
Sister: But, don't you know admitted patients are in hospital clothes?
Intern: But...
Sister: But what?
Intern: <shuts up and goes to collect the patient's blood now>

{Yeah, this story wasn't even related to psychiatry. But it happened during my Psyche rotation. You will have to just grin and bear it.}

I have had this love-hate relationship with Psychiatry since I joined MBBS. As a subject, it has always fascinated and intrigued me to no end. All the oppurtunities the field brings, to people-watch, and psychoanalyze, and counsel (which very ironically I think I would be good at, believe me or not!) had me in this excited state for a couple of years, and I seriously thought that this is what I would get into. But then, my family explicitly forbade me to even consider this an option, and gradually I realised the field is very sidelined in India, with most people looking down upon Psychiatrists as well as their patients.

But then, I was faced with an even bigger problem. I could not find a single Psychiatrist who would command some respect, in the professional sense, and in the way they conducted themselves. I found no one I could look up to. And I looked. But all of them seemed to have issues. When they came and conducted lectures for us, the lectures were huge embarrassments. None of them seemed to treat their own profession with respect and/or like a science. Disheartened, I gave up.

I know, I'm probably sounding like a demented snob right now. But I have nothing else to blabber about so bear with me. I eventually decided Psychiatry would not be a good career choice for me.

But then, during this rotation, I think I may have finally come across a sane Psychiatrist who commands some respect. Not too sure though. Let's see.

Saturday, November 19, 2011

I love you, blog.

Writing by *dybern

Yes, this post was written just to say that.

I love you, blog. You're the most amazing thing I got.

You always know how to set things right, and you help me whenever I feel lost. You let me say whatever the hell I want to, no judgement. I don't know what I would do without you. Life just wouldn't be the same. So if sometimes I don't talk to you for days on end, you shouldn't worry. I can never desert you. And I would never desert you.

Like Taylor Swift once said, you're the best thing that's ever been mine.

Thank you, blog. I love you.

Sunday, October 30, 2011

Tearing through the night (Part III)

- Written by Dr M.

Tearing through the night (Part I)
Tearing through the night (Part II)

After much manipulation and struggling, when Dr M managed to pull down the cervix, he saw a full thickness tear on the left lateral cervical wall, along the whole of the vaginal part of cervix, about 5 -  6 cm in length. He had never seen a cervical tear before in his life. Definitely not a full thickness one like what he was seeing. He now wonders for a while how he can repair the tear in his current situation. The cervix is no more continuous, no more cylindrical. Tear is too small a word to describe the magnitude of the injury. Rupture can come close, perhaps. Dr M demonstrates the tear to the nurse and explains to her that repairs of such injuries should ideally be done in the OT, with anesthesia, good light, proper retraction and most importantly, by an obstetrician. He then tries to just pack the vaginal vault, and wait for hemostasis, but the patient continues to bleed profusely. She must have bled at least a liter of blood by then. She looks pale, shivering, pulse 90 and thready, but BP is stable at 110.

Second pint of RL is dripping through the small blue scalp vein now. The nurse becomes presyncopal looking at all the blood and sits down on the floor. This is the second time she has become dizzy that night, as the patient continues to drench many a dupatta with blood. The nurse once again asks anxiously, the same question that she has asked multiple times that night: "Sir, you will be able to stop this, right?” Dr M's answer to that has now changed from a strong and confident 'yes' to a small, hopeful 'yes'.

He requests the nurse to call the senior in-charge, it is 12am. After repeated pushing of the redial button, the senior answers the call, and Dr M explains the situation and says that he can attempt to close the cervix but he may not be successful and without proper retraction it would be very difficult. Dr M gets the green signal. But then, he already knew he would, which is why he had called the senior at this hour. Who would not allow a repair at this stage, when the patient is actively bleeding to the extent of going into shock, at midnight, and at a place from where transportation to a higher center was impossible? Dr M just required this permission so that he was in the clear if anything went wrong, and he got it. Perfect timing, he thinks. Dr M is now relieved.

Dr M jokingly asks for a gown. He is amazed when they actually bring one. He changes his gloves, of course the gloves are also being reused after 'autoclaving'. As he puts on the gown, the lights go out. A single tube light at the patient's head end starts to ionize the gas inside it. This still means it is dark at the working end of the patient. Dr M always carries a torch in his pocket; it has other uses as well. This was not the first time the torch had come in to save the day. Few months back it had helped in a taxi delivery at his parent hospital. Dr M uses the needle holder to remove the No 0 chromic catgut, holding the round bodied 3/8th circle needle. He rubs the 40cms of the thread with isopropanol based solution and keeps it aside. The peon holds the torch, the nurse holds the Sim’s and AV retractor, the assistant holds the sponge holder and volsellum attached to the torn ends of the distal most cervix, the mother-in-law holds one of the patient's leg onto her chest while the other leg is held by the patient herself.

Dr M still isn't able to visualize the apex of the tear as the retraction is insufficient, he can barely see the tear at all. He adjusts the retractors again and asks the nurse to hold still and give fundal pressure to cause descent of cervix; it works to some extent. He takes the sponge holder in his hand and gives the first bite to the anterior end of the tear, exchanges the sponge holder for the volsellum and finishes off the first suture with three throws. As he starts to readjust the retractors and forceps, the assistant pulls on to the volsellum too hard and unknowingly takes a part of cervix along with her. New bleeding point. Luckily this is easily visualized and closed with a single interrupted suture. Dr M continues to toil, trying very hard not to shout at the nurse. How does one not learn how retractors are to be held, he wonders. After the second suture, Dr M's right hand starts to ache. He had fractured one of his metacarpals in a boxing match few days back, remembering that match brings back good memories. After the 5th suture at the distal most part, there is no more active bleeding. It is 1:00am now. The patient hasn't passed urine and her bladder feels empty on bimanual exam. He orders a pint of NS after the RL and then leaves, saying "We will wait for 15mins to confirm hemostasis".

As he waits in the gown sans the gloves, he chats with his colleagues about the events that ensued. They make him realize that he has forgotten about the infant, and that feeding hasn’t been initiated. They wonder for how long the infant can survive without the first feed. The mother is hypovolemic and in too much pain to begin feeding. There is nothing he can do at the moment. Dr M looks down at his brown leather shoes, there are blood stains over them. All his attire is in shades of brown that night. Auburn colored pants, dark brown belt and buff brown shirt. He is regretting not clearing his shoes from the path of blood.

He goes back to check on the bleeding, there is none. To be safe he wants to pack it with tampons. Tampons this time are recovered from the floor. They are previously used ones, and have been soaked in phenol and then Betadiene. Phenol came into the picture when the nurse confused phenol for Betadiene and poured some over them instead of Betadiene. Dr M is forced to use those phenol drenched tampons anyways, since he has nothing else to pack the vault with.

Dr M is reminded about the Pepsi he had bought by the peon. He goes to the refrigerator located in the dispensary and has half of it. 20 minutes later the tampons are removed and they are soaked in blood. So they start exploring again. Dr M decides to take few more stitches even though the patient begs him not to. Every time retractors are placed she winces in agony. Two relatives are now required to hold her down. Dr M picks up the catgut, it has dried up and there is no more solution left to wet it. With great difficulty he maneuvers it through the tissues in spite of the great deal of friction. He applies two more sutures and that’s as far as he can go. He knows for a fact that a 100% hemostasis will require going up to the apex, something that is out of the question in his situation. So he stops. There is still some minimal bleeding for which there is nothing he can do except pack the vault again, with used tampons and cotton ie. He allows moving the patient out of the labor room and prompts her to initiate feeding, and starts a pint of DNS as well. The infant takes up feeds well. Dr M removes the gown which he was told will be reused in the future. He doesn’t ask how it would be washed or sterilized, he knows the answer. As everyone retires to their beds, Dr M goes back to his cell phone, searches for causes and prevention of cervical tears. He wants to know if he went wrong somewhere. Turns out there was nothing much he could have done to prevent the tear, except maybe he could have been harsher to the nurse and assistant for their fundal pressure practice. Another breath of relief and then Dr M too retreats to his bed at 3:30am.

In the morning, his alarm will ring at 6:10am but he is up a few minutes before that. Soon he goes and checks on the patient. Subjectively she is fine and so is the infant. He can't examine her without the nurse present. She is sleeping, so he goes off to stroll in the farms nearby, looks at the sunrise and thinks to himself "This is a day that follows a night of no losses, no regrets. It was a great night, perhaps the best till date".

When the nurse wakes up, they go to examine the patient. The packing is soaked in blood but that is it, no active bleeding at all, and the most satisfying part is that she has passed good amounts of urine. The infant too has passed both urine and stools by now and OPV is administered. Dr M writes puerperal orders and generous analgesics and antibiotics to cover all the infections he can think of. He waits for the senior doctor to arrive and give him the thumbs up to leave. He gets done with one bottle of Pepsi and opens the other. At around 8 am, another patient in labor comes in. Gravida 4 this time, with contractions every 5minutes. Within half an hour she is done delivering, very uneventfully that too. Very vanilla. Good for the patient, as there isn’t a single unused piece of equipment left at the centre. Between then and 10am, two other patients come in with vague complaints, then turn out to be UPT postive. Coincidence? Whenever Dr M thinks about coincidence, the words of Dr Sheldon Cooper flash before him: "Coincidence is for those who don't understand the law of large numbers".

Saturday, October 29, 2011

Tearing through the night (Part II)

Tearing through the night (Part I)

The new nurse panics and requests Dr M for a referral or to at least call the senior in-charge. Both are politely denied. Another dose of Nifedipine goes in, and the increase in duration and frequency of contractions is reassuring. Dr M at this point consults his colleagues. But he has already decided to accelerate the events of labor. He thinks about artificially rupturing the membranes but then decides against it and is fixed on only stripping them for now. He starts creating a partograph of the data he has gathered. Graph makes it obvious that the labor is progressing normally, but what bothers Dr M is that it will take another 2-3 hours at this rate. By 9:45pm, the cervix is fully dilated. Dr M now approaches the relatives, explains the high risk and the chances of poor prognosis to them, and that referral is required urgently. Of course, he knows very well that they will not agree to it, now that she is so close to delivering, no matter how near the referral centre is or how the grave the patient can become. The same was presented in writing and without hesitation they signed the high risk/poor prognosis write up. A grin appears on Dr M's face, it grows in size as he turns away from the relatives and walks towards the patient. Dr M is now getting all the action he hoped for at the start of the night.

Dr M swabs the perineum, albeit not liberally on account of limited betadiene that is left, introduces two fingers and gleefully strips the membranes off the lower uterine segment.

Back at his table, Dr M is approached by the peon who offers him food from his own house. By the time Dr M realized it was time for food, everything around had closed down, so he had been prepared to fight the MMC that would eventually come to trouble him. But of course Dr M couldn't turn down such an offer, so he agreed to eat with the peon. They were joined by the nurse and another assistant. During dinner conversations it became known that the assistant was asked to come over by the nurse as she had been present in a number of deliveries at the centre. Dr M didn't mind. He was open to any help he could get, but none that would interfere with his autonomy.

After dinner, Dr M goes out to get others and himself a bottle of Pepsi. The general store is a 5 min walk, but has closed down by then. The shopkeeper is there however, and recognizes Dr M. Turns out he had come in the late afternoon that same day with his son who may or may not have swallowed a coin, to the centre. He opens the shop; Dr M buys two bottles of Pepsi, a liter each. As Dr M walks towards the health center, he is greeted by many who invite him into their homes. It is an auspicious night, a night of celebrations. That is another reason why Dr M wants to hasten the delivery, besides him being bored of repeated observations of course. The fetus could be born on this auspicious night if his efforts are successful. Not that he cares when it is born. Yes, Dr M referred to fetuses as 'it'.

Back at the centre, he can't find anyone. He grabs his stethoscope and rushes to the labor room. Stripping has worked. Labor pains have accelerated, membranes have ruptured and liquor is clear. She is getting contractions every 2 minutes lasting half to a full minute. Prior PV exams had confirmed vertex presentation in occipitolateral postition. On PV now, head is well flexed and internal rotation has occurred. Her contractions and efforts to bear down forcibly are disproportionate to the outlet provided by the perineum, as a result of which caput is evident over the occiput even before crowning. The assistant starts applying fundal pressure. Dr M instructs her to stop, but she continues anyway. The mother was getting exhausted and crowning wasn't occurring. She had already taken many a hit from the peon and assistant. Dr M, though violent by nature himself, contributed nothing to that. On the contrary, he asks them to stop hitting her. They slowed down. Dr M at this point expresses his concern that an episiotomy will be required. The nurse remarks that they aren't ready for it and that nobody has ever performed an episiotomy over there. So the labor continues in the same way and forcible crowning is achieved after which the neonate is delivered.

No cord cutting scissors or cord clamp is available. With a suture cutting scissors, the cord is cut and ligated with two ties. A female neonate is delivered at 10:30pm weighing 2.6kg with caput and acrocyanosis. APGAR at 1 and 5 mins were 10. Placenta was delivered 15 minutes later and it was evident that a segment of it was retained. Dr M inserts his hand inside the uterus and removes the retained placenta, and whatever clots he can discern. Bleeding still doesn’t stop.

He orders 4 misoprostol tabs and gives them orally to the patient. There are no other oxytocics available. Half an hour later, the bleeding still continues. Dr M once again introduces his hand to inspect for clots or placenta, none found. The uterus is well contracted and hard to feel on PA exam. Dr M now starts swabbing the vaginal walls to inspect for tears. Swabbing is done with cotton, as gauze is not available; this leads to strands of cotton fibers being stuck everywhere, on the vaginal vault, on the instruments, on the gloves, all mixed with blood. It is difficult to work in the bloody mess, but Dr M manages somehow.

Vaginal walls seemed intact after inspection. Only plausible option now was the cervix. What worries Dr M is the possibility of coagulopathy. There is nothing he can do for that and from what he has heard, the referral unit doesn't send help after 10pm, another thing that he had been informed of and had ignored earlier. When Dr M asks for speculums and retractors, the staff looks at him as if he had spoken in an alien language. He instructs them to get all the instruments they have along with a veinflow, RL and Foley's. They return with two instrument trays, a scalp vein, DNS and nothing instead of a Foley’s. Apparently those are all the obstetric instruments they have. Dr M searches for an RL and startsa pint. He inserts a Sim’s and an AV wall retractor and can now see the cervix. He tries to teach the nurse and assistant how to hold them, and fails. With great difficulty the cervix is held with a sponge holding forceps and a single volsellum. There is no other atraumatic instrument available. Small tears are found on the anterior and posterior cervical walls. On swabbing them, none bleed actively. Dr M starts walking around the cervix with the sponge holder and is shocked to his core with what he finds over there.

Tearing through the night (Part III)

Friday, October 28, 2011

Tearing through the night

Today I present to you a medical tale, in three parts, which was sent to me yesterday via email by someone who calls himself Dr M, in response to my call for guest posts. He sent me a short profile about himself when I requested it:

Dr M is a medical intern at a Government hospital in a metropolitan city of India. He is slightly obsessed with all things medicine, and socially inept otherwise. He loves taking risks and is known to frequently take leave of rational thinking. He often seems to lack a sense of self-preservation. He used to sketch well in his childhood, but later gave up on sketching as he thinks no one in this world is worth sketching anymore. He also feels that the need for love and the need for food are complementary to each other, so he stuffs himself with a lot of food in order to balance out his need for love.

After enjoying reading the story he sent me so much, I was more than eager to publish it. The story will be published in three parts, one part each day, starting from today.

Warning: People outside the medical fraternity, read this story with caution. It is full of difficult medical terminology and gore, and might scare you off doctors for life.

Tearing through the night: Part I (by Dr M)

At a distant peripheral health center in an Indian village, it’s 6 in the PM and Dr M is in-charge tonight, alone. Desperately hoping for some action in the seemingly boring night shift ahead of him, he happens to overhear the staff talking about a woman admitted in labor. He doesn't say anything, finishes off with his dull patients and quickly checks on the patient in the labor room without the knowledge of the nurse. A 25yr old, second gravida with contractions 30 minutes apart in no distress at all. With this brief information, he says to himself "There is still a lot of time to while away".

He goes back to his chair - a comfortable blue reclining chair with adjustable height which also rotates. He plays with the height and rotation, changes his moment of inertia, observing the change in angular velocity. His thoughts jump to the unification of electromagnetic and weak forces and how it was explained on the basis of energies at different speeds of rotation. These flights of thought are interrupted by patients, again. Routine injury cases, nothing to do. Reassuring them that their injuries are nothing serious never worked, and eventually he was forced to yield to their perceived need for a parenteral analgesic.

He looks behind him, realizes that the patient will be pricked by a used needle, sterilized only by dipping in spirit for the amount of time allowed between two patients asking for the same drug. He also realizes that there is nothing more he can do. The patients know for a fact that Dr M is here only for this one night, and their tone of voice reflects the confidence in their demands and the lack of trust in Dr M. Maybe they will realize their mistake when they contract HIV and the source is unknown, he thinks with a shrug. Unlikely even then, he knows. Dr M prescribes with a heavy hand, going against his principles, and calls the next patient to the chair.

Amidst all this the nurse comes in and takes the sphygmomanometer and walks away, Dr M knows why, or at least he thinks he knows. The nurse comes back, keeps the apparatus in place and goes back to her chair, but then comes back once again in half a minute and in a low voice says "Sir, a patient has been admitted, she is in labor. At admission her BP was 160/80 and it is still the same. What should we do? "

Dr M raises both his eyebrows, wrinkling his forehead to give a look of concern, one that shows him looking startled. The forehead gradually clears as his eyes close, and all that can be seen through his glasses are closed eyelids that appear smaller than they actually are without any activity underneath. He is listing in his mind the problems the patient could have, and what he is supposed to do, as he gets up from his chair and approaches the patient. The thought process continues as he grabs the BP apparatus and walks hastily with the nurse towards the labor room, while the other hand supports the stethoscope hanging around his neck. Some would not even call this patient a patient, thinks Dr M. They would argue that pregnancy is a part of normal physiology and not a deviation from it. Well, for all those, the pregnancy in question was no more normal, and she was now a patient by all definitions, Dr M thought to himself with satisfaction.

As he nears the patient and starts securing the BP cuff around the patient's right arm, he hopes the BP would be actually elevated and not an error on the nurse's part. The mercury is at 170 when he starts hearing the taps. Dr M is delightfully distressed even before the taps; he had already felt the pulse even as the mercury rose to 160. He informs the nurse, in a pseudo-forced tone, a tone that would not divulge his joy, that the BP was 170 over 100 millimeters of mercury. Dr M asked the nurse if there was any Aldomet or Nifedipine available. On receiving a negative response, he went back to his desk and wrote a prescription for Nifedipine 10mg. The patient's husband took the prescription in his hand and tried to read what appeared to be something scribbled in a flow. Dr M explained to him why that drug was required and its urgency. Also scribbled in the prescription was Hydralazine and MgSO4, which Dr M explained the husband, had to be checked about for availability only, and not to be purchased as of now. Dr M then goes back to the patient, this time with a full formed set of questions in his head.

After about 10 minutes, the husband returns. By now he has gathered that the patient has conceived after 11 years and has had no antenatal care till date, with her first delivery being at home. She had an uneventful current pregnancy except for the bilateral swelling of feet that comes and goes with various factors  that the patient hadn’t paid attention to. Dr M is told that there are no sterile, packed needles available when he asks for them, and is told to use ‘autoclaved’ ones instead. Dr M lets out a sigh on hearing this, not because of the non-availability of sterile needles, which he had expected, but because he hears about the so-called ‘autoclaved’ needles. He uses an 'autoclaved' needle and places the capsule under the patient's tongue, instructing her not to swallow it as a whole, all the while hoping his instructions weren’t going to vain. He checks his wrist watch, the two arms of his watch were apart by 2/8ths of a circle and the hour was 6th. He wore this same watch all the time, felt incomplete without it, and yet he maintained it poorly.  Dr M elevates his right arm to visualize his watch again, this time noting the FHS, as, unsurprisingly, the Fetal Doppler at the facility isn’t working.

Dr M informs the nurse that the FHS is 130, and tells her that he wishes to do a PV exam. 2FT/O/engaged/intact is what he jots down on the paper over which he decides to record his findings throughout the course of labor. The nurse seems tense, and informs Dr M about a referral center that has dedicated labor services and an obstetrician, 10 minutes away from their centre. Dr M had already anticipated a concern for referral and was prepared with a confident explanation against the same. He wilily imparts only selected information to the nurse about the implications of the case, so as to ensure she does not bother him too much. She then asks if the senior in-charge should be informed, and is quickly dismissed once more by Dr M. Finally she asks if Dr M had conducted a delivery before and if he could handle this one. On hearing an affirmative reply to the last question, the nurse informs Dr M that she will be leaving and another nurse will come for change of duties.

It is 7:15pm now; the new nurse comes in and informs Dr M that she has had very little experience in delivering. She walks with Dr M as he enters the labor room again; he records the BP and renews his faith in medicine on noting that BP is 130/80, FHS 120, P 90. As the nurse tries to monitor the patient, Dr M soon realizes that she doesn’t even know how to record BP, and has no idea what the normal range for BP is. And here he had been thinking that he would learn from her the palpatory method of recording BP that he had always wanted to master, since she seemed to know it well, at first glance. Now Dr M can feel his hopes getting crushed. He then takes over the apparatus with resignation and operates it, all the while explaining to her how to record BP.

Another PV exam record reads 2FL/1/engaged/intact in Dr M's paper with a BP of 130 systolic. He goes back and orders slow sips of water to the patient. Between half hourly exams Dr M fiddles with his cell phone, browsing the net, chatting, and getting advice for further events which were to be expected. In fact his phone was irreplaceable to him and he had gone great lengths to get it back. This was, as he understood, the reason for his sanity over the past few weeks given one of his vitals was not available to him. A repeat exam at 8:45 gives him a scare. BP is 150/100.

Tearing through the night (Part II)
Tearing through the night (Part III)

Thursday, October 27, 2011

The Nairite's guide to rural posting

1. Attend your rural posting at Ganeshpuri. Take those twenty days off from your year of internship and whatever it is that you're doing with it, to attend this posting. It really won't make any difference in your entrance exams, but it will make a lot of difference in your lives.
2. Pray that you have great batchmates. You'll be living with them for twenty days, and not having a good batch sucks. That said, it is very easy to bond with almost anyone, including the weirdest alien in your class, during these 20 days of your rural post. So give it a shot. You may just acquire a brand new set of friends.
3. Don't run home on the weekends. Takes out all the fun from the posting!
4. Go for early morning walks, to make the most of the best weather in the day and the fog. Though I wasn't posted there in the summers, so I can't say how the weather will be in summer (from what I hear it's unbearably hot in the daytime during summers).
5. Every night, climb up to the terrace and watch the stars. If you're a girl, throw the guys out of their hostel so as to get access to the terrace.
6. Places to visit: Usgaon dam, river nearby, bridge in the market, Vajreshwari temple, hot water springs, Akloli kund, Gorad village for Warli painting, Great Escape water park near Parole, and Mount Mandagni if you have suicidal tendencies.The village is a great place to buy some Warli merchandise.
7. In the midst of all this, do not forget to attend your postings.
8. While at Ganeshpuri you will experience a new high in the quality of drugs available, at Parole you will experience a new low in the quality of drugs as well as medical care available. Experience both.
9. You will get a chance to sit in the ART OPD, I think this is the only time you get this opportunity in internship. You get to see follow-up cases of HIV patients, deal with their complaints, learn about the side-effect profiles if various anti-retroviral drugs. 
10. If a certain pan-chewing MO asks you to take off your apron (female interns) tell him to take a hike.
11. You will get many opportunities to learn a lot of new things, don't waste them.
12. Cook often, if you posses any culinary skills. Otherwise, eat at the local restaurants.
13. Go snake spotting. Also revise how to treat snake bites before you do the same.
14. Go with the mobile unit for medical camps to obscure, untouched villages.
15. Experience personally the Indian people's belief in black magic, till date, as a working cure to all disease.
16. Learn the way of life in a village. Wait for hours for ST buses, stuff yourself into share-e-rickshaws, have random conversations with old ladies you are very likely to meet, and do everything slowly and without a care in the world. Forget that you live in an instant age, for once.
17. Ride the bicycle everywhere, if, unlike me, you do know how to ride one. Easiest and best mode of transport you are likely to find.
18. Do not try to find cake or cheese or butter in the village. All attempts will be unsuccessful. Ice cream, though, you are likely to find.
19. Do not forget to look for fireflies. You will definitely find one. Or tons of them. Depending on your luck.
20. Go with old friends for this trip, or make new friends. Either ways, it will be a memorable affair, that, I promise you.

Sunday, October 2, 2011

Movie Review: Drive

Drive tells the story of a man we know only as 'Driver' or 'Kid' (Ryan Gosling, of Half Nelson fame). Driver is a man of very few words, with a toothpick sticking out of his mouth, and a wide eyed non-judgmental look at the world most of the time. He works as a getaway driver for criminals, as a stunt driver for the movies, and also as a mechanic at a garage. He mostly does what his boss tells him to do, he gives his criminal clients a strict 5-minute window period to avail of his services, and he performs his stunts with unnatural nonchalance and precision. He also has a liking for an ugly silver jacket with a scorpion on the back.

Soon, Driver meets his neighbor, Irene (Carey Mulligan), eavesdrops over her and her son in the supermarket, plays staring games with the son, and well, begins to fall in love with the neighbor (or so we're told). Driver continues to behave like an innocent child who doesn't really know how to react or what to say in a situation like this. There's a scene where both the leads just keep smiling alternately at each other, for at least 5 minutes, and though you laugh initially at all the sweetness, you just wish someone would get on with it.

The entire first half of the movie plays out with minimal dialogues, a captivating background score, and a slightly irritating song called A real hero playing multiple times throughout the movie, each time while Driver is doing stuff which the director thinks would make him look like 'a real hero'. The first time especially, it just ends up looking super-pretentious. Every time Driver opens his mouth and actually says something, it comes as a slight shock and an achievement, since he looks like he is incapable of uttering any words.

Though nothing much is really happening in the movie in the first half, everyone seems to be overstrung, both the people on-screen and those in the audience. We know something is going to happen, so we watch and wait. I spend most of the time trying to guess which psychiatric condition Driver has.

Soon enough Irene's husband, Standard, is released from jail, and comes back into their lives. He is in trouble and is being blackmailed by some goons. When Driver realizes that Irene and her son are in danger, he decides to help Standard out in order to save them. But, things start going wrong, and that's when you sit up in your seats and start enjoying the movie.

There's a scene when half the theater jumps out of their seats, which signifies the start of the second part of the movie with its uninhibited violence. Thus begins a series of kills, and every time a person enters the frame from that point on, you can't help but hold on to your seat and wonder how he is going to die. The violence, the sheer amount of controlled and ruthless rage which Driver displays, and the novel ways in which people are killed without the use of firearms, is, according to me, the USP of this movie.

Driver manages to look devastatingly terrifying, which is a wonderful contrast from his innocent wide-eyed look in the first part. There's a sequence where he wears a mask and kills someone on the beach, it is so brilliant, you should go watch the movie just for that sequence. There are also two brilliant car chase sequences in the movie, likely to leave you open mouthed with awe.

Ryan Gosling acts fabulously well, and so does most of the supporting cast. Carey Mulligan does nothing much but stare at Driver. This movie isn't good or bad, it is an experience, and one I think you should have. Don't expect entertainment, don't expect a sweet romance, don't expect an action movie with a hero who punches everyone and then gets the girl. No. Expect something different, and, in it's own way, beautiful. You'll be glad you watched this movie, if nothing, just cause you got a change from our regular fare.

Rating: 8.5/10.

Thursday, September 22, 2011

Date a girl who reads.

I found the most perfect quote ever. EVER.

Quote by Rosemary Urquico.
Quote found here, sent to me via Sunrise.

Source: here

"Date a girl who reads. Date a girl who spends her money on books instead of clothes. She has problems with closet space because she has too many books. Date a girl who has a list of books she wants to read, who has had a library card since she was twelve.

Find a girl who reads. You’ll know that she does because she will always have an unread book in her bag.She’s the one lovingly looking over the shelves in the bookstore, the one who quietly cries out when she finds the book she wants. You see the weird chick sniffing the pages of an old book in a second hand book shop? That’s the reader. They can never resist smelling the pages, especially when they are yellow.

She’s the girl reading while waiting in that coffee shop down the street. If you take a peek at her mug, the non-dairy creamer is floating on top because she’s kind of engrossed already. Lost in a world of the author’s making. Sit down. She might give you a glare, as most girls who read do not like to be interrupted. Ask her if she likes the book.

Buy her another cup of coffee.

Let her know what you really think of Murakami. See if she got through the first chapter of Fellowship. Understand that if she says she understood James Joyce’s Ulysses she’s just saying that to sound intelligent. Ask her if she loves Alice or she would like to be Alice.

It’s easy to date a girl who reads. Give her books for her birthday, for Christmas and for anniversaries. Give her the gift of words, in poetry, in song. Give her Neruda, Pound, Sexton, Cummings. Let her know that you understand that words are love. Understand that she knows the difference between books and reality but by god, she’s going to try to make her life a little like her favorite book. It will never be your fault if she does.

She has to give it a shot somehow.

Lie to her. If she understands syntax, she will understand your need to lie. Behind words are other things: motivation, value, nuance, dialogue. It will not be the end of the world.

Fail her. Because a girl who reads knows that failure always leads up to the climax. Because girls who understand that all things will come to end. That you can always write a sequel. That you can begin again and again and still be the hero. That life is meant to have a villain or two.

Why be frightened of everything that you are not? Girls who read understand that people, like characters, develop. Except in the Twilight series.

If you find a girl who reads, keep her close. When you find her up at 2 AM clutching a book to her chest and weeping, make her a cup of tea and hold her. You may lose her for a couple of hours but she will always come back to you. She’ll talk as if the characters in the book are real, because for a while, they always are.

You will propose on a hot air balloon. Or during a rock concert. Or very casually next time she’s sick. Over Skype.

You will smile so hard you will wonder why your heart hasn’t burst and bled out all over your chest yet. You will write the story of your lives, have kids with strange names and even stranger tastes. She will introduce your children to the Cat in the Hat and Aslan, maybe in the same day. You will walk the winters of your old age together and she will recite Keats under her breath while you shake the snow off your boots.

Date a girl who reads because you deserve it. You deserve a girl who can give you the most colorful life imaginable. If you can only give her monotony, and stale hours and half-baked proposals, then you’re better off alone. If you want the world and the worlds beyond it, date a girl who reads.

Or better yet, date a girl who writes."   -Rosemary Urquico

Wednesday, September 14, 2011

Nasbandi and Indian Chemists and... other stuff...

I have been setting aside a LOT of stuff inside my head with the tag "has got to go down on blog" for such a long time, that I've started forgetting all those stories and the details that go with them. So, without further delay, I'm just going to try and put it all down in this post. Here goes.

Location: Casualty Department, Tertiary Hospital in Mumbai.

A young man walks in, almost runs in, then sits down, panting, and and tells us: "Mujhe nas bandhi ka operation karwana hai". We all stare at him, pretty amazed (at least I was). I turn around, to check with the MO, and confirm whether he really does mean what I think he does (that he wants to get a vasectomy done!). The MO asks him, "Are you married?" He says no. Then the MO asks him, "Who told you to get this operation done?" He says he figured it out by himself, after watching the Govt. ads on TV, which said that you get paid by the Govt. if you volunteer to undergo a vasectomy. He said his sister was very ill, admitted to a private hospital, and he was falling short of Rs. 900/- for her treatment. She was his only sister, he wanted to save her, so he decided that undergoing a vasectomy would be a good solution. I don't think the ad explains the actual implications of the surgery. Anyone seen the ad? Then tell me what it shows because I haven't seen it. Embedded below is an ironic as well as hilarious video regarding nasbandi that I found while trying to search for a government ad video on the internet.

Anyways, the man didn't seem to realize that undergoing this surgery meant that he would not be able to have a child in the future. He just seemed concerned with the monetary compensation he would get. We sent him away, telling him this wasn't an option for him and that he should probably get his sister treated at a government institution if he wanted to save some money.

Location: Casualty Department, Tertiary Hospital in Mumbai.

An old lady is brought in on a wheelchair, transferred from a peripheral private hospital. She comes with reports of deranged RFTs and S. Creat at 8.3. She gives a history of irregular, unsupervised intake of NSAIDs and other Ayurvedic medications over the past two years, to treat her joint pains and some form of arthritis she supposedly had. The medicine registrar on call cites her chronic intake of NSAIDS as the cause for her renal failure. Makes me think about the tons of patients we subscribe NSAIDs to rampantly, everyday, with or without indications, and without thinking about the dangers of a situation where a patient may start self prescribing and abusing those very same NSAIDs. After all, how difficult can it be to read a drug name, ask the drug dispenser what it is used for, and, upon hearing the magic words 'pain relief' start popping it as and when your fancy arises after obtaining it from your friendly local chemist!

Location: Ob/Gyn OT, Tertiary Hospital in Mumbai.

A patient is taken up for an emergency LSCS, she was already in labour when she came to the hospital...I was posted in anesthesia and I just cannot remember what the indication for her LSCS was. Sorry about that. So anyways, she was wailing and screaming loudly the entire time inside the OT, everyone there was distracted because of her, and this while another surgery was going on in the same room. She had to be given her spinal, twice by the housie, I think the first time it was unsuccessful, thanks in no small part to her screaming and thrashing around. Then, when she didn't stop screaming at all, even after two attempts at a spinal, the senior anesthetist came and asked them to give it for a third time before starting the surgery, just to be safe. Inspite of this, the patient continued her voracious wails of "Aaaaaaa....owwww....majhyaa aai la bolva...aaaaaaeeeeeee" ("Owww....get me my mother...please...aaaaaeeeeeee") at a shocking volume, and atleast 20 people gathered to watch the spectacle. Finally, the obs people started the surgery in all this confusion, it was an emergency after all.

About 10 mins into the surgery, the patient seemed to be calmer, and had taken to just calling out for her aai in a normal voice as opposed to screaming. Now the much-more-visibly-relieved-looking-anaesthetist asked the patient, hopefully: "Aata tumhala dard kami jhala na?" ("Has your pain reduced now?") to which the patient (whose uterus was about to be cut open, may I remind you!) who had so far not given up on her incessant wailing, replied: "Ho, aata jara kami aahe, pan tari pan majhya aai la bolva!" ("Yes, now my pain is relieved, but you must still get me my mother!") At this, the 20 people who were inside the OT spontaneously burst out laughing at the same time, many of them shaking their heads in disbelief. I suppose the wonders which mothers can make happen in this world have no bounds! And I am sure that was the noisiest day ever in the history of that particular OT.

Location: ANC OPD, Peripheral urban health centre, Mumbai.

A young handicapped pregnant patient comes in. She seems to have a deformity in both lower limbs. She doesn't even use a wheelchair, she crawls in with the support of her hands and knees. Her mother accompanies her. We find out that she is unmarried and is now about 8 months pregnant. The patient refuses to take anyone's help to get onto the examination table, and shouts at the doctor for trying to help her. When after several attempts she's unsuccessful, her mother and the doctor try to help her, but it's still not possible to lift her onto the high set examination table. Finally we get her to agree to lie down on the floor of the room and get examined. When asked why she didn't get married, we find out that the father of the child is also handicapped, and he is also unemployed and doesn't have any family to look after him. So they chose not to get married. The patient's family is currently looking after both of them. And it is understood that they will have to look after the baby as well. When advised a visit to an obstetrician in a proper hospital, since this was just a health centre, the mother says she cannot afford to take her daughter by a taxi to any hospital, and the daughter being disabled cannot travel by any other modes of transport available in this city. The patient then crawls out, after telling the doctor haughtily that she need not prescribe any medications because she wouldn't be taking them, and then bursts into tears while leaving. Her mother plans to conduct her delivery at home itself with some local woman's help. I cannot even begin to imagine what it would feel like to be in that patient's place. The entire episode left me pretty dumbstruck.

Her one story just seemed to highlight so many issues in the country - lack of proper rehabilitation or a support system for handicapped people... the handicap-unfriendly public transport system... societal bias against handicapped people... poor reach of healthcare services to the people who need them the most... unemployment... motherhood outside marriage... and I don't know what else!

I'm still reeling from the shock of this story here.

Okay, I have forgotten the rest of the stories. Yes, there were more.


On another note, today's feature in HT Cafe 'Is your chemist the drug-peddler?' was quite interesting, informative and amusing. Being all three at the same time is definitely an achievement. Reading that article reminded me of when, about four years back, I was suffering from some kind of a UTI, and had already taken two courses of medications from my family doctor, with no great relief. I was a lost kid in my 2nd year MBBS at that time. So then, the third time I went to the doctor, he got irritated by me I think.

He wrote my prescriptions, and told me to get one particular drug from the chemist and sent me off with a wide smile. I went directly to the chemists' from there, and gave him the prescription. The chemist read it, gave me a long stare, then got the meds for me. He asked me whether he could keep the prescription. I was mildly surprised, but didn't think too much, gave it to him, and went home. At home, I opened up my brand new, hitherto-untouched pharmacology textbook, and looked up the drug the doc had prescribed. It was a tricyclic antidepressant! With embarrassment I now realised why the chemist had wanted my prescription. I felt angry and insulted, and got up and threw the entire strip, untouched, into the dustbin, and vowed never to go back to that particular doctor! Thankfully, my UTI resolved soon enough so I didn't need to either ways. But this reminds me that the chemist at that time was a good one, who did his job well. And he probably thought I was a teenager with issues. Oh well.

On yet another note, being posted in PSM (Preventive and Social Medicine) is taking its toll. I thought that working in the branch would actually involve practicing some preventive and social medicine. But I am starting to doubt whether the PSM people even practice medicine at all. They just seem to occupy themselves with being lazy, supervising the interns, making us run the dispensary and do all sorts of other clerical work, being humongous pains regarding attendance and (god-forbid!) dropped tablets, and incorrectly treating patients. Let's just hope this trend isn't really as generalized as it is appearing to be.

So. I think that was about enough to make a blog post. Entertaining or not, you tell me.

I will now head off to bed. And to yet another day of new stories to tell you people.

Friday, September 2, 2011

Book Review: The Host by Stephenie Meyer.

I really can't write reviews. But I have desperately wanted to write this one for a long, long time now.

First things first, if you be a Twilight hater, don't judge this book just because of it's author. This book has a very intriguing story to tell, which has nothing to do with the Twilight series, or even vampires for that matter.

This story unfolds in a universe where earth has been taken over by an alien race, called Souls, which inhabit humans and live as parasites in their bodies. The humans are called hosts. Before you start imagining aliens with superpowers and multiple limbs and spaceships and what - not, please stop. This book is nothing like the usual science-fiction fare out there, which is lapped up by many an over- eager geek (including me). Oh no. The book tells, in fact, a most memorable and moving love story (ladies, are you listening?), and it involves nothing about radioactive aliens and genetically mutated offspring, rest assured.

It is a unique combination of science-fiction, romance and drama. I love me some drama.Of course, it has its own dose of sappy lines. And I found I didn't mind them that much.

Do try to ignore the prologue if  by any chance you get bored by it. Do not, I repeat, please do not give up on the book, just because the prologue and the first couple of chapters seems boring.

We get to meet Wanderer (Wanda) first, she is the alien, the Soul. I have to say hers is the most idealistic and most humane fictional character I have ever come across in a book. How ironic then that this character should actually be an alien. You get to know her better as the story progresses, and you come to love her, like everyone else in the book seems to.

Then we meet Melanie, she is the host whose body Wanda has been given to inhabit. When a Soul enters its host, it starts anew in the host body, the host's mind having been erased out. The Soul is supposed to be in complete control of the body. However, this does not happen with Wanda, who, when she wakes up in her host body, discovers, soon, that her host, the original owner of the body, Melanie, is still alive and present inside her head! This leads to a unique situation, and forms the plot for the story.

Melanie is portrayed as a fierce, independent, and beautiful woman, a survivor, someone I would love to become like one day.

Melanie loved a man, Jared, in her lifetime. The way she sees him in her memories, which Wanda now has access to, makes Wanda fall in love with him as well. Messed up, I know.

Unable to control and extinguish her stubborn host, and unable to control her own strange desire to see Jared, Wanda, along with Melanie of course, sets out in search of the man they love.

Go read the book and find out more about this story....

I love the way the author portrays the human race throughout this story, as seen through the eyes of an alien. It just shows people, in general,  in a whole new light to me. And I love the flashbacks in the initial part of the novel, that is all I kept reading for, in fact.

This is a wonderfully told tale, though a bit slow at first, with many unforgettable characters, hateable villains, and tear jerking moments. I have read this book five times, and I wept at least a little every time. And I am not such a sap, in general. I swear.

I love that this book doesn't have a tall, dark, and handsome hero, who sweeps in to save the girl and to save the day. Oh no. This is the two heroines' book, all the way.

All the human characters (both male and female) in this book are flawed, and amazing, and lovable, and well, human. I love the author for creating them.

And then we have Wanda, the alien, who's almost flawless. Another victory for the author here.

Somehow, through this book, the author makes me value being a human, something I never even thought about before!

Judging by the number of times I have used the verb 'love' while writing this review, I think you can gauge how much I, err.... love this book. I am so glad I own this book, and I look forward to reading it many more times in the future, curled up and happy, knowing it will always satisfy my need for romance and drama, and leave me with a warm happy feeling and a satisfied smile every time I read it.

Thank you, Stephenie Meyer. A 10/10 and a huge hug for you.

Some quotes from The Host:

1.“I held you in my hand, Wanderer. And you were so beautiful.” - Ian.

2. "Something I've never seen in all my lives. I'm staring at...hope." - Wanda.

3. "I won't erase you, Melanie" - Wanda.

4. "My house, my rules" - Uncle Jeb.

5. "Eight full lives. Eight full lives and I've never found anyone I would stay in a planet for, anyone I would follow when they left. I never found a partner. Why now? Why you? You're not of my species. How can you be my partner? It's not fair. I love you." - Wanda.

6. "You and I won't lose each other, I will always find you again. No matter how well you hide. I'm unstoppable." - Jared.

7. " It's a strange world."
    "The strangest."

8. Ian: "She is. Melanie is a very pretty girl. Even beautiful. But pretty as she is, she is a stranger to me. She's not the one I... care about."

Wanda: "It's this body."

Ian: "That's not true at all. It's not the face, but the expressions on it. It's not the voice, but what they say. It's not how you look like in that body, it's what you do with it. You are beautiful."

9. "You never know how much time you'll have." - Melanie. 

10. "We girls have to stick together."-Melanie

11. "Right now, if I was given the choice between having the world back and having you, I wouldn't be able to give you up. Not to save five billion lives." - Jared Howe to Melanie Stryder.

Monday, August 15, 2011

Internet Snobbery

It's funny how with the advent of widespread internet usage, people seem to suddenly have opinions about every single thing on the planet. And with platforms such as Facebook and Twitter, they want to voice their opinions regarding every miniscule thing and foist them down everyone else's throats.

And, God forbid, should someone not agree or not like what they have to say, well, they're ready to defend their opinions till their dying day, in their chat lingo, on every internet forum available to them.

Frankly, I am about tired of these internet wars. They seem to serve no purpose in life other than boosting people's egos and wasting people's time.

Watch any YouTube video, and there will be a war in the comments section. On topics totally unrelated to the video. Pick up any random status update on Facebook with any observation or comment about anything, and there will be at least one person in the comments who begs to differ. And then they will both proceed to squabble and establish their superiority over each other.

Like this:
Source: here

I wonder what ever happened to the notion of having "differences of opinion" ....and just leaving it at that? Never heard of the saying "to each his own"?

There's a new culture developing amongst people these days, I call it "Internet Snobbery". These are people who think that "I am smart, and so if I feel like this, I am right, and everyone who doesn't agree with me is a dumb loser". It's just not done.Why can't people accept that everyone is going to have a different opinion about everything and just let it be. Whenever someone says something on a virtual platform, someone else will have to disagree and call him a dumbfuck and laugh at him for saying that thing.

I am all for sensible debates about important issues where both sides benefit and it broadens everyone's point of view regarding the issue. But just putting down someone because you don't agree with them and carrying around a "holier than thou" attitude all the time is so not done.

Everyone is entitled to their own opinion. But constantly squabbling, disagreeing, and insulting what someone else says/thinks/writes, is just bad etiquette, and it's irritating as hell. I just don't see how it's justified in any way.

I know it's considered good to call a spade a spade, but what if no one wants to hear YOU call their spade (which may or may not be a spade), a spade? Wouldn't it be better to just leave them alone, then? Rather than going to their blog or Facebook wall and shouting "THIS IS A SPADE, THIS IS A SPADE", when no one wants to listen to you. Did they ask for your opinion about their spade, seriously? Then why can't you just ignore their spade, for once, and go do something more useful? So what if he's got a spade and he doesn't know it? Let him live his illusion. You just go live your life. When someone asks you for your advice, then you can call a spade a spade.

I know that people might be ignorant and stupid at times, and you might feel the need to banish their ignorance by snobbishly proclaiming, what, in your opinion, might be the better point of view, but do you really always need to proclaim your opinions to others?

There's this obsession we all are developing for instant gratification by getting people to like our status updates, or agree with what we say, and love what we love. It's scaring me.

I am not even saying that I haven't been guilty of everything I am writing about. I am pretty sure I have. And I am not being diplomatic over here. But now I am finally realizing how pointless squabbling over the internet can be. And how short lasting this instant gratification thing is.

I mean, is it really necessary to even HAVE an opinion about everything? For example, here are some things I have no opinion about. I don't care enough about them to have an opinion.

Justin Bieber. Indian Cricket team. Independence day. Politics. Economic depression. Saifeena. Your relationship status. Gay marriage. And probably a lot more.

See, it's just so much more easier to not care. Why rack you brains, come up with an intelligent sounding opinion, and then bombard it on others?

Writing this post reminds me of the Jain Principle of Anekantavada. That is one notion that has always fascinated me to no end. Translated literally, "Anekantavada" means "no-one-perspective-ism," in other words, the multiplicity and relativity of views. By this, they meant that in many cases the arguments proposed by the various participants in a debate all hold some validity. It is the notion that truth and reality are perceived differently from diverse points of view, and that no single point of view is the complete truth (Yes, I just copy pasted that line from somewhere). It basically teaches you to accept other people's points of view and allow that they might be true in their own right and within their limitations.

This principle is best explained by the story of the blind men and the elephant. (Source: here)

 "A well-known story from Jain mythology helps to illustrate Anekantavada. Five blind men have never seen an elephant. When one day an elephant is brought to the village, the five approach, touch and attempt to describe it. One man, who is standing by the trunk, describes it as a thick branch of a tree. The man who feels the tail disagrees, insisting it is rather like a rope. The man who touches the side, in turn, submits that the elephant is actually like a great wall. But the man at the elephant's leg says it is like a pillar, and the man who gets hold of the ear describes it as a huge fan. Luckily, a wise sixth man is nearby to mitigate the dispute. He proclaims that, in fact, all are right, but only partially right. An accurate description of the elephant lies in combining the various partial views. Consequently, a complete understanding of any truth requires the consideration and acceptance of a variety of viewpoints."

Yeah, I know, it's sort of difficult to understand this principle. I don't think I actually have, till now. But it's definitely fascinating.

I realize I may have veered off topic.

Moving on.

I also strongly believe that if you don't have something good to say about some particular thing, it is better to say nothing, rather than to say something bad. But then, that's just my personal opinion. I will not force it upon you. I guess.

But then, what did I just do by writing this post? I don't know. I give up. :-P

So then this is the end of my rant. Just rest assured, that I won't be participating in any internet wars from now on.

How have you all been? Let me know :-)

Monday, August 1, 2011

Catching up. And deaf culture.

I know.

Long time, no see.

I was just going through a hide - underground phase. Didn't feel like writing much. Now I'm back. And I'm rusty.

Anywho. Internship's been going on pretty much as usual and as expected. But most times I really enjoy the contact with various kinds of people it brings for me.

Now just during my last 15 day Ophthalmology posting, all I did was check the visual acuity of the patients in the OPDs. Very boring, you might think? Yeah. I guess. But you know, not really.

It's just fun coming across so many people and all their idiosyncrasies and wondering about their back stories.

And I just love it when a patient comes and wishes me "Good morning Doctor" with a really excited smile. It makes my day.

So, ophthal brought me tons of kids who thought reading out the visual acuity chart correctly was like passing in a school test, old ladies who forced their life stories upon me instead of getting tested, the relatives who tried to prompt to the patients whenever they wouldn't read correctly, the little kid who tried to cheat by peeking through her good eye every single time I asked her to read anything, the proud uncles who were too embarrassed to admit they couldn't see, and the pros who were so used to the testing they just told me up to which line they could read. And of course, the occasional lecherous old men. But yeah.

I pretty much enjoyed the experience. 

But there's one story I'm unlikely to forget. A 17 year old kid came in one day along with his father. He was thin, lanky, and otherwise looked non-descript. Once he took his seat his father informed me that he was deaf. I was mildly surprised, but didn't react. Instead I was pretty much in awe.

*More info required here* So, of late, I have taken to watching a new series called 'Switched at birth'. One of the two protagonists on the show is deaf, and the show also has a lot of other hearing-impaired characters. The show has vastly improved my knowledge and education regarding the community of deaf/hearing-impaired people, acquainted me with the kind of lives they live, and helped me develop an immense respect and greater awareness about them. It also introduced me to what is known as deaf culture, as well as to the ongoing debate in the community regarding cochlear implants.

I have never ever met a deaf /hearing-impaired person earlier in my life. So when I came across this kid, I looked at him in wonder. I know that some deaf people talk aloud, and some don't. He was one who didn't talk aloud. His dad pretty much talked for him. I also noticed that neither of them used sign language, quite unlike what I saw on the show. Neither did the kid seem to know lip-reading. But then again, this was India. So then their problems and the way they live over here and how they deal with it would be totally different. I probably still need a lot more education in this area.

Anyhow, so, back to the story. The kid sat there, a bit confused about how to proceed. I immediately got up, and started pointing out to the boxes I wanted him to read, and he immediately responded by gesturing the answers with his fingers. He looked sad when he couldn't read beyond two lines with one eye, and nothing with the other. That meant even his vision was poor.

When I glanced at his papers, his history said that he had been diagnosed with a cancer in his lymph nodes a couple of years back and was still undergoing treatment for the same. And now, from the looks of it, even his vision was receding. he didn't wear spectacles, so it had to be a recent development.

After knowing all this, I couldn't  bear to ask his father anything else. About whether he was hearing impaired since birth, since when and why was his vision receding, and how was he dealing with the cancer. How can one person have to deal with so many problems and that too so early on in their lives?

It scared the shit out of me. So I acted like a coward. I was too scared to find out what his life was like. I didn't want to know. I wouldn't have been able to bear it. So I didn't ask. I just politely sent him his way.

Hopefully I will learn better. But I have thought about him often after that.Which has obviously led to this post.

Then just a few days after that incident, I came across this quote put up in a frame inside my ENT department:

"I am just as deaf as I am blind. The problems of deafness are deeper and more complex, if not more important than those of blindness. Deafness is a much worse misfortune. For it means the loss of the most vital stimulus-- the sound of the voice that brings language, sets thoughts astir, and keeps us in the intellectual company of man.

Blindness separates us from things but deafness separates us from people."

- Hellen Keller.

While I had heard of Hellen Keller before this, I didn't really know her story very well. Researching that thought-provoking quote led me to read more about her. I am so glad that happened. Her story was one of the few truly inspiring ones I have read.

It also made me realize that the Hindi movie 'Black' must be inspired by her story. I just wish it hadn't starred Amitabh Bachchan (Yeah, I don't like him too much). Just watch this trailer and you'll see how similar the two movies must be if you've seen Black. Now I am going to watch the original movie.

Anyhow, so I am going to correct my lack of knowledge about hearing disabled people. Hopefully my post will make you want to do the same.

I guess I'll leave you now with all this food for thought. End of post.

Good night and good bye.

Sunday, July 17, 2011

Not yet forgotten

About this photo: Dug this one up from some of my old shots. This was clicked with my first camera, a film SLR, Nikon F55. Clicked in a tiny village in Punjab, about three years back, this little girl was staring sullenly at us, while we roamed around like the quintessential city tourists who seemed to have landed up in the village by mistake. :)

Now I wish I had spoken to her at that time. I wonder what was her name, and what was her story? Guess I will never know.

Sunday, July 10, 2011


I am finally making a list of things to do before I die. Because I woke up today morning feeling like I am wasting my life away.
Image Source: here.

 1. Publish a book.
2. Write fiction.
3. Become rich enough to afford a bad-ass camera and lenses.
4. Become a great derdermatologist.   
5. Travel a lot. (The exact guidelines for this item on the list are yet to be made)
6. Run a famous blog with an anonymous identity.
7. Have a pet.
8. Change atleast one person's life.
9. Become an  excellent teacher. 
10. Start a charity.
11. Build a hospital.
12. Watch every awesome movie ever made by mankind.
13. Attend a live music concert by an international artist I love.
14. Get in shape. As in, get fit. (I am not overweight at all, don't think like that! I just want to force myself to exercise :P)
15. Don't lose any more friends.
16. *
17. Read every book written by Judith McNaught.
18. Become a good doctor.
19. Look down (err...up?) a telescope
20. Save a life.
21. Win a poetry prize.
22.. Visit Disneyland.
23. Master the art of cooking.
24. Simulate a fairy tale at some ipoint in life
25. Send parents on vacation.
26. Design my own beautiful house.
27. Buy own car and finally be a confident driver. 
28. Visit Greece, Galapagos and the Amazon valley.
29. Read this list often. Atleast it will remind me of what could have been.

This list could go on and on. I am ending it for now and going to pursue some of my more immediate goals. But this list is an ongoing dynamic process.

This is definitely not the last you are hearing of it.

Have a blessed Sunday :)

Thursday, July 7, 2011

Looking back on June

A list of some of the things I enjoyed a lot this month.

Song of the month:
Someone like you - Adele.
I don't think I will ever get enough of this song. 

Book of the month:
Something Wonderful - Judith McNaught.
I recently discovered this romance author, all thanks to my friend Nikshi, and her books are by far the best I have read in a long, long time. Not at all like the superficial, fluffy, romances we get to read everywhere these days. She creates such strong characters and tells such beautiful stories it is difficult to not be moved every time you read her books. The one I have picked here has a story which I am unlikely to forget, ever.

Quotes from Something Wonderful:
1. "What are you looking at?" Jordan demanded finally, watching her.
"A dragon." When he looked bewildered she lifted her arm and pointed to the sky in the southeast. "Right there—that cloud—what do you see when you look at it?"
"A fat cloud."
Alexandra rolled her eyes at him. "What else do you see?"
He was quiet for a moment studying the sky. "Five more fat clouds and three thin ones."

2. "Conventionality is the refuge of a stagnant mind" - Alexandra Townsend.

3. "A lie is an affront to the soul, as well as an insult to the intelligence of the person to whom one lies."

4. "Think of my immortal soul, sweetheart. It's black and,without you here to make me mend my ways, I'll undoubtedly slip back into my old habits." - Jordan.

Movie of the month:
Hotel for Dogs.

You don't have to be a dog lover to enjoy this movie. But all dog lovers should definitely catch this movie. One of those uncomplicated, feel-good, entertaining movies that comes along once in a while. A lot of furry love, animal jokes, goofy humour, weird kids, and melt your heart moments. Sometimes it just feels good to shut down your brain and act like you're a 15-year-old with no worries in life. With this movie, I could achieve that.

Blog of the month:
In and Out of Love

Thursday, June 30, 2011

Movie review - Transformers : Dark of the moon

 Let me just say this first. Ohmygosh....that was SO-DAMN-AMAZING!

If you were smart, you would just stop reading this and go watch the movie right now.

If you still want to continue reading, here goes.

When the first Transformers movie released, I was in love. It was brilliant, out of this world (I had never heard of the Transformers before this), and introduced some very lovable mean machines. I was sold. I have since watched the first movie five times, and enjoyed it just as much everytime. The relationship between Bumblebee and Sam has always been the best part about the movie for me, and always will be.(No guys, I did not forget to consider Megan Fox when I said that).

Then the second movie came along. The entire thing was just a forced attempt to make a fancy sequel and introduce meaner machines, without any real story. In plain words, it was a let-down, but not such a huge one so as to end my love affair.

And then, today, the third movie released - Transformers: Dark of the moon. From the trailers, I knew I was going to watch it, but I didn't expect anything too different or anything too fabulous. However, the movie did deliver 'too different' and 'too fabulous'. And how.

The initial story and the way the movie starts is ingenious. The humans' first expedition to the moon is shown to actually have been a super-secret mission to investigate a UFO landing observed on the moon. Only 35 people knew the truth about that mission, and they are all dying suddenly. All the videos and the footage to make this story believable have been shot fabulously. So that was an engrossing start.

Then we meet our hero, Sam Witwicky (Shia LaBeouf) who is now job-less, and BumbleBee-less (temporarily, while Bee works at saving the world). He has a brand new hot, rich GF. No explanations about the changes in his relationship status are given or asked for. Somewhere along the movie, she is shown to be "the one" for our hero, and they share an undying, legendary, and totally difficult-to-believe love affair, complete with the cheesiest lines and the corniest background score.

So this movie has no Megan Fox. But the replacement is pretty much similar. I don't know her name and don't care to find out. One thing I do appreciate is that her character gets an opportunity to actually use her brain, in the climax of the movie. That, and the ability to tear off the foot of a soft-toy bunny, just like that, in one swipe.Those are her most important contributions to the movie.

The kid's parents make their appearance and say their lines, evoking a chuckle or two in the process. Two very notable and very hilarious appearances by Ken Jeong (of Hangover fame) and John Malkovich, had me laughing my ass off. John Turturro as Lennox was everything one would want him to be.Very lovable, I must say.

As the story progresses, it stays quite interesting, and we're treated to some absolutely stunning visuals and action sequences. Beautiful stuff. The 3D is very good, and being the impartial 3D lover that I am (I love all 3D, be it good, bad, ugly, or headache-inducing), I have absolutely no complaints. Unlike the second movie, where the last half an hour was just a mass of moving, crashing metal, here it's very easy to see what's going on, and who's killing whom, and how. And they make it all look gorgeous. Enough to induce a Sci-Fi-gasm in all you Sci-Fi lovers out there.

We meet new Autobots (the good robots), we meet new Decepticons (the bad robots), and we meet Lennox's love interest. Shockwave the Decepticon is awe-inducing. Patrick Dempsey makes a sumptuous villain. As a Grey's Anatomy fan, it was good to see him play a negative role.:)

The last hour of the movie is a stunning climax where we're treated to breathtaking visuals of Chicago city, tons of people die with a poof, their only remains being vapor and broken bones, no soft tissue. Many acts of bravery are committed, and the Autobots and the US soldiers get to shine in all their glory. The limelight, however, is all on Optimus Prime, and he does not disappoint. I found myself searching for him in all the scenes, and waiting for him to enter any ongoing action sequence, just so things got more interesting. He gets to mouth some very cheesy, yet very memorable dialogues in the movie. Of course, your heart can't not go out to BumbleBee, and you can't not want to hug him, as always.

You can't help but feel the American patriotic undertones during the last hour, as the battle is fought, and many a brave soldier risks his life, and dies. Adds to the entire good feeling you get at the end of the movie, I guess, though I may not have connected too much, being a non-American.

The soundtrack of the movie is lovely, the background score though, was too patriotic and war-movie like, got on my nerves at times.

I wish there were a female Autobot though. Optimus Prime totally needs a love interest. Maybe next time?

Overall, the movie was fabulous, very entertaining, and I already can't wait to watch it again. It will make you glad you ever watched the first part of this installment, and even more glad that you stuck through the second part. Go watch it, you are in for a treat.:)

My rating: 8.5/10.