ELATION!
CONTEMPLATION!
BLISS!
SUSPICION!
SOMNOLENT!
EXASPERATION!
ASTONISHMENT!
CONTENTMENT!
(All photos copyright Dr Manjunath Byadigere, 2011)
Monday, June 6, 2011
INNOCENT FACES!
ELATION!CONTEMPLATION!BLISS!
Thursday, March 31, 2011
An Ode to the Rain Tree
A few days ago when Anitha (my wife) and I were on our usual post-dinner walk our discussion turned towards the nearby rain tree. She noticed the tree and said something was different in it at night. I told her that the tree was sleeping as the leaves were folded. We stood under the tree and gazed at the canopy for sometime wondering at its animal like behaviour. Looking at the bright fluorescent street light close to the tree she asked me how could the tree sleep with the bright light so close by. This question made me think as I didn’t know the answer but raised some more questions in my head. Are we doing any justice to the tree for all the things the tree is giving us? We are shamelessly utilising the many benefits of the tree and not even allowing the tree to sleep peacefully at night!
I see you every morning,
Wholesomely green with not a chink,
With your leaves shining,
And with your blanketed canopy pink.
To find you feeding the parakeets,
With your ripened sweet pods,
And the bees buzzing on your flowers,
For your sweet nectar in florid pots!
I wonder at the glow,
Your flowers show,
Echoing the sun’s rays,
To lift my mood in many ways!
Am in awe looking down,
To see your shell like pod,
With the seeds in line as if sown,
Flattened and adhered to the road.
I wonder if I can make a ball,
Like I made them in my childhood years,
With the thick gooey pulp,
Of those dark ripened fruits of yours.
[Video link http://www.youtube.com/watch?v=6HwR5ZE99RA ]
In the golden dust of your dead flowers,
I stand shielding myself from the callous sun,
And seeing the scorched flowers tumbling down the air,
Ah! Yes, they remind me of my granny’s hair!
I gather as the sun goes down you fall asleep,
With the darkness your leaves fold in a clap,
But I wonder where at night will you go,
With all the city bright and aglow?!
I see you every morning,
Wholesomely green with not a chink,
With your leaves shining,
And with your blanketed canopy pink.
To find you feeding the parakeets,
With your ripened sweet pods,
And the bees buzzing on your flowers,
For your sweet nectar in florid pots!
I wonder at the glow,
Your flowers show,
Echoing the sun’s rays,
To lift my mood in many ways!
Am in awe looking down,
To see your shell like pod,
With the seeds in line as if sown,
Flattened and adhered to the road.
I wonder if I can make a ball,
Like I made them in my childhood years,
With the thick gooey pulp,
Of those dark ripened fruits of yours.
[Video link http://www.youtube.com/watch?v=6HwR5ZE99RA ]
In the golden dust of your dead flowers,
I stand shielding myself from the callous sun,
And seeing the scorched flowers tumbling down the air,
Ah! Yes, they remind me of my granny’s hair!
I gather as the sun goes down you fall asleep,
With the darkness your leaves fold in a clap,
But I wonder where at night will you go,
With all the city bright and aglow?!
Thursday, February 24, 2011
'Devaru'... The God. A short story.
This short story is dedicated to all the Postgraduates in all the specialities of Medicine.
This story is completely fictional. All the characters and situations are entirely fictional and do not carry any medical sense nor legal significance, and have been created only for the purpose of this story. Any resemblance is purely coincidental.
[Prologue:- This story is about the doctors who are NOT gods but humans. Human beings with all the characters, sentiments, feelings, emotions, beliefs and idiosyncrasies like the rest of us. This story is not just about the protagonist, or his mother or the intern but also about his junior, ‘Trauma’, and also the assistant to the obstetrician who are all human and doctors... but not gods.]
‘Hi Sir’ she smiles at me with her dimples showing off as she whizzes past me holding a lab sheet in her hand. I feel a breath of fresh air for a moment and feel relaxed forgetting the fact that I was working nonstop for eighteen hours and getting grilled by ‘Trauma’ in the OT. ‘Hello...’ I reply, but she’s gone already past me into the emergency lab. Well, what the hell... I still had two days to ask her out before she completed her internship postings in my unit. Every time I saw her she disturbed my thought processes. I now try and concentrate on the call I was given by my junior as I rush down to the Casualty from the OT.
The patient is almost breathing heavily as I can hear him at the emergency room door. My junior, a thin, tall, spectacled Bagalkot guy rattles off before I even reach the bedside ‘Eighteen year old male, RTA two hours ago, pillion rider, driver dead, pulse one twenty and going up, BP sixty by forty and dropping rapidly ....now not recordable, tachypnaeic, GCS fourteen, CVS and RS clear, no external injuries other than a bruise right chest, abdomen tap nil, fluids started with green needles ...’ ‘Heart, chest sounds?’ ‘Clear ree sara, nodeenree’ (Its clear Sir, I’ve seen it) but he hands me the steth. The patient is now restless and throwing his arms around. I try and listen to his heart in the emergency room with all the noise around. Multiple sounds ... from the surroundings, ‘whoooosh’ his left lung goes and with a slightly duller right side. I take out the steth and watch his chest. The ribs showing in his emaciated chest... the gap between the ribs on right side more than the left side..... ‘Large bore needles’ I call out ‘It’s a pneumothorax’, I quickly stab in two IV fluid cannula’s at the second (ICS Inter costal space) with the false hope of removing the air in his lungs as the nurses hold the boys limbs ... and as my junior searches for a large bore needle in the metal cupboard. Luckily I remember the blade in my pocket... I take out one and stab between the cannulae .... ‘aahhh’ the guy cries in agony as he experiences pain without any anaesthesia .... I take out my metal Jetter pen; take off the refill and stab the sheath in with all my weight... the muscles give way as I hear the soft whistle of escaping air...
I wipe away sweat from my forehead and foggy glasses and blood from my hands as I notice a middle aged man beside the bed in his torn shirt covering his mouth with a dirtied towel... and staring at me with bewildered eyes. My junior runs back to me ‘Saraa, large bore ...’
-----------------------%------------------------
I look at my mobile. 3:22am. ‘Vrrrrrrr...’ the vibrations in silent mode makes me almost drop the Android. ‘Trauma calling...’ Well, Trauma was my very sadistic very senior staff member. He was interested in trauma cases and derived extreme sadistic pleasure from traumatizing us with his trauma related patient management and questions. ‘Yes, Sir ....’ I’m now more humble than it sounds. ‘Yes Sir, coming Sir...’ The bloody quack wanted to do a quick rounds at this hour and so I run to the wards.
She’s there, in front of Trauma, both showing off their teeth and smiling at each other for some f**king silly reason I assume. His face turns ominous as he sees me; she acts serious as if she has not noticed me. He looks down at the patient and with his deep gurgling voice thunders ‘Ahh..., eega araam iddira?’ (How are you now?), the patient is almost in stupor and sleepy but manages to mumble ‘parvaagilla saar’ (not bad sir), ‘Passed flatus?’, before I realise that the question was directed at me Trauma asks ‘I’m not asking the patient if you have passed flatus’, She giggles. His face is shone as if he has won a battle. ‘Sir, he is taking orally ...’ He realises his mistake of misrecognition now ‘Ahhh... he is the intestinal obstruction patient, right?’ ‘Yes sir, the operated blunt trauma patient is on the other side...’ ‘Yes, of course, but the exams are fast approaching and you guys still have no wind of when patients break wind, ehh’ He chuckles at his own joke and she, somewhat strangely continues with her giggles.
Racing down to follow-up another patient at Casualty I curse Trauma immensely and request divine intervention in sending him back to his wife at Delhi or even to his getting-aborted-twice-a-year unmarried daughter who was ‘studying’ in the US of A. Trauma, as I understand him, he himself must be under a lot of trauma at present!
Oops! My Android! I remember keeping my mobile beside the Obstruction patient’s bedside... I rush back in haste. Just as I’m passing in front of the Duty doctor’s room I notice I’m attracted to something sounding familiar. I slow down in front of the dark room and listen to the familiar deep gurgling voice, paradoxically which is something like a whisper now. As I wonder with whom Trauma was talking at this hour I hear the attractive giggles, muffled at the same time!
-----------------------%------------------------
I walk in silence to the patient’s bedside; pick my Android which looks as if it was lying there orphaned. My assumption had come true. The whole world seemed as if motionless and insignificant now. Unknowingly I’m in my duty room tired... and almost deceived, gazing at my mobile pointlessly. And I don’t know why, at four in the morning and after forty days I remember her for the first time. I call my mom.
I hear a woman howling as my mother’s voice breaks in ‘One minute Putta...’ Yes, she still called me ‘Putta’. I wait as the howling gets intense and as my mother requests her assistant ‘...will you please continue with the delivery, I need to take this...’ a voice answers sincerely ‘No problem, ma’am’ ‘Yeah, call me if there is anything... I will be just outside’. As a practicing Obstetrician she was deliberate with her processes. I hear her ripping off her gloves as she comes back on ‘Studies chennagi nedeetha iddya putta?’ (How is your studies going Putta?)Is she worried about my studies more than me! ‘Huu... nedeetha ide.’ (It’s going on) I answer more vaguely. I hear her breathing softly now.
Silence.
More silence follows as I don’t know what to talk. ‘Avalu siglilva...?’ (You didn’t get her, right) ‘Aaa...’ I’m speechless, ‘hmmm... aa intern thane? Avaligintha olle hudugi sigthale bidu ninage... You are worth more than that girl. She didn’t deserve you!’ Again, I don’t know why but some tears rolled down my cheeks as my voice was caught in my throat. In the background the howling had stopped and I could now hear the first cry of the baby.
Forty days ago I had made a passing comment about my intern, and that’s it, now she knew the whole story! As I found it difficult to breath I quickly managed to utter ‘Will call you later mom’ and cut the call... and I broke down.
-----------------------%------------------------
I wait for some time to get ‘stabilised’ and wash my face before coming out of my room to see what my junior has done with the newly admitted patients. As soon as I come out I notice the middle aged man with the torn shirt sitting directly in front of the room on haunches. His eyes look sunken and bright at the same time now. He gets up seeing me. As I turn towards the Casualty he almost leaps to my feet to hold them together. I wait. He is now in tears as I feel the drops of warmth on my socks. He stutters between sobs ‘Devaru saar neevu, Devaru neev nange...’ (You are my god Sir) I hold him by his shoulders to lift him up. As he gazes at me and wipes his tears with his dirtied towel I slowly walk away from him to inspect a freshly wheeled-in young lady who is burnt from head to toe.
This story is completely fictional. All the characters and situations are entirely fictional and do not carry any medical sense nor legal significance, and have been created only for the purpose of this story. Any resemblance is purely coincidental.
[Prologue:- This story is about the doctors who are NOT gods but humans. Human beings with all the characters, sentiments, feelings, emotions, beliefs and idiosyncrasies like the rest of us. This story is not just about the protagonist, or his mother or the intern but also about his junior, ‘Trauma’, and also the assistant to the obstetrician who are all human and doctors... but not gods.]
‘Hi Sir’ she smiles at me with her dimples showing off as she whizzes past me holding a lab sheet in her hand. I feel a breath of fresh air for a moment and feel relaxed forgetting the fact that I was working nonstop for eighteen hours and getting grilled by ‘Trauma’ in the OT. ‘Hello...’ I reply, but she’s gone already past me into the emergency lab. Well, what the hell... I still had two days to ask her out before she completed her internship postings in my unit. Every time I saw her she disturbed my thought processes. I now try and concentrate on the call I was given by my junior as I rush down to the Casualty from the OT.
The patient is almost breathing heavily as I can hear him at the emergency room door. My junior, a thin, tall, spectacled Bagalkot guy rattles off before I even reach the bedside ‘Eighteen year old male, RTA two hours ago, pillion rider, driver dead, pulse one twenty and going up, BP sixty by forty and dropping rapidly ....now not recordable, tachypnaeic, GCS fourteen, CVS and RS clear, no external injuries other than a bruise right chest, abdomen tap nil, fluids started with green needles ...’ ‘Heart, chest sounds?’ ‘Clear ree sara, nodeenree’ (Its clear Sir, I’ve seen it) but he hands me the steth. The patient is now restless and throwing his arms around. I try and listen to his heart in the emergency room with all the noise around. Multiple sounds ... from the surroundings, ‘whoooosh’ his left lung goes and with a slightly duller right side. I take out the steth and watch his chest. The ribs showing in his emaciated chest... the gap between the ribs on right side more than the left side..... ‘Large bore needles’ I call out ‘It’s a pneumothorax’, I quickly stab in two IV fluid cannula’s at the second (ICS Inter costal space) with the false hope of removing the air in his lungs as the nurses hold the boys limbs ... and as my junior searches for a large bore needle in the metal cupboard. Luckily I remember the blade in my pocket... I take out one and stab between the cannulae .... ‘aahhh’ the guy cries in agony as he experiences pain without any anaesthesia .... I take out my metal Jetter pen; take off the refill and stab the sheath in with all my weight... the muscles give way as I hear the soft whistle of escaping air...
I wipe away sweat from my forehead and foggy glasses and blood from my hands as I notice a middle aged man beside the bed in his torn shirt covering his mouth with a dirtied towel... and staring at me with bewildered eyes. My junior runs back to me ‘Saraa, large bore ...’
-----------------------%------------------------
I look at my mobile. 3:22am. ‘Vrrrrrrr...’ the vibrations in silent mode makes me almost drop the Android. ‘Trauma calling...’ Well, Trauma was my very sadistic very senior staff member. He was interested in trauma cases and derived extreme sadistic pleasure from traumatizing us with his trauma related patient management and questions. ‘Yes, Sir ....’ I’m now more humble than it sounds. ‘Yes Sir, coming Sir...’ The bloody quack wanted to do a quick rounds at this hour and so I run to the wards.
She’s there, in front of Trauma, both showing off their teeth and smiling at each other for some f**king silly reason I assume. His face turns ominous as he sees me; she acts serious as if she has not noticed me. He looks down at the patient and with his deep gurgling voice thunders ‘Ahh..., eega araam iddira?’ (How are you now?), the patient is almost in stupor and sleepy but manages to mumble ‘parvaagilla saar’ (not bad sir), ‘Passed flatus?’, before I realise that the question was directed at me Trauma asks ‘I’m not asking the patient if you have passed flatus’, She giggles. His face is shone as if he has won a battle. ‘Sir, he is taking orally ...’ He realises his mistake of misrecognition now ‘Ahhh... he is the intestinal obstruction patient, right?’ ‘Yes sir, the operated blunt trauma patient is on the other side...’ ‘Yes, of course, but the exams are fast approaching and you guys still have no wind of when patients break wind, ehh’ He chuckles at his own joke and she, somewhat strangely continues with her giggles.
Racing down to follow-up another patient at Casualty I curse Trauma immensely and request divine intervention in sending him back to his wife at Delhi or even to his getting-aborted-twice-a-year unmarried daughter who was ‘studying’ in the US of A. Trauma, as I understand him, he himself must be under a lot of trauma at present!
Oops! My Android! I remember keeping my mobile beside the Obstruction patient’s bedside... I rush back in haste. Just as I’m passing in front of the Duty doctor’s room I notice I’m attracted to something sounding familiar. I slow down in front of the dark room and listen to the familiar deep gurgling voice, paradoxically which is something like a whisper now. As I wonder with whom Trauma was talking at this hour I hear the attractive giggles, muffled at the same time!
-----------------------%------------------------
I walk in silence to the patient’s bedside; pick my Android which looks as if it was lying there orphaned. My assumption had come true. The whole world seemed as if motionless and insignificant now. Unknowingly I’m in my duty room tired... and almost deceived, gazing at my mobile pointlessly. And I don’t know why, at four in the morning and after forty days I remember her for the first time. I call my mom.
I hear a woman howling as my mother’s voice breaks in ‘One minute Putta...’ Yes, she still called me ‘Putta’. I wait as the howling gets intense and as my mother requests her assistant ‘...will you please continue with the delivery, I need to take this...’ a voice answers sincerely ‘No problem, ma’am’ ‘Yeah, call me if there is anything... I will be just outside’. As a practicing Obstetrician she was deliberate with her processes. I hear her ripping off her gloves as she comes back on ‘Studies chennagi nedeetha iddya putta?’ (How is your studies going Putta?)Is she worried about my studies more than me! ‘Huu... nedeetha ide.’ (It’s going on) I answer more vaguely. I hear her breathing softly now.
Silence.
More silence follows as I don’t know what to talk. ‘Avalu siglilva...?’ (You didn’t get her, right) ‘Aaa...’ I’m speechless, ‘hmmm... aa intern thane? Avaligintha olle hudugi sigthale bidu ninage... You are worth more than that girl. She didn’t deserve you!’ Again, I don’t know why but some tears rolled down my cheeks as my voice was caught in my throat. In the background the howling had stopped and I could now hear the first cry of the baby.
Forty days ago I had made a passing comment about my intern, and that’s it, now she knew the whole story! As I found it difficult to breath I quickly managed to utter ‘Will call you later mom’ and cut the call... and I broke down.
-----------------------%------------------------
I wait for some time to get ‘stabilised’ and wash my face before coming out of my room to see what my junior has done with the newly admitted patients. As soon as I come out I notice the middle aged man with the torn shirt sitting directly in front of the room on haunches. His eyes look sunken and bright at the same time now. He gets up seeing me. As I turn towards the Casualty he almost leaps to my feet to hold them together. I wait. He is now in tears as I feel the drops of warmth on my socks. He stutters between sobs ‘Devaru saar neevu, Devaru neev nange...’ (You are my god Sir) I hold him by his shoulders to lift him up. As he gazes at me and wipes his tears with his dirtied towel I slowly walk away from him to inspect a freshly wheeled-in young lady who is burnt from head to toe.
Sunday, January 23, 2011
'Shop Class as Soulcraft' by Matthew B. Crawford. A book Review.
Most of us at the end of our work days may find something amiss amidst the chaos which surrounds our works. The pleasure we get in our routine may only be restricted to the weekends and not to our workdays. Are we being carried away by the abstractions of life much hyped in the so called information and creative economy? What importance are we giving to the works of the electrician or the mechanic and what lessons have we learnt from them? The phony advantages of the white collar jobs are easily exposed in this work of Crawford.
Matthew Crawford quotes from philosophers, sociologists and psychologists and from some interesting studies and experiments to drive home the view of what we understand about the manual trades (blue collar works) is utterly specious. He makes us understand the ‘abstractions’ in which we are buried deep with relation to the contemporary ‘knowledge work’ (white collar jobs). His philosophy digs deep into the deliberation processes associated with an individual, the job he does and the community he lives in. He deals with the idiotic suppression of the manual trades and the similar amplification in status of the clerical cubicle jobs. He gives us an understanding about our jobs in particular and about our lives at large. Once we get into the flow of understanding his views and ideas the book transforms itself into an interesting enlightening source drawing inspirations from our own daily life situations.
The author is also deeply concerned towards students and is worried about the dispositions we are trying to instil in young minds. He tells us not to treat students as ‘brains in a jar’ and tells us to cultivate knowledge instead of trying to produce credentials in the learner. His book shows us the value of real knowledge and how it needs to be procured.
Two very important questions on which the book is about are
1. What advice should one give to a young person with regard to education, college and job?
2. Why a career in manual trades should be given equal importance to pursue?
Outwardly the book may seem as if to dwell ONLY with the manual trades and their superiority with relation to the cubicle jobs. Of course, the book is a strong case presented in support of the manual trades, but what for?, ultimately the pattern of jobs are discussed in detail to give the students a clearer picture of what awaits them and their choices. The final conclusions to be drawn refer only to these two queries. Crawford answers these questions by digging into the sustaining reasons behind his own personal life and also by explaining the events why thinking and doing are the same and need not/cannot be separated, why man desires to be the master of his own stuff, why there are a lot of contradictions for the cubicle professional life, how a manual trade requires thinking as good as doing and finally how pleasurable a trade can get akin to leisure or work with full engagement.
Crawford’s philosophy leads us into a thoughtful finale regarding what advice a youth can be given regarding education and what is a college for. If the student is capable of sitting in the school for 17 years and wants academic achievements to pursue his dream job (ex:- if the persons aim is to become a teacher/professor {in India} maybe an M.A or B.Ed is required, if he wants to do research maybe a further three years of schooling is required after his graduation), he has to go through the schooling processes, no doubt there is no argument regarding this. But if a student wants to become a mechanic or an electrician there is no need for him to endure further schooling after 10th or 10+2 for he can attend a short course in his desired field and then attain expertise by gathering skill and knowledge by experience. There is no need for higher education in this case and this will definitely work for him.
What if the same person who wants to become a mechanic is pushed into college and higher education? At the end of his collegiate education (which he goes through in frustration) the person may be further compelled to sit in a cubicle all throughout his life (which he goes through in frustrated frustration) as now he has a degree to carry and live up to! Maybe he will wear a clean white shirt and a matching tie and join a BPO or something similar and earn less than a mechanic too!
Crawford argues that our society has created a trail for every individual to pursue without considering individual preferences. Universal knowledge and choices overrule individual knowledge and predilections. The society we live in has created a false world with ‘abstractions’ in which somebody daring and positive is treated as an unconventional eccentric. Crawford rightly calls his book a ‘cultural polemic’ and starts from our education system and annihilates the myths our society has towards what is called a good education.
Crawford also argues that in sharp contrast with the blue collar worker’s job the knowledge worker’s cubicle job at the end of the day is filled ‘with layers of abstractions’ as the knowledge worker doesn’t know if his work for the day was of any use to others, he had nothing to do with authority nor command but only with obedience to rules and regulations, he doesn’t have a community to associate his work with, he doesn’t know the character/personality of his consumers he is dealing with, he cannot discuss or encourage individual preferences as they are treated as obstacles to progress of the ‘team’, if ever there is a peer group he doesn’t get any regards from his peers as his own expertise is unrecognised, respect in a cubicle is for indebted discipline and not for individual sovereignty, remuneration he gets paid is for toiling to do somebody else’s work and not for cultivating his own passions, he is more concerned with results and profits than how it is achieved, focus is on getting things done and labour cost with no importance given to the larger gestalt, he lives in a narcissistic utopian world where creativity and innovation are just ‘unleashed’ potentials from ‘bizarre mavericks’ rather than mastery of a work through long practice, he works in a setup where ‘extraordinary human ingenuity’ is ‘being used to eliminate the need for human ingenuity’, where idiocy and the capability to do nothing are treated as a idyllic virtue, etc., etc. The list is endless.
The author also deals in detail why the manual trades are seen as low prestige jobs, simply because they are dirty and because of the false assumption that they are stupid. And if the important question is to earn a living why are talented and poor students forced through the routines of higher education to end up in earning academic credentials which in turn lead to a cubicle job, which is in all ways an advanced stupidity! The job may be white collared but not without neck deep dissatisfaction filled with ‘layers of abstractions’.
Strongly but rightly, Crawford diverges from the ‘middle class discipline’ to disapprove of encouraging college and higher education as a further extension of schooling. As discussed, Crawford worries about the talented and creative students who are not willing to sit in a school for 17 years and later on end up in cubicle jobs to sit there for all their lives. (In the Indian scenario sadly, a large group of students may not be able to go through their schooling simply because of their economic status). He wants the youth and their parents to bury the unintelligent attitude shown towards the blue collar jobs and embrace them to find true satisfaction in their professions.
Crawford quotes from Marge Piercy’s poem “To Be of Use,” which concludes with the lines “the pitcher longs for water to carry/and a person for work that is real.” This passage struck me the most. At the end of the day’s work what will you answer if somebody asks you, what have you accomplished today? The ‘knowledge worker’s answer will be nonspecific, vague and obscure unlike the mechanics ‘the car is now running’ or the electricians ‘and there is light’. The manual traders work is there for everyone to see, feel, utilise and experience. Aren’t the works of manual trades real? By this Crawford precisely identifies what was amiss among our work lives, the aptitude in a human ‘to be of use’ to other humans.
A hard to put down book concerned with the essence of job and life, wonderfully researched and executed to drive home a disregarded fundamental point.
Tuesday, December 28, 2010
Tales from BR Hills.
(The following three short tales signify to me the days I spent at BR hills as an Intern. I remember these stories because they are not just stories but some kind of mantras! They might have occurred at a place very remote to ‘civilization’ and to people with remote sense of ‘civility’. We may think ‘what else can they do, they are just those tribals’, but in some what deeper sense is there anything else they could have done? How is that what they do is in some way related to me and to what I do? Yes, they make me think, again and again of a simple question: - what is progress?)
The photograph, taken from my mobile camera is that of Doddasampige mara, near BR Hills, with some Soliga tribal kids around the tree.
I was in BR Hills doing my internship, where we had to visit the tribal settlements deep in the jungles in an ambulance to provide health benefits to the tribes’ people. I enjoyed those rides as we had to pass through the thick forests and sometimes steep slopes. Most of the times we would be lucky to find wild animal’s en route to the camp site. It would get almost dark in the jungle as the sun would find it hard to pierce through the thick foliage. The eerie silence with the rustle of the leaves and the usual spattering of the bird calls mixed with the engine sound of the ambulance and the apparent darkness gave me a sense of fear and curiosity.
The other reason why this ride was joyous was because we got to meet the ‘interesting’ tribes’ people. It was interesting, for me, as the tribals found ‘us’ interesting. We were considered aliens by them as we did not understand their culture and rituals. Sometimes they laughed innocently on our faces talking about the dress we wore and the manner in which we behaved! As far as they were concerned they were just some ignorant illiterates to us. This makes me wonder how civilisations have grown up and how they see each other. A typical example follows...
I sat at the rear of the mobile ambulance and checked the patients who approached me in a queue. The queue would usually consist of less than five people. Each patient who came up to me gave the details (history) of their illnesses as I checked their pulse, measured BP or sometimes inspected their chest with a stethoscope. I would sometimes cross question (lead) them until I was sure of their disease condition. Having made a diagnosis I would dispense appropriate drugs. If the patients’ situation was worse and needed hospital admission for further treatment or investigations, the patient could be picked up in the same mobile and brought to the health centre at BR Hills for further treatment. A nurse sat on the opposite side of the ambulance seat and would collect the prescription I had made and dispensed the drugs to the patient.
An elderly lady with shabby hair and dirty clothes approached me warily. The lady kept quite without giving the details about her illness even after she had approached me. So, I casually prodded her ‘Enaithamma thondare?’ (What’s the problem lady?). The lady gazed at me as though I was not there at all and kept quite without speaking! I rephrased my question more carefully ‘Ninge en thondare aagide ajji?’ (What problem do you have granny?’). She saw me from the corner of her eyes and said ‘Neenhelu’ (You tell me)! I was taken aback! I could not realise what she was telling me. I put some efforts to make my point clear this time ‘Ajji, ninage enadru khayile, thondare idre helu, adakke maathre kodthini. Jwara athava mai noviddiya ninge?’ ( Granny, if you have any illness you tell me, I will give you tablets for that. Do you have fever or body ache?’) She shot back ‘Neen thane maathre kodake bandhiradu, ninge gothagallva nangenu thondare antha. Maathre kodu!’ (It is you who is treating me; you should know what problems I have. Give me the tablets!’) The lady wanted treatment without telling me anything about her condition! The nurse beside me started laughing looking at the guiltless lady. I could not speak for some time. I raised my hand to my head, closed my eyes for a moment and took a deep breath! By the time I had recovered, the nurse was making her best efforts to convince the lady why it was necessary to give some details about her illness before we treated her. We could finally convince the lady to agree to give the history of her illness after we had some elaborate ‘discussions’ with her.
I was perplexed! The lady probably had taken me for a witch doctor who had magical powers. A doctor who could identify the problems in a person’s body and mind by just having a look at the person!
As far as our science of medicine was concerned it was based on the disease history we got from the patient. The patient first tries to tell us what problems he/she is facing after which we (doctors) take over and sometimes lead the patient with questions until we arrive at a diagnosis (which may need further modification after certain investigations) which can be treated with medications. This old lady was unaware of the basic facts of our science! I wondered what on earth was going on here, where was the problem? Are we in anyway responsible for this?
(The following two tales were originally posted as comments in one of the blogs of my dear friend Srikanth. Here, I have posted them again after going through the stories and modifying them a bit).
The first thing I remember about B R Hills is Jadeyappa!
During my internship rural training programme I had the honour of serving at B R Hills for a month. It was a rewarding experience for me. I preferred to go into the jungles on the mobile ambulance for health checkups.Now...the old hospital has become a welding workshop and the new bigger hospital building has come up! That’s progress! Yes, but how progressed are we? And how fast are we progressing?
Jadeyappa was a 20 year old Soliga tribal (recently married), who was admitted in the hospital when I was posted as an intern at VGKK (Vivekananda Girijana Kalyana Kendra). He was suffering from Pericardial Effusion (fluid collected around the heart), probably of tuberculosis origin. As, obviously, (VGKK had no high end technology and manpower,) he needed further investigations and evaluation to obtain further treatment, he was referred to Mysore. It was a case of life and death! In Mysore, if everything went to the plan, he could have been all right in 10-15 days! He and his parents refused to go to Mysore as they did not have the money or the knowledge to go and survive in the ‘external world’! (Mysore, for them was a place which was in the external world!).We tried to do whatever was possible to help Jadeyappa and his family. They didn’t budge to our plea. They told us they would rather die in their birth place, than go somewhere else for treatment. Unfortunately, we could not help Jadeyappa as he soon succumbed to the deadly disease.
As I do not want to finish with a bad note, I will tell you another incident which will cheer you guys a bit!
One cold night I was woken at about 3am in the morning as there was an emergency case. As it was the colder period of the year, not many patients were expected at that time of the day. As I entered the hospital....I heard a woman breathing heavily, almost gasping. She was accompanied by her drunken husband who had beaten her when he had come home late last night. She was immediately administered nebulisation, as she was a known patient with asthma. After the patient was stabilised I scolded the patients’ husband in harsh words telling him that his beating had precipitated the attack and it would have killed her if she was brought late to the hospital. He did not utter a word, and seemed apologetic. I came back and went to sleep immediately.
The next morning, as I wondered how the patient had come to the hospital as no ambulance was sent out the last night, I was told that the patient’s husband had carried her for 4-5 kilometres in the jungle to reach the hospital!
Maybe that’s what is called junglee love!
I only hope we will do something good for the people who deserve the right to progress.
The photograph, taken from my mobile camera is that of Doddasampige mara, near BR Hills, with some Soliga tribal kids around the tree.
I was in BR Hills doing my internship, where we had to visit the tribal settlements deep in the jungles in an ambulance to provide health benefits to the tribes’ people. I enjoyed those rides as we had to pass through the thick forests and sometimes steep slopes. Most of the times we would be lucky to find wild animal’s en route to the camp site. It would get almost dark in the jungle as the sun would find it hard to pierce through the thick foliage. The eerie silence with the rustle of the leaves and the usual spattering of the bird calls mixed with the engine sound of the ambulance and the apparent darkness gave me a sense of fear and curiosity.
The other reason why this ride was joyous was because we got to meet the ‘interesting’ tribes’ people. It was interesting, for me, as the tribals found ‘us’ interesting. We were considered aliens by them as we did not understand their culture and rituals. Sometimes they laughed innocently on our faces talking about the dress we wore and the manner in which we behaved! As far as they were concerned they were just some ignorant illiterates to us. This makes me wonder how civilisations have grown up and how they see each other. A typical example follows...
I sat at the rear of the mobile ambulance and checked the patients who approached me in a queue. The queue would usually consist of less than five people. Each patient who came up to me gave the details (history) of their illnesses as I checked their pulse, measured BP or sometimes inspected their chest with a stethoscope. I would sometimes cross question (lead) them until I was sure of their disease condition. Having made a diagnosis I would dispense appropriate drugs. If the patients’ situation was worse and needed hospital admission for further treatment or investigations, the patient could be picked up in the same mobile and brought to the health centre at BR Hills for further treatment. A nurse sat on the opposite side of the ambulance seat and would collect the prescription I had made and dispensed the drugs to the patient.
An elderly lady with shabby hair and dirty clothes approached me warily. The lady kept quite without giving the details about her illness even after she had approached me. So, I casually prodded her ‘Enaithamma thondare?’ (What’s the problem lady?). The lady gazed at me as though I was not there at all and kept quite without speaking! I rephrased my question more carefully ‘Ninge en thondare aagide ajji?’ (What problem do you have granny?’). She saw me from the corner of her eyes and said ‘Neenhelu’ (You tell me)! I was taken aback! I could not realise what she was telling me. I put some efforts to make my point clear this time ‘Ajji, ninage enadru khayile, thondare idre helu, adakke maathre kodthini. Jwara athava mai noviddiya ninge?’ ( Granny, if you have any illness you tell me, I will give you tablets for that. Do you have fever or body ache?’) She shot back ‘Neen thane maathre kodake bandhiradu, ninge gothagallva nangenu thondare antha. Maathre kodu!’ (It is you who is treating me; you should know what problems I have. Give me the tablets!’) The lady wanted treatment without telling me anything about her condition! The nurse beside me started laughing looking at the guiltless lady. I could not speak for some time. I raised my hand to my head, closed my eyes for a moment and took a deep breath! By the time I had recovered, the nurse was making her best efforts to convince the lady why it was necessary to give some details about her illness before we treated her. We could finally convince the lady to agree to give the history of her illness after we had some elaborate ‘discussions’ with her.
I was perplexed! The lady probably had taken me for a witch doctor who had magical powers. A doctor who could identify the problems in a person’s body and mind by just having a look at the person!
As far as our science of medicine was concerned it was based on the disease history we got from the patient. The patient first tries to tell us what problems he/she is facing after which we (doctors) take over and sometimes lead the patient with questions until we arrive at a diagnosis (which may need further modification after certain investigations) which can be treated with medications. This old lady was unaware of the basic facts of our science! I wondered what on earth was going on here, where was the problem? Are we in anyway responsible for this?
(The following two tales were originally posted as comments in one of the blogs of my dear friend Srikanth. Here, I have posted them again after going through the stories and modifying them a bit).
The first thing I remember about B R Hills is Jadeyappa!
During my internship rural training programme I had the honour of serving at B R Hills for a month. It was a rewarding experience for me. I preferred to go into the jungles on the mobile ambulance for health checkups.Now...the old hospital has become a welding workshop and the new bigger hospital building has come up! That’s progress! Yes, but how progressed are we? And how fast are we progressing?
Jadeyappa was a 20 year old Soliga tribal (recently married), who was admitted in the hospital when I was posted as an intern at VGKK (Vivekananda Girijana Kalyana Kendra). He was suffering from Pericardial Effusion (fluid collected around the heart), probably of tuberculosis origin. As, obviously, (VGKK had no high end technology and manpower,) he needed further investigations and evaluation to obtain further treatment, he was referred to Mysore. It was a case of life and death! In Mysore, if everything went to the plan, he could have been all right in 10-15 days! He and his parents refused to go to Mysore as they did not have the money or the knowledge to go and survive in the ‘external world’! (Mysore, for them was a place which was in the external world!).We tried to do whatever was possible to help Jadeyappa and his family. They didn’t budge to our plea. They told us they would rather die in their birth place, than go somewhere else for treatment. Unfortunately, we could not help Jadeyappa as he soon succumbed to the deadly disease.
As I do not want to finish with a bad note, I will tell you another incident which will cheer you guys a bit!
One cold night I was woken at about 3am in the morning as there was an emergency case. As it was the colder period of the year, not many patients were expected at that time of the day. As I entered the hospital....I heard a woman breathing heavily, almost gasping. She was accompanied by her drunken husband who had beaten her when he had come home late last night. She was immediately administered nebulisation, as she was a known patient with asthma. After the patient was stabilised I scolded the patients’ husband in harsh words telling him that his beating had precipitated the attack and it would have killed her if she was brought late to the hospital. He did not utter a word, and seemed apologetic. I came back and went to sleep immediately.
The next morning, as I wondered how the patient had come to the hospital as no ambulance was sent out the last night, I was told that the patient’s husband had carried her for 4-5 kilometres in the jungle to reach the hospital!
Maybe that’s what is called junglee love!
I only hope we will do something good for the people who deserve the right to progress.
Monday, November 29, 2010
A thrilling experience!
It was a fascinating experience driving up the Himavad Gopalaswamy Betta as the road was very steep. The gravelled road was also very slippery as recent rains had washed of parts of the road. Anitha (my wife) and I had always dreamed of seeing a tiger in the wild and had even planned to go to Ranthambore or Bandhavgarh for the purpose. Suddenly while climbing up the Betta Anitha remarked ‘How nice it would be if a tiger crossed the road now’. I laughed out loud as I said it was very rare to see a tiger in the wild and we would be lucky even if we meet a person who had seen the tiger in the wild! Yes, we were officially on the fringes of the Bandipur Tiger Reserve area but that didn’t mean Anitha should sound so positive!
It was already getting dark as we checked into the Forest Guest House near the temple and switched on the solar lights, which flickered for a moment and then went off! The servant/cook there looked at us and said it was cloudy all throughout the day and it would be better if we had some candles. As we had none he went to the servants’ quarters/kitchen to get a lamp. We followed him to discuss about our dinner. Just when we were about to enter the Guest House again as the servant had placed the lamp inside, Ranganath (my bro-in-law) spotted some movement at the base of the huge trees some 25 meters from us and whispered it was a tiger. A TIGER! That gave me a shiver down my spine as my heart beats sounded loud in my chest. Scared to the bone we (four of us including Vidya, Ranganath’s wife) gathered in a huddle behind the car very close to the Guest house door and watched the silhouette of the beast walk graciously to the base of a huge tree. It was twice the size of an adult dog and wagged its long bushy tail. My hands moved to my camera instantaneously (which I was luckily carrying at that moment!) and focused the animal which had just come out in the form of a silhouette in the dusk. After the first click I zoomed in on its head and tried focussing the lens, which I could not for some reason (was it excitement, I don’t know!). As I saw the eyes of the animal flicker like light bulbs through my camera my hairs stood straight! The animal was looking from side to side and kept looking at us for a few seconds. The discussions between Ranganath and the cook (who had joined us by now) had taken a turn as they were discussing the animal possibly being a leopard. I didn’t worry about them as I continued to look at it through my camera. That was it, I couldn’t spot the animal again, and it had disappeared! I searched the area with my camera but couldn’t spot it again. No more movements. Only stillness and some silence. It had gone, after exciting us for only a few minutes and what great minutes they were! Wow! We were all super thrilled. We slept late after hours of discussions on the animal.
We never could come to a conclusion whether it was a leopard or a tiger but who cares! The photo has saved our memories in it. We can savour the moment again and again because of the simple photograph we have in front of us. What thrill it produces! Wow!
It was already getting dark as we checked into the Forest Guest House near the temple and switched on the solar lights, which flickered for a moment and then went off! The servant/cook there looked at us and said it was cloudy all throughout the day and it would be better if we had some candles. As we had none he went to the servants’ quarters/kitchen to get a lamp. We followed him to discuss about our dinner. Just when we were about to enter the Guest House again as the servant had placed the lamp inside, Ranganath (my bro-in-law) spotted some movement at the base of the huge trees some 25 meters from us and whispered it was a tiger. A TIGER! That gave me a shiver down my spine as my heart beats sounded loud in my chest. Scared to the bone we (four of us including Vidya, Ranganath’s wife) gathered in a huddle behind the car very close to the Guest house door and watched the silhouette of the beast walk graciously to the base of a huge tree. It was twice the size of an adult dog and wagged its long bushy tail. My hands moved to my camera instantaneously (which I was luckily carrying at that moment!) and focused the animal which had just come out in the form of a silhouette in the dusk. After the first click I zoomed in on its head and tried focussing the lens, which I could not for some reason (was it excitement, I don’t know!). As I saw the eyes of the animal flicker like light bulbs through my camera my hairs stood straight! The animal was looking from side to side and kept looking at us for a few seconds. The discussions between Ranganath and the cook (who had joined us by now) had taken a turn as they were discussing the animal possibly being a leopard. I didn’t worry about them as I continued to look at it through my camera. That was it, I couldn’t spot the animal again, and it had disappeared! I searched the area with my camera but couldn’t spot it again. No more movements. Only stillness and some silence. It had gone, after exciting us for only a few minutes and what great minutes they were! Wow! We were all super thrilled. We slept late after hours of discussions on the animal.
We never could come to a conclusion whether it was a leopard or a tiger but who cares! The photo has saved our memories in it. We can savour the moment again and again because of the simple photograph we have in front of us. What thrill it produces! Wow!
Sunday, October 24, 2010
Internet Medicine.
Working in a government setup I rarely get patients who are well-off or well-educated. But occasionally I find patients who are more interested in their diseases. They want to know the cause and the kind of treatment they are receiving. I’m obviously delighted to make them understand about their ill health. Some patients (usually young techies) have come back and told me about their search for the disease conditions on the net. I encourage them to discuss about the information they found on the internet. Some of them are convinced they have a big disorder, some others could not find the disease if it existed, but most of them are confused. I’m not surprised!
There are reports which appear very frequently in the newspapers, about receiving medical advice on the net. One recent newspaper article gave statistics about how accurate one particular website was in predicting the diagnosis. There are many websites which purportedly ‘treat’ the patient. My own relatives have come to me after taking ‘advice’ from these websites. Off course, it’s a wonderful thing if people find information about their disease conditions and learn more about it, but at the same time people are often misled by the ads or sometimes are even carried away with the information. So I thought I should try and explain how and when internet references may be helpful for an individual.
I myself went through some searches on the net and found that all the websites I referred take extreme caution in making the reader understand that the website in particular is not a substitute for a doctor. They are only to be used as supplements for the advice from a doctor/physician. Some of the sites even ask the reader to go through only such references recommended by his/her physician. They also make it clear that they offer no treatment but they only provide information which may help in understanding the disease condition in a better way. The drugs which are very often ‘prescribed’ are non-prescription drugs which can be bought over the counter. Non –prescription drugs are advised as readily as they have lesser side effects, but the point to be noted here is that they have side effects.
OK fine, websites have to be used only as information portals and not as treatment options, so why is this confusion created if you search for such references?
Obviously, there is a huge load of medical info on the net and trying to access the net for a piece of information may mislead anybody. So how and where do you search for the info? If the info is found, is it the same info which we had wanted? How does one confirm the reliability of the information? The questions may seem very simple, basic and uncomplicated, which they may be, but the answers are absolutely not!
Before we try to untangle the answers to the questions I again make a request to discuss the doubts among the doctor concerned. The web references should only be consulted on the advice of your physician/doctor. On consulting the web pages do not try to glean inferences directly or come to any conclusions without professional help. Well I’m hoping I’m not scaring you guys, I just want to make things clear as I feel this is very important.
As for finding info on the web, the first thing to do is of course Google the specific information required. If you have access to the net through any of the digital libraries or universities it would be ideal as more relevant info can be collected easily as they usually have accesses to journals and publications which are otherwise difficult to enter into. Go through the Google references one by one and select the articles on preference which are from an official website of an Institute/University or the government. Examples for such institutes could be the National Institutes of Health or Centres for Disease Control and Prevention or websites belonging to the government of India. Find out when this particular article was edited as older articles are not very relevant in this fast changing medical age. Small publications/websites may not be believable as the information may not be discussed elaborately. See if you can find articles which have many authors who belong to that particular field only. Find for articles which encourage you to find/interpret the answers rather than which say or mean ‘this is the only answer’ or ‘we are absolutely right’. Publications are more reliable if they have some negatives in them, which tell where they were wrong and which needed to be corrected later on by a second group or individual/s. If you are a professional and want articles for your reference or to quote somewhere look for articles which are ‘peer reviewed’. Articles are better rated if the information is relevant to your specific region, age or sex. I mean the publications are good if they specify region, age or sex related changes. As in any publications articles are good if they do not have spelling mistakes or grammar mistakes. This shows that the articles have been closely reviewed or re-written for the benefit of the reader. If you find articles which have statistics and graphs, they should be good as they make the reader understand things more easily. It is better to read full-text articles than just abstracts, as abstracts may mislead you without the full info.
Do not search for medical info on the web in an emergency other than for contact info. Always get professional help in emergencies.
Of course these are only some basic guidelines. It is very much subjective what the individual reader prefers. Even with all this knowledge some people may not find what they had wanted. If you can’t find the relevant info or if you are not satisfied with what you have found out, try again another time or another day with a fresh mind. It only takes a bit of intelligence and a lot of patience to search for medical info on the web.
I would like to know by my medical and non-medical reader friends what kind of medical info they refer/search on the net and how they do it. It would help all of us to share some knowledge. Hope this blog will serve a good purpose.
There are reports which appear very frequently in the newspapers, about receiving medical advice on the net. One recent newspaper article gave statistics about how accurate one particular website was in predicting the diagnosis. There are many websites which purportedly ‘treat’ the patient. My own relatives have come to me after taking ‘advice’ from these websites. Off course, it’s a wonderful thing if people find information about their disease conditions and learn more about it, but at the same time people are often misled by the ads or sometimes are even carried away with the information. So I thought I should try and explain how and when internet references may be helpful for an individual.
I myself went through some searches on the net and found that all the websites I referred take extreme caution in making the reader understand that the website in particular is not a substitute for a doctor. They are only to be used as supplements for the advice from a doctor/physician. Some of the sites even ask the reader to go through only such references recommended by his/her physician. They also make it clear that they offer no treatment but they only provide information which may help in understanding the disease condition in a better way. The drugs which are very often ‘prescribed’ are non-prescription drugs which can be bought over the counter. Non –prescription drugs are advised as readily as they have lesser side effects, but the point to be noted here is that they have side effects.
OK fine, websites have to be used only as information portals and not as treatment options, so why is this confusion created if you search for such references?
Obviously, there is a huge load of medical info on the net and trying to access the net for a piece of information may mislead anybody. So how and where do you search for the info? If the info is found, is it the same info which we had wanted? How does one confirm the reliability of the information? The questions may seem very simple, basic and uncomplicated, which they may be, but the answers are absolutely not!
Before we try to untangle the answers to the questions I again make a request to discuss the doubts among the doctor concerned. The web references should only be consulted on the advice of your physician/doctor. On consulting the web pages do not try to glean inferences directly or come to any conclusions without professional help. Well I’m hoping I’m not scaring you guys, I just want to make things clear as I feel this is very important.
As for finding info on the web, the first thing to do is of course Google the specific information required. If you have access to the net through any of the digital libraries or universities it would be ideal as more relevant info can be collected easily as they usually have accesses to journals and publications which are otherwise difficult to enter into. Go through the Google references one by one and select the articles on preference which are from an official website of an Institute/University or the government. Examples for such institutes could be the National Institutes of Health or Centres for Disease Control and Prevention or websites belonging to the government of India. Find out when this particular article was edited as older articles are not very relevant in this fast changing medical age. Small publications/websites may not be believable as the information may not be discussed elaborately. See if you can find articles which have many authors who belong to that particular field only. Find for articles which encourage you to find/interpret the answers rather than which say or mean ‘this is the only answer’ or ‘we are absolutely right’. Publications are more reliable if they have some negatives in them, which tell where they were wrong and which needed to be corrected later on by a second group or individual/s. If you are a professional and want articles for your reference or to quote somewhere look for articles which are ‘peer reviewed’. Articles are better rated if the information is relevant to your specific region, age or sex. I mean the publications are good if they specify region, age or sex related changes. As in any publications articles are good if they do not have spelling mistakes or grammar mistakes. This shows that the articles have been closely reviewed or re-written for the benefit of the reader. If you find articles which have statistics and graphs, they should be good as they make the reader understand things more easily. It is better to read full-text articles than just abstracts, as abstracts may mislead you without the full info.
Do not search for medical info on the web in an emergency other than for contact info. Always get professional help in emergencies.
Of course these are only some basic guidelines. It is very much subjective what the individual reader prefers. Even with all this knowledge some people may not find what they had wanted. If you can’t find the relevant info or if you are not satisfied with what you have found out, try again another time or another day with a fresh mind. It only takes a bit of intelligence and a lot of patience to search for medical info on the web.
I would like to know by my medical and non-medical reader friends what kind of medical info they refer/search on the net and how they do it. It would help all of us to share some knowledge. Hope this blog will serve a good purpose.
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