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Tuesday, July 31, 2012

Sweat is, at times, pricier than blood

Certain things in life are not cultivated; they either exist or they don’t. I feel my penchant to become a Surgeon had been an ordeal of my ultimate destiny, and I carried this as a part of my Kismet. I suffered my own share of ups and downs in the pebbly ride of my professional voyage; yes, I used to feel less jinxed during the gall-filled moments that could have overpowered someone with fewer proclivities to accomplish a defined aim. No one is blessed the Godspeed just like that; one has to earn every pie of it.

Since my early college days, I had always been so excited to see myself as a Surgeon that I used to work very hard to have a firm grasp of my subjects. Had I not been innately motivated to wear the white coat one fine day, chances are ripe that a stumble upon could have sucked on my energies and I would have either not succeeded in my profession, or would have changed my profession altogether. I had a pretty normal college life. I also used to feel bogged down at times by the work burden , but then the next moment, when I started to realize that these are the stepping stones of me being ushered into the league of Surgeons, all the associated uncertainties and boredom used to thwart away.

Sweat is, at times, pricier than blood; I have always given it my one hundred percent whenever something required hard work and dedication in my professional realms; yes, there had been this driving force that I had to be the best, and it worked most of the times. The ‘hurry-hurry’ person eats goat; the one who takes his or her time eats beef. Even to this day, I don’t consider myself to be a veteran; every day is a day to learn something new, and that is precisely the beauty of a mind captivated by surgical sciences.

Déjà vu or Programming?

Have you ever looked upon the sky on a cloudy night? If you have, I am sure your gaze must have got transfixed with little deviance of your mind. That is the power of Nature; or shall we say some kind of déjà vu? If you ever happened to be alone in a beach and observe the tides, chances are bright that you would have attained exemplary nothingness in your mind. Have you ever got drenched in monsoon with no acquaintances nearby? How did that feel? Would you want to re-experience the enchantment of those moments? How do you feel when you come across a face that eludes nothing but innocence? Aren’t you left spellbound?

Why do we feel at ease in certain situations? Why do we feel longed for in certain situations? Do these events and occurrences belong to some sort of left-over representations of our numerous celestial avatars? Or Nature has coded us in a way that we feel warmth, contentment and joyous in the company of its primordial elements? What effect does thunder-lightening induces on your psyche? Do you think fear originates from objects and subjects or from within your own self? Do you believe in the eternity of love? I place my bet on the fact that love is the precursor of the Mother Nature. Every man for himself and God for us all; self-preservation is the first law of nature. But then what is ‘self’?

RML Hospital, My Alma Mater

During my stint at my Alma Mater, Dr R M L Hospital, New Delhi, I used to start seeing my admitted patients and in spite of starting my ward rounds early, these used to extend till early afternoon. This exercise used to be followed by surgeries in Operation Theatre; those were the days when RML Hospital was known as Willington Hospital. The patient load at Dr R M L Hospital used to be colossal, and we had to work really hard taking care of all the patients in our unit. Once our unit chief went for a vacation and could not join on time due to his own reasons. In those days, I and one of my very able colleagues, managed the unit on our own. Those were such good days; work used to be the only passion.

The entire hospital staff was like an extended family. When we used to perform some good case, we used to celebrate with the nurses and other medical staff by arranging fast food. I made some real good relations with staff nurses out there; and even to this day they visit me on Raksha Bandhan to tie the sacred rakhi on my wrist. The days were never dull; there was a chutzpah in every moment. There was so much to learn from life, which was pacing at an aggressive momentum to load us with the fundamental values of this profession. As time passed by, I became quite popular in Dr R M L Hospital and on rare days when I used to be a bit late, I was missed by my colleagues and seniors during those absent minutes.

Those days were so lustrous, so spirited that memories of those days still lie lily-fresh in my mind. Those days made me the self-willed and headstrong individual that I am this day; I have never allowed a day to bygone without really putting its events into the machinery of my brain for an in-depth analysis. To think is what I love the most; thoughts are my constant companions and I can never be left alone in this world.

I love you all my patients

A lot of times my poor patients give me such honeyed comments that I am taken aback. I am taken aback instantaneously without my will or efforts. They call me their messiah, and they never forget to bring me home made delicacies, hand made gifts during the festive season. They love the fact that I take interest in their lives. They feel ingratiating that I know most of their family members by names. It is no that I am approached for the medical disorders by my close-held horde of patients; they approach me for their personal and social problems as well. They trust me that whatever advice I would render would be the best one and that is the driving force in such situations. I have been made to intervene a lot of family feuds where I hold regard from both the parties involved in bad blood; and in most of the cases, my decisions have been duly respected. I feel good. 

I am not a doctor for whom there exists a demarcating line between professional and personal worlds. A lot of things that I do professionally embark on my personal spheres and the vice versa is also substantially true. Sometimes I wish I had copied down all the incidences of my life that happened after I started my hospital; I have seen the aspects of life and relationships in such a diversity that I am sure a lot of human behavior related theories could have been inferred from my experience. And I don’t want to be self-aggrandizing to take all the credit back home myself; I am sure a lot of doctors feel the same way. Patients come to us and uncover their problems in details. In a lot of cases, the source of their problems lies in their lives, in their minds, in their relationships. We become witness to them and this never ending process of learning keeps on going and going.

7 tips for anger management

Arrange a timeout: This is imperative; only those who have practiced it know its importance. Whoever told you that counting till 100 is for kids only must have smoked something gross. You ought to take a break from the circumstances of the heated moment, to be able to assess the situation from a different perspective.

Take deep breaths: Yes ! If you know how to meditate, you are so close to master the art of killing the angst prematurely. Deep breathing takes your concentration away from the problem and in turn, dilutes its memories. It is said one who knows art of breathing knows exactly how to keep anger under check.

Drink some water: More the merrier! It has been shown in numerous experiments that drinking water does something detrimental to the life span of anger and you must note that down. To enhance the effects, drink every gulp with a lot of savoring. Make your affair with water a grand one and prized one.

Get some physical exercise: Physical exercises are known to provide that vent for suppressed emotions. People go on for instant running, or weight lifting or brisk walking or any form of exercise they indulge in, the moment they start feeling their anger level escalating. Exercises release a spurt of positive hormones which restores the body’s environmental mileu to the optimal level.

Think before you speak: Only fools speak just like that; a cultivated mind knows the words that would be shooting from the lips. Anger suppresses the tolerability and wrong selection of words can create mayhem; don’t allow yourself to get provoked and think twice before you utter a sentence.

Identify possible solutions: Focus on something that takes your attention away from the anger source. Identify the reasons for your outburst and look out for the measures to contain it right there. Remind yourself that anger won't fix anything, and might only make it worse. As they say ‘Don’t go near the water until you learn how to swim’. Either lower down your threshold of the repetitive stimulus that causes you anger or plainly learn to modulate your mind using bundles of practicality.

Use humor to release apprehension: Humor is the antidote for all anxieties and angst. Use it effectively and watch your humor-proclivity-index breaking records along the y-axis. Don't use cynicism or sarcasm, though — it can hurt feelings and make things worse by contributing to misunderstandings and keeping grudges.

First illness of my life

During the first week of my life, beneath my seemingly glowing angelic skin, not everything was as normal as it appeared. As the days passed, my skin color started turning yellow. I started regurgitating out and turned sluggish. As if I started paying out for my past life’s sins in eagerness; how else can one relate a childhood illness? I was examined by the pediatrician and was diagnosed to be suffering with ‘Neonatal Jaundice’, a condition that takes place soon after birth and is characterized by development of deep jaundice. I was given conservative treatment at first, which included a lot of intravenous fluids and allied medications. 

My parents passed sleepless nights on my hospital bed, as in those days infant mortality was quite high and refractory neonatal jaundice was not a common phenomenon. Hopes were taking a jolt and gloom was the predominant emotion in my family. It was then that my pediatrician announced to subject me to an interventional procedure, exchange transfusion. This is a process in which the blood is made to pass through a machine in which the blood is filtered to thwart the toxic levels of bilirubin and other metabolites. I was made to undergo left sided exchange transfusion that very night; by that time my face had lost all its sheen and vitality & I had started getting dehydrated. But then as they say ‘faith will move mountains’, affection of my parents and competency of my doctor put me back on the pedestal of life, with double the vigor.

Random moments to cherish

The olive-coated voice of your love interest when you met first.
The chutzpah of childhood.
The thrill of overpowering someone in a game where you had been an underdog.
Your highest academic exploit.
The all time favorite tune of yours; which you consider yourself to be a part of.
The moment when you realized that life has more hidden meanings than some of the supernatural teleserials put together.
Mixed feelings when you flip down one of the old family albums.
Waiting in the crisp attire and bated breaths to be interviewed for the first time in your life for that 9 to 5.
Touch of icecream to the tip of your tongue.
Cumulative sound of hundreds of cuckoos, on a bright spring morning.
Pulling the window curtains to allow first ray of light enter your room.
Cuddling with your kid.
Suddenly coming to know that you actually shed tears watching a film.
The day you converted a foe to a friend.
The affection in your parents’ eyes when you outperformed yourself to make them happy.
When you start relating bits of your life with quotes from others (and you actually spend hours searching quotes).
Someone calls you with such an incredibly familiar tone that you instantly succumb to an induced déjà vu.

Keep it simple, keep it fair

I start my morning ward rounds very early in the morning. I believe that the first rounds of the day should be the most committed ones as one can devote a lot of time to the patients. And I must say, I have been bestowed with some of the most efficient nurses and staff that make this exercise a tonic for the day ahead. The rounds incorporate a lot of clinical examination, asking questions, reviewing lab reports, assessing clinical progress, answering queries, sensitizing about the change of treatment when required, counseling etc. I have an intense inclination to see things going on in an orderly way in my hospital. I take note of every patch of dust on the floor and every cripple in bed sheets. I feel bad when a patient complains that air conditioning in his room was not working properly during the night. I feel bad when a patient tells me that he had to press the ‘Nurse Call Button’ two times before he was attended by someone. Initially, when I had started my hospital, I used to get irate with such complaints and the concerned staff had to bear the brunt. As the time passed, the number of such episodes started decreasing, and my paroxysms of anger started getting evanescent. Now I don’t easily get angered by such things. By getting angered and displaying wrath, one can never achieve an objective fully. Anger handicaps the ability to use the conscience clearly, and in healthcare sector, we just can’t let ourselves work without our conscience and insight at proper places. I have made it mandatory for all the new staff to attend an induction program. This has been in practice at my hospital much before it started in most of the corporate hospitals in India; I learned about this in details during my stints at Hong Kong in early nineties. And I have seen the benefits. People joining my organization clearly get to know what their objectives and how do they fit in a certain role; that eases my load and spares me from unnecessary worries.

Potential Power of Prayer

I believe that the authority of prayer is first felt by the realization of what a prayer is all about. Prayer has power and it forms the sacred cord between us and God. It's a sense of God's assent in our dominions. People have different thoughts about possibilities that a prayer beholds. To some of us, prayers stimulate our own belief-cells and by virtue of positive thought process, we accomplish what we had been praying for. To some of us, prayers activate positively skewed energy chakras of Nature and help making us and our wishes in rhythm. To some of us, prayer is an outlet to communicate our feelings with God, and he blesses us just like a parent would do. Whether prayer is the astrophysical entity or a soliloquy, I can’t say with certainty; however, I have realized that a prayer has a lot to do with our own energy fields and power of belief.

I believe that we experience the stellar power of God when our wishes start getting fulfilled. We realize that God has been reaching out for us all along and the realization of establishment of bimodal dialogue is one of those priceless feelings one never forgets. Apostle Paul wrote to the people of Ephesus about God's yearning for us in a quite exquisite way "that we may no longer be children, tossed to and fro and carried about with every wind of doctrine, by the cunning of people, by their craftiness in deceitful wiles." In prayer, the essence of our hearts and minds are streamlined to stir the super conscious and in this effort we also stimulate our own subconscious mind; the forces, in unison, make the most of the miracles. Prayer has such transforming power that it is said ‘Courage is fear that has said its prayers’! And along the same lines it is also said that the function of prayer is not to persuade God, but rather to change the nature of the person who prays.

Random Childhood Memorabilia

A dry May and a dripping June bringeth all things in tune. Such are the ways of childhood; some sunshine and some shades and what you get is a perfect blend of life in return. During my growing years, I tried my hands at every possible sport. And as I did that I found as if I was having a look at my own inner world, from different dimensions and varying focal lengths, of course. I used to be the ace shooter for my basketball team and contributed heavily in a series of triumphs in various tournaments. Playing basketball gave me that urbane edge, that stylish connotation. I used to play cricket also; my primary role was that of an off-break baller, though I fitted in the skin of an all rounder perfectly; I loved to keep the wickets on ‘as and when required’ basis. I used to score runs when in need, used to be electric in field and used to rough up the umpire on an odd day.

I was this typical Indian teenager, full of fracas and froth. The days gave enough reasons to be jubilant, and the night gave enough reasons to sleep tight. As the final exams of 9th class were approaching, my jig at sports blessed me with fractured patella bone (right sided), and to my apprehension, I had to miss the classes for a good two months. It came as a shock, as an eye opener you may say. It was so difficult sitting at home and not doing any activities that mention sports; it was like arriving at a screeching halt from a full throttle ride. It was one of the palpable Kafkaesque experiences of my life, and I can still feel the gloom that used to haunt me then.

Glory, uninterrupted.

Let your triumphs define you. There are two broad types of triumphs, or rather two kinds of ability displayed in the achievement of triumph by us. There is, first, the success either in big packages or small packages which comes to the man who has in him the innate power to do what few other can match; and what no amount of training, no determination or will power, will enable any run of the mill man to do unless the urge is pure and unyielding. The quality which the man possesses may be that which enables him to run a fifty yards in six and three-fourth seconds, or to play twenty separate games of chess at the same time blindfolded. No amount of training of body or mind would enable any good ordinary man to perform any one of these accomplishments.

This is the most outstanding and distinguishing kind of success and it can be attained only by the man who has in him the quality which separates him in kind no less than in degree from his fellows. But much the commoner type of success in every walk of life, in small moments and in small packages. This kind of success is open to a voux populi, if only they seriously determine to achieve it. It is the kind of success which is open to the average man of sound body, intact insight and fair mind, who has no remarkable mental or physical attributes, but who gets just as much as possible in the way of work out of the aptitudes that he does possess. As it is said popularly ‘every man must skin his own skunk’, we are the designers & the architects of our successes. 

An affair to remember

I remember my early days in operation theatres when I used to observe the procedures being done by my professors; it used to give me such a giant thrill those days. I used to observe every single happening in operation theatre with a child-like keenness; the dazzling sight of newly arranged surgical instruments; magic-like burst of rays from OT light, as if the light would heal in itself; the pre-operative fervor in preparing the patient; the penultimate moment before the scalpel touches the skin to make first incision; everything seems so astutely fallen in proper places.

As a child and a youth, the scene in films where they used to depict an Operation Theatre with a room that had a red bulb, an authoritative bulb I must say, used to make me feel the moments of anxiety that relatives of a patient had to experience while waiting outside Operation Theatre with their glances fixed on that red bulb. Even today, I am pretty moved by the relatives who wait outside the Operation Theatre to receive the best news at the earliest. How can one not move by such events? I mean we have our own emotional side, which turns vulnerable at times; and certain virtues don’t loose their sheen with the passing days. 

Compassion is a quality that a patient always tries to find out in his doctor, and the moment he sees a hint of that, his faith swells with multitudes. I make it a point to keep the relatives amply updated about the status of their patient who remains inside the ‘red bulb’ territory for this is the next best thing I can do apart from operating the patient in my best skills; I feel this is one small step in making the world a kind place.

Good looking apples are sometimes sour

Life is a glorious outcome of little pieces of randomness where events are not as random as they seem in the first sight. For every little thought there lies a motive in the backseat; conscious, unconscious or subconscious. We win friends in our life times; the friends who remain there with you to vitiate the poisonous fangs of adversities; we earn enemies in our life times; the enemies who fail to recognize you as the flesh-and-soul versions of their own alter-egos.

You know a man by the sweat of his brow and the strength of his word. Life would present before you an assortment of masquerades, for you to judge and make the choices that help you soar high. If you want something, take positive action to get it: Ask, and it shall be given you—don’t just sit there hoping that something will turn up. As you brew so shall you drink; it’s as simple as that. You expect to see ghouls and you would start seeing them; you focus on the wafer-thin stream of white light and you would start seeing it. We, ourselves, are responsible for the opportunities we get and for the chances that we miss.

Probably the only difference between stumbling blocks and stepping-stones is the way we use them.

God gives nuts, but he doesn’t crack them

Life is an equal opportunity beneath the sheaths. It doesn’t eschew one at the face value, but embraces people with a clear mind and warrior instinct. The chances are equal; everyone gets the same supply of sunrays and morning whiff of air. Everyone has been given the measures to experience dejection and pleasure. Hope thrills everyone; opportunity strikes every door; a 6 year old’s smile charms every sinking soul; people perceive the tastes and smells equally; the sight of a blooming flower is soothing to eyes, both to a child and a veteran.

God gives senses and instinct to attain an understanding with the available options, and then to explore them in the way you like it to reap the best results. Just like they say ‘Trust in Allah, but tie your camel’. One is expected to toil for one’s needs and desires, for nature is automated in this very way; nothing bequeaths you just like that, there is an intact, and sometimes complex, purpose behind the curtains. Its us who have the power to make a difference in the way we live our lives. Like they say in Yiddish, Everyone is kneaded out of the same dough, but not baked in the same oven.

Since birth, we are exposed to different philosophies, different cultures, different religions and different bent of minds; we must practice our own inner intellect and intuition to select a path that illumines the way to our destinies. We must be more receptive to changes; like they say if the Stone Age children had obeyed their parents, we would still be living in the Stone Age. Every mind is a factory in itself that has the ability to churn something really new; we must stop being repetitive for this defies the primordial purpose of life. Seek out the truths with open mind and embrace the source of pleasure, which lies just inside your own shell.

The legend, Sushruta

Whenever I get sometime, I like to explore the lives of past surgeons and doctors to know their thought process, their times and their contributions to the society.  I feel, like most of my colleagues, extremely fascinated by the life of Sushruta. Sushruta, the father of surgery, who lived nearly 150 years before Hippocrates, brilliantly described the fundamental principles of surgery in his famous ancient treatise 'Sushruta Samhita' (1,2) in 600 B.C . Sushruta taught the surgical demeanors to his students on various modules, such as, giving incisions on fleshy fruits and vegetables (like watermelon, cucumber, gourd etc.), probing on moth infested and worm eaten wood which acquires soft consistency etc.

Sushruta strongly believed and advocated that knowledge of both surgery and medicine are essential to make a good doctor who otherwise is akin a bird with only one wing. Sushruta had been a staunch believer in importance of knowing anatomy well for anyone who wished to become a doctor, or a healer.  For most of use, it would be hair-raising to know about knowledge base of Sushruta even in those days. Shushruta has astutely described surgery under eight heads C hedya (excision), Lekhya (scarification), Vedhya (puncturing), Esya (exploration), Ahrya (extraction), Vsraya (evacuation) and Sivya (Suturing).

On of the famous sayings of Sushruta that is often quoted in high-profile seminars these days says, ‘Any one, who wishes to acquire a thorough knowledge of anatomy, must prepare a dead body and carefully observe and examine all its parts’. Upon knowing the legends of Sushruta, one automatically tends to think of the role and scope of pre-surgical anesthesia in those days. Sushruta famously writes that wine should be used before operation to produce insensibility to pain. The patient who has been fed, does not faint, and he who is rendered intoxicated, does not feel the pain of the operation. It makes me feel so inspired when I turn around pages of history in want of surgeons who contributed in their own ways. They had eaten more salt than we have eaten rice. Long live Sushruta ! 

Only love is real