THE CLIMB

My mum ever so often told us in our formative years, “those that work hard will never be doomed”. We grew up with that belief, until I thought I was grown up enough to stop listening to her.


And when I discovered this piece of genius on a T-shirt in our college fest, “Hard work never killed anybody, but why take a chance?” I thought, Good one, Ha-ha… wish I could afford that! This may not serve well in the field of medicine, where every minute your mind is on its toes.


During my medical school years, I looked at the senior doctors, practicing year after year, decade after decade, not tiring of doing what they do, with the same drive and zest. I would wonder, what do they run on? ‘Aviation fuel’, would be my best guess.


I got my keyhole view into the world of ‘dedicated’ docs when I worked with one, and to my great fortune, for one whole week. The experience of length of time is relative to the experience you have with the time. Every second seems an hour long when you are waiting for your date to show up, and an hour seems shorter when that is all the time you got to spend with your loved one.


Well, before I digress farther, I need to retrace. So, this week I worked with Dr. Climb (as I will refer to him), and he is one of the most experienced, knowledgeable, respected and loved Attendings in our program. There was so much I learnt from the week, more than you could fill into just seven days. This may be because I got to witness his daily schedule hour by hour. And these luxuries don’t come so often in the hustle bustle of a hospital.


Dr. Climb’s day always started before the sun. He would be at the hospital early, doing his ‘pre-round’ paperwork, dictations and discharge plans. He would then round, patiently on every patient, meet with the families and answer all their queries. I would often catch him in some corner computer room, helping out a newly recruited Attending with the nuances of ‘billing’, or discussing with a small group of med-students about ‘this interesting case’ on his service. For one, he seemed to have the time for one and all, and had so much to give others out of his day.


And then later in the afternoon, I would meet with him to discuss about a minor chunk (although a big number in itself!) of his patient’s that I was taking care of. His attention and patient care, even at the end of the day, was ‘wholesome’. We would do ‘walking’ rounds on every patient, sit down to discuss the plan, and finish off with the wisdom pearl.


Close towards evening, after seeing all the ‘follow-up’ patients (those that we have been following all week) and the ‘new’ ones, I would be exhausted. And there have been times, when the thought of rounds at the end of an already late day, sounded murderous to me. But Dr. Climb would walk in with a big smile hiding those sunken and tired eyes, and say, ‘You know, I had this interesting patient today….’ and continue the story in a velvet voice. There must be something about this man that, at the end of his story, you feel like you just drank a Redbull, and are raring to go for another round of rounds. The fatigue fatigues. You bounce back!


What is it that keeps him going? There is another doctor (heart-surgeon) I grew up in awe of, who once said, ‘Skill, is what you can teach, but what you cannot is Passion’.


So, that was the secret of Dr. Climb. It was no rocket science any more, and not aviation fuel that kept him running…(well, I confirmed that one after being around for one whole week). His work seemed to always excite him. Even after working day after day for a fortnight without a weekend, he still came to work full of life, looking forward to another day of excitement. Every patient was interesting, every diagnostic dilemma was challenging, a mystery waiting to be solved, every difficult family was a learning experience. There is something to envy and imbibe about these folks.


They ooze and enthuse with energy. He taught me a bit more than medicine… to love my work despite the vagaries of long hours and tough terrains, to care for patients unbiased and to keep going.


So what my mum said was right. So long, until we discover that passion and that purpose that charms. When you really enjoy what you do, it’s no longer work and work becomes play.




“Work fascinates me, I can watch it for hours.” -- Calvin and Hobbes

AN INTERN'S INTROSPECTIONS

FREE FLOW… No, I am not talking about iodized salt to prevent goiter!! Free-Flow, that’s how I describe residency in US.

I was, like all my peers in medical college, very curious to know how It’s different! I had my own assumptions….may be they see more interesting cases… COPD, CAD, CVA, CRF, CLL…. (voh, yenn idella naav noDde irodaa??). Of course, we have seen it all (bejaan times) during our medical school years back home, and perhaps even more! The amount of clinical exposure we received in medical school was enormous, it was a boot camp! It is a foundation we built on, and I will be ever grateful for that. Yet, if I were to take sides, I would lean towards the US’ system of learning.

I recount one of my earliest cultural shocks during my interview season for residency. It was the morning rounds and one of the interns was ‘presenting a case’ to an Attending (equivalent of a ‘Professor’) and was chewing gum!! Rounds and Chewing gum, they just did not seem to fit into a single frame in my mind. I felt so unsettled, and was seconded by this other Indian co-interviewee with whom I kept exchanging flabbergasted stares. Imagine a scenario of ‘getting caught’ chewing gum in classroom during one of the lectures in medical college… well, you may as well imagine spending the rest of the afternoon outside the lecture-hall preparing your apology speech.

The next shocking episode came during the very first monthly-birthday-celebrations in residency (which included ‘My birthday! My birthday!’), when our Program Director (I might equate him to the Department head- HOD) cut the cake and served it to us. I was stunned….wha…. That’s the camaraderie that exists when you let the reins of your authority go, treat all like colleagues and work as a Team.

Casual- is how things function here, and it is good. Infact it is great, because it allows ‘free-flow’ of discussions, and knowledge. Everything in medicine is so relative, and so dynamic. You tell me what you think, I tell you what I think, and we learn. I cannot recall a single casual conversation with any of my medical college professors, and I never had a great rapport with them. Well, there was never a chance to! I recall our rounds during internship as this one-way conversation by the boss, while the minions just listened. By the way, do you have a point to make? Well good, then keep it to yourself! Don’t even try to ‘act smart’ with your addendum to the big-boss discussions. And if you ever dared to ask a question, awww….bad move….you are either melted under the lava of the volcano that you just unscrewed, or you get this little sermon of, ‘why don’t you tell me? Go and read up!’

Some of the things were FIRSTs for me in US. For the first time, I heard a resident being nonchalant about NOT knowing something about a patient’s history or blood work… an Attending being ok with accepting he learnt something from the minion… history and progress notes dint have to look like Presidential speech (Attending notes can look like this, “I underestimated the patient, he looks awesome!" "Today, the patient really tried to die on us")… and yes the big relief of dropping the ‘Sir’ before referring to a senior doctor. During my first year medical school, my Anatomy professor threw me out of exam hall for being disrespectful, because I didn’t begin the answer with a “Ma’am”. But how do I explain to her that I really had a huge respect for her, until that day.

Going by the case-load (that’s the magnitude of patients we saw back home) and clinical knowledge (=number of readings of Harrison’s / year), there is a huge difference in the way we train in India and US during a PG 's life. I can never compare with quality of the medicine PGs I worked with in B’lore, they were geniuses. So, what is it that makes medical training in US different? Well, it’s not the books, not the patients, not the rare diseases, not even those hi-fi investigations you do…. As I see it, it’s the learning, and the way it happens. You learn as you do, and you learn as you discuss. And the freedom of expression wins the gold medal!

We went out for a team-dinner last month, after finishing one busy month of floors (wards). Needless to say, it was fun! The Attending narrated the story of how (many years ago) he met his future wife on one of the hospital floors as a medical student. We laughed over the times in the past month when we had success stories, near-misses and goof-ups. Just then, I was reminded of a showdown incident from my second year medical school, when a psycho Professor had passed an uncalled-for vulgar comment for walking alongside a boy “roaming around in college shamelessly instead of going home and studying”. Well, ‘Sir’, that was a great display of manners from you right there!!

To “Freedom of expression and Freedom of knowledge” I told myself as we raised a toast and my glass clinked with my Attending’s….. “CHEERS….. to the Team”!!

INDIANs and the temple of DOOM

Well, just this week, I was boasting to my American friends at work about ‘how secular India is!’ and about ‘how Unity exists amidst the diversity’…blah blah and blah. Now, I am just glad about one thing. This is the weekend, and I get a couple of days to hide my shameful face from them! Shame shame!!!

India .…. “WE, THE PEOPLE OF INDIA, having solemnly resolved to constitute India into a SOVEREIGN SOCIALIST SECULAR DEMOCRATIC REPUBLIC” (The Constitution of India). Is this just a boring sentence from a one of our high-school social-science textbooks… ! Is this just an imaginary concept that our national leaders dreamt for us when we got our freedom… ! Is this just a ridiculous cock-and-bull-story passed on from one generation of complacent seniors to the next generation of gullible kids… !

There is a news report of a nun assaulted, raped and paraded semi-naked by a Hindu mob in Orissa. I have always believed that one’s religion should be like their bank account….very personal and not to be talked about. But, at this point, I do feel like talking about it. Being raised as a Hindu, I have been very proud of the values instilled in me. Hinduism talks about how all religions are equal, and how all religions preach the same thing. It teaches tolerance.

How some people have proclaimed themselves as the sole protectors of the religion, brandishing orange flags on the streets, burning buses and public property, raping, killing men and women, and engaging in atrocities that are too disgusting to be mentioned! And then, they call themselves leaders? What do they lead us to? They are the misleaders, who are creating a new generation of misled youth, who kill and burn in the name of religion they hardly understand. To what end are they fighting? And do they even know anything about the sacred Hinduism they are corrupting everyday with their heinous acts. They slash others just because someone told them that that is the right thing to do. Oh, do we even see where this is going!!

This is the creation of next generation in-tolerant, un-secular youth of our country.

Where do we even attempt to begin solving this mess? Is it one religion against another… that would have been something less perplexing than the new ‘developments’. Here is the story of a power and publicity hungry social demon who takes a shot at chopping the nation along its geographical boundaries. Clever!

The recent rampage created by SarkarRaj. Jr is a slap on the face of modern India. He is a national threat to be shunned. There was quite an intelligent attempt at tossing him in from one police custody to another, although his lawyers did manage to bail him out for a couple of days. Now, he can get home, and peacefully scheme in his air-conditioned room, about which train to be burnt next, and which exam to be attacked next. This should be serially planned, lest he fall out of (? repute….ha ha, you would think!!) the new found limelight.

Now people from one state in the country treat a person from another state like an alien (perhaps a ‘Foreigner’ seems like a more friendly being here). Maharashtrians against North Indians… North Indians against South Indians, South Indians against East Indians….Indians against Indians….lets rip shred and burn each other, and call ourselves a Democratic country, where all of us have the fundamental Right to equality; misinterpreted by our so-called gone-astray ‘leader’ as the dumb-a-mental Right to superiority. These evils are to be ‘nipped in the bud’ and not be given ‘disproportionate importance … for indulging in pure lumpenism(sic)’.

This is a crucial point in time where Central government took notice of this issue, and did something swift and prompt about it. This man is a threat to our national integrity.

It’s a pity, that for a major part of my life, I thought ‘Mumbai was in North India’ (just like most ‘South Indians’ would believe). Then, and even now, I do not know how being located in the north or south or east of west of this great country mattered to this magnitude.

In both these issues being discussed here, of ‘religion against religion’, and ‘state against state’, we need to notice the common thing. The ones partaking in these endeavors don’t even know to what end they are fighting, and are like the sheep with just an instinct to follow the (mis)leader blindly, no questions asked!

Now, all said and done, I firmly believe we will be safe and secure, and remain the wonderful nation that we are, if we recognized ourselves as ‘INDIAN’. Against all the religious barriers, and geographical borders and multicultural diversities, there is a deeply etched identity that we can never lose. Do take a minute at this point to think how momentous this lineage is that we have inherited, of being an Indian and experiencing the richness of ‘Unity in Diversity’.

As I write this, what is gushing into my mind all along, is what the Nun outraged in Orissa said at the end of her press statement, it is so poignant and so relevant.

“ God Bless India”….. “ God Bless you all”.

____________________________________________________________________

…………….BLAME Mc (Me?) …………….

I could do what that guy (Morgan Spurlock) did in the film / documentary ‘Super size me’.
Go on a ‘Mac Attack’ for a month? ….Sure…!
But at what cost? No, here we aren’t talking money; we are talking health, Honey.

McDonald’s has set my taste buds asking for more. Ever since the first Mac opened in ‘our’ Forum, I have been a regular there. Now imagine a fanatic like me ending up in a Mac forest like Manhattan for 2 months!!

Manhattan, is supposed to have 4 McDonald’s per sq. mile…more than 83 outlets in 22.4 sq. miles!! I could hardly resist plunging into a Mc. Chicken each time I walked past an outlet. But when you see them in every other block and in every other street, that calls for some extreme self control really. I now wonder why they dint rename it Machattan?

This guy (Spurlock) in the film goes on a McDonald’s diet, 3 times a day for 30 days. And guess what…it’s not just those extra pounds he gained (24.5 lbs = 11 kgs in a month!!…That’s what a woman gains through her 9-month pregnancy!); his body cholesterol levels soared sky-high. So did his liver enzymes, which surprised even his doctors (he had 3 of them monitoring him while on this bizarre diet). This usually happens only in heavy alcoholics when the liver can’t handle the excess ‘toxins’ you are throwing into your body.

He dint die (Of course! Or they would have had all the Mac’s shut!), but he got quite close to damaging his heart and liver with that sort of food.

I personally don’t diet, nor have been a very healthy eater. But this film has been an eye-opener of sorts. It’s not just about the Mac, it’s about all sorts of food we ‘eat-out’. US Congress passed a new law (Cheeseburgers Bill) in ’94 that said consumers couldn’t sue food companies for ‘making them obese’.

That’s logical…look what you eat!

It just takes a month of reckless eating to add those extra pounds, but many months of physical exercise and dieting to get rid of those love handles.

Now each time I pass the fast food outlets, I tell myself,….
“Time to watch your diet and get in shape”.


[Yeah I know, ‘Round’ is also a shape…but still!!]

Ain’t a child no more!

‘Like a pearl precious, long after it’s lost’.

It was some time early this year that I began to realize this was going to be the end of my childhood. I tried figuring out ‘Why?’. And suddenly, this seemed to be an all-consuming question.

Being a doctor is itself such a daunting profession. No, not because I don’t like being one….I couldn’t have been anything else even if I had another chance. But when you look around your contemporaries in non-medical jobs and get measured with their yardstick, it can get pretty taxing on your conscience. But the upside of this is you can enjoy a childhood longer than others……he he…

I have been giving exams and going to school for as long as I can remember. It’s always referred to as a ‘very tough thing’…going to medical school. I don’t think so. What’s more tough is coming out of it, and living in the real world. But you see, it’s the same with all jobs. Once you are out of school, and slip into the professional garb…it’s a war out there!

Oh yes, that brings me back to the ‘point’ where I lost my childhood. I realized the point was when I had to take up a job. During that month of contemplation, I was feeling like being dragged out of school and squeezed into a grown-up mould. I could sense the sudden heaviness on my shoulders … “I was going to earn a living”. Eeeeeekkss!!!! Here I was in blissful confines of medical school (which being as long as it is…almost seems like a lifetime!!) and can you think of something scarier?

And when this is uprooting my peace, I chance upon these lines from Longfellow, leaving me all the more stirred.

“There was a time when I was very small,
When my whole frame was but an ell in height,
Sweetly, as I recall it, tears do fall,
And therefore I recall it with delight.”

Well, finally the big day happened… when I reported to the first day at work. Phew!! I was having not just butterflies in my tummy, but baby dragons! I just smiled at everyone (you never know who that might be!!), and surprisingly turned out to be a quick learner. I tried to understand the intricacies of the way things work within a week. That way, I dint have to smile at everyone for everything…saving me those ATPs!

‘Looking’ confident at the work place can do wonders! Everyone then assumes you ‘know’, and so don’t try to mess your mind with their classified tips and expert advice. You learn how much you can interact with whom, how to avoid being involved in office gossips and petty arguments, and most importantly how not to get used beyond your remuneration!

Every evening I came home happy with myself, with an air of having done so much and learnt so much that day. I loved my work!!!!

Then one fine day, when I finally got my first ‘off’’ (that, I learnt was the office lingo for Leave) after 10 working days, I used my precious time to reflect. Deep introspection can at times lead you to the realms of unknown yet obvious wisdom you see … The biggest realization was that I absolutely adored my job and felt more confident.

Yet, there was some unexplained void somewhere. After all, I had been preparing all my life (thus far!) for this… to get a job, work and (Eeeks!) ‘earn a living’.

And then it finally dawned on me….. the cause for my fuzzy feeling in that past week,

“I had grown up!!”