We owe this to ourselves!

I have known Nithin for five years now. He was a teenager when I first saw him sometime in late 2004. He had come to me for a leave certificate for his friend. Though I have known his family for over a year by then, I had never met Nithin till then. A jovial and very good looking boy in jeans and Tee-shirt introduced himself with “Hello Doctor, I am Nithin, Shibu Thomas’ son” Since then I have met him several times and in him, I had noticed a very balanced young man who was very protective of his younger sister Nimitha.

He also did baby-sitting for the grannies at home when his parents and other relatives went out on tours. Though I can’t claim to have “Known” him in the real sense; I can emphatically say this was a very nice boy and the first born child of his generation in a very reputed family in Kochi. Obviously he was the doting son, adorable grandson, friendly nephew and an ideal big brother to different people in his large family.

And today at the age of 23, he is gone forever; another victim of a road accident. While waiting at his mourning home for his body to be brought down from Kozhikode, ironically I noticed an article on Malayala Manorama. That was about how unsafe our roads were and it had Malayalam Movie-Star Suresh Gopi spearheading a campaign for responsible driving.

What is responsible driving? I have noticed so much of arrogance, rudeness, recklessness and absolute lack of values on roads in Kochi. I myself have been a victim of road-rage; not to forget my own anger and occasional skirmishes. I have steadfastly refused to buy a two-wheeler for my wife. Though she got one of our common friends to canvas for a scooter; I flatly refused saying, “You are my only wife and I need you. I will pool in a little more money and buy a Nano for you but NOT a two-wheeler”

It is true that when the time comes everyone has to leave, irrespective of age, gender or class. But haven’t we seen too many of these two-wheeler accidents costing us precious and young lives? So much so, I have developed a fear of two-wheelers. We can perhaps call it “Bikeophobia”.

I frequently feel what can be described as an “Impotent Rage”. I get so agitated when the reckless youngsters drive through busy roads crisscrossing bigger vehicles and missing death by the proverbial whisker. Yes, I do shout at those kids but I also know there is no use. They would’ve disappeared by then. It is the associated feeling of “Immortality” that drives the boys of this age and in turn leads them to doom. My rage is impotent because I know I am not going to make an impact. Everyone is in a hurry to go somewhere. All warning signs and traffic curbs are of no use when an entire population has no value for ‘Human Life’.

What can we do to prevent these tragedies? Though I know I can do precious little; I am confident WE can do a lot. WE the people should act and act fast. I believe we must come out with a number of changes on our roads. All the people can suggest more ideas for better coordination of traffic. I am enumerating those things I believe could help.

1. First of all bad roads lead to bad traffic and bad traffic leads to road-rage and this leads to all problems. I believe pot-holes are killing more people today than AIDS. We must demand and get good all season roads that don’t end up as continuous terrains of potholes after the second rain. Can our ‘Elected Leaders’ assure that?

2. Enforce traffic rules very stringently. Don’t spare anyone. Heavy fines should be collected from all offenders without any intervention. The police should consider catching offenders in live action and not just gratify themselves with parking fine collection. Over-taking from the left side, over speeding, jumping the line and rash driving; all offenses should be dealt with strictly. Six months are enough to teach a society to ‘behave’. But is our Police-force up to it?

3. Bus-drivers and Auto rickshaw Drivers inside the cities and the truck drivers on highways are the worst culprits when it comes to rude and dangerous driving. Take them for counseling, teach them, discipline them and if they don’t reform, debar them from driving. But will our unions allow this?

4. Buses, two-wheelers and three-wheelers should be compulsorily brought under speed-checkers. Those wonderful inventions that prevent a vehicle from going over 30 - 40 - 50 kilometers per hour are a crying need. But who will bell the Cat?

5. Two-wheelers kill in one more way too and this is an insidious and hideous manner. With the availability of multiple choices of bikes and easy loans, every youth worth his or her name is on a two-wheeler today. They literally live on bikes or scooters. Due to the convenience, fuel economy and ease of parking anywhere and everywhere; we see young people depending upon the ‘bike’ even to visit the grocery store just a few meters away. This is breeding a generation of lazy people who don’t like to walk at all. This will result in more and more cases of Hypertension, Diabetes Mellitus and Heart Attacks in young people. Only by educating the youth to use vehicles only for distances more than one kilometer, we can get some semblance of reason into our life. But will anyone agree for this?

I don’t know how many people will listen to me or agree with me; but these are my sincere, honest and passionate views. I believe ‘WE’ can make a difference!

One passionate request to all the parents of young boys, “Love your children for sure, but don’t pamper them and certainly don’t buy them the fancied monsters called Bikes”. I can tell you how shattering it is to see Shibu and Jasmine, those young parents who have lost a very young son. I hope we will not have to lose another Nithin every other day!

Let us save our youth... We owe this to ourselves!

Matters of Historical Importance, Part - 6

That is why WE are what WE are!

Working in Cardiology since my graduation has made me familiar with most of our clients. “Once a Heart Patient, always a Heart Patient!" is what we believe and propagate. We advise people to stick to their diet, moderate exercise and medication, come rain or shine.

But it is equally true that there are millions alive without following any of these "Commandments". But we can do only those things that we know and have to stick to what we believe are Science or "Evidence Based".

We had a long standing client, a retired Bank Clerk. He was a very regular client and stuck to advise most of the times. One day, he came to the ICCU with a severe chest discomfort and heart failure. We had great difficulty in resuscitating him and he was stabilized after 3 days. Then on the fourth day, he confessed to have defaulted on treatment. When I asked what was the reason for the default, he told, "Doctor, there is a 'Traditional Healer' at our village. He claimed to me that he can CURE my Diabetes and Heart Disease completely with a 6 months course of treatment that costs rupees five thousand. So I went for that. I was fine for 2 weeks and then I developed this problem"

Now I had a reason to condemn him. So went like this, "Do you know there are Nobel Prizes for the taking for anyone who finds lasting Cure for Diabetes, Hypertension and Heart Disease? If your Healer is so good, why does he sit and practice from a village home? People as eminent as the President of America would be waiting to be treated by him. How foolish could you be?"

Well... I had just finished when the gentleman politely told me, "Doctor, that is exactly why YOU are the Doctor, and I am the Patient. If I were to know all these things and were as wise as you, I would've been a Doctor too!"
I have never tried to be Judgmental, Dogmatic or Authoritative with people after this.

Matters of Historical Importance, Part - 5

I continue with my favorite topic of my interactions with people who happened to have some or the other medical problems and ended up lighting up the environment. This one is a short one for a change!


The Wait is Over?

We routinely do Treadmill Stress Testing for people who are going for Insurance Policies. This is done mostly for people above 45 years of age. One day we had an appointment to do a test for a 29 year old lady. I was surprised when I heard the age, but I had no choice because the Insurance Company had insisted on it.

I was stuck with some emergencies in our Intensive Care Unit and was late for the appointment. This is not unusual in Hospitals. We usually apologize to the waiting persons and carry on with the job. So after a delay of about an hour, finally I managed to enter the Stress Testing Lab. There she was waiting for me; a gigantic young lady whose weight was recorded as 107 kilos. When I did my routine apology job saying, "I am sorry I kept you waiting for so long" she shot back rather curtly, "Uff... Finally the Wait is over..." Being harassed myself by a hectic day; I retorted, "Yes Madam, you are absolutely right. The Weight is indeed Over... And that is why You are here and I am doing a Stress Test for a 29 year old lady"

She was really a very jovial person and hence realized the wit in my lines and started guffawing. And thus a hectic day and a little tense situation ended up in a well-deserved laugh!



To be Continued...

Matters of Historical Importance, Part - 4

History repeats itself…

“History repeats itself” is an old saying. I remember reading this line so many times. We never could be sure when, where and how history repeats itself. But in our practice, we do see this phenomenon very often. Patients come with same complaints or same History. For example, an Asthmatic will come with same history of wheezing and a migraine patient will come with headache, what else?

So Doctors tend to become a bit casual when they see old faithfuls. I believe in maintaining a primary case file or an in-patient file neatly and always try my best to keep it up-to-date. But when the old patients come repeatedly, I just copy and paste the history notes from previous files to the new file. A senior Doctor once happened to go through one of my charts. He obviously was interested because I had inserted print-outs from my PC. So next time when we were chatting, he told me “You do a pretty good job of keeping the files up-to-date. But in one of your files I was surprised to see same notes on different dates, everything same; now I definitely believe “History repeats itself”

It was just that in the casual mood of knowing the case well, I had copy pasted even the vitals and examination part from the past files. That meant the blood pressure, pulse rate and every other information was the same in almost all the admission notes. I am more careful after that when I copy and paste from old files.


His and Her Story!

I have known this young fellow for about five years. He came to me within a couple weeks of his marriage. I didn’t have many clients that evening and I saw this boy beating around the bush. I could see from the window there was only one person sitting outside the Clinic. I asked him, “Okay, spell out your problem” He told “I want an abortion for my wife” I was shocked and yelled, “But WHY?”

He told, “See Doctor, we are just married and my wife is 3 months pregnant. My family will be scared and my friends will ridicule me” I asked, “Is the baby yours?” He was confident, “It is mine. We love each other and did IT after our engagement. But now this has become a problem. My family is too conservative and they will kill me” I asked again, “Is the girl here?” she was the person waiting outside and he called her in side. I saw a demure young girl who didn’t look pregnant at all. I asked her, “Do you want to abort?” The girl was very forthright in what she said, “I love this man and this is his and my baby. I want it. But I am ready to do anything for him because he is scared”

Now my job was easy. I told them, “See you just can’t abort a child of your love. All you have to do is to confide in your Obstetrician and keep it under wraps for now. You can declare the ‘good news’ to your family after another 3 or 4 weeks. When it comes to delivery time, you can always say it was a premature delivery. But no way are you going to abort this precious thing” I emphatically assured them of all my assistance in whatever way needed.

Two weeks ago they came to me… Just to show me the bundle of joy! A healthy, bubbly and absolutely adorable baby girl who is almost 6 months old now. I asked that boy… “And this is the little gift of your love that you wanted to abort. Right?” He said, “Never even mention it Sir, I can’t imagine how foolish it was! Can’t spend a day without her now”


Life after Death!

I have a hypochondriac client who is about the same age as me. He is so scared of something happening to him that it had become an obsession to him. One evening he came to my Clinic with his wife, who is a cheerful kind of girl. When I saw an obviously healthy looking couple, I asked “Which one of you is the patient?” She quipped, “No patient here. I have no problems and this is a Ghost!” He was now smiling. I was smiling too and asked, “Ghost?”

“Yes”… She shot back, “Yes Doctor, around mid-noon today, this man called me over the phone and told… Please take care of our kids and please forgive me for all the hurts I have caused to you. I am going to die now. I am feeling very week and my pulse is going down. Please take good care of my parents, your parents and also my brothers and sisters too… I tried calling him and his office several times since then and couldn’t get anywhere. All his brothers and friends too are out of station. Can you imagine my plight Doctor? And now about half an hour ago he came home. So I believe this is a Ghost”

The Ghost then opened up… “I woke up late today and didn’t take breakfast because I had a lot of work. I felt hungry by noon but couldn’t eat anything. There was nobody in the office today. All of them had gone out and hence I had no help. Then I really felt I was going to die. I was sweating and felt dizzy; my pulse was not felt and could not sit up. So I called her and told her. I felt sad for her. Then I fell asleep on the office sofa. I woke up about an hour ago and found out that I am still alive. What was wrong with me Doctor?”

I just told, “Nothing much… but just out of curiosity, may I ask… How is Life after Death?”

Monsoon; Never too soon...

Almost two weeks and I haven't been able write anything on my blog. There are three reasons.

One, I started another blog along with my Wiki World Book account. All I did was to copy paste my posts from here on my new blog. That doesn't mean this will be redundant. It is just that I want to update that blog to this level and then manage both.

Two, I was so busy with work over the past two weeks; it was easier to copy paste than to think.

Three, I was not able to recollect suitable incidents to compile the "Matters of Historical Importance Part-4.

So... This is just to assure myself that I am not going through another of that dreadful "Blogger's Block"

One positive thing about past two weeks has been the arrival of the rain. The much awaited annual cooling down process of planet earth came almost a month too late. Must add here that I had almost become paranoid about an impending Drought! Thank heavens, the heavens have opened up finally and we are enjoying the much needed monsoon! Hope it will last for at least two months.

As the years have passed, the arrival of monsoon has become so erratic that we are forced to say, "Monsoon; Never too soon!"

Rainy Day Tales!

I wrote this piece on Rediff.com under a column "Rainy Day Romance Stories". When I read it after it was published, I thought this should be added to my blog too. So here it is with a few additions and some editing.

I just love the rains! I was born in the month of July in 1970 in the sleepy town of Karkala at the bottom of the Western Ghats near Mangalore. My grandfather used to chide me saying, "You are an incarnation of Lord Varuna. It was raining so much that we could see you only when you were 3 days old." I was born at my maternal home just two kilometers from my home, but the heavy rains prevented my family from seeing me for three days!

My love for the rains is next only to my love for life. All my childhood was spent enjoying the rains and the associated fun. Hot coffee with crispy jack fruit papads specially prepared for rainy days, spicy curries prepared from seasonal shelled mushrooms with boiled rice and the sensational idli-sambar prepared by my mother were some of the rainy season specials I miss badly now! Not because my mother can't prepare them today. But the rainy days have lost all the sheen. Literary greats like Shivarama Karanth, Kuvempu and Tejaswi too added to the ambiance of the monsoon days. My love for literature has always been intertwined with my love for the rains.

I enjoyed riding my bicycle in the rains! The smell of soil after the first downpour, the sound of the rain falling over the tiled roofs early in the morning and fishing in those tiny ponds that came alive during the monsoon seem so unreal today. Those were the days when one would never want to leave the bed in the morning due to the wonderful atmosphere. Playing Indoor Cricket in our neighbor's rice mill while it rained outside was another of those unforgettable memories.

When I moved to Bellary in 1988 to pursue my medical education, the rain song went out of my life. I tried my best to rush to my hometown during the rainy season, but that was not always possible. Now I have settled down in Kochi, once famous for rains and water logging during monsoon.

Most of the important incidents in my life were greeted by rains. It rained when I was born; rather I was born when it rained. It rained in Bellary the day I went there for my admission to Medical College. My wedding was in the month of September, and it rained. My daughter was born in November a year later and it rained on that day. When I managed to construct a home for my family in Kochi, it rained, rained and rained for three whole days during the housewarming. The joke then was, "This house really needed warming and even heating!"

When I met my girl, I told her my idea of romance was to walk in the rains sharing the umbrella with my free hand on her hip. We have enjoyed several of those romantic walks since then. This was especially beautiful when we lived all by ourselves at a small town called Ponkunnam soon after our wedding.

I still love the rains and would love to do all those wonderful things over and again. But unfortunately, the rain gods have become unkind to this part of our planet. So we have to make do with whatever we get.

I am extremely saddened when people say, "We hope it doesn't rain today, we have a movie program" or "We have conducted prayers so that it doesn't rain today during the wedding of our daughter". In the middle of the monsoon season, people are praying for no rains. What will happen to us? Where will we go for water?

The only mantra I chant in my life is this: "Kaale Varshatu Parjanya, Prathweem Sasya shalineem!" (Let the earth be green with timely rains!)

Come rain, shine or more rain; forever in love with life and rain!

Matters of Historical Importance, Part - 3

I continue with the History of Matters of Historical Importance...



No past history of ...

This one is from our Medical College. We had to write the case charts in detail and in a prescribed manner. These notes were randomly checked by Professors or some seniors and hence we had to be on guard. All Medical case charts start with Presenting Complaints followed by history of Presenting Complaints and then Past History and Personal and Family History. We were expected to write in detail about the complaint and when and how it started and what is the intensity and so on. One of my classmates was particularly keen to keep it up to date. So he wrote as follows...
Presenting Complaint: History of Dog Bite.
History of Presenting Complaint: 27 year old boy was bitten by a street dog on his right leg at around 3:25 PM today. The Dog was unprovoked and the boy was unprotected.
Past History: No past history of any illness and...
No past history of Dog Bite!
Family History: No Family history of Dog Bite...!

After reading this, we all started to tease this guy with our own versions:
No past history of fall from the coconut tree
No past history of bull-gore injury
No past history of snake bite
And the prize for the most ridiculous piece went to this one:
No past history of headache and vomiting after watching a Telugu movie!



Lost in translation

A Kannada speaking Doctor from Bangalore was new to Kerala. He was just about learning basic Malayalam. A young mother brought her 1 month old baby to the Casualty. She told the Doctor in her colloquial tongue that the child had breathing complaints and he was raising his chest as if he is jumping. The Doctor wrote in the case-chart: 1 moth old baby jumping and jumping in the air and breathing through chest! Now whatever he meant was known only to him. But we sure ended up jumping and jumping with laughter!



Injured Kidney :-)

A twenty something man came to the Casualty on a rainy night. He was a bit flustered and looked to be in pain too. But he was too hesitant to come out with history. As his luck would have it, there was a Lady Doctor on duty. He insisted on seeing a Male Doctor. So I was summoned and there was a look of relief on his face when I went and asked him what is the matter. He wanted the nurses to be out of the room and so I ordered them out. Then he told, "Doctor, I have hurt my Kidney". I asked, "How did it happen? Did you get hit on the lower abdomen or back?". He told, "No, no... It is the kidney. We are newly married and we were doing IT. Then my wife in a mood suddenly climbed on me and her knee came and hit my kidney and it has swollen now and paining too!". Now... This was news to me. I had never seen a swollen kidney. So I wanted to examine his abdomen. When he was down on the table, he pointed down further and told, "Doctor, not there on the stomach. Down down there, the kidney you see" and he slipped his underwear down to show a grossly swollen pair of testicles!

Continued...

Matters of Historical Importance, Part - 2

I continue from where I had stopped in the first part...

Hyphertension!

Relatives accompanying patients often cause howlers. With half or quarter knowledge, some people would like to flaunt their intelligence. One such lady was in our OP with her husband who came with complaints of fatigue. So I asked the patient if he or anyone in his family had Diabetes or BP. The wife was instantly on full swing, “Yes Doctor, whole family of this man has Hyphertension. [Please note: It is not a spelling error. It was perhaps her way of stressing the severity of Hypertension]. They all get angry very easily and start fighting. For the past 26 years I have been suffering because of this Hyphertension!” I was a bit taken aback and asked, “You mean he has BP?” And she came up with this answer, “If he has BP or not is for you to decide, that is why we have come here. But all his family members suffer from Hyphertension!”

Absolutely No Problem!

An 82 year old man was coming to our hospital for the first time. So I had to take a detailed history to record it on our medical case file. He had come due to repeated attacks of breathing difficulty at night. He was woken up from sleep and had to sit up to breathe. This is a serious problem in medical field. We call it PND – Paroxysmal Nocturnal Dyspnea. So I asked him, “How long have you been suffering from this?” He told, “About a week and a half”. So I asked, “Have you had any illnesses in the past?” He emphatically told NO. I was impressed and asked, “You’ve never been hospitalized before? Never had any major problems?” He told, “Well, actually I have Diabetes since 38 years, BP was detected in 1989 and I had a heart attack that was treated at Bombay in 1993. Then I underwent Operation for Cancer of Prostate in 1995. Generally I have Asthma attacks when it is too hot or too cold. Due to kidney failure and fever I underwent dialysis at Lisie Hospital in 2000. I remember it was just before Christmas. Then I had my second heart attack in 2003 when we were in Chennai. Then some kind of a hernia was there in my right thigh and I was operated for that in 2004. Apart from this, I have no health problems at all. Even now I feel perfect except for this breathing problem at night!” Now should we call this Great Spirit?

Understanding the situation!

We had a 67 year old Muslim gentleman coming to our ICCU with a heart attack in 1996. This was on a Saturday evening. This man was obviously very fortunate and had over forty people waiting outside. They had practically sealed the entry to our ICCU. He was in a very bad shape and was put on a temporary Cardiac Pacemaker and intensive support therapy. After all the procedure was done; I explained to all those people that his condition was very critical and we may not be able to salvage him if his heart doesn’t start responding to treatment. I also advised them to inform relatives and children if anyone was far off. I gave enough evidence to make it clear that his condition was extremely serious and we might lose him. After going through all this, one of his sons asked, “It is a busy season in the shop. We are having problems in managing the counter. Can he go to the shop on Monday?”

To be continued…

Ram Rajya; Why was Ram Great?

I have since childhood believed Ram of Ramayana was an impractical man and was narrow minded. I loathed his act of sending his pregnant wife to the jungle. I disagreed with my mother when she tried to defend Ram. In spite of Seeta coming out unscathed from the trial by fire, Ram left her due to some inebriated brawl of a lowly idiot. I refused to accept Ram as a God and even opposed anyone favoring Ram. My argument was that he had insulted an entire womanhood. According to me, what he did to Seeta was no better than what Kauravas did to Panchali. I found Krishna's approach to life to be superior.

My mother tried to reason with me saying Ram always lived according to Dharma and was a nobleman like none during his time or any other time. But I disagreed saying, "Seeta too was his subject and he had a duty to safeguard her, especially when he knew she was pregnant. Why did he have to send her to the jungle?". And when Lav - Kush, his twin sons came back to his kingdom, he again refused to own them up till Seeta proved her purity. What a torture of a life that saintly lady must have lived to beg Mother Earth to take her away?". I felt it was a just punishment to Ram as well as his subjects that history will always remember them for what they did to Seeta.

This was last week when the Ramayan serial on NDTV Imagine came to an end. Then I read today's newspaper. The Headline screamed "Mayavati spends Rupees 3000 Crores to erect statues of her own, her party leaders and her party symbol elephant". Now in a state that was begging for some development of infrastructure and quality of life, isn't this audacious? This is just arrogance, megalomania, lack of concern for the people and simply atrocious. How could she do this when the voters had reposed so much of faith in her? I just told my family about the magnitude of this gigantic looting of public money.

That is when my mother told, "This is why Ram IS remembered as Great! He for sure sent his wife to jungle. But from that day to death he slept on the floor. He refused all kind of worldly comforts. He kept a statue of Seeta in his room and always stayed loyal to her. He never married again and never even thought of another woman. He had a precedent of his own father marrying thrice. But all Ram did was dedicate his life to the people of Ayodhya. He believed, being the King, he had the maximum responsibility to remain unblemished in whatever he did. He never blamed anyone for all that happened. Being a King, he was more than a King to his people. He was actually a Father figure and a Demi-God! How many of our 'Elected Leaders' will behave like this today? Ram was just one of his kind. And that is why even Gandhiji had a vision of 'Ram-Rajya' for India. We don't have that today, simply because... Ram was born only once and they don't make people like him anymore!"

Am I wiser today? Thanks to all our Rulers in general and Mayavati in particular!