Updates from The Eyrie, Joel G Mathew's blog..

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The newest addition to our 'fleet'

Hassles of Owning a car in Kerala

podcast@eyrie.in (Joel G Mathew) — Wed, 01 Sep 2010 02:33:36 PDT

We were to get a new Tata Nano which we’d booked right after the launch ceremony. Since we weren’t included in the first list of ‘allotees’, we had to wait for more than a year to get our car. Having initially booked a ‘Champagne Gold BSIII’ model, we later changed it to Yellow color after my brother said he preferred that color. There were hassles in getting the color changed, but after a couple of complaints with the Corporate Head of Tata Motors and the Head of Tata Nano, we got the color reallocated. Then followed problems with getting the car delivered from Kulathunkal Motors after registration.

For registration, we had to submit a proof of address and identity. I’d initially submitted my mother’s passport, since the car was supposed to be for her. The application for registration was rejected on the basis that the passport had expired a year ago. Logic doesn't work with the Motor Vehicles Department. Does expiry of a passport mean change of address? A passport’s validity is for a period of 10 years. What if we’d moved right after renewal of a passport?
I phoned up the Motor Vehicles Department (hereafter known as MVD). They told me that they could accept only the Electoral Card, Passport or the address proof issued by the Village Officer. The electoral card was issued more than 10 years ago when our house was still in a ‘village’ (technically a village. Come on, if the heart of Trivandrum city is a village, what do you call a real village?), and hence the address read as “Vettathu, 351, Ulloor” while our ‘real’ address should also include our lane’s name and locality (Pongummood). Anticipating problems with the MVD, I set out to the village office to get a certificate from them. They wanted the tax receipt issued by the Corporation before they issued the certificate.
My father had last paid tax for the house three years ago. He didn't pay after that because when he approached the Village Office for payment of tax, they told him to get the new revenue number from another office, Government Offices which employ staff who either sleep throughout the day at their desks or are vacant from their desks (for tea, lunch, games, or picking up their wards from schools amongst other family matters) seem to fail to understand the fact that the general public are also busy with their own personal affairs. Since I didn't have the tax receipt, I told the Village Officer that I hadn't brought it with me. He told me to come with the receipt on another day. I told him that I was a Doctor working in Health Services and that I’d have to waste another day of leave if I had to come again. That seemed to do the trick.
Note: If you want to have something done at a government office, you need to do one of the following:

Try to do it in the normal way-waiting long queues
Approach a clerk or officer, and explain your official title and position (if you’re employed in one of the State or Central Government departments). As for myself I failed to mention a subtle nuance that though I’m employed (temporarily) as a State Medical Officer, I’m working on Compulsory Rural Service. Why should I? He doesn’t need to know what he doesn't have to know! :)
Make one of your top government contacts call up the officer at the desk. These contacts may range from a retired officer of the same department to a senior officer at the Secretariat, to a Minister.
Discreetly talk to one of the guards or peons at the department and ask them who to bribe. Note: I have never and refuse to ever try this method.
If you have time to spare (30 plus days), submit your application, get the file number, and file a Right to Information application the same day asking for information on the status of the file. Technically they may still refuse the file, in which case you may have to resubmit the application with the information sought for. But in case you’re sure that your application is correct in all details, this will work.

I got the required certificate and visited the Tata Motors dealership at Kulathunkal Motors. There, I talked to Azad Harry Pothen, one of the Managing Partners (owners), who called up the RTO (big private firms often are on first name basis with big government officials. The reason must be obvious to you). The RTO told him that the certificate I’d submitted was not enough. Following Mr Pothen’s persistence, he agreed to accept the certificate.
Next day, the application was again rejected! They were now asking for the Election ID or Passport. The Passport had expired and the Election ID technically did not have the address recorded as we’d submitted in the form. 90% of the Indian population doesn’t have a passport. Does that mean they can’t buy a car if their Election ID details have issues? There are other identification documents accepted by the Government for other purposes, like Ration card, Driving License, PAN Card. Apparently the MVD does not accept any of these. Maybe they think the departments which issued these are as corrupt as them!
As of now, the car registration is still pending before the MVD. Since I’ve paid the registration fees to Tata Motors, I refused to pursue the matter personally and told Kulathunkal they had to do it. Even after Sixty three years of Independence, government departments are still as corrupt and inept as ever. The situation demands a radical solution. But forums like the Right to Information Act, and the Consumer Protection Forum are shod in legal technicalities. The State Information Commission recently posted a politician Sony.B.Thengamam as State Information Commissioner in blatant violation of the RTI Act. If there is no constitutional provision to see that even a Ministry violates the law, the fact that the situation at the MVD isn’t different isn’t strange.
You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

To cast away prosperity for silent honor?

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:41:40 PDT

When we finish school, there are a lot of career options. Many would have decided on a career choice in lower classes itself. There is the ubiquitous choice of trying to be a doctor or engineer, there are lesser trodden paths of lawyers, journalists, and various others. But what is the thought that runs through our minds when we choose a career. Needless to say, for most of us, it is a desire to earn money, a good social standing and have social security, a.k.a get ‘settled’ in life. But who chooses one of the finest professions, and decides to change lives and save the lives of people hitherto uncared for, even at the cost of social isolation and no monetary remuneration? Some people do. We know people do because we know them by revered names or call them saints.

The story of the doctor couple Regi George and Lalitha has been acclaimed in many newspapers and magazines in India. I came to read of the story in a recent edition of the India Today and was moved. The story is that the couple sought out one of the poorest and backward tribal areas of Tamil Nadu searching for the place with the worst health statistics and transformed the population and healthcare over the years. They looked after the isolated and forsaken tribal people who had no access to modern healthcare and were at the mercy of ritualism, black magic and quacks, and cared for them by practicing Modern Medicine there.

They had to establish a hospital, and live with minimal resources. Initially they had to deal with the mistrust the tribal people had towards outsiders too. But as they saved lives, word spread and now their hospital has a heavy OP and attends to most of the labor cases. Infant mortality scales have been radically changed, and today Healthcare in the tribal village of Sittilingi, in Dharmapuri district of Tamil Nadu is on par with the rest of the developed world.

It is not often that one can take such a big decision in life, forego a prosperous life in favor of a life wrought with hardships just for the sake of caring for people. What makes them different? What makes them decide to sacrifice their lives for others? What makes these normal people from ordinary circumstances godly? One decision to live a life of humility and service? How many have the courage and nobility to take that decision?

You can read about some of the stories reported about Regi and Lalitha here (Courtesy: Ashok’s Blog) :

The Outlook (“The Druids Of A Lost Tribe”)
Open Magazine (“Doctors on Call”)
Livemint.com (“Providing low-cost healthcare to villages”)

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Two Off days

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:42:39 PDT

Though I had two days off from work, I couldn’t really read up as much as I wanted. Time seems too short nowadays. There was a time when I could just sit and read as much as I wanted. But now, with daily work, there seems to be a lot of distractions. Even days without work seem to flash past like those momentary scenes from a moving train.

I had a terrible experience with Kulathunkal Motors in Trivandrum, one of the two dealers of Tata Nano in Trivandrum. They had initially promised to give us the vehicle of our chosen color. But following full payment, they tried to cheat us into accepting the car they had in stock. It took a complaint to the Head of Nano Group and the Corporate Head of Tata Motors to solve the issue. Sales representatives over there seem to be of the opinion that the customer is supposed to be trodden upon. When talks with the rep failed, I asked to talk to the Manager. He wouldn’t give me the number.In addition, he tried to persuade me to accept that I was being difficult. Unfortunately for him, I record all transactional phone calls. One of the advantages of a smartphone is that one can record every phone call received without any hint of tracing.

This also saved me a lot of money and a possible swindle by Speed Medical Institute in Chennai (Refer my previous post). Before joining their residential course we’d enquired about every detail of their institute. What they’d told us were blatant lies. On reaching there, we were accommodated into a partially renovated godown of a Cotton mill! They wouldn’t refunded the money until I showed them the recording of their previous promises and the photos of their present accommodation.

Of course you could argue that I was being paranoid. And I may contest the argument by saying that I’ve got a great intuition, and did definitely have an inkling that something of this sort might happen. Anyway a stitch in time saves nine. Not a very apt proverb, yet I can’t think of any other! ;)

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

The Memory lost forever

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:44:36 PDT

Remember my older posts when whatever I wrote seemed to be speculative? Oh well, speculation happens when I’m moved by something. And since I’ve generally been busy living the life dictated by the odd turn of turns which saw me become a doctor (Sometimes I really wonder when I really decided I wanted to be one), I have had only few such events which have made me record such events for posterity. No, don’t get me wrong. I’ve had detailed diary entries for each year since my second standard, when my Father bought me my first diary. Ah I remember it so well. At those times, money had so much value. The diary itself cost Rs 25 (a huge amount in my memory, my father having taught me the value of money from my early childhood days itself) and was printed by Malayala Manorama. The early entries of course went like, “Today I woke up at 5 a.m. Amma made me coffee..”.. lol..
But as years passed, I began to spend time pouring my mind and soul into it. Diaries are excellent for introspection. And whatever you think, blogs don’t even come close. You don’t share secrets through blogs. Whatever you may feel while reading them, blogs are exactly what the author wants you to read. Just like novels. So, of course blogs are fake, and feigned. Anyway, my diaries have dealt with everything from Birthday presents, imagined breakups, death of pets to favorite books, school assembly speeches to farewell parties, entrance exams and failures.
Sometimes one must re-read diaries. There may be people who do that often. I don’t. I don’t know why, but once I archive a diary, the next time I see it is in years! But re-reading diaries broadens ones perspective. It is interesting how over the years ones likes and cravings change. The one thing you wished for years ago seems so small now. And the colors and sounds which you seemed to wallow in seems lost to you now. People speak of a child’s innocence. What’s it? A lack of knowledge about the world? Nope. It’s ones imagination. Remember the time when the world was huge. When from the time one walked to the school bus stop, got onto it, chatted with friends, fought with each other, played on the ground or park (the park itself seemed so huge). I remember each tree in my school, and the hollows in some filled with mud. I remember playing with tents made with friends. I remember…
This is my turn at nostalgia. I don’t feel nostalgia for my school. Not the school per se. I’m nostalgic about those memories, melancholic about not being able to see those friends as much as I want. Indeed I’m nostalgic of my childhood! Ever wonder how much imagination one had then? Ever remember how one would believe anything? How ghosts and demons were real? And how worldly cravings seemed so huge then but seems so limited now?
I remember living through Enid Blyton and Fairy Tales. I remember all those wonderful creatures that existed ‘then’. I remember of learning of chivalry and honor through those childhood authors.
Life goes on. One day those people who seemed to be constantly around you, being the source of inspiration, and who you took so much for granted, will be no more. You will grieve, yet the moment will pass. Memories which seemed etched on diamond will fade. And yet, there will come a day when you are alone, when you lie in bed alone and your mind flutters to those distant memories. Then, right then, you will wonder how you ever you took those people for granted, how you failed to appreciate them, and failed to make them happy. Of course that day will come, and you can do nothing more then, at least no more than you can now.
For me, introspection comes uninvited. During those brief flashes of clear consciousness, you will resolve to make those people around you happy. But life is tough. And whatever you decide, until the moment of grieving, until that forlorn moment of separation, until that moment when you realize that whatever that has happened is irreversible, that the person you grieve is not going to come back, you wouldn’t have done anything for them. At least not something really worthwhile. You are so twisted into your role of living life, of building a future for yourself that you fail to see those people who mattered and still do.
But probably for some of you who are reading this, that moment probably has not yet come. There still are people who long for your care and love. They may be friends, family, partner, teacher or other acquaintances. Have you really given them what they really deserve? I’m not talking about charity.. I’m asking you if you’ve really cared..and even if you have in your heart, have you shown them that you care? While they are still around to be made happy?

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

An Ounce of Respect

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:46:22 PDT

Some people visit hospitals just for making trouble. There are days of rural service when one actually feels like one is doing a service. Of course, most of us Compulsory Rural Service docs feel like CRS is a necessary evil, there are those who stop it midway to pursue PG entrance preparations (I was in the set last year), but on most of the days, going to work gives me a sense of satisfaction. The Art of Healing (no pun intended) is one of the noblest, and though recent happenings and newspaper reports along with the acts of certain doctors might have reduced the respect of general public towards doctors, people still do appreciate and respect you when you cure them. More so, in the rural areas. Mine is a semi-rural (or semi-urban) area. Having worked in Nemom, an urban area, I can appreciate the sharp difference in attitude of people towards us.

Still there are people and episodes which sting, which makes you wonder why you bother to put in the extra effort to be nice. I’ve seen all sorts of doctors. I believe a majority of doctors in Government service have a languid spirit towards patients. The aim in most cases is to disperse the queue in front of the OP before the duty hours are over. I don’t claim to be special or different. I too like to be on my way when duty hours are over, still I spend time with patients and try to relieve their problems as much as possible (the aim of medicine, one comes to realize is to control symptoms and provide comfort. Cure comes second. Diagnosis a third. You think diagnosis comes before cure? Experience taught me otherwise. But that is another story!). So I felt rather affronted when a patient started speaking rudely with no provocation. He said something was wrong with his eyes. I couldn’t quite understand what he was saying. He repeated something.

In many cases, one can’t quite understand local slangs. I asked him to repeat again as I couldn’t quite follow him. He seemed to take offence at that and started verbally abusing me saying if I was incompetent to examine him, he could see another doctor. Without raising my voice, I told him that I couldn’t examine him if he couldn’t be well-mannered. I told him that as primary care physicians, I wasn’t really expected to undertake a close examination of his eyes, and could very well ‘just refer’ him to an ophthalmologist. He said he could just visit an ophthalmologist if he wanted. He wanted to know if I could treat him or not.

I don’t work well under ultimatums, and I told him that Compulsory service or not, a doctor whether a government doctor or private practitioner was entitled to refuse to see a patient if he wanted, and that he was welcome to see an Ophthalmologist. I handed him his O.P. ticket back.

Even though we’re employed in Government service compulsorily, we don’t have to condone threats from anyone. The guy was obviously the leader of some non-existent party, judging from his demeanor, and by the way he wanted to pick a fight. Doctors aren’t scum, and deserve to be treated with respect. One doesn’t walk into any other government office and misbehave with the official there. If he does, it’s bound to happen that the issue would be stretched in time, and take ages to get completed. In most government offices, you don’t see half of the staff at their desks either. We start OP punctually at 9 a.m and don’t even take a tea-break, though we’re entitled to one. So when one does his job properly, the least that is expected is to be respected for his job.

Of course this guy was an exception. Still as an old Malayalam proverb goes, “even a bite of a non-poisonous snake is enough to make one miss one’s dinner”!

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Posted via email from Joel G Mathew's Posterous Page

Does Online privacy exist?

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:46:59 PDT

The news associated with Blackberry service in India, UAE and Saudi Arabia that has made recent headlines doesn’t seem to have made too many people worried. Of course, Blackberry users are worried, but how come not too many have taken in the bigger picture out there? Blackberry is being banned in UAE and Saudi Arabia because it won’t allow security agencies to snoop on the hapless users. Isn’t anyone concerned over the fact that the government and its unseen dark hands already have access to the millions of users of other services-Nokia, Samsung, LG, Motorola?
Security agencies must already be sifting through the petabytes of data that is transmitted daily by billions of people around the world. So what do they do with this data? Do they already have smart bots to sift through voice and data communications, convert speech to text live, and execute keyword searches to identify possible terror activities and civil unrest? Or do they really stop at that? Do they maintain archives of data sent by people, and store them to use at a later date? In such a case, is there true freedom?
We are not all terrorists. Oops. That came wrong. The majority of people have nothing to do with terror activities. Still, we are entitled to certain degrees of protest against the government against policies. There are amongst us civil liberty activists, social activists, Public Interest Litigants, and more recently Right to Information activists who openly criticize the government for its policies and invite its ire. How can we act without fear if there is the constant threat of a looming towering image of a governmental agency tracking our moves?
Imagine a scenario of an election between two major parties, one of them being in power and controlling government agencies, including the ones in charge of the Information networks. Wouldn’t access to secret information provide an unfair advantage to the party in power? Of course in India, this is rather toned down, since we don’t have any Prime Ministerial or Presidential elections, at least not in the real meaning of the word election. It’s more of a nomination by the ruling party a.k.a the party with the largest vote bank.
And how can we act freely knowing that all our activities are being tracked by agencies, our conversations and emails archived to be retrieved at will, and could even be potentially used to blackmail us too? On hearing a horrific incident, many a time have we expressed an opinion saying the particular minister responsible for that should be ostracized, or even used stronger words. In case something like that really happened and investigation agencies got their hands on a tape of our particular conversation related to this, wouldn’t that constitute circumstantial evidence, supposing that we also could be proven to have the motive behind the crime?
Of course I am being paranoid. A little. Or am I really? Robert Ludlum’s novel ‘The Prometheus deception’ describes a super spy agency having live access to video and audio of the entire population, and how the data is used to preempt action by a dark agency of the government which thence turns rogue. It may not entirely be implausible. Storing exabytes of data is impracticable, but with the pace by which technology is evolving, the impracticable today will be hackneyed years later. So do we want someone spying on us? A glorified Peeping Tom? So, is Liberty really a mirage?

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Love at first sight

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:47:55 PDT

Yesterday, on my way to my hospital, I decided to take a short cut. I ended up losing my way altogether.

The road from Peroorkada to Tholicode meanders through a volley of hills, and passes through Nedumangadu. There is a lesser known road which goes through Nedumangad Town, a road which I’d been avoiding because of traffic snarls in the town. I’d returned a couple of times by that route, but never before, taken it on the way to the hospital. Since Saturdays aren’t usually busy in my hospital, I decided to give it a try.

The shortcut is supposed to be 2.5 kilometres shorter than the regular road. So I was surprised when at the end of half an hour of drive, I found that the dash speedo was showing 4 km more than the calculated distance, with my target nowhere in sight. If truth be told, I hadn’t seen a single main diversion on my way. But guess I must have missed one of the smaller, more devious ones. Anyway,when I stopped at a wayside eatery and enquired on the road to me destination, I was petrified on hearing that I had about 20 kilometres more to go. The total distance from my home to the hospital is 30km, and I had already traversed 12 km when I decided on teh shortcut. Now, apparently, I had somehow managed to distance myself in the farthest possible direction!

I got directions and proceeded at a slower pace. Two or three kilometres later, the road narrowed to a dirt trail with small streams on the side with crude bridges atop, made of felled trees. After a turn, the view in front was stunning. Huge mountains garlanded with cumulus clouds glistened in the rain, and the road in front was seperated from them by a deep abyss. The amazing thing about this was that I’ve often visited so-called Tourist destinations for enjoying Nature in its fête. But this, so close to home surpassed any other in beauty. And unbelievably, this still was Trivandrum district.

I took a couple of photos. Being late for OP, I couldnt spend much time there. But I will go back and revisit. Such is the magnetism of Love at first sight!

Update: Next day, I got the fortune of following a VSSC bus along the same (or not) shortcut. To my consternation, I found that the turn I’d missed was the first turn after entering Nedumangad town! I’d gone straight ahead. If only I’d been humble enough to stop and ask.. But I guess if I had, I would have never discovered this tiny paradise. All it lacks is a shimmering lake flowing in the midst of the hills.

I take the shortcut daily now, and have not got lost again. But I didn’t get the pleasure of getting lost again too. Why couldn’t I have got lost when I had enough time on my hands? We go about seeking leisure trips. We plan elaborately. Yet, it’s those unplanned forays into the unknown that satisfy us. Such is Life. It gives us what we hadn’t hoped for, and often hides from us, that which we strived for!

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Tholicode Primary Health Centre

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:48:03 PDT

Tholicode Primary Health Centre is an hour's drive from my home. It's a few kilometres from Vithura and on the way to Ponmudi, a popular tourist destination. The people seem pleasant and the staff very comfortable to work with. It does have inpatient facilities but since there are only two doctors available (we need at least four), we aren't admitting many people. The drive is relaxing, a far cry from the one to Nemom, where I was posted last time.
Yes, studies are suffering, but I've resolved to finish this compulsory service, at least to continue it as far as I can. I had a quick appointment at Shankar Netralaya an eye hospital in Chennai. I wanted to confirm the diagnosis of Retinal degeneration that was stamped by the Regional Institute of Ophthalmology in Trivandrum. It's supposed to be a progressive condition, but what I have seems to be benign. Shankar Netralaya is impressive. The entry pass there consists of multicolored wristbands which they snap around - the wrist, of course! Well, I forgot to remove mine after appointment, and wondered at the looks people threw at me on the bus. Funny-I thought they were staring because they might have understood I wasn't from TN-not that it deserves a stare!
It's so strange how all the metros seem so similiar to each other. I now am sure that I won't have a problem living in any of them. I'm fluent in Hindi, so that means North India and Mumbai is easy. And now I am becoming fairly fluent in Tamil, so much so that people have started to respond to my queries in fast Tamil-they don't do that if they think you're an outsider. But the problem is with wayside peddlers. After a sentence of so of bargaining with them, they start speaking to you in Malayalam!! Which means a bad bargain for the goods you were intending to buy! I suppose they are adept in finding out people from other regions too.

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Posted via email from Joel G Mathew's Posterous Page

On The Escapade from Speed Residential Course, Mangadu, Chennai (a.k.a Hell on Earth), and another trip to Chandigarh!

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:49:21 PDT

(This article was written in profound hast… err, haste… ;) , so it so obviously resembles an English composition. My apologies!  I promise to improve upon it, when time permits. For now, let it serve as a plain decoction of events.)
Last week, having requested a refund of fees paid for Speed Residential course, we were asked to vacate the place, within half an hour of submission of the letter asking for refund. The reason quoted was that on receipt of our letters, the Speed Director had made arrangements for some pending applicants to join immediately and that they'd be coming on the very next morning. We were shocked when the Manager of the Speed Residential hostel at Mangadu, Chennai came into our room within half an hour of the letter, and asked us to vacate immediately. On calling up the Manager of Speed, Mr. Senthil Kanna, he confirmed that we were supposed to move our things and leave immediately. It was then 5:30pm in the evening. In my letter I'd pointed out the reason for leaving, the promises they'd made, and how they had not lived up to any of them.
Aside: Speed is a coaching institute for postgraduate medical entrance test, based in Chennai. FYI, according to the brochure printed by Speed and distributed all over India, we were supposed to be studying in a state of the art facility, with 24 hour AC library, fully furnished rooms, with a gym, tennis court and the rest of the works. What we lived in for the first three months was a dilapidated old cloth mill partially converted into a building inadequate for residence.
For the first month of our course, since the building was not ready, we were accommodated in a facility called World University Service centre, at Egmore, where we had rooms without toilets or plug points, where charging cell phones had to be done in the car park or the reading room in the basement (Yea, of course you had to sit with your phone, unless you were trying to recycle your cell phone!). All this after paying Rs 10,000 a month as room rent for a ‘deluxe’ room. It came to our attention later that the rooms at WUSS cost Rs 50 per day (=Rs 1500 a month).
At the time of paying advance (Rs 39,000) we were told that Deluxe rooms were large suites with contained reading rooms within. It turned out that Deluxe rooms were no different from any other rooms, and all were partially finished rooms, and the entire building was swathed in perpetual cover of dust. We were supposed to have AC rooms, and at the time of shifting to the hostel, we were told that ACs would be fitted in two days. Two months later, ACs have now been fitted, but the last time I called up a friend there, they were still to be switched on, as Speed had yet to arrange for a permanent power supply from the Electricity board!
24 hour Library was just a big hall where though ACs were activated after a month, they were stringently switched off at 9pm on the instructions of the Director. It should not have been dubbed library, because how can a library exist without any books? And I should not be made to comment on the hall where Speed Regular course in Chennai is being conducted! It houses about 1000 people (according to their data) in a single hall (belonging to Surgeons Association of India), and the ACs are never switched on. Well, actually they are switched on before the students arrive, and promptly switched off five minutes after class starts! With the present temperature in Chennai hitting a staggering 40 plus degrees of mercury, it's a wonder no one has ever experienced sunstroke. Well, there's always a first time, I guess! Speed charges Rs 14,850 per person for regular course. That means they get Rs 1,48,50,000 per course (1.48 crores!). After paying a couple or more of lakhs for teachers and employees, one would expect that they'd have enough decency to provide adequate facilities for continuing the class without hospitalizing students.
And classes in Residential course were like training teachers to teach us. I have to admit that Dr Shanmughapriya who teaches Biochemistry in both Regular and Residential course is one of the best teachers in the subject. And the OB/Gyn teacher is also good at her subject. But the rest of the faculty (those who taught till May) were people who seemed to us, to have been chosen for classes because of the sole fact that they lived in and around Chennai. The surgery teacher, Dr A* (name withheld) for instance, after one month's teaching, asked us whether we had negative marks in our exam! That is is the level of knowledge that those teachers had about entrance exams which they were supposed to teach. Another similar teacher was Dr B* (name withheld) in Medicine who'd just passed his Medicine PG exam this year, and started teaching in Speed Residential course. He was totally inadequate in getting his concepts understood by students, and on being asked a doubt about an error in his notes, replied vehemently that the reference text "Harrison's Textbook of Medicine" gave the same facts. A quick check was enough to show that he was wrong. Through class, the Director would sit with us, admonishing and guiding Dr B* while the latter taught. The experience was like participating in a Teachers training programme which I attended in my third year of MBBS.
Coming back to my story, apparently by criticizing them, I'd irked Dr Vinayak Senthil, the Director (and owner, along with his family members). The Director wholeheartedly took the task of kicking us out, with an overwhelming personal vendetta. We weren't planning on staying, we just wanted enough time to pack our things and move. Honestly, wouldn't even a house owner with armed goondas give a sufficient notice before throwing his tenants out? It was later that we learned that the teacher we'd respected so far was nothing more than a businessman.
Normally I'd have stayed and fought for my rights, but I don't know what got into me that day. I didn't want to stay for any more time in their hostel, and packed my things in a heightened frenzy. I sent 190 kg of my books by parcel within an hour, and packed the rest into four large suitcases, along with a table (foldable) and other household items I'd bought from Chennai. Fortunately, my friend's aunt lived in Chennai, and I stayed with him for the night. The next day I tried getting a bus to Trivandrum, but they were all booked out for the week. Obviously, since I'd not booked a train in advance, I was looking at having no means of returning to my home. Honestly, I have to admit that I was stumped. Finally, I decided on getting back in an unreserved general coach of a train, and did just that. It was my first ride in the general compartment, and I found myself packed in with an innumerable number (hmm..that doesn't sound right!) of people, ranging from migrant laborers from Bihar, to beggars. I believe at least 8 people were sitting on the seat which normally accommodates three. The train commenced journey at around 11pm, and somehow I got a few broken hours of sleep.
A lot of thinking had gone into the decision to study in Chennai for a year. Those who were following my tweets might have seen me rambling about comfort zones. Oh, it's just something I read it a book! On returning, it was like every hope had been dashed. Before leaving the hostel, I was under the impression that they'd allow a transfer from Speed Chennai to their centre in Cochin. But Dr Senthil would not allow that. He told me in plain words that he didn't want us informing the Cochin students about the conditions in their Chennai Mangadu Residential course. He would not even refund the regular course fee. Of course at that point I decided that if he didn't want those students to know how we were offered false and empty promises, I would make sure that they knew.  When we became doctors, we swore by the Hippocrates oath (and I believe Dr Senthil did too), whereby we promised to treat fellow doctors with courtesy and respect. It's part of medical ethics. Kicking out someone from a hostel at night is, what I feel is, the rock-bottom of violation of our honorable code of conduct. Apparently to some, it doesn't exist!
Note! The above is a very honest account of the conditions that existed at the Speed Residential Course in Mangadu, Chennai, at the time I joined it in April 2010 along with my friend. They might have improved facilities (or not). My aim was to record a blog, and whatever personal feelings I have, have not colored the facts highlighted. But be sure that before you join any big venture which has implications for your career, you enquire personally, and in detail. Especially if you join a place like Speed, do visit the place and talk to the residents there!
Update.. When the Director had pointblank refused to transfer me to Cochin, I'd left telling him I'd meet him in the Consumer court. When I returned to my home after writing the PGI exam, I found a cheque waiting for me. It was the full refund. Apparently they don't want the world to know about their swindling. So public opinion does count.
Now, let me come back to my trip to Delhi and Chandigarh.. The following was compiled hastily, and I promise to give an enthralling account later! ;)
It was in November last year,that I'd first visited Delhi and Chandigarh. My memories are still fresh with reminiscences from the first time. This visit, however, was a totally different matter altogether, and it was just businesslike (read exams!).
I boarded the aircraft from Chennai. The trip to Delhi was a routine affair. Economy flights are cramped. To get out and to go to the loo, both people sitting next to you have to get up (if you have the side seat. I always do!). And if you're a guy who likes to maintain a healthy homeostasis (fluid balance! Get it?), you do have to get out a number of times. Cabin crew seem so matter-of-fact nowadays. Powdered faces with wanton fleeting smiles don't actually make you comfortable. Once I was in my seat, I wasn't allowed to get out to get my headphones from the luggage rack. So much for Spicejet's on-flight hospitality. I remembered warmly of my last flight on Spicejet in November. I'd even written a recommendation note as feedback about one of their air hostesses. And before you even ask, she wasn't just pretty!! Her hospitality was excellent! ;)
Last time I'd travelled to Delhi alone. This time, however, I travelled with a friend, so it was more fun. After four hours, the plane deserted us in the inhuman Delhi heat. Though we'd decided on getting food from the airport, we couldn't find any food outlets at the exit. Finally, we thought of getting a Metro to the Connaught Place, but finally ended up eating from a food outlet in the Metro station. Our train to Chandigarh was at 3pm, and we'd almost four hours of waiting time at the railway station, which we'd planned on spending in reading at the railway waiting room. The distinguishing feature about the AC waiting room in New Delhi railway station is that there isn't any! Of course, there is a sign directing you to one, but after navigating the busy terminal, we saw a room which its door wide aloft (which meant no AC!). But even worse was the fact that there were at least 100 people crowded in a small room, sitting or sleeping on every square inch, nay, millimeter of space. So that was one plan dashed. We winded up sitting on a bench near the train. I read a little, but was hampered by the severe heat. At the opposite platform, we could see crowds of people pushing each other, all vying for a space on the incoming train. (See photo).
Finally it was 3pm, and time found us carrying bottles of cold water onto the UHL Janshatabdi train. The AC sitting coach was quite comfortable, except for the big (I meant obese!) Punjabi lady who got in at Kurukshetra, and argued with the TTR loudly, disturbing my studies. The coach was packed with PGI candidates (Post Graduate Institute, Chandigarh. Didn't I tell you that the trip was for writing the entrance test for PGI?). The train was delayed by half an hour, but finally at 7pm, we hailed at Chandigarh station. With experience behind me, I confidently went to the bus terminal. But after twenty minutes or so, we couldn't find a bus to our destination. And it was getting late. It was then that we got the help of a Good Samaritan in the form of a girl from Himachal Pradesh. She was trying to get to her hostel, which was on the way to our accommodation. The three of us took an auto to Sector 17, and she was even so helpful as to arrange a rickshaw for us too, even fixing the rates with the driver! It set me thinking that if people from H.P were so helpful, H.P should be a very interesting place indeed. She told us that she was doing her Masters in Pharmacy in Chandigarh, and offered excellent suggestions about all the interesting places to visit in Chandigarh.
After an hour, we reached our boarding at YMCA, Chandigarh. I'm a bit of a planner, hence, though the room at YMCA was one of the most coveted when it came to PG aspirants staying for 'one-nights', we had one of the best rooms, since I'd booked it four months in advance (on the day PGI exams were announced, to be precise). The air-conditioned room had cost Rs 1100 for two people, but it was cozy and roomy enough to house five. And since we'd come in from a Delhi that literally burned, the room was like paradise. I read for a couple of hours. It was then that we saw the news of the air-crash at Mangalore. It was shocking. It was chilling when it hit upon us that we'd been flying from Chennai to Delhi at that time, that the other flight was on its way to Mangalore. It's never wise to read up too late on the eve of an exam, especially if one's in a foreign place. So we slept early.
And I did wake up early too. My friend was late waking up, as usual. After a bath, we had breakfast from a nearby Dhaba. The food was delicious, and we were almost late for the exam. The exam was at 8 this time (It was at 10 last time), and we got there only by 8. I should've gotten there in advance, but actually we were under the mistaken impression that 8 was the time to report at, not the time of commencement of exam. A minute after I got to my place in the room, the bell stated ringing for commencement of the exam. PGI Chandigarh exam itself is tough, and time is just not enough. I rushed through the paper without confidence, and finished it without satisfaction. I hadn't prepared well. But for the last couple of weeks, my studies were hampered by the travel from Speed, and the bundled problems.
The return from Chandigarh to Delhi by bus was tedious. If it weren't for the boys who jumped onto the bus at each junction to sell cold water, I'm sure most of us would have suffered heat-strokes. At the Inter State Bus Terminus at New Delhi, I sent off my friend in a prepaid auto, and took the Metro to Janakpuri. Though I'd stayed in Delhi for only a week last year, it was almost like I knew every place on the way. I didn't have to ask for the way and didn't have any problem bargaining with the cycle-rickshaw-wallas. If it weren't for this special class of workers, travel in Delhi would have been cumbersome indeed.
After staying in Delhi for the night, I took a return flight from IGI Airport. I'd paid for economy, but got executive class by a nice turn of events. Unfortunately, I left my cellphone charger in the flight. After extreme heat in Delhi and Chennai, I returned to find Trivandrum beaming under a heavy monsoon.

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Visit to Delhi

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:49:38 PDT

I believe I haven't talked (blogged) about my visit to Delhi last November. I had gone there to write the AIIMS and PGI Chandigarh PG Medical entrance examinations. These two were held over consecutive weeks, so I had no option than staying there for a week.

It was winter, and the first winter for me. You don't have winter in God's own country! (Kerala, if you really didn't know that). In Kerala, we have a steady 28-32 degrees throughout the year, and don't have to worry about changing clothing according to the seasons. This meant that I had to go shopping for sweaters, blankets, and even gloves.

It was also my first visit to Delhi. The farthest from home that I'd been to so far, was Bangalore (Bengalaru?? Bengalooru?? I can't believe that they changed the name to such a horrible one!). Anyway, I took a flight to Delhi, and the first thing I noted on stepping out of the plane was the stale air, air "so thick that it could be tasted" (I don't know who originally said that, but the expression was plaguarised recently by Shashi Tharoor (in his tweet of course! Apparently the best strategy for becoming famous nowdays seems to be by tweeting!). I'm just retweeting his version. Apparently Twitter promotes plagiarism via its 'Retweets'..

In Delhi, the best bet for travelling from the airport is by hiring a prepaid taxi, so I did just that. After half an hour waiting in queue for a prepaid taxi, I stepped into a battered old taxi driven by a very enthusiastic youngster from Bihar, who even helped my luggage into it. The ride was bumpy, but I didn't mind it in the least since I was engaged in enthusiastically chatting with my driver (in Hindi of course. I'm very adept at talking in Hindi, didn't you know?) about Delhi. He was shy at first, but a couple of well pointed praises of Lalooji (Laloo Prasad, M.P.), was enough to get him talking. The funny thing is I'm not political, and the only news about Laloo that I've heard are those commented on television about his sense of humor. From my new acquaintance, I got to know that Chawri Bazaar was actually Chori-Bazaar (The Thieves' Market!). Having read in an issue of T3 magazine that computer-ware were cheap in C.B, I had come prepared to visit it! He also told me that one could get anything in Delhi cheaply, if one bargained long enough. Of course, there was also the very realistic possiblity of being swindled if one wasn't careful enough. Our journey took about 45 minutes, and finally we reached Vikas Puri, where I was supposed to stay with Mr. Anil Kumar who worked in Indian Overseas Bank with my mother. Vikas Puri was a big locality with a lot of bylanes and apartments. But having thoughtfully downloaded Google Maps onto my phone, it was easy telling the directions to the driver. Only problem was that my phone wouldn't get a GPS fix, and I was too much of a miser to allow it to download real-time tracking via net. We did have to stop and ask for the way a couple of times, but within 10 more minutes, we pulled into the driveway of Triveni Apartments.

Alighting from the car, it was then that I realized that it was cold! It was not the kind of cold felt at our mountain resorts in South India, which was a delicious kind of cold! This was a persistent cold that gnaws and bites at your ears, face, and anything else that you've exposed to it.

The apartment was simple but the lodging being on the fifth floor, and there being no lift, I had to trudge along puffing with my bags packed with 19.5 kg worth of books (I know because I weighed it for the airport, to see if it satisfied the baggage restriction limits! Yup, 20 kg's the limit! ;) ). The stay was pleasant. Anil uncle lived alone, since his family was in Trivandrum. The stupidest thing that I did was packing all the books for my stay of a week. I believed that I would read a lot, and hence would regret it if I'd carried few books. As things would have it, I had to regret taking the whole lot of books, and finally had to courier some of them back. A word of advise here. If you're travelling by air, do not load your luggage to the limit! You wouldn't be able to bring back anything from your shopping jaunts otherwise!! I learnt it the hard way.. ;)

I was supposed to be studying well, but with the oppressive cold and the feeling of having prepared 'nothing-at-all' (Ask any medical student. The expression is one unique to our dictionary!), it didn't happen. Finally, I decided that if I couldn't study well, I would at least visit some places in Delhi!

The very next day, I had the AIIMS exam. It was a nice experience, writing the exam wearing sweaters, and in a Delhi public school. Examinees in Delhi seemed so strange from ones in Kerala. Here, we maintain silence in the hall, and attend to our work in peace. There, it was a totally different matter! People virtually harrassed the examiners because of losing 2 minutes because they were providing instructions about the exam! The exam was tough as expected, but it was a worthwhile experience. After the test, I got an auto back to my place.

Over the next few days, having got a map of the famous Delhi metro, and a smart card which allowed me to recharge any amount, and thus enjoy ticketless travel, I visited all the places which were accessible by Metro. There was a big fair at the Pragati Maidan at the time, however I didn't go there, since the Times had informed us that it was tough to get tickets if you weren't a VVIP.

I hailed a train from Vikas Puri to Chandni Chowk. The Delhi Metro operates feeder buses which circle the city and transport people to and from the Metro stations. I got one to take me to the Janakpuri West station. To go to Chandni Chowk, you've got to alight at Rajiv Chowk (popularly known as Connaught Place or Central Park ), and then change route. Rajiv Chowk is a nodal point for all routes. It's here that you have to change route for the Indian Railway's Station (Gosh, I almost sounded like the public announcement service in the Metro. It offers proactive advice like this all the time!).

The Metro took half an hour to Chandni Chawk station, from where it was an easy walk to the Red Fort and Juma Masjid (See photo). Did you know that the Juma Masjid can accommodate 25,000 people at a time for a namaz? It must be true, the building looks so huge, looking from the courtyard. Walking from one of its gates to the other takes half an hour! In front of the Masjid are innumerous shops selling kebabs. It's a savoury delectable which melts in the mouth. Oh the incident of the ATM and not having enough money with me.. I'd almost forgetten that! It was also the time when I shed my overconfidence about knowing enough Hindi! I'll get to that later! :) I visited the Red Fort at first.

The Red Fort isn't a very scenic or picturesque place, but it had a lot of history, and so I roamed inside for an hour. You've got to keep your bags in a check-in counter. I lost the counterfoil of the bag on returning, and finally had to name all the things in my bag, as a security question! :)

They don't allow you to climb up to the terrace of the Red Fort (I'm not sure if it is called a terrace. I didn't bother getting a guide. Could'nt afford one anyway!). I can only imagine that the view must have been magnificent from there, since the Red Fort overlooks Old Delhi, with all its traditional Bazaars. I remember a poem learnt in school about the bazaar in Hyderabad. But living in Trivandrum, you could only imagine a bazaar. But go into one and immediately you're transformed into some alien place. Your senses are captivated by the aroma of the spices on sale, people crying out their wares. You have to walk, navigating crowds and cycle rickshaws pulled by Biharis. Still one has to be alert for pickpockets. Apparently there are such a lot of them there.

I didn't have to worry. I usually keep my purse in the front pocket of my jeans, and keep my hands in my pocket so it would have taken an expert to rob me! Anyway, I got into Nayi Sadak (New Street) and purchased a couple of books.

(to be continued…)

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Cloudy times - The Ortho episode

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:49:51 PDT

I didn't plan on posting anything today. In fact, I was just browsing a friend's blog, but then happened to stumble on my own blog (if that's even possible!) and got the idea to write on something that had been pushed down to the bottom of my mind by Time.. J

Well, if you've read some of my previous posts, you'd have got the impression that House surgeoncy was a wonderful time for me. Generally, it was, more so from the present, looking upon those 'ol times, but I had my share of dark experiences with it too. (Um, dark isn't that dark!)

I believe I've shared here that I hated Ortho postings. We had a wonderful Head of Department, a gentleman named Dr Vikraman, who headed the Ortho II unit at the time. He was nice and wanted to teach us a lot of things. It'd have been the best experience in House surgeoncy except for the fact that we were tortured by some of the meanest Postgraduates in the unit! I literally mean torture.

When you're a house surgeon, your attitude and mindset is quite different from PGs. It also differs according to whether the speciality you're posted in, is one you're interested in. As for me, I was in love with Medicine, and Ortho wasn't on top of my list of favourites. Still, I didn't hate it. Academically, I liked it, and I did well in both theory and practicals during my 'undergraduate days' (:wink). But House surgeoncy was a totally different matter.

When I was posted in the unit, there was only one other house surgeon with me, a lazy good-for-nothing guy who used to cut postings without second thoughts. It used to be said that the private hospitals in a certain town thrived only because of him, since he used to have daily GPs (General Practise, the practise of undergraduates parading as Doctors even before getting their degrees). Don't get me wrong. I've gone for the occasional GPs too, adjusting my free time after duties in the ward, but this was a totally different case! Anyway, the gist is that he only occasionally appeared for ward duties.

Some wards had more than four house surgeons, but with just two, I suffered extreme burnout! There are only four Ortho units. This meant that every theree or four weeks, we'd get a week with two OP days, and two to three theatre days. Theatre days in themselves are hectic, but add to it the hectic day or night duty on theatre days. Basically, you've got to enter the theatre at 8 AM, push trolleys around in the theatre (Yea, attenders don't do that in TVM Medical College), prep patients for anaesthesia, monitor them in the Recovery Room, and leave after everyone else has left the theatre. And then tag along for Post-Theatre rounds! After that, one of us had to take Day duty till 8 pm, and the other had to relieve him at 8pm and take the Night duty. This schedule happened twice or thrice a week. Do you blame me for rebelling?

Well, technically PGs are supposed to be the more responsible people. At the time, the Residency system was not yet implemented, and the PGs were used to us doing the donkey work, and they wanted their sleep undisturbed. Thrice a week I was called in at 1 and 2am for blood transfusions. We could sleep at home (Oh it wasnt an allowance. They had no rooms or beds for house surgeons at the hospital), but were 'on-call'.

On the day before the 'incident', I had Theatre duty. Theatre duty is 24 hours duty! PGs take their turns to sleep while house surgeons slave away for 24 hours! On the last day, on a night duty I was called in at 1:30am to start a blood transfusion. I started it, wrote the orders, and told the sister to call the duty PG for any problems, and went home. I switched off the phone. Apparently that night the PG had to wake up to attend a ward call. It wasnt an emergency, but she probably felt heckled at losing her sleep. The next day, she complained to the Duty MO.

The MO didnt bother to hear my side of the matter. Ortho MOs and PGs were a tight band. Probably it came from working closely in the Theatre. Anyway, he gave went to his ire in front of OP patients and asked me to see the Chief. Well, I did go to see the Chief.

When I went to see the Chief, he was seeing patients. He asked me to sit down, and explained some of the cases, and I helped him with some of the 'investigations'. An hour later, the MO came that way. He was shocked at seeing the Chief smiling and talking to me. The PG was asked to inform him of my offence. But I'd already told the Chief all about it, along with the reason why I did what I did. His response was "That's Ok. I know you're getting too much work"! :D Now you know why I said the Chief was a gentleman!

Well, that's the one and only time I've been guilty of dereliction of duty. I couldn't help it. There should seriously be some rule against slogging interns. I believe there are in some places.. There should be a limit to the maximum amount of continous work prescribed.

Update: The very next year, the Residency system was started. PGs became responsible for all the cases. House surgeons now need to only help. They even did away with the system of house surgeons doing the blood workup-drawing the blood and sending it to labs-the single duty responsible for us losing the time needed to inculcate necessary skills, and becoming Draculas. But I've already posted on that evil elsewhere. :)

N.B: I don't condone shirking duties. In fact I'm ashamed and embarrassed of myself for doing what I did. It's possible that a real emergency may have arisen in the ward, which could not have been dealt with swiftly because the nurse might have been calling me and lost time in calling the Duty PG. In fact, I'd have landed in a lot of trouble if that happened. But back then, I did what I did, and can't help it. I learnt a lot from that episode. The best possible course of action might have been to report to the Chief or HOD about the heckling by the PGs.. But more than 96 continuous hours of work without respite is enough for one to lose one's mind!

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Post-PG Entrance Examinations..

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:50:35 PDT

This post is just an update of my life post-house surgeoncy (internship to some). Well, as is the 'kismet' of those unlucky people who entered any of the Government Medical Colleges in Kerala through the Kerala entrance, I too had to serve my compulsory one year in a rural area. (Funny..It almost sounded like I was talking of the pokey!) I got Nemom Community Health Centre. Well, it's not at all a rural area, being located in the heart of Trivandrum city, but it's a very busy hospital, having over 600 O.P cases in the morning itself, and about a quarter of that throughout the other duty times. We had to take shifts through the 24 hour period. Well, if the need for getting an MD seat wasn't constantly hanging over my head like Damocles' sword, I might have actually enjoyed my tenure there. It so happened that this institution was in the line running for an upgrade to a Taluk hospital, and although the Government hadn't sanctioned it, the population catered to didn't seem to mind semantics, and turned up in large numbers. Afternoon duties in particular, were rather hectic, since people turned up like they would at a morning O.P, and the situation was complicated by the presence of a single doctor on this shift.

Anyway, it was a pleasant experience. Though I couldn't get much studies done, it was interesting working in a peripheral health institution. In particular, the way people trusted and respected doctors here, was in itself rather dainty. And I had no formal lessons in growing up from being an Intern in Medical College, where we interns were looked upon rather condescendingly by teachers, Postgraduates and patients alike, to being a respectable doctor enjoying the privileges and fulfilling the obligations that a real job brought in with it. Admitting people in the ward, and monitoring their progress felt great. And when they got discharged from the hospital, cured, their gratitude expressed in the form of a smile was all that was needed to brighten your day.

But, nothing could have prepared me for the aftermath of the PGME examinations. It was like post-MBBS entrance all over again. I was ill-prepared, and even before writing the exam, was sure that this year exams wouldn't favor me. Still, there is a lot of turmoil that goes in your mind when your classmates get into a groovy specialty, and you fail to qualify. It's quite fair since you didn't prepare well, but the thought renders it all the more distressing. And the vast majority of people who got through were those who've either not had to do CRS (Compulsory rural service) at all (those who got admitted through the All India entrance-their case against the Government is still pending before the High Court), or those who deserted CRS from the outset, and studied well. But all these reasons cannot satisfy your superego. You have only yourself to blame. You weren't gutsy enough to defy the Government and CRS. Those people who were, those who knew exactly what they wanted, and were passionate about pursuing their ambition, were rewarded. At the end of it all, you've done the Government and a lot of patients, good service. But there is a shred of thought that whispers, "If not you, there would have been another person". It isn't like you've saved a lot of lives, as those voice-overs in soaps seem to murmur incessantly.

Working in a periphery, you get only rare moments of glory. You think you've been great, diagnosing a pulmonary embolism, cardiac tamponade, an early malignancy, or controlling resistant diabetes of someone who was deserted by the other doctors. You take pride in being a good doctor, one who actually cares to listen to patients and their needs with a smile, rather than the expression of disdain and boredom borne by the others. You brighten when bystanders tell you that if it weren't for your thoroughness of examination, their ward might not have been saved. You may be proud of such a lot of things, but ultimately, when results come and you've not qualified when others have, that one moment is enough to cancel all the brightness. It's like a sunny sky is instantaneously extinguished of all its brightness. Yes, I'm bitter. And bitterness and contemplation have persuaded me to take some tough decisions.

I don't mind hard work. Not when there's an objective to be attained. If staying at home in my comfort zone is what stands in my way, I'm ready to step out. It's kind of like a war, and you've got to sharpen your arms, and keep them rust-free. Some sacrifices are worth giving. After all it's only about 9 months till the next exam. Seconds will trickle into hours, which will drizzle into days, and pour into months! And then even before you know it, a terrible storm is upon you, wreaking havoc mercilessly! If you weren't the ant who made hay in sunshine, you'll be left gasping for breath, your green wings flapping helplessly in the flood.

I don't think I might be blogging in a while, or updating my activity profiles. They're mighty time wasters. This blog is just so that my friends don't think I've disappeared off the face of Earth without a notice! There might be a phone number change too, since I'll probably be on 'roaming'. But try texting my current (as of now) cell number, and if you're in my Contacts list, I'll call you back, or text you. Or you can mail me at joel@eyrie.in.

You are reading this post on The Eyrie, Joel’s Blog. For more interesting posts, visit www.eyrie.in for the homepage, or http://blog.eyrie.in to jump directly to the blogs.

Goodbye Rural service..

podcast@eyrie.in (Joel G Mathew) — Thu, 19 Aug 2010 00:51:11 PDT

Trivandrum.

27 February 2010.

"The first step is the hardest"

Correct that last post! Technically I did join back for rural service, and worked a tiresome two weeks too, but I handed in the 'papers' today! Well, you can't "step in two boats at the same time", to quote a Malayalam proverb! I asked for permission to be able to work 2-3 days a week, but was denied. I was told that they needed people in the OP too. Well, truth is there are too many people in our CHC, and people have gotten comfortable with that. So much so that some people take too many leaves, Casual leaves, Compensatory leaves, and other categories of leaves. Some people (read Health Service Doctors) have everything. We CRS doctors put in as much effort, and get paid a pittance. We get a paltry 15,000 (no not dollars per annum) rupees a month, and a scrimpy 20 days of leave per year, while health service doctors have all the fun, and get paid easily four times that much. Even NRHM doctors get paid double.

It isn't the lack of cash benefits that affects me. I believe that CRS is an interim 'essential evil'. People who've skipped it this year have got all the best seats in All India PGMEE this year. I haven't heard of more than one person (Praveen Shenoy's an exception) who's completed rurals and got a PG seat too simultaneously. So when asked to either come for regular duty or write a long leave, I chose the latter-the lesser of the two evils. I'll probably receive a 'show-cause' notice from the Health Department, but at least, I didn't just disappear without a trace. I gave a formal notice of leave. If they find fault with that, they can fire me! ;)

So it's also Goodbye to Trivandrum. At times, you've got to do what you think is best. No matter how many misgivings you may have, at in some convolution in your cortex, there's a clear cognitive signal that favors one decision over another. It's the impulse that's involved in choice. It's also what some people dub fate. I'll reiterate here that I don't believe in fate! Sure, fate may have role in accidents, lotteries or other events that we dub chance. But certainly not in things that matter, or are life-saving. Why, if you believed in fate, you'd as well go stand in the middle of the road and have fate decide where to take you! So much for fate. Yawwwnn… I've got the penultimate of my CHC duties tomorrow, and it's a morning duty too! So I'll finally heed the cozy bed! Goodbye World… So long..

P.S. I don't know when the next post will be. I'll probably banish the computer from my life for a few months. And there might be a phone number change too. Call my old cell number, and if I know you, I'll call u back from my new one.. :D The whole point is to avoid roaming charges, my friend!

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If it isn’t broke, don't fix it. A case in point for CMEs

podcast@eyrie.in (Joel G Mathew) — Fri, 19 Mar 2010 23:12:27 PDT

"Humans seem to have the urge to improve things. Prehistoric hand-axes were made by repeatedly chipping small flakes off pebbles of flint with other hard objects. Million-year-old examples of these have been found that give the impression of being ruined by being chipped just one time too many. That pang of regret we have probably all felt after spoiling something by adding that unnecessary final touch was first faced by Ugg in his cave." -aphraseaday.com

The daily mail I received from the site today made me remember an incident that happened a couple of days back. I was working in my hospital. It was OP time, and among others, I saw a middle-aged lady with a characteristic facies you usually associate with chronic illnesses. She told me that she had come for admission. I asked her why. She told me that she was under treatment of one of the senior Medical Officers (but a General Practitioner) in the hospital, and that he had told her to come and be admitted for treatment. What he had failed to mention was that it was his duty-off day. Because I had no clue about what illness she was suffering from, I asked her for further details. She gave me an investigation result which showed that her ASO titers (Anti-streptolysin O-For the uninitiated, let's just say that it's a marker of Streptococcal antigen, our common cause of sore throat, and also the cause of Rheumatic Fever) were high, in the 300s. She told me that she has taken repeated shots of Penicillin in the hospital. I then asked her whether she had any cardiac condition. She told me that she had been thoroughly evaluated, and was found negative. I then asked her when her 'disease' was found out. She gave me her history, and this is how I recall it:

Dakshayani (true name withheld for obvious reasons) wasn't suffering from any disease till a couple of years back. Two years ago, when she had a fever, she was evaluated by a physician, and an ASO titer was taken. It apparently showed high levels, and she was referred to Medical College Hospital, the referral tertiary hospital, for further evaluation to rule out Rheumatic heart disease. Aside: Rheumatic fever is a condition which commonly presents in young age (5-15years), and may in case of non-detection or inadequate treatment, cause heart valve damage. Long standing cases and severe cases lead to a disease in cardiac valves. Anyway, in her evaluation at MCH, any serious illness including Rheumatic Heart Disease was completely ruled out, she was given a clean chit and asked to complete an oral course of meds at home.

She returned to the primary physician, who also assured her that contrary to his primary diagnosis, she was fit to be sent home on meds. Somehow at this point, she must have become unhappy with the service provided at MCH and by this doc, because she sought a third opinion with the General Practitioner at our Hospital. And this almost-octogenarian impressed upon her that her condition was very grave, and asked her to be admitted for a protracted course of meds for cure. Accordingly she got admitted, and was treated with a rigorous course of parenteral (IV) antibiotics. Since then, she has been continuously monitored by her ASO titer, and as soon as a mild increase was noted, she was admitted and the same course repeated.

At this point, as a side note I must say that Rheumatic fever and Rheumatic Heart Disease is a clinical diagnosis, and an ASO titer is only an 'essential' criterion, which is not specific for the condition. The course of treatment which this 'experienced Medical Officer' meted out has never been mentioned as part of any medical protocol, and is completely contrary to Evidence Based Medicine.

Truth is, this doctor had passed out from one of the very early batches of Medical College, Trivandrum, and ever since has been employed in Health Service in primary care in the periphery. Like many others now practising in the Health Service, he has never bothered to update his knowledge on the basis of evolving medical knowledge, and has been content to practice what he knew. The fact that he has never bothered to keep abreast of the latest medical knowledge has never deterred him from his practice. Whatever may be the case, this is prima facie, a clear violation of the principle of Primum non nocere, meaning First Do no harm. He has made a perfectly normal human being suffer needlessly and waste two years of her precious life, just because he misjudged and misdiagnosed, which is a direct consequence of his not updating his rusted knowledge.

This is a clear case for the MCI (Medical Council of India)'s stipulation that Doctors must attend a set number of hours of CME for renewal of their Medical Registration. But maybe they should make doctors take some basic tests periodically too, so that weeds of incompetence and laziness in the greatest profession can be uprooted.

Of Doctors and Humility

podcast@eyrie.in (Joel G Mathew) — Fri, 19 Mar 2010 23:14:47 PDT

Many a time, as students and later on as fresh graduate doctors, we've scoffed at old timers in the health services, for their irrational use of steroids for treatment. Even in my own hospital, I know doctors who talk critically of a particular doctor for prescribing steroids to many of her patients who present with joint aches. Steroids provide rapid symptom relief, but they have a personal arsenal of side effects. So much so that many people shy of using them for even conditions where they're strictly indicated such as asthma. But now it seems that our colleague had the last laugh after all. It's odd how knowledge opens our eyes to many things which previously were hidden from us. It seems that most of the patients whom we'd labelled as functional, and who used to complain of aches all over the body, were actually suffering from a disease called Polymyalgia rheumatica which actually explains every symptom they were suffering from. But here's where it gets better.. Steroids are actually the treatment of choice for these patients! No wonder they were reporting dramatic symptom relief after the 'wonder injections' given by our colleague.

Well, the truth is that the doctor didn't actually know about this particular condition and was treating from her experience with similiar patients, and that steroids in this case are preferred orally. But it's also a lesson for us doctors who scoff at something just because we're blissfully ignorant of something. It's time to open our eyes, and to learn a little bit of humility.

Posted via email from Joel G Mathew's Posterous Page

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Of Medical Officers, the Police and Drunkards..

podcast@eyrie.in (Joel G Mathew) — Mon, 10 Aug 2009 21:23:05 PDT

It irks me that I haven't written anything on my current workplace for posterity to ponder! So here goes.. I joined Community Health Centre, Shanthivila, Nemom as a 'Snehithan Doctor' (Ah that's the name coined by the Kerala govt) under the Compulsory rural service scheme of the Government of Kerala. My thoughts and opinions on this are extensive, esp with regard to the unfair posting of only government medical college students here, while the private medical college graduates who studied at the same fees were set free. Anyway though my blog is by definition, my place to rant for hours, it is only highly probable that such harangue will dissuade any reader from a second glance here, as noone would be daft enough to grasp a live wire twice, so to speak.. :) Anyway, CHC Nemom, is a beautiful place, speaking relatively. The journey there is after crossing the busy Trivandrum city. It takes me about 40 mins to get there in the morning and close to double of that in the evening. We have all shifts in rotation. OP's from 8am-1pm. There are also, afternoon and night shifts. Since the CHC caters to two Police Stations-namely the ones at Nemom and Karamana, it's not an odd sight to see two police vehicles parked outside our OP at the same time. We're called upon to give drunkenness certificates, and other medicolegal certificates, which is of course my first brush with the legal aspects of our profession. It does carry along with it a certain respect from the lawkeepers, since they hold medical officers with a certain kind of respect. Though there are of course the odd policemen who refuse to salute, and make do with a gesture which can best be dubbed as the bracing position in which we percuss the anterior chest wall! Medicolegal certificates are interesting. Some drunken people take it upon themselves to abuse us, and some stress that we're corrupt because blood is not being drawn for testing the alcohol levels. Actually blood isnt being tested because of the procedural problems. If drawn, it needs to be preserved with a special reagent, which isnt available at most of the hospitals. Then there is the problem of transporting it to the chemical examiner's lab in a sealed condition. I asked an Assistant Professor in Forensics for the legal aspect. And he confirmed that the law didnt specify it essential that blood be drawn. And that our medical findings are the final word! There was also the occasional sparks that went flying when I gave a medical certificate of "Not consumed alcohol" when the Police Sub Inspector had recorded an evidence that the person had consumed alcohol. Of course I held my stance. The guy may have consumed alcohol, quite possibly, but I had no medical evidence in favor of drunkenness. And being an expert witness in court, I think I wouldnt have any difficulty in explaining my stance. I also have deviated from the usual practise done by medical officers here in writing "Consumed alcohol but not under its influence" in all cases. This of course is a ploy on their part to save their own skins. This is a statement which is pleasant to all parties concerned. The police who catches hold of people just to make their tally, the person who has consumed alcohol but is under its influence, and the medical officer are all happy. I don't shy away from giving "Consumed alcohol and is under its influence" reports. It is my stand that persons who have actually consumed alcohol heavily and is actually in no position to drive, should by no means be allowed to drive. And if a doctor goes along with the general trend and gives him a certificate of not under influence, he'd be escaping justice, and we'd just have ourselves to blame when we read the news about people who've hit pedestrians or some child on the footpath by overspeeding or other rash driving after being drunk. Again, I have no sympathy with the police who bring people who have just taken a beer or so, and have most medical signs negative for alcohol consumption or influence. Last time I gave a certificate of "Not consumed alcohol", it had the effect of drawing the Karamana Sub Inspector to our hospital demanding an explanation. I gave him one.. :)

Without much ado

podcast@eyrie.in (Joel G Mathew) — Mon, 01 Jun 2009 08:14:36 PDT

My quote of the day "Nothing much is asked from Snell, nobody references Snell, So why the Hell was I reading Snell?" Met a senior today at the college office. I had gone there for routine paperwork concerned with graduation, and we just ran into each other. I had never met him before, as he was about 5 years senior to me. Ansar chetan had been practising in the UAE and was well paid. 8 months ago, he came home, and decided to study for entrance. He worked, really WORKED hard, and didn't allow any failures to set him back. He wrote all the entrance exams this year, and didnt score enough to land him a seat in Kerala, All India or NIMHANS, not in any of the most reputed PG institutions, at least not enough for Medicine. He was depressed, but didnt allow it to get the better of him. He studied harder and wrote more exams. He got 15th rank in AIIMS!!! He was a most inspiring person, and listening to him was enough to inspire me. At least I got the idea that you don't have to be the one who shouts out all the answers in the IMA classes, to get a great PG seat. You dont even have to attend the PG classes. What matters is your work and the hours put in!

It's over!

podcast@eyrie.in (Joel G Mathew) — Sun, 31 May 2009 07:43:46 PDT

It's all over! House surgeoncy is over, and I'm a free bird, at least for the moment! ;) It's good that house surgeoncy is finally over. It means that I will have an enormous amount of time on my hands, to pilfer...er..and to divide among studies and leisure. It's weird how your outlooks and priorities change over the years. The mettle and core is still the same, and your response in some situations is indeed stereotyped. But it's kind of interesting to see how one develops over the years, conquering on a personal level, inhibitions and unsurety. (To be contd....Something came up! ;) )

End of one road and at crossroads to another...

podcast@eyrie.in (Joel G Mathew) — Thu, 28 May 2009 12:00:02 PDT

Finally...after a long time, one which seemed to stretch to eternity, my life as an undergraduate is officially over! I have almost (2 days left) finished my house surgeoncy (internship) and am now (pending university degree bestowment) a graduate doctor. Wow, it does sound cool. As the culmination of years of toil, days of tense insomniac preparations for exams, and even before that, months of preparations for medical entrance, it does give a lot of pleasure. Of course the happiness seems tinged with a sting in the gut as thoughts of the next PG entrance creeps in. But of course this is the life of a doctor exactly as I had envisioned! I know this seems like the time for recollection...of deep pondering about the gains and losses over the years..of knowledge gained, friends made, and even ones distanced from, of happy incidents and disheartening ones. And is also the time to finally let go of the emotional turmoil and its remnants that sprouted from a disappointing first failure...I MBBS...In the long run, it doesnt matter but it does have deep rooted consequences, in that I learned about things that ultimately matter, and to recognize on a deep personal level about people who matter most, and how you can find them in the most unexpected corners...There were long moments of apparent isolation, as I struggled to cope with the stress of coming to terms with the fact that people who didnt deserve to pass, had done just that and were smirking at you...Of course I wasn't entirely delusional about it, but I was indeed being heavy about it! Anyway, that phase of academics were soon over, and I soon realized how I really could understand subjects once I put my mind to it, and how exams were a joy, esp when results were out! House surgeoncy was a huge experience. Learning about responsibilities and duties..learning lessons from mistakes, knowing what it meant to cure someone, or at least to try to, and enjoying the satisfaction gained from the smile of the patient or an acknowledgement from their bystanders as a kind word put in.. It was all a lot of fun...Medicine, which provided me the strong base to handle anything and everything. Surgery where I learned that I am equally god with my hands as with academics, SAT where we became responsible doctors and Paediatrics where duties became enjoyable and SPM where I got a taste of what it is to be an MO in the OP. Taken together, house surgeoncy was indeed an enjoyable time, perhaps the most enjoyable time in my five year career. My career still looms ahead, the way dusky and dark, the path overstrewn with slippery undergrowth and fallen leaves, the vision shrouded and the destination hazy. Where the road forks, I'm not sure that the path I choose will be the right one, but still one has to choose, and pray for the best. Sambhavami yuge yuge..

Valentine's Day post

podcast@eyrie.in (Joel G Mathew) — Sun, 31 May 2009 07:50:30 PDT

Fooled you! If you came here hoping for a good story, you came to the wrong place, my friend! This post is not about my valentine! This is just a continuation of records of my boring phase of life, the latter few months of my house surgeoncy. It's strange isn't it, about blogs and how they preserve shades and snaps for life for posterity. Imagine how it might be, if these pages still survive, and my great-great grandson was to read these pages, as part of his genealogy project! Internet, and blogs have really twisted life. Genealogies (is that name right? Hmm...Google says it is! :)) are no longer blurred memories of old withering granduncles. They are now documented and supported with evidence. Photos, videos...Thinking of videos, I must really remember to take some videos. It's strange how you look at your photo albums and remember how odd it was that at the time you didnt think yourself particularly dashing to look at, but right now, you think that you were absolutely handsome! The self-image occasionally needs an overdue boost, and old memories, photos and diaries can do that. Nopes, I am not advising an affinity to dwell in one's own past, but, of course the past makes the present, and leads on to the future, and is the most important teacher. Learning from one's own mistakes, as someone rightly pointed out is the only sure way to avoid making it again! The cat who scorched his whiskers in the boiling milk will never drink milk again, to quote Thennali Raman! Enough of the past, present and the future. I've got night duty again tomorrow, and need to catch my sleep. About News. Kerala entrance results were announced today, and two of my classmates, Joe and Shamim got good ranks. Heck, people have started congratulating me, mistaking me for him! After all, only an L seperated our names!!

Some labors are painless

podcast@eyrie.in (Joel G Mathew) — Wed, 17 Dec 2008 15:42:42 PST

Finally, it's labor room posting. Already half of it is over, the day duty is now over..It really is odd. If you ask me, don't you think it's odd for a person who hasn't slept at all, gets a chance to do exactly that, and instead of succumbing to the luscious temptation, gives vent to typing away on his blog at 5am in the morn? You do? So do I! Labor room is kind of an exciting experience. It's one place where you feel that you are someone important, that what you do really counts! Don't take a wrong inference, I don't mean I'm interested in 'choosing' it as a speciality! Not that I have anything against the subject or against male ObGyns, but I dont think I'm cut out for it. I get the thrill of learning only while reading Med or Pharm, or Patho for that matter. According to a career choice book, that means I have an aptitude for Med..But having an aptitude isn't all that's needed...It's work, and desire to work. Unfortunately I haven't been doing much of reading after house surgeoncy started. Maybe it was the delimma that I wouldn't be able to appear for the first entrance along with most of my classmates, maybe I'd resigned myself to it.

Untitled

podcast@eyrie.in (Joel G Mathew) — Wed, 26 Nov 2008 03:05:49 PST

Since all my posts are a distillation of random thoughts, nay, correct that to a ravel of dishevelled mentation, I won't write a title just yet..it ought to settle in at the end.. Anyway what to jot down, um...patter away? Medicine is over, and so almost, is Surgery (Good lord, I don't even know if that phrase is right!). I've also left behind, postings in four specialities (ENT, Ophthal, Ortho and Dermatology). Internship is the time when we're supposed to get hit by that supreme revelation, isn't it? Whew, I wasn't at all thinking about the Buddha path! The speciality to choose, silly! I've still not decided, apparently. I still don't know what I'd 'shine' best in, to choose the colloquial. But one thing is damn certain..It most certainly won't be Ortho, that's one subject I absolutely detest! I've heard it said that the teacher is the one who influences you the most..I have nothing against any (well, correct that to most) of the teachers, but the point is that during internship in Ortho, there wasn't much teaching...I may have something to do with it, maybe I'd already decided I wanted to hate the subject. Don't take me in the wrong sense..I wasn't any bad at studying the subject in my UG days (Golly, did I really say that? My UG days?? What am I now?? ;) ) but, the subtle difference between studying theory and loving the practical 'doing' side of a subject is the same between a Paedocypris and a Balaenoptera musculus (um...er..Nopes I am not a nerd! I googled it just like you did just now, if you are not as lazy as me! There's a contradiction there, if you note, but I'll leave it for the present.... Anyway the point is one is the smallest fish, and the other, the largest, not a fish, but nevertheless...). And there is of course the matter of breaking the bones of my arm as a kid, which was treated by casting without even the milodest sedative...it was the most pain I've tolerated physically.. Anyway, case in point, the gist of the issue is that I'm now a die-hard Ortho hater...There's a strong likeness between Orthopaedicians and carpenters..both deal with similar tools, if you notice it, but carpenters are probably more delicate in their handicraft...Anyway, I think this post is starting to look like an Ortho hate page...So I'll veer astern! To be brief, I hate and would never take up Ortho, and there the matter lies, at the bottom of the rolling ocean. Surgery maybe? Nopes..I thought I liked it after my 'stitches' were admired in the Labor room by my seniors. But ........ (to be continued when I have more time at my leisure..)

To believe or not to believe is the question..

podcast@eyrie.in (Joel G Mathew) — Sat, 16 Aug 2008 10:34:34 PDT

The superstitious would have you believe that 'Karkkidakam', the last month of the Malayalam calendar is the time when deaths occur by the deluge..I, don't, as a rule, believe in superstitions, so much so that I was about to buy my first car on the last day of Karkkidakam, but there are times, when you feel your resolve weaken..when you have a hunch that there is something beyond reason and the obvious... I had night duty yesterday...well, I've been having perpetual night duties ever since I started going for GPs, but this one was in the MCH wards..It was post admission night, and as is usual, the night duty, the heftiest of all duties fell upon my squared shoulders. Well, if truth be told, I hadn't much choice in the whole matter. Having gps on almost every other day (well I did sign up for it), I voluntarily signed up for it. Well, back to the story... I finished my usual chores in ward..distributing FBS chits and bottles, and after pinning my name and phone number on the board (for the night sister to call, if any patients got 'bad'), I went to the Ward 2 HS room, where I found to my utter dismay, that some girl HS had turned in, on my favourite cot..The only other HS was Rajeev, and it was their ward. I asked him who the intruder was...the answer was that it was some HS from Alappey. I asked him to request her to move to the Female HS room. He did...but ask isn't the word for it..He requested, and as is usual when he requests, was turned down promptly...The time had come for action...and I went in, and cooked up a cock and bull story about how that room was the male HS room, and that there used to be a notice (in older times ;)), proclaiming the same. Well, she bought it and left the place, which I immediately decorated with my sheets... Eventually, I turned in...The first couple of calls were uneventful. The first was a psychiatric patient who wanted me to counsel his daughter to loosen his knots! I pacified him, and went back to try to catch a wink. Early morning, I was awakened by my phone ringing. It was the night sister. On rushing to ward, I saw a patient gasping. It was cardiac arrest, and I hadnt enough time to shift him to the MICU. I commenced Cardiopulmonary resuscitation on the floor (MCH has patients on floors, didnt you know that?), and later shifted him to MICU. There the MICU pg joined me. He put in an ET tube, and I renewed CPCR with vigour. My efforts seemed rewarded when the paddles showed electrical activity. But unfortunately it soon went back to zero bpm. It was a giveitall or loseall situation, and I tried my hand (for the first time) at delivering DC shock. 200J didnt seem to do anything. I charged it to 300J and pressed the button for all it was worth. The effort made a dent in the patient's chest. The beats did come back for a sec, but it was desync activity. We stopped the effort soon. I went outside and declared him. The next call was from a guy who'd consumed formic acid for the second time! The first time he was lucky, and escaped after an emergency surgery in the pylorus (a part of the stomach). This time he'd been admitted in a great state of pain. He anxiously tugged at my shirt, trying to struggle to say something. But I had no sympathy for the person who tried to take his life for the second time. I would perhaps had paid greater attention to him, if I'd known that he would be successful this time. An hour into our rounds, we were called by the lecturer in the neighbouring unit, saying one of our patients was sick. It was Vijayakumar, the formic acid drinker. He was already dead when I got to him, and frothing at the mouth. But anticipating a big scene in the ward, we shifted him to MICU. It still didnt stifle the wails that emenated from the wife and mother, as news was broken to them. These were just two. There were more than a couple more deaths that night. It made me a believer...in superstitions, so much so that, I postponed the date of bringing home my first car, to the 17th of August, Chingam 1st according to the Malayalam calendar, and a very auspicious time for events!

Of two sides of the coin..

podcast@eyrie.in (Joel G Mathew) — Wed, 13 Aug 2008 04:25:29 PDT

It's back to Medicine wards..Medicine is fine. It never feels exciting while u're at the posting. It feels like a lot of work and no play..but of course the only thing I hate is acting Dracula all the time! I hate having to draw blood all the time, as I've oft reiterated...but of course there's nothing one can do about it, than weep and lament! ;) There are good times and bad times. At times, they tend to cancel out each other, but it's the other kind of times that you've got to be wary of...the really gloomy times, and the too happy times...When you feel either of these, extreme caution is advised! Coz it's the foreboding of disaster! :D lol...Of course there are people who say enjoy happy times to the max, and to weed out the sad times...They're right of course...but saying is something, and practising is another!

On Specialties...

podcast@eyrie.in (Joel G Mathew) — Sat, 05 Jul 2008 09:17:12 PDT

Specialty postings are time for relaxation. While you're in Medicine, you get one month of specialty postings. I've got Skin, Rehabilitative medicine and Opthalmology. They're a welcome break from the fuss and ado of Medicine wards. It's funny...In Medicine, you've got to handle about a couple of dozen patients on your own. Guess how much you've got to manage in Skin...well? Nought! A big zero! All of the patients on 'my' beds have been discharged, and none have been admitted over the past two admission days! So what do I do during my postings? Nothing!! :D We get to sit around lazily. There are some who pour down volumes of MCQ books...Well, I try my hand at them too, in my own lazy way...but for better or worse I won't be able to appear in the first entrance test after house surgeoncy, so I have more leisure time on my hands, you see.... :) Anyway, there is something in this laziness that evokes a gasp of protest from your conscience..but of course, when has your conscience ever solicited fun? So of course, you set your foot down firmly upon her nagging, and continue your reverie...