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Friday, November 13, 2020

The Man From Zurich.

 *Bhompu bhompu* my phone rang as it notified a new WhatsApp message. Now, what sort of a ringtone is that you'll think..... but I am well known, amongst other things, for choice of the legendariest ring tones.

'Meh, yet another happy Diwali forward' I thought, and the best part is that "the prosperous new year part" is going to be repeated again after another two months.

So I went on to give a finger print impression to unlock my phone. There goes all my education in the drain.... sirf angutha hi lagana tha to itni magajmaari kyu ki?

Open WhatsApp and there's a message from "Zurich Uncle". Who was this? I couldn't quite recollect. So I opened up the chat. The last exchange we had was way back in 2014 (that's when the JV debuted on WhatsApp)...... Actually no.... We never had a chat. Who was this Zurich Uncle????? "Think.... think"


It had so happened, that Owais and I had once gone to catch a movie at Phoenix, in the latter half of our internship, probably once the entrances season was over. And afterwards, we had headed to a Mc D. It was evening time and the coronary artery choking food's outlet was jam packed with people. We had to wait around 10-15 minutes to grab a table. And that too we had achieved by jumping onto a seat vacated by the previous customer (and future heart failure patient) even before his gluteii had bilaterally vacaed the airspace over the seat. The spoils of his war with his physical wellbeing still lay bare on the table, uncleaned unkept. But, all we wanted was a seat at that time. (PG Seat > McD seat.... in that priority, but we contended with the McD). I held onto the table as Owais went to get the order. After sometime, an elderly gentleman came around with his platter of cholesterol and everything that's bad, and politely asked us, if he could join (There was a third chair vacant on our table and nowhere else). Since he seemed polish (in manners, not in nationality), we let him seat. 


Dressed in a kurta, or may be it was a Safari, he spoke in a Hindi, that was way too polite in its accent from Mumbai standards. "Are you from Lucknow?" I asked.


"No I am from Zurich." He said.

"Ah! Its in Germany no?"

"No! Its in Switzerland."

"I come to Bambai often for business. Usually I stay in Taj or other hotels. This is the first time I'm staying in Palladium. Must say, it is a nice hotel, The rooms are quite spacious. And its very cheap. Only 12500 per day."

Back then, I had no intension of taking up ophthalmology as a career. Still, after listening to that last sentence, I think I developed a transient self sealing spontaneous high flow caroticocavernous fistula..... (for the lay and non-ophthalmic folk: my eyes popped out)

"What do you do? My monthly stipend is 6500" I asked in dismay. (also with an element of a childish greed that a child who sees another child play with a fancy toy and then nags his parents ki mujhe bhi chahiye).


"I am an investment banker."

"What is that?" I asked. There's a joke that final year MBBS students crack that we felt shortchanged when we realised that ortho-pedics and pediatrics are two different subjects! I just didn't want to look uninformed so I replied, "O! OK!".

"Come to me when you have your millions." Saying so he handed me his visiting card.

That Zurich uncle had messaged me today. I was expecting "Happy Diwali", but what I got was

"Imtehaan ho gayi intezaar ki!"


*****Wish you all a very very happy Diwali and a prosperous New Year *****

Monday, August 31, 2020

Eureka! Oops, not yet!

Six months into the pandemic, life has become restricted to an arc of 100 meters. Home to hospital and back with the odd weekly outing to buy some fruits and vegetables. Long conversations with friends (luckily, of which I have many), phone calls, WhatsApp calls, video calls (nah, not many, cause I’m perennially running short of internet and being the Scrooge McDuck that I am, getting a bigger net pack is out of question) have not only helped alleviate boredom but to some certainty definitely helped to soothe frayed nerves.

A discussion on restarting the blog has become part of my daily conversations. But, call it a writer’s block or sheer lack of enthusiasm or the weight of uncertainty that has preoccupied the thought space, the inertia is a bit too much to overcome. But, when one is in the medical profession, there’s no shortage to stories to narrate. Thus, somewhere, it’s the narration that has taken the back seat.

Seeing patients is a roller coaster ride. Sometimes, you see a rare condition and feel that “Wow!” factor. The feeling is all the more rewarding when you’re the one to make the primary diagnosis. Academically rewarding always and emotionally draining sometimes. But, then you move on to the next patient and first is relegated a memory archive, only to be retrieved when you sit discussing with a colleague, or preparing a presentation for a clinical meet or when it just bursts into your conscious and you wake up in the middle of the night frantically reading up your textbook and searching PubMed for the most recent studies and researches and treatment modalities and prognostication indices etc. etc. And, yes, you won’t fall asleep until you haven’t read to your heart’s content. Heart? Or brain? Or both? Depends on what drives you, emotion or academics? Or both?

 Whatever be your USP, IQ or EQ, needs to be well balanced. Otherwise, the OPD is the right setting for you to become a classical display of a textbook nutcase of bipolar disorder. Happy and over the moon when you see a patient responding to therapy, and sad and soggy when he isn’t or you can’t offer anything.

“A doctor needs to be coated. You should be able to see, but not get affected. So, it must be a glass coating, not an asbestos one” said a teacher once. Second year MBBS students that we were then, nodded our heads in affirmative not catching a single meaning of the spoken words. “Kya mast bola na Sir ne.....” is all that we said at the end of the clinic.

A couple of years ago, during a Saturday charity OPD that I was attending, a postop lady in her 60s walked in accompanied with a male in his early 40s. Seeing her discharge papers, she had come for review a week earlier. In a heavy OPD, any unnecessary patient does give that feeling of having wasted your precious time. But now that she had come, and I had examined her, what was the point of feeling anything?

So, regaining my calm I said, “You’ve come a week earlier. Continue these eyedrops and come again next Saturday.”

“Dekha.... bola tha maine.....” she said in a scolding tone looking at her attender – the man in his 40s. Then turning to me she continued in the same chastising tone, “Doctorsaab..... ye hamara ladka.....” and got off the examination chair and limped out of the OPD, still taking support of that man in his 40s, now blushing with embarrassment.

The next patient who walked in had an advanced eye problem. She had been advised a monthly review, but she had come a good leisurely six months later. 

‘Super Laid back’ I had already made up an opinion. ‘She’ll say I had gone to the village’ my thoughts continued and I placed a wager with myself. And now, in just a second I was about to be proven right and get the rush of that Eureka! moment. So, in a single breath I asked, “Kaha chale gaye the? Ek mahine baad bulaya tha?”

“Teen ladke hai hamare. Par koi dekhne ko taiyaar nahi. Aaj ye hamari padosi aa rahi thi, to uske saath aa gayi” she replied. Eureka! indeed. What to do now? “Hmmm.....” I nodded. “Ye do test karane hai, dekhkar fir dawai badli karenge. Tab tak poorani chalate raho.” I said as I jotted down my advice and prescription on her OPD sheet in under 30 seconds and moved on to the next patient.

Many a thousand patients later, these two still come back to memory time and again, the scene feeling fresh out of the oven.

Almost a decade later, I’m still trying to figure out if I’ve gotten the glass coating. And if I have, how do I prevent it from becoming asbestos? Where does the sweet spot of titration lie? 

Still awaiting my Eureka! moment.

Monday, May 25, 2020

A Year with Mother: The evolution of a Mumma’s Boy.

(Note: This article was first drafted  in mid 2016. And well, it then remained in the drafts. Residency or some other thing took me away from writing. With the lockdown, once during a conversation with a friend, we got discussing a blog I used to once write. I lamented how I’ve lost the zeal to write, but we decided at least there must be an attempt to reignite an old hobby. It’s Lockdown 4.0, and I still haven’t come up with anything original of substance to write about, but then this draft caught my eye. So, a lot of this is from 2016, and some from 2020. Four years on, I’m baffled how drastic drift my ethos has taken. And thus my attempt to chart an evolution.)


You’re a total Mumma’s boy!” exclaimed Pallavi as I cracked yet one more of my famous (or infamous, nonetheless, as they say, no fame is bad fame) standup type jokes. There was no audience (cause three’s a crowd but there were just the two of us), but I’m sure if there was one, I would have been mobbed (for autographs and selfies, of course).

Pallavi is a simple creature, pure of heart and not much wit. She gets fascinated by simple things. Like the other day, when I showed her my new phone (edit 2020: Still using the same phone), her eyes lit up with excitement – “Isme to front facing flash hai!!” (edit 2020: At that time there was no Oppo, Vivo and mine was perhaps one of the first phones [yes it is Chinese, but whose phone isn’t] to have a front facing flash. Tech Savvy, ain’t I?)

So, a post call 1st year resident (i.e. Pallavi) realising and emphasising my mumma’s boy status meant that the cat was out of the box. And that has got me thinking. How do I quantify this trait? On a scale of 1 to 10, where do I stand?

For one, all through the five and half years of MBBS (internship included. Do i smell someone one fire?)  I’ve been going home for lunch, being served fresh hot fluffy rotis. Well, if your house is 5 minutes walking distance from College, who wouldn’t go home. In my defence, during my 12th I used to carry two tiffins – one for breakfast and other for lunch. So, that definitely doesn’t count as a mumma’s boy attribute. Yet, I do concur with the observation. But scientific thinking mandates that conclusions have to be backed by plausible evidence (edit 2020: WHO/ICMR are you reading this?) Hmmmm.........


1st August 2008 I joined the famed GSMC & KEMH, and thus began a romance, one which has only enriched me. Here, I’ve got the opportunity to bloom to a full potential, in both my academics and extracurriculars. Well, this is my second home, I intend to be here for much longer and many more innings (edit 2020: I won’t. And I’m much grateful for that. I now have many more places I call home viz. Delhi, Coimbatore..... and counting?)


But, what had happened over the past 5.5 years is that the home where I live had just become a boarding and lodging facilty. Go home, sleep. Eat food. Back to Gymkhana for all those youthful activities (edit 2020: Gymkhana is love.) Hopping from one activity to another, one semester to another and one exam to another has been so engrossing that one hasn’t realised that time has flown away. I joined MBBS as a 17 year old minor and by now I have voted in 3 elections, have a political ideology (edit 2020: That has watered down. Now, they are all just clowns in different colours.) I have a degree, I deal with life and death (edit 2020: no longer. Hope to continue to make life livable..... the quality of life aspect that I now deal with....... that’s content for another blog), and hope to save many more lives in the future by calculated heroisms that only medicine can offer one to do.(edit 2020: Meh!)


So many things have changed over these years, but there has been a steady backbone through all the trials and tribulations, like a shadow which never leaves – the constant called mother. Yes, there have been complaints that I have had towards her and she towards me and both have amicably communicated to each other. But, there has been a comfort in her presence and much of what I have been able to do, has been because of this emotional cushion that she has afforded.


In stark contrast to the ever absent from home 5.5 years of MBBS, this past year of preparing for NEET has been spent within the confines of home. I’ve talked more with mom this year than perhaps the last 6 years put together. She has stories to tell and I have more. And now dwelling on that innocuous observation that Pallavi, my dissection partner (not quite partner, she was afraid to dissect, so Owais and I did all the work. No complains, we loved dissecting. It was a mutual arrangement. Just one complain – she never went on a dieting fad or I would have gladly eaten all her cadburys as well),made brings me to the realisation that I have now come to see the white hair that she (mother, of course) has, much more than 6 years ago. 

Those fine wrinkles on her face, they weren’t there the last I recollect. So, while as much as I may claim that she’s been a constant, she probably has been largely relegated to being a shadow.


Have you seen your shadow carefully? Does it have a face? Does it have features? No. It only has a silhout. And you never bother to notice that because it’s just so taken for granted. People talk to mirrors when they are bored and not necessarily psychiatrically ill (edit 2020: most would’ve by now, courtesy the lockdown!), but no one talks to the shadow.


But this, year has given me an opportunity to see a face in that shadow. Indian boys are so attached to their mothers (edit 2020: this one still holds), and so am I. But the shadow with a face, makes me realize that the tables are turning. Sooner than later, as these wrinkles deepen and more of the hair turns white, a change of roles is on the card. I will be the care taker, her constant, her backbone. This happens to all and sultry.


But, what will be different? Well, for her I’ll always be the one with a face, the one she reads and deciphers- emotions that I have been unaware that I was experiencing – she always has. To her, I’ll never be a shadow. And this day forth, she’s definitely not a shadow anymore.


Post Edit 2020:

Long story short, in a couple of months I moved to Delhi for my residency. Over the 3 years in Delhi, I’ve learnt to cook, keep my books (financially), manage my groceries and shop for my clothes and wash them and iron them too. Mother has been visiting often, her trips ranging from 1 week to 1 month.


October 2019, I completed my postgraduation and moved back home in early November. Then, for two months I was home, till I moved to Coimbatore in early Jan 2020 for my fellowship. In the two months, while mother insisted on cooking breakfast, I realised that my food tasted better. So, from taking culinary instructions over the phone in the Nov of 2016, here I was dictating terms in the Nov of 2019. Minor tussle. Everyone’s happy now, cause my food tastes better. As mother says, there’s something in the hands of boys who cook. Yeah!!


Come Jan 2020, mother made a trip to Coimbatore. Something here was feeling new, the house wasn’t feeling like home. But, ever since she’s been here, it has been. In our temples we do pranpratisthan for the diety’s idol. Well, her visit was kind of a pranpratisthan for the house I live in now. 

After that 1 week visit was over, we had planned a longer one in March. This time we were to go around to Ooty and all the scenic hill stations around CBE. Just a few days before her departure from Mumbai, the frenzy around Corona was building up. Being at that stage in my career where most of my batchmates have joined as senior residents or lecturers or junior consultants, there was a flood of information about the landfall that this pandemic was going to make – raw data, the one that was not yet analysed or manipulated or disguised under official figures. Real on ground situation!! And that was still March, before the official lockdown.


So, in all sense of safety and security, it was mutually decided to postpone the trip to a safer time, say October, tentatively. How have the last two months been? Extremely stressful? Yes and no.


I am happy, I don’t get to go home. I can’t. I’m a thousand miles away. Also, I see patients. Wouldn’t have wanted to go home. Win-win.


But, there’s also always a moment every day, that I am scared and worried. Every time, I hear of some so and so case. Some batchmate testing positive. Of the shortage of hospital beds. Of being unable to be of any use, despite all the resources and contacts at my disposal, because, frankly, they themselves are stretched beyond imagination.


Ever since we’ve resumed OPDs since early May, I’ve been using a N95 mask daily. It is a torture. It drains your energy. It starves you of oxygen. And the headaches are like you’ve never experienced before. Then I speak to some friend. And I feel happy that at least I’m not wearing a full PPE in this sweltering May heat. At least, I am spared the dehydration and electrolyte imbalance.


A few days back, I was speaking to Mom about how bad the situation in Mumbai has become, and just as a fleeting thought I said "May be, I should’ve let you come over.” Then again, I remembered speaking to my friend, “At least you are lucky you’re getting a PPE!"

Can’t have both heads and tails, can we?


Going back to 2016, I had written 
“Sooner than later, as these wrinkles deepen and more of the hair turns white, a change of roles is on the card. I will be the care taker.”


Come 2020, am I? Not being around, is probably the best care that I can offer. We all are at nature’s mercy. I hope the answer is in affirmative, but only time can tell.


What makes a hero standout? He makes a sacrifice. And recollect, in 2016 I had a dream to undertake “calculated heroisms”. Well, at this point, to that end, we both are each others heros and rest is for fate to decide.


Have you seen these guys?” one of my professors had once said. “30 year olds, still having their parents standing outside their exam halls. When will they ever cut the umbilical cord?” It was probably in context of DM entrances or MD final exams, I don’t recollect clearly, and he surely was unhappy that full grown adults were incapable of fending for themselves.


To Sir, I reply. Yes, I have cut the umbilical cord. Independent I am, a bird that has left his nest and gets his own worm. And that partly, is also the reason why mother dear isn’t as worried. 

I've tried to make her tech savvy. Pushed her out of the house as much as I could. In Delhi, I bought her a metro card and told her to go around sight seeing on her own, whilst I was in the hospital. She would then come home and tell me about easier routes around Delhi.
So mush so that, when she came to CBE, I told her that I’ll come to the station to pick her up, she actually sounded surprised. And that’s the reason why I am not as worried. I know, she’ll manage. 


The umbilical cord has been cut from both the ends. We now stand to each other as mirrors, not as shadows.


Coming to whether I’m still a mumma’s boy? 
Well, more than ever! On a scale of 1-10 where do I stand? at 11.


(P.S: That March ticket which she told me she’d cancelled – well she’d actually rescheduled it for April. This she told me in April when IRCTC messaged her that they’re not running the train. We both had a healthy laugh about it. 

It’s just not us, there are so many amongst us that yearn for our loved ones. My heart aches when I think of the tragedy that the poor migrants are facing, left high and dry. Were I to be a daily wager, I would also have taken this thousand mile journey for sure. 

But, we should be lucky to be privileged that we are – me for being able to write this, and you for being able to read.)