Uncoding Online Reviews!

"These are dark times, my friend, " said one fictional character to another....... and my friend who is a big fan of the series, kept on repeating it all day, for days on end, until one day I punched him on the face and gifted him dark times around one of his eyes.

I quote this incident, because currently I do feel that these are dark times.

I will be visiting a far off city, for the 1st time, for a couple of days, a couple of months later. And so, the preparations are in full swing and most of them "a-swing-and-a-miss". One of the things I am very worried about is my accomodation. They say the city is safer than Mumbai...... which should make it the safest city in the country, but then the true-blue Mumbaikar will not accept that claim.......

So, to be on the safe side, it's good to be assured that you have booked a good accomodation.
In the era of the internet, everything is online..... e-mails, e-payments, e-transfers. We Indians, anyway, have been making hay of the internet even before it was in its stage of genesis. For centuries we have been e-smiling at each other, talking and gossiping about the e-smooches in E-nglish e-stories converted to films, playing all sorts of e-sports, going on e-strikes and what not in our own e-special e-styles. But, all this doesn't bother me. What bothered me was my first experience of booking hotel rooms the e-way.

In the e-ra of social media, communications have broken down. In those olden days, people would inquire with friends and friends and relatives of friends for such queries. But, the confident youth of today (such as myself) more often than not, e-mpowered by the e-nternet, take things into their own hands, go to google and get all our querries answered.

So, I rub my magic lamp, and a Google comes out of it. "Hukum mere aaka! Aaj kya maangta???" As if reading my mind, it has already given search results before I have finished typing........ "You know, interrupting others is ill manners" my mother stills reprimands me, but the standards for Google are different.

Cheap hotels....... and some 200 pages and 200,000 search results in 0.0025 of a second. E-mpressive! I look up the first few results........ Click on photos for preview..... I am blown out this world into the outer e-space! Such beautiful rooms at such throw away prices!! Why rent an apartment, when staying in a hotel is profitable.

But, one must always read reviews...... So, I began reading.
Everything seemed very pink and rosy. A particular site had a good system of having classified their reviews from family to solo and business, excellent to terrible. Might as well see, what problems people had with it...... (Just to see if it's worth taking a shot)

Under terrible:
#1: No windows...... rooms nothing like the ones shown in the photos.
#2: Flush not working.
#3: The room on the ground floor has a broken window....... people from the neighbour building just kept peeping in the room all through the night...... made me very uncomfortable...... (Yeah, that's what Indians do.)
#4: Very noisy.
#5: Rude manager.
#6: The toilets were not clean.... The sofa had molds..... AC wasn't working.
#7: No maintenance. The bathroom was filled with hair of the previous visitor.....
#8: Area is surrounded by brothels...... Not good for women travelling alone!

Those under Solo and Business read
# 1:Excellent place, warm people.
# 2: will come back again.
# 3: Excellent room service.
#4: Reached there at night for a stopover on a trip to Delhi.... could have done with better sound proofing as it is located on the highway..... But, great place at this price.
#5: I've been here thrice, gets better each time.
#6: I never write any reviews, but this place is so good that I am writing it. (That was all, and indeed that user had this lone review to his credit)

Eventually, since I am going for an exam, I have decided, this is definitely not the place I want to stay at. I have gotten in touch with a couple of people who know people residing in the said city to refer me to a safe place.

By-the-by, the following review requires a special mention. Categorised under the one rating the said hotel as excellent-

Stayed here for three nights. Poor ventilation, poor room service, charged me more at checkout. But on the bright side, J.W. Marriot is bang opposite, so you can pop-out of here in the middle of the night and go there.

What do you mean???

This hasn't been my first experience reading online reviews....... A month ago, my old laptop crashed and I had to buy a new one. Read online reviews and bought a Leovo..... which crashed on day one.... Went back and exchanged it for an HP.... which was reviewed to be bad..... Has been working e-smoothly!

Conclusions:
1. When Indians write reviews, they can't be trusted. Either we don't know what we are writing or forget to include the "pun intended" in brackets.
2. It all boils down to the price..... If its cheap its e-xcellent.

Contact someone who you know personally and follow their advice.

Death - The Best Medicine

Laughter is the best medicine..... or is it? The more one dwells into the abstract, the more one realises that it perhaps isn't.

"How was your MICU posting?" I asked a colleague. I expected he would say things like x number of CPRs or y number of Central lines or something of that sort. But he replied," Kuch nahi..... ABG karo and then around 3-4 am patients start dying. It happens everyday.... 4 -5 to jaate hi hain." Chuckle, and we moved on.

Such is my profession, that we laugh at almost any and every thing. My mother says, especially since my internship has commenced, that I have become very pessimist..... that I do not say 'good' things any more. 'Good things', how do you define good things?

About a year and a half ago, a bunch of us junior college buddies met up. Being the sole medico in a hitherto group of 6 +/- 1 engineers, I tried to keep pace with the conversation and give my inputs as they spoke of Accenture, Infosys, Patni going out of business, fat packages and so on and sultry. Then, probably after a few PJs which made it clear that I was loosing tract, they courteously asked, "So, Jayesh, what do you do? Tell us about the best thing you have seen in medicine."

"It was on Diwali night of my second year", I began enthusiastically. "A diabetic wheeled in. He had gangrene of his foot. Three of his fingers had rotten and we performed an amputation......... We cut his leg just below the knee...." I simplifiied so that they could follow what I was saying, as we chewed on a sumptuous lunch. "I assisted in that procedure. It was beautiful!" 

"God! Jayesh, what's wrong with you! How can you say that rotten feet are beautiful?" They echoed as one choked and the other gagged on their morsels.

Okay, I get it, i don't speak 'good things' any more.

But, while my profession has been making me heartless.... emotionless so to say.... squeezing me dry and devoid of the very aesthetic that differentiates sajeev from nirjeev, it has indeed opened a portal to the mystic and the subconscious. I perhaps understand life a little better now. And nothing helps understanding life more than understanding death.

Death is universal. I probably learnt to spell death in Sr. KG when they taught that the opposite of life is death. Then, when I was around 7 my grandfather expired. As the rituals about the funeral proceeded, I wondered why the ladies in the house were weeping so inconsolably? More elders dressed in white poured in and tried consoling them. All this time, I only wondered, trying to configure what was going on. This is all that I remember of that day.

Then, about a couple of years later, my father rescued a sparrow and it became my pet. I used clean its cage, feed it grains..... and then one morning, it just lay motionless. My dad said, it had died. I cried.... for my friend..... not because it understood what death meant. 

A few years later my grandmother expired. I cried because, I realised I wouldn't get to see her any more. Death, per se, still remained a strange entity. I never gave it much thought.... never pondered over its complexities...... partly because I got too engrossed in my own life and also (luckily) due to the fact that no one else in my family has passed away since. 

In between, my English curriculum in school had two poems, 'Death be not proud' and 'Death the Great leveler', but still I failed to grasp the abstract.

Now a days, people just keep dying all around me. And, I realise that some people are valuable when they are alive and some others after they are gone. There are some for whom you wish they are better dead, some whom you wish, live forever.

A distant relative of mine sent me a MRI for opinion. The report was suggestive of Interstitial lung disease. ILD- one of my hot favourite topics these days in view of my exams. Different diseases causing ILD of upper lobe predominantly and some others of lower lobe predominantly..... their treatments, for majority of which none exist.... and few experimental novel drug..... which I mug up but which in reality will probably never get out of the labs and in clinical practice. But its exams..... pet ka sawal hai.

So, I tried, in my hallmark mask face and expressionless emotionless monotonous voice, explaining that the disease had a very bad prognosis, that there was only one way...... going down and none other that they should NOT believe any ayurvedic or such practitioner who will claim a cure..... ayurvedics claim a cure for everything..... that she has little time left and they should brace themselves for a tough time maintaining her. That it is not cancer and not infectious.

Today, as I was discussing the same with my mother that how bad an end awaited her, it came to my realisation that knowing every disease and more importantly seeing the end, has just made me a bit paranoid when it comes to the health of my beloveds. 

There is an entity called "The Final Year syndrome" - it occurs universally to everyone irrespective of age, gender or race or culture- in which Final year medical students read of diseases and start finding symptoms of the same in themselves. Can you imagine, diagnosing yourself with a near fatal disease every single day....... that's why the final MBBS exam is called the toughest exam. And, to the quote the idiom. 'What doesn't kill you, makes you stronger.'

So, as we were discussing, the phone rang with the sad news. "Be happy" I told my mother. "She has actually been spared of a lot of pain and suffering. Imagine, if had lived longer, she would have been confined to a bed, wouldn't have been able to breathe without a ventilator .... her caretakers would have had their personal lives destroyed....... Be happy, that she died peacefully."

She had gone to the village, for a change of air and to pay her respects to the family diety. "If she had been in a hospital, we wouldn't have let her die and she wouldn't have given up a life that wouldn't have been worth living."

Life in a hospital is all about witnessing battles for survival.... brave battles, day in and day out. You feel overwhelmed sometimes by the extent to which humans cling on to life.... till very last bit of it. But then, death is so good.... No pain, no suffering. No worries, no anxieties. Do we live lives? No, we only live worries... some real worries and some only a creation of our minds. We live our ambitions, others' ambitions, we live protocols and etiquette. No where, do we live life.

Death on the other hand is so liberating..... In death at least, perhaps, is a chance living life. Death, should be celebrated, not mourned..... for it is the best medicine!

Am I ready to die? .......... No....... I am mortified by the thought of death. But at least, I think about it....there are so many a ways to die, that one must be just plain lucky to be alive, let alone be  healthy and alive. We all live on borrowed time..... and so, I value life even more......may be understand life a little bit more, EVERYDAY.

                    May the departed soul rest in peace. 

A Saga Of Love

Internship, in a way to put it, is in itself an independent phase of life. An era in itself. You are no longer a student, but aren't a doctor either; you are somewhere in between, and sometimes you wonder, if even that is where you belong? There are many a trials and tribulations in the intern's life, frustrated housemen, frustrating schedules, depressing backlogs and demotivating Government Resolutions.

And yet, just somewhere in between, someone comes around, whose pain supersedes your pain, whose confusion makes you realize how lucky you are, that you at least have a rough idea of what you want in life, someone who you just cant pass off as just another incidence......

It was my 4 th night shift on the trot in the EMS - I can boast of it and I will, but I wasn't particularly comfortable or happy doing it! The three of us were chatting with each other as we mechanically cannulated IVs in the que of patients lined up ahead of us..... a que which had no end till so far as the eye could see...., simultaneous collecting blood samples 2 EDTA, 2 Heparin and 3 Plain bulbs, filling out forms and pausing our conversations briefly as we shouted out the instructions, simultaneously surveying the arms of the next patient for a good vein. This whole routine was so intense that it occurred almost at a spinal level, the only higher function involved was in our conversations.

In this din, trolleyed in a patient- not an occurrence of significance in our part of the world. He was a typical patient, cachexic, dehydrated, semiconscious and accompanied by two cash-strapped relatives. I got up and proceeded to his trolley holding a cannula, a spirit soaked cotton swab in my double gloved right hand and a 3-way attached to a syringe in the left, collection bulbs and a strip of dynaplast in the pockets of my apron. The man seemed to be in his late 60s, was bare chested and only a bermuda covered him below the waist. As I set out to do my job  I was interrupted rather annoyed by his wife who asked me, "Will he die?"

This was annoying for two reasons, one, relatives usually asked if patients will survive, not the other way round and two, for the tone of her voice and the way she kept aloof from the patient. But, ours is a profession where personal beliefs and emotions and prejudices are kept in the locker as the white coat is retrieved from it. I did what I had come to do, and directed her to the registrar for ant further queries..... no intern knows how much his involvement in patient care is supposed to be, so prophylactically, it s safe to keep it at a bare minimum.

The registrar asked her for the history, she annoyed him by her attitude, her obsession with the patient's death and her ever changing answers. No one could afford to spend so much time on one patient, there were 50 others waiting in the que. So, after initiating preliminary treatment the Reg moved on to others, leaving minute intricacies of his history for such later time as would be possible.

For the next three hours that followed, the female ensured that she was noticed by everyone in the EMS by her mannerisms and high pitched quarrels with a semi-conscious husband. It was becoming very irritating for all present..... when we were racing against time to save lives, she was one we could do without.

Finally, at around 5 am the que ended, the reg began interrogating her. She enjoyed every bit of feeding us mis-information and backtracking on her previous statements. By now it was clear that the patient has acute renal failure and would require dialysis for the near foreseeable future. Even if we are a government set-up, procedures such as these cost money, howsoever less that it may be. And she replied, "I don't have the money. If you don't give him dialysis, will he die?" We left it at that, your patient, your decision.

With that had to be asked asked, with all that had to be explained explained, the reg moved on to covering up other formalities. "What is your relation with him?" the Reg asked. The obvious two answers could be sister or wife. And this is where the mystery unfolded. She answered, "Wife...."

And then after a few seconds, glanced back at the patient, her eyes lit up with a resolution and she murmured  as she tried to control a sort of a wicked smile..... "Friend...."

With a startle, the Reg asked, "Wife or friend? Make up your mind."
"Friend" she confirmed.

"Is he married?"
"His wife stays here only, In Elphinstone...." she answered, "but he come to me when ever he is sick."

"Give us his family's address".
"Why? Why do you want his family's address? I have brought him here, I have given my address..."

"If he dies, we have to inform his family."

"Ah.....!" That wicked smile smile finally broke through. 'He dies' - this is what she was waiting to hear for so long.... this is why she was pestering us since the time they has wheeled in.
I think, she had received  a very straight forward answer for her question, no element for ambiguity. But may be, she had some other calculations in her mind. "One minute..." she said. And walked to the trolley which was barely a meter away. I thought, she wanted to whisper something into the patient's ear. But, she echoed, "Doctor is telling you will die. Who will take your body?"
"My wife" he answered, with a smug.
"Why? She does not take care of you. Who will take your body?" she echoed again.
"My uncle's son" he answered in the same demeanor.

At this point, our irritation had been blown away so beyond the roof- added with the exhaustion- that this whole incidence started appearing entertaining, so to say. Both of them were past 60, yet they quarreled like newbies in love exchanging sweet little nothings. The question was not of life-death-suffering, it was of establishing authority.

It was 8am and the next intern came to relieve me. As much as I wanted to stay back and audience this conversation till its end, all my senses were overwhelmed by the prospect of a good shower and the much deprived sleep that would follow.

On my way home I thought over the conversation and the female's obsession with death. It was a very Barbarian emotion that she harboured. Greed - to get what she wanted, at what ever cost it came or closure, that she finally got the recognition she deserved?.

His dead body, a trophy symbolizing her victory in the war, where she had lost every battle or, a conquest over what had been stolen from her? Till death did others apart, but he would be her's even after his death!

This is the beauty of medicine, it isnt just disease and treatment and minting money out of it, it is taking the understanding life and its various aspects to a completely different level. It is understanding the human behaviour- Human behaviour with all its simplicity, with all its complexities, with all its benevolence and malevolence. An opportunity to understand human psyches and emotions.

A skeptic like me will describe her emotions as extreme possessiveness, at it lowest, sickest level.
A die-hard romantic may counter it as eternal love, an epic romantic tragedy  - A Saga Of Love !