Doctors as Travellers

Like the most other thoughts, even this one originated from the bathroom!

All of us were inspired by Ranbir Kapoor in YJHD, and must have had a thought of roaming around the world, traveling to the must - see places around the globe. Who wouldn't want such a kind of life.

Given a chance, even I would have chosen that. The travel show hosts, air hostesses, pilots, Navy ship merchants, globe trekkers, adventurers, even monks did that matter! are the people who get to visit the maximum number of new places. An addition that I'll make to this list is a doctor.

The essence of traveling isn't just taking photos of those places and uploading to social media. You may very well use Google Earth and Google 360 for that.

The true essence of travel lies in connecting with the place and the people,  knowing their culture and traditions, understanding their way of life. And who else can achieve all of this, better than a doctor?

Few weeks ago I was walking through the corridor of the old building when this young chap with huge spectacles, unkept Hair, checked shirt and a loose formal pant approached me asking where is the radiology department. I just decided to take him there rather than just give the directions. On the way I happened to ask him what does he do and where is he from. "I'm doing MA in Hindi from Ruia" was his reply. And then we ended up talking animatedly about Mr Premchand and I told him whatever little I had learnt about him in school.

Such instances, I m surprised, are engraved in my mind...given the fact that I don't even remember birthdays of my friends.

Looking forward to meeting more interesting people in my life. Looking forward to being a good doctor and Traveller.

Exams

Exams!
These are systems in place since ancient times. Conducting an exam is very similar to doing an experiment.
You do an experiment or a trail to separate salt out of water. You need a suitable experience or a test for that. You can choose to distill the water or evaporate the water.
Or suppose you wish to separate iron particles from sand. You hover a piece of magnet above it.

Similarly, you wish to segregate the able from the less able student, for which you need to do some experiment or some examination. But please note, you can't use distillation to segregate iron and you can't use magnet to get salt.

In the same way, you cant use drawing as a test or a criteria for picking out good dancers. And finally, you can't use MCQs to choose the better doctors!!!

Keeping that aside, the pattern of exams for their respective specialities has been more or less constant. Physical tests for being in army, memory based tests for science, calculation based tests for engineering, logic based tests for IQ, grammar based tests for language, etc

Coming back to the corollary, very few new experiments or methods of segregation have been devised recently. So I thought about a new test for finding out the "street smartness" or pragmatic approach of a person.
We can ask the person to define very simple and trivial things. And mind you, things like
- thought
- dream
- soul
- love
- sky
- magic
- death
- to be alive / to live
- good and bad
- sleep vs coma
- aim vs objective
- wind vs air
- friend
And more and more things can be added to the list, forever.
Asking a person to define these things for you, will give you an insight into the thinking of that person. It may help us to "judge someone" better.

Till then, kindly comment if you know of more such words that are difficult to define but everyone knows about it. Thanks!

Oncoradiology and oncopathology

Each of us have our own unique story to tell. Some people can go on for hours even while talking to a complete xeno homo sapiens.
Similarly, each cell, tissue and organ of the body has a story to tell. All we need is some one to listen to. Here are some examples :

The debilitated person - that's similar to agonised women who scream their heart out when given a chance to talk about their sufferings. It's a pain that keeps troubling you forever and won't leave you at all. It's a sign that your cells are dying!

The shy person - These people need to be made friends first before they open out to you. You have to tend to them with care and only expertise and patience is the key here. These are diseases that need a high index of suspicion before you are able to diagnose them.

The drunk person - you give them 'Madeira', the "elixir" of happiness, ie lots of alcohol and they ll speak their heart out. Not remembering later what they said. That's like radiologists putting dyes and enhancing the contrast of the lesion to make the pathology clearly visible.

The confused person - they say yes when asked in public if they have a problem but later it turns out that they did it only for someone's sympathy. These are biological 'false positives' as we like to call them.

The hidden person - these people don't put their fingers up when asked in front of the whole classroom if they have a problem but will try to hide under the desk when the problem arrives. These are biological false negatives.

And finally the happy person - they are the healthy cells and tissues of our body

As you saw, the stories of the pathology is as varied as the stories of different people. What we need are better clinicians to find out the shy people, good radiologists to know more about drunk kind of people, better pathologists to help us weed out the confused and hidden people and better public health doctors to improve the quality of public health.

I would end by appreciating the contact role of all of these, as pathologists and radiologists who learn, study, read, understand, interpret, translate and convey the results from the language our cells speak, to the language we speak.

PS: the last sentence was the thought I had while appreciating the role of pathologists and radiologists during the multi disciplinary meetings in a conference at Tata Memorial Centre, Mumbai.

What is blogging to me?

Today, a friend asked me, "Why don't you share the link to your blogs?"

THAT made me think why did it never occur to me to do so...
I had already put a link to the home page of my blog site on Facebook and Twitter accounts. And even after writing blogs over 3 years now, I have never shared any particular blog with "people" 

I got my answer in my next breath itself. I never wanted anyone to read my blogs. All I wanted was to vent out my thoughts, in a way that they are accessible to me as it is, even my hair will turn salt and pepper.

Google Blog, for me, is a chest of ideas, random yet structured, abbreviated yet connected and with layman English yet deep meaning.

What the Pensieve is for Dumbledore, that's what is Google blog to me!

So, the plan is to just keep uploading random ideas and to hope that it will make sense, sooner or later in life.

To the Depths of Darkness

27th February, 2016. Saturday

Third minor is that year of MBBS course when you just have to study 3 subjects : ophthal, ENT aaaaaaaaand PSM!
The journey from 'help-me-figure-out-whats-going-on' in the first year, to 'putting-your-fingers-in-every-damn-event' in the second year, I had thought that third minor should be comparatively chilled out.

From holding the necrosed ear ossicles to examining the nucleus of cataract lens, from observing into the friends' ears, to unsuccessfully trying to evert my eye lids, ENT and ophthalmology postings have already taught me a lot.

But there is this one case I saw in the ophthal OPD that I cannot easily forget. A 13 year old girl from a low socioeconomic background, a known case of B cell acute lymphoblastic leukemia, had come with endophthalmitis ie infection of inner coats of eye.

She screamed in pain as the attending doctor tried to examine it. She got herself admitted to the neighboring Tata memorial Hospital for the leukemia and had already been through 3-4 days of course of few of the strongest systemic antibiotics I knew of.

The doctor called her father and explained the need of continuing the treatment and also putting more topical antibiotics, otherwise the infection could spread to her brain. She said, "hamein jaan bachaane ki koshish karni hai pehle".
To which he asked, "aankh toh theek ho jayegi na baad mein?"

And the girl broke down when the doctor shook her head and said, "iss aankh ki roshni ke wapas aane ke chances bohot kam hai" 

I can never forget that moment. The moment of horror for that poor girl, when all her dreams must have got shattered at once.

That's when reality dawns upon me.

What Khurana or Parson never taught us was that 'the Eye' is not just an organ but the most prized possession of the body!

During the OPD in the next week, I saw that girl and run after the doctor who had seen her. My joy knew no bounds when I learnt that she was responding to the treatment!

Why is the incidence of Cancer increasing?

I read the first chapter of Parks, book of Preventive and Social Medicine for the first time today,
That led me to Ponder over this :

Man was plagued by diseases (Pun intended) created by the piling of garbage, rapid industrialization and poor city planning, during the 17-19th centuries.
These diseases had micro organismic causes and soon the Germ Theory of Diseases was propounded by Robert Koch and Louis Pasteur.
The invention of microscopes soon led to the discoveries of pathogenic micro organisms in quite succession in 1940s to 1970s.

Soon, Man succeeded in developing chemotherapeutic agents that could kill these agents. Cheaper and widespread availability of drugs led to its drastic use and subsequent fall in acute infectious diseases was noted.

Man, at this point, had mingled with the mother Nature. He tried to alleviate fellow humans and increase standard of living by prolonging the expectancy of life.

The next generation which followed, had the luxuries of lesser infectious diseases but, Nature had another challenge in store for us.

Chronic non infectious, lifestyle or genetic diseases became more common. Drugs for cancer have become the Holy Grail for modern Medicine.

Some day when mankind achieves victory over these chronic diseases, age related debilitations will prove to be the limiting factor to the immortality of mankind and then we will have to search for anti aging drugs and elixirs of life.

"Nothing is immortal in the material world" will finally dawn to the homo sapiens sapiens and that's when, man WI learn to lead a simple but meaningful life.

Let's become "chaabiwallahs"

What's the difference between a "chaabiwallah" and a "doctor" ?

A chaabiwallah or a 'key maker' as you imagine him, is a shabbily dressed man sitting idly for most of the day, on a dented stool placed on the pavement besides a small cupboard containing keys, ready to be shaped into the required outline.
Sometimes no key is available and you desperately wish to open the lock, which is difficult to be broken. To your rescue comes the key maker!

Many of them succeed by trial and error method. But that also makes them powerful enough to be able to open any physical Lock!

Have you ever then fretted about the security the lock makers promised? The peaceful sleep that I used to get after locking my possessions, will never be the same after knowing this fact!

However, also think about another fact. These chaabiwallahs are capable to breaking into houses and cars, capable of making easy money in the wrong way. Yet, they choose the right path.

Now let's talk about doctors!
They have knowledge. They too, have a key (treatment) for the lock (disease). But you won't see them sitting idle, dressed pathetically. On the contrary, they ll boast of having made better fitting keys to the existing locks.
These chaabiwallahs will go to the extent of even destroying the lock in the quest of finding the best key. They sometimes do not ask the basic question "is another key required?"
Now we have companies that make keys for locks that are alike. Even a child can tell you that no two locks are made alike. Thus, buying keys from these companies claiming to make the best keys, is nothing but a business of fooling the customer.