Thursday, December 29, 2011

to get it or to forget it

Satisfaction is a strange word, or it’s vague, obscure having no clear meaning… or it’s some ideal condition unachievable in real situation. It’s a stimulus driving some strange humans to do some strange things. Not all people are mad for it, but for sure it drives those people mad who strive for it. It’s not money, not pride, fame; it’s not security, position, not physical pleasures, not even love… but alas, it’s not ‘nothing’. People get tricked when they search it in the above things, they sell their self esteem, sacrifice their innocence, do the bad things, get corrupted to feel secure to get some money, position, fame or anything they think will make them satisfied, and die in the end unsatisfied, worried, hungry or forlorn.

Maybe it’s different for different people, making it a useless term. Maybe some humans exist who get satisfied with piles of currency and luxurious facilities and fame they don’t deserve… maybe some hearts do achieve eternal peace in filth of corruption… but mostly such people are unsatisfied, misguided or blind worrying for what they lack when they have nearly everything… or they are scared, weak, unable to change the situation, unable to achieve or to find out or even to search for the missing thing that would fill up the emptiness in their lives.

There are people with personality disorders, neurological and psychological pathologies making them blunt minded, or ignorant to others, or extremely selfish… but it would be really a horrid situation to think that most of the people in society are affected with such miserable conditions… Is it really a ‘normal’ thing to be corrupted, to get black money, to cheat in exams or in other things, to do things that could harm others for our own benefit… and if it’s not why is it acceptable to the community? If satisfaction a tell tale or a mirage… and if it’s not why it’s not getting any importance in human life?

Maybe satisfaction is a highly personal thing, depending upon the value system our parents and the society has imprinted in us, or on the situations we’re exposed or on our experiences in our life… maybe it depends upon our motives, our goals in our lives, our intelligence and our ability to feel others. We can’t expect a beast to be altruistic and yet be happy… but we’re not beasts. We need not to be beasts, we can still live life of human beings; and it’s our responsibility to stop the evolution of the community in direction of being that of beasts.

I may be too young or inexperienced to define something as complicated and abstract as satisfaction… but I guess it’s a good feeling, it’s a strange joy, the strange feeling we get when we make someone happy really for nothing, when we sacrifice our most beloved thing for joy of someone else, when we fight for justice for strangers, when we tolerate for benefit of others, when we protect our self esteem against all the temptations… the list has to be big, as satisfaction is a big thing… though it’s vague, it does exist.

Thursday, December 1, 2011

Why violence

It was a pleasant moment, some joke had happened and was blessing everyone with a smile, was trying to relax their tired minds… but the moment ended, and their minds screamed, the smiles disappeared, and the faces got covered with that regular fear. The horror occupied their hearts. The older ones were so adapted to this fear that fearful expressions were tattooed on their wrinkles… because this wasn’t new; this was a usual scene in their house.

I don’t know whether it’s insecurity, or lack of confidence, whether it’s some kind if epilepsy, or some prefrontal lobe lesion… effect of media or wrong concepts of manhood; I don’t know what makes people so violent that too to their closed ones, to those who’re extremely harmless and even useful. Why on Earth is domestic violence so profound? What makes them to make their homes most dangerous places in the universe and most painful and harshest to survive to their own loved ones?

Is it some kind of territorial display or is it some effort to show dominance… an effort to hide incapacities, or pathological method of gaining some confidence? Or is it some revenge of some mighty harmful person around, directed to the harmless ones? Are those acts thoughtful or are they just thoughtless tantrums thrown for some thoughtful purpose? Why do they get isolated from their family, why do they suspect their family? Why do they wish to ‘own’ their family members instead of thinking of themselves as a part of the family?

The questions are endless and they don’t have good answers. Maybe it’s the mixture of everything above… whatever it maybe, it’s very painful to have a home that lacks safety. Insecurity stimulates the efforts to survive and they are not always good ones. Like a genetic disorder violence spreads from one generation to the next and like some epidemic it also haunts complete societies. Media, movies celebrate violence… and it takes just some little anger to convert a human into a blood thirsty ghost.

The future of this violence is dreadful… we don’t want to be an extinct species killed by their own pals, we don’t want to end up in low intelligence species consuming most of its time in fighting and then recovering from the big injuries. This must end somewhere… but who’ll end this and how?

Tuesday, October 18, 2011

Thoughts as a ‘Post intern’

Being a parent isn’t a negative thing, I feel. There are tons of biological, psychological and social benefits of having an offspring and of raising her. There’s sense of responsibility, sense of joy, pride, achievement and also curiosity, initiative and creativity a child gifts to a parent. Caring someone without any expectation is the most wonderful thing in the universe… but it becomes troublesome when care mutates to worry, and tons of expectations take birth. It’s nothing less than horrible to worry about the future of creatures who by no way simulate the parents, or who don’t listen to them or refuse to act as extensions of the parents. Kids are different than their parents and they grow to be yet more different adults; though not always they’re bad, I get a shivering sensation when I imagine myself fifty plus or something and having a daughter who’s like how I am now.

It’s natural for the parents to crave for the safety and success of their kids and anything unusual, eccentric, or adventurous is ‘less safe’ or riskier than what is traditional, conventional or routine behavior (no matter however mundane it is for the kid). Worry takes birth in mind of a parent when their kid’s ‘safety’ comes to question; and the worried mind can’t understand that safety isn’t ‘everything’ in life of any person. We can’t shoot for any goal unless we take at least some risk. The more we take the risk, more are the chances to achieve or to lose something; and it’s not like that we always have to lose something. We’re humans, not machines programmed to achieve success or to do tasks incapable of captivating our minds. Goals matter to us, so do dreams. We become restless, and it’s a fact that we can’t enjoy anything until we ‘get’ that thing. There are passions we can even die for and there are attractions transforming us into miserable iron particles dancing to reach to that merciless source of magnetic force. There are addictions, some habits we go on craving for even when we get hit on our face in trying to quench that thirst.

Of course, I’m not speaking about addictive drugs, or habitual wrong behaviors; but alas, behaviors those are not routine even though they’re good are also considered as ‘wrong’. Neither I’m saying that following our mind is always rewarding, or blessing us with positive outcome… there are hitches, negativities, frustrations, depression, tons of loneliness, and pools of tears when something goes wrong, when we lose something or when we fail or fall. But one failure doesn’t imply that we’ll fail always. Losses are not permanent; though they’re painful sometimes they act as essential keys to open the doors to success. But alas, the worried mind looks to such sentences as ‘bookish unpractical statements’; it ignores the fact that books are nothing other than written or typewritten experiences or thoughts of some living human beings. Of course it’s very hard to convince this to my worried parents… still I know that they don’t hate me; it’s obvious that they want all the things to be positive in my life. I can feel the heart of them, and I’m not having any prefrontal lobe lesion to accept useless and harmful risks (though it’s a fact that risks bless us with the ‘high’ of adrenalin rush). But even after thinking a lot over it, I find some risks are worth to be taken… some dreams are worth sacrificing the ‘safety’ and even ‘whole of the life’.

But truly (don’t tell this to my parents) sometimes I feel relaxed that I’m not a parent of a kid like that of me…

Monday, October 3, 2011

Thoughts as a ‘Post intern’

It wasn’t easy to retake the entrance examination… in addition to reread the books you know line by line and to get the damn boring job of solving those mcq papers done again and again, I had to face people offering tons of advices, trying to convince me against wasting a year… my parents used to trust me as they always do, but they were also unable to hide their worry from their faces. I was immature (and it’s normal for a teenager), and was determined or more properly I can say I was haunted, fascinated, infatuated by the medical field. Even sight of a white apron or stethoscope was sufficient enough to elicit physiological changes in me showing excitement. My habit of daydreaming is as old as I am, but this time it was very intense, like some drive. But improperly for a teenager I was worried too, was extremely tensed, I couldn’t imagine myself taking admission to any other course than this MBBS… the thought of failure used to affect me like some terror attack would do, I used to have panic attacks, crying jerks and all those psychological symptoms a person exposed to extreme stress would have. The door of private medical colleges was closed for me; we didn’t have that much money… in fact that was the only reason for which I was retaking the exam.

Some years have passed since then; today I’m waiting for some documents to apply for MBBS degree certificate. I’ve completed my MBBS from a government medical college and am about to be a registered medical practitioner… I own a stethoscope and a couple of aprons and have been attaching "Dr." before my name since last one year. But strangely, I miss something. I don’t feel satisfied; I feel I still haven’t got something I wanted to have.

I’m no more a rebellious immature teenager. I’ve learnt to think hundreds of times before doing anything. I’ve developed methods to keep myself away from infatuations… and to stay calm in stressful situations. Nowadays I don’t get excited easily either. But yet, I’m not the person who I was craving to be… and ironically to be that person, I’m still craving. And am still figuring out what I shall do to quench that strange craving.

But it’s not easy to sit and think upon this… in addition of attempting to get over this frustration and searching for some stimulation in this medical profession, I’m facing people who call me mad for not feeling satisfied… my parents too are confused, now they don’t even attempt to hide their worry and even force me to try for a stable life, to appear for MD entrance to get MD to get money and position…

Is it possible to be an adult and still be an immature or to be mature and still searching for some satisfaction?

Saturday, September 24, 2011

To be unwise

It’s very easy in this world to get lost somewhere, or to get hypnotized. Some dreams, some thoughts, some persons or some incidents like some drugs are bound to make us mad or to make us to think of ourselves as near perfect or most suitable deserving the endless joy of our life. There are stimulants destined to give us a high and there are thoughts which seem to be wild games of the mind… though there is the consciousness always busy in trying to keep us awake and to differentiate reality from the constructions of the mind, sometimes it’s just ok to fall prey to enchanting creations coming out from deep inside…

Tuesday, September 13, 2011

diary of an intern

Life doesn’t come sometimes as it should be… hitches come or obstacles or beautiful distractions. Sometimes the path becomes so demanding that we forget where we were going. Sometimes there are illusions of dreamland, oceans of ambrosia which turn out to be mere mirages, constructions of our own minds which in reality are nothing. The heart gets broken sometimes, sometimes it bleeds… but how obstinate it is, it always loves it beats; always hopes that this journey will end somewhere, where it’ll meet the cause of its beats… where it’ll forget all of its mistakes and the pain it has received after committing each of it…

Sunday, August 21, 2011

To be selfish…..

It rules the world, people say, it rules motivations actions adventures risk taking behaviors and even something as delicate as feelings of love and affection. Selfishness is the utter cause of animal behavior, books say, including that of us humans. It’s the ultimate truth, essential for survival… for combating the demanding situations, and for gaining what that is required. Male quadrupeds fight for area of food, for females; females go for strongest mate to have safe future… even single cell organisms do changes in themselves only for the sake of survival, and no one can even compare the selfish acts of animals called as humans; in Darwin’s world even deepest human relations, families can be reduced down to one or other form of commensalism.

After all we’re animals, biological things, and effects of some molecules and physical forces leading to some chains of chemical reactions or electrical or physical activations; why shall we bother to behave as selfishly as some unicellular organism swimming with its flagella or something in search of a better place of survival even without understanding the meaning of it? But we do bother, all of us, as per the capacity of structures called as brains or more broadly as per the complexity of the bodies of the organisms. Responses of a more evolved multicellular organism to a stimulus are different than those of a unicellular, biologically backward animal. I’m not sure about the plants, fungi or animals with extremely primitive nervous tissue development; but in humans and animals with developed brain there is something called as cognition… we have a picture of the outer world in what is called as ‘our mind’ and we all live in our own private worlds formed in our minds due to the trillions of experiences we get from the outer world. We all are gifted by the universe with our capacity of ‘feeling’ the world… and humans form the most gifted species with astonishing capacities of ‘feeling’ the feelings of others, of peeping into the mental worlds of others and even that of changing them, of seeing the future and dreaming and doing efforts to bring the dreams to life.

We’re not flagellates swimming in response to some chemokines, neither are we quadrupeds thinking nothing except food mates and then shelter… we’re humans, though we’re biological things our joys are far more wider as we’ve intelligence, and that makes us vulnerable to become most selfish species on the planet or most selfish person in the universe… but it is the only thing- ‘our intelligence’ which awards us the ability of being completely altruistic doing the acts of helping others and caring others without any direct benefit to us. We might have inherited selfishness from our selfish brainless ancestors, but altruism is a product of evolution, I think. And for us it’s as true as selfishness, and for some of us it’s even truer than selfishness, and those ‘some’ are legends, responsible for the survival and evolution of humankind. We would have been extinct by now, if altruistic people were not there to save the world from destructive acts of selfishness…

I think we must honor this gift of evolution to us, we must allow at least a bit of altruism to survive in us… then and only then we’ll be able to build a world full of altruistic people, and that world will be filled with true love, affection, with a guarantee of being cared and without any fear, without any stress, that is that will be like what we call today as ‘heaven’.

Thursday, August 18, 2011

the reason to draw something

I really wonder what exactly arts is…? What’s the purpose of creating something strange, really strange that has no survival value? Or maybe it has… we don’t know it yet! It’s like some potent addicting drug acting directly on the brain… a stimulant, an analgesic, a hallucinogen or maybe a depressant; maybe it’s a way to escape from the harshness of boring dull uselessly competitive real life, or a door to enter our long wished dreamland or a measure of communication with our own self, a companion who never gets bored with us, an advisor suggesting solutions to problems unrelated to the topic of itself… I don’t know what’s the experience of others, but when I draw something, my drawings speak to me, that too… in silence.

Monday, August 8, 2011

searching for some time machine

Once upon a time I was immature, a curious kid
Wondering why things happen and how do they occur
Life was a miracle for me, or was a wonderful puzzle
At that time I always used to be in some hurry
As every moment of life seemed to me
Like some beautiful irreplaceable opportunity…

Once upon a time I was very romantic,
Where everything in the world had a beautiful challenge hidden in it
Every word had some secret poetic meaning
Every face I saw used to sing some wonderful tunes of music…
Where even worst things had some goodness attached to them
And every failure was nothing but a chance to learn some lesson from it

Maturity comes at its own price, and some experiences are potent enough
To wash away the sense of being alive from life…
Too much of adversity ruins the life,
Where every step is a danger, nothing appears romantic…
Life seems unruly, a collection of unexplainable bizarre happenings
Or it seems like some long dull journey, without any destination for it……

Now I find myself struggling with my own mind,
Or attempting to get out of the inertia caused by some unknown thing
Or lost in search of some miracle or some time machine
Which will take me back to my youthful state of my mind…
There I’ll relearn to wonder,
And to look at life like some secret miraculous power…….

Thursday, July 21, 2011

to be a patient

It’s hard to be a good patient. “Strength is important, so is health and hence the rest,” I say to patients, some of whom are workers working for daily wages hence can’t tolerate or afford the ‘rest from work’… some of them still co operate, some get admitted and take complete bed rest, some have to go for ICU, and they do go there… I’m a medical student, an intern, and at least two three beds in ICU here are always reserved for people like me, and I don’t require to be in a critical health condition to get admitted in the ICU.

… But what happens when I myself get ill is contradictory to the situation; I’m the most unruly of the patients I’ve ever met. I take medications whenever I feel need of them (especially the pain killers- even though I know that THEY ARE NOT GOOD FOR HEALTH), then totally forget about them (something like the antibiotics or the vitamins). I like to stay away from other doctors (I don’t trust them), I never consult seniors about my own health, and I never take what it’s called as rest. One day absence from work for me accounts for one day extension of my internship; and I want to reach my destination as soon as possible…

I keep on working, doing job of an intern physician even though my capacities are seriously impaired, even though I’ve to struggle with my lower cognition levels and headache due to fever for doing tasks like measuring the blood pressure or inserting branulas or taking blood samples or taking the patients to the CT scanners… or even taking histories and advising treatments (that includes rest)… but doing tasks requiring still more cognition like reading understanding, working at night without sleeping becomes just impossible, I find myself sleeping miserably when I want to write or to do something meaningful for my goal of life. Still no one understands and even imagines that I might be suffering from something called as deranged health condition. And I get bombarded by duties of patients one after another.

Am I a bad doctor? I don’t think so, I never do injustice to patients… and I try my best to protect my health from being deranged, never even taste bad foods never go for addicting chemicals and try to give time for my body for doing exercise; maybe that’s the reason I’m able to work in conditions compelling others to lay helplessly in bed. But to do tasks those I love, I need to be healthier………….. but it’s hard to be a good patient!

Sunday, July 17, 2011

being a human

Life is like some journey from birth to death, some people are lucky to choose what type of journey they want… they may take it like some entertaining trip or an adventurous tour or like some mission to discover something or to help someone, or like some routine dull rush of everyday life where more than the journey something else is important! But there are some people for whom life is nothing other than an everyday struggle to survive… when their existence is in question, creativity is a far away thing… they never get a chance to get their neocortex used and developed. They too have a journey of life like us, but it’s restricted, instead of enjoying and learning from new experiences they’ve to turn their back to them and to ignore them to conserve their energy only to have their life sustained till death arrives. They get tired while attempting to fulfill their basic needs to the extent that they don’t even think of having big goals and planning to achieve them…

We don’t wake up worrying about what to eat and where to sleep; instead our worries are totally different. We’re among the lucky ones, who’ve got education and some safety… we’ve got a chance of using our parts of brains those are exclusive to humans; we can exploit being a human, and we have to, I feel. And instead of turning ourselves into some highly paid robot, we’ve to preserve our humanness and have to try to give the world something as a thanksgiving for this rare chance it gave to us of being and living like a human, and have to work to make this world a better place so that each and every human will get a chance to live like a human…

Friday, July 15, 2011

diary of an intern

I wonder sometimes what’s in the alcohol that makes some person an honest slave of it…. an honest consumer who’s almost never honest about his (yes I see almost all males) drinking habit. I know the neuroscience of addiction, I’ve read it, and I also have read that it uses the reward centre of brain- the same that gets activated when we feel happy and makes us to crave for something, the same that gets activated when we fall in love with someone or something, the same that makes us to feel the bliss. Then why people go for alcohol when they can get the same joy from other things like being addicted to some good habit or to some good person? Are they all depressed, or ignorant about the effects of that drug which can damage anything right from the guts, the liver, the brain to the DNA? Is it peer pressure, or pressure from the stress of life, or a silent slow way of doing suicide? Though ignorance can explain alcohol addiction in illiterates, I wonder why people who themselves are doctors also go for it. I’ve read that alcohol forms long term memories and associate the positive feelings of the environment of consuming alcohol- like a group of intoxicated funny talking friends, high fat foods which themselves stimulate the reward centre, the music of pubs to the alcohol and makes the person a fan of it. But our brains are not dead hard wired things and we can change the programming whenever we want, at least theoretically… long term potentiation isn’t a permanent thing. But then why it doesn’t happen in reality, why people continue to go for it again and again even when they know that alcohol is dragging them to death, when they get complications like cirrhosis, ascites, fatty liver, alcohol induced dementia, tremors, anemia, gastritis, and even alcohol induced psychosis, when they have to get admitted in the hospital for these complications for number of times? Why do they go for it at first place, and why do they lack the willpower to fight against it when they become slave of it? I’ve seen people shouting for alcohol when they’re laying on the death bed constructed for them by alcohol only… and I wonder what would have happened if they had loved some person or cause to this extent…

It makes people to ‘see’ everyone as beautiful as their depressed brains can’t recognize the asymmetry of faces, people become more ‘adventurous’ or ‘helpful’ as the inhibition making them ‘shy’ from the prefrontal cortex is reduced… but these depressed adventurous brains are more prone to accidents which could be lethal to themselves or others…

mm… love also makes us to trust others more, to look at and concentrate at the positive things of others, but the causes are different… Is alcohol like love… no, love is totally harmless and alcohol is known to damage many things, we could treat alcoholics with love, but in their case they’re in love with alcohol only… they value alcohol more than any other person or activity in their life, even more than themselves. Whenever they’re happy they celebrate it with alcohol, they look at alcohol for washing away their tragedies and stresses, they go for alcohol for entertainment when they feel bored… alcohol is everything for them, they don’t need family and friends to the extent they need alcohol. Some think of themselves as dedicated to their families, they never drink at home, but for them joy and family are two distinct things… and the ‘joy’ is alcohol.

I’m writing this because I’m really horrified to see the number and severity of patients who get admitted repeatedly only for the sake of alcohol. I encounter poor people mainly who’re illiterate or semi illiterate or maybe educated. They’re mainly males of varying ages, of varying stresses and family backgrounds… till date I’ve seen only one woman who had got admitted for alcohol induced psychosis and she had told that she learned drinking to accompany her beloved drunkard husband.

Alcohol isn’t a small thing to ignore; it’s at the top of list of drugs causing harms to human lives, and still people adore it! I don’t really know why people take everything lightly, including their health, their relationships and their lives? I don’t know why they succumb for drugs like this, and will it be ‘possible’ to make the ‘possible’ thing of changing their synaptic structures possible? I can’t keep guessing now… because I’ve to go, I’ve to tap the ascetic fluid of a dying chronic alcoholic patient.

Sunday, July 10, 2011

diary of an intern

The more you crave for something the more difficult it appears to achieve it, I feel sometimes; but we still keep on craving thinking that at least at some time we’ll get at least a trace of it… I dream of a heavenly world, happy humankind and me a tiny neuroscientist working to make it happier… but what I encounter everyday is a series of extreme tragedies sadder than even those of Shakespeare’s, violence enough to evoke disgust even in medieval soldiers, heights of carelessness, drug seeking behavior putting the whole families at risk of extinction, and me a helpless small intern physician doing my job of internship, preparing for documents of internship completion, worrying whether I will get some extension, trying to concentrate on the necessities for getting a good PhD position, making some vague efforts of reassuring the patients and of reassuring myself that one day or other the situation will be better!

I don’t know where to start and how… I don’t know whether dreaming what I dream is ‘normal’ psychologically or whether I’m suffering from some ‘disorder’. But I dream, truly, that too while awake, and I crave for making them to come true, and I try for them at my best… but this my best is not enough, I feel always.

“Why my right hand is not moving doctor, I try but I can’t move it? I can’t work without it, I can’t eat… there’s no one to look after me, I’ll lose my job… please do something, do anything, leave my leg paralyzed, but make my hand as it was… give me some medicine,” a fifty some man begs me when I reach him to insert branula and to take blood samples. I tell him to practice moving his hand, but who’s there to motivate him, who’s there to give him physiotherapy… is there any drug to reverse damage occurred due to stroke? I can’t wait there with him, I’ve to move on to the next patient, there are fifteen admissions today and my job is to send each investigation of every patient before closure of the labs, to bring the x- ray films, to do other irrelevant meaningless official things an intern has to do…

Not all stroke patients are old, not all hypertensive persons are above forty, and not all patients who visit hypertension OPD regularly have their blood pressure under control… they seem to be waiting for a stroke or heart attack or renal failure. There is a tendency to write the blood pressure as 120/ 80 mm of Hg to avoid complications, no matter what the real blood pressure is. And advices about good diet and exercise are neither given nor taken seriously… even the doctors are victims of junk food and lack of exercise leading to increased girth of abdomen and decreased diameter and elasticity of blood vessels. Some patients are also so horrible that they come to visit the OPD fully drunk, with their exhaled air containing nauseating quantity of alcohol. Conditions like dementia, Alzheimer’s, and even Parkinsonism are not big diseases here, they’re mere byproducts of aging… and people with these conditions are admitted very rarely only and only if there is exam of students that too as ‘exam cases’! Everything is as if superficial, lacking depth, being done just for showing or for legal procedures… nothing including health is taken seriously; there is no question of caring for the health of others. No one has time for useless things like sympathy, initiative and even curiosity… I guess if classical case of H. M. would have happened here, he would have died in the darkness even without getting noticed!

I fear I’ll get blind if I don’t get any light of hope… I fear my curiosity will die and I’ll become an input output machine examining predefined things called patients. I feel smothered many times and I think of giving up… I think of going far away from everything and never to return, I think of finding peace within myself like the monks, by doing meditation and by increasing the size of the brain’s reward center or of becoming mad or drugged to live permanently in my dream ignoring the horrid real situation… I can do that, that’s not difficult, but that’s not challenging either… I want to see my dream as a happening without altering my consciousness. I want to bet my life, no matter how hard it seems even to survive the real situation. I’ll keep on trying and searching for hope… maybe on some blessed day in the future I’ll get somewhat closer to my dream.

Monday, June 27, 2011

Abstract… whirlpools of odd thoughts

Our minds are bizarre beings… they make us to sense art in some useless drawings and compel us to search meaning in some weird poetic lines. We find rhythm in some strange voice, and tend to fondle part of our mind beating in any other mind. Life comes as a series of riddles, and we name them as incidents transforming our lives… But it is this strangeness of mind that makes us capable of being called as alive.

Sunday, June 19, 2011

diary of an intern

I don’t know when people are going to stop taking everything for granted… and why they do it. I work in NICU these days, its intensive care unit for neonates, and babies arrive there whose uneventful birth and maturation had been taken for granted by their parents. The mothers are nearly always teenagers (many are below eighteen, but their age on our papers is almost always twenty or above… no proof of age is required to have a baby in a hospital), uneducated or half educated… who doesn’t know that it’s necessary to take some active care to have a healthy baby and it’s not a kid’s play to have a baby. They are accompanied by their mothers or mother in laws, sometimes father, brother… husbands arrive only rarely, mostly they come to collect the body if the baby dies in NICU. Low birth weight babies are so common here, so are babies with severe anemia. Sometimes the mother gets PIH, the baby is hypoxic due to delay in birth, and sometimes suffering from IUGR… sometime’s it’s struggling with some infection since in utero. They never come to know this before the birth, because they never attend ante natal clinic. Then after noticing some abnormality, or if some local doctor refers, they rush the baby to NICU in nearly lethal condition…

They marry because they think it’s necessary to get married as everyone does it, and then they get pregnant because everyone has kids after marriage… and they think it’s obvious that the baby will be normal. They don’t know the concept of spacing between the kids. Many know about tubectomy as a method of contraception but according to them, it must not be done till you have a son. To improve their condition, we need to give them health related education and education in general… but what about those who are highly educated?

People don’t really know why they’re doing whatever they’re doing. The most common cause of doing anything is because everyone does it… and there is general tendency of taking everything for granted.

Prepare for the entrance and get the admission and then you’ll become happy, get a post graduation then you’ll become happy… get a highly paid job then you’ll get happy… get some promotion, then get married, then have some kids… then earn more money collect properties, earn some fame… then you’ll become happy… they keep on doing one thing after another and take their own happiness for granted which rarely arrives in their life. And when they get old, they expect the next generation to do the same things… doing what ‘everyone’ is doing, chasing the happiness without knowing exactly where it is!

I get shocked to see my friends who are MA, MSc, MBBS, and PhD crying before me because their ‘to be’ husbands are demanding too much dowry. Then I see my pregnant professor friend praying the god and following some quack regimes to have a son… and mother of my doctor friend, a lawyer’s wife undergoing one abortion after another after diagnosing the sex of baby as female before birth of the baby- till she attends menopause, only because everyone has at least one son and she hadn’t!

Where are we? What is the role of education if everyone is behaving like an illiterate person, and doesn’t know what in actual they want from their life? Does education means only a way to get highly paid job and nothing more? When are we going to stop taking everything for granted? Is it really necessary to do something only because others are doing it…? Or is my brain extremely eccentric to think that we can have happiness in doing things what ‘others’ call as ‘strange’?

Friday, June 17, 2011

Abstract… it doesn’t require words

Life is like a wave of some ocean; sometimes it’s a tsunami, and sometimes a tiny ripple… but it’s not ever lasting and is never constant. All it’s a dance of driving forces- our wishes, our desires, our passions and our needs… sometimes they back up each other, sometimes contradict… and we keep on craving for that summit while struggling to meet the needs to survive. And a tsunami occurs when we throw ourselves into our heavenly dreams and just forget to stay alive.

Tuesday, June 7, 2011

to prove myself......... to machines!!!!

I wish I should have been born thousands of years ago; I would have ignited first fire or would have sown the agriculture’s first seed.… I would have written books on anatomy or would have lived my passion of finding new things to make health better, without getting trapped into today’s tasteless education system. I would have felt proud in being called as a ‘mad’ scientist. But today mad people don’t become scientists. I live in an era of robots… and madness is a contra indication of what they call success. I live in an era where passion has become just a sexual thing… people don’t and even can’t imagine having it in other areas of life. They work because they have to work to survive, to earn money, to get reputation, to get recognition, to win a competition to get prizes or to get admissions to get a chance to do a more ‘reputable’ work. There is no value or ‘reputation’ to creativity, initiative is a useless thing, there’s so much pressure of proving yourself before other machines that you forget what your inner drive is. Questions are not those which arise in mind after understanding but they are those which appear in exams or interviews… and answers are not those which consume your lifetime but are those which are already given in textbooks. Schools are nothing better than factories of robots who grow up to fight amongst themselves to master strategies of scoring in exams for getting work positions those are completely constructed for robots. And robots are hardwired things programmed for success with unchangeable programming; they don’t possess weakening human feelings, they don’t dream leave apart falling in love with some dream, they can’t understand the delicacy of loving, scarifying, doing something that isn’t related to ‘succeeding’ or achieving things associated with success. In the world of robots, people learn to mutate themselves into robots thinking that it’ll be a reversible change and they’ll become humans once they’ve achieved a ‘safe position’ in life… but the ‘safe position’ never arrives, and they continue to be robots for their lifetime.

For me, being a robot is worse than living the worst nightmare of my life… and I wonder whether there are little suppressed humans still alive in their robotic minds? I have no chance of finding this out, and I’m too small to help those little humans even if they are there to grow up and to express themselves. Meanwhile, I have to prove myself before other machines so that I can survive… that too without forgetting my inner drive. It’s a hard thing to do… what to do, I’ve been born at a wrong time in a wrong era! Alas, I should have been born thousands of years ago………….

Thursday, June 2, 2011

Heart of a mother………..

The most mysterious thing in the world is love, I feel as it makes us ready to give up many things just for nothing. It’s a surprising thing, how a mother loves a baby and why when the baby has nothing that can help her in her life. She never demands the child to take care of her in return, or never gets angry in real if the child fails to understand her and even to respect her… but it hurts her if the kid fails to assure her of his or her pleasure. She wants the baby to grow up independent of her, she wants her or him to be successful happy healthy and fulfilled in every aspect of life. She tolerates many things, sacrifices her everything only to make the child an independent satisfied person, and demands nothing in exchange except a sense of assurance that the child is safe happy and is leading a productive meaningful life. If the situation demands, she can give up the warm hugs, can give up the relaxing baby’s touch; she can give up the sense of importance the baby gives to her… but she can’t give up the need of baby’s safety and her need of constant assurance that the baby will continue to be safe and is having and will have a good life.

She doesn’t crave for the presence of the baby in her life (though it’s joyous to have it), but it’s the progress and pleasure of the baby she really craves for. But if the baby suddenly disappears from her life, she can’t stop missing her or him…… I miss you Raani, and I worry for you; just tell me where you are and how.

Sunday, May 15, 2011

static vs dynamic

Sometimes life feels like static, never going forward……! And one moment seems like one era; but that moment goes away after some time, and life starts getting its regular pace. What we’ve to do at that slow moment is to wait, survive and keep walking at snail’s pace while trying to accelerate our life till it becomes faster than light. And once it becomes so, we’re free to use our motion to energize the world.

Saturday, May 7, 2011

Can someone hear my mind........ ?

I sit here in casualty and examine the patients, both parties- the culprits and the victims… and I try to imagine the cause of their deeds, the tsunamis occurring in their minds causing such gross violence… their faces appear anything ranging from cold dead looks to look of a rabid animal, from crying moaning expressions to expressions throwing smiles like that of Batman’s joker. I can’t understand how some human being can take away the ear lobe of other by biting, or break someone’s eye, or make someone to land in coma by hitting on head.

I wish I could see this world with the eyes of these violent people. Is it threatening like some lonely midnight with giant cannibals ruling their small scared minds? Or is it disgusting with every other creature called human evoking a sense of nausea and discomfort in them? Do they lack feelings for the sufferings of others, or do they get pleased with them? Or do they have become insensitive to the pains of others due to the burden of pain their own hearts carrying? Or do they do it just as a part of routine life, and don’t understand the consequences of it? Do they feel really satisfied after doing it, do they like it, or is it mere their helplessness? Is it some effort of showing power, or of feeling secured in the hostile world created by their minds?

They’re not mad like the rabid dogs, they’re conscious enough to know the laws, to sue each other, to try to find flaws in the laws and to try to mislead others and to collect the proofs or to wipe them out. Why can’t they understand that what they are doing is bad…..?

I know a doctor is not supposed to think over all this stuff, my job is to offer health services to their bodies ignoring their ailing minds, and I must and must forget everything happening in the OPD just after getting out of it, but it never happens. I feel stopping such violence is the first thing I should do as a building block of my dream world; I take it as a purpose of my life. I want every person in this world to smile with a child’s smile coming out right from the bottoms of their mind.

Then I’ve to give up thinking as a seriously dehydrated diarrhea patient arrives there, I get out of the wound care area to attempt inserting branula to pass intravenous fluids to increase the volume and to avoid him from landing in shock… but I find cigarette smoke feeling the outside air, making the diarrhea patients to struggle for normal air. I frown and search for the source of the smoke… and what I find is that it’s not the relatives of the violent people taking treatment for their wounds, but it’s the doctor’s room before the dehydrated patient’s treatment area… and I see my colleagues, MBBS doctors, smoking mercilessly without thinking of the patients fighting with death just outside… … I get shocked, but run short of time as the patient is really dying. I close the doctor’s room’s door to leave them smoking inside and by the time I deal with the patient they escape from the room. Who’s more violent, those people damaging each other’s body parts, or these doctors enjoying their puffs without thinking about others and the laws? I think both are equal.

Where I’m living? Where are morals, where’s humanity? Are they real, or mere myths… or hallucinations created by my mind and I a schizophrenic? I think it would be better if I were a schizophrenic; at least I wouldn’t have got troubled by the happenings in the outside world to which we call as ‘real’.

Tuesday, May 3, 2011

I want heaven here on my planet

The world would have been a much better place to live if violence were not there; if there were no cruelty and people were caring for each other.

I see violence every day, and it’s not easy to find a trace of humanity over here. What people want is destruction of each other. I always have hated low class violent movies with lots of fights and injustice and assaults… but never in my life had I imagined that they could be this true. There is no peace, there are no smiles, what their faces shower is anger and revenge flooding from their minds, and sometimes there are tears and fear. There is blood, broken bones, bumps, lost organs caused by people who are members of the same species, humans. There are rapes and rapists, lies, frauds, fake care and showiness… I crave for goodness, I search for hope and I see darkness; I don’t feel convinced about my role in casualty of treating their wounds and helping the Medical officer in medico legal procedures……..

But some goodness is there, I see it when I see people bringing complete stranger accident victims for treatment, when some nurses really care for the patients. And I want to exaggerate that goodness. I wish I could get that goodness out of their brains and amplify it by several folds and then spread it to every human brain in the world like some infection resistant to hatred. I wish I could bring this horrid situation to an end and make a world where humans would act as humans. And I want to do it, no matter how impossible and strange it may sound… just trying to figure out how.

Saturday, April 30, 2011

A Causality of humanity

How nice it would have been if I were a robot….! I would have done my duty as per the order and would be satisfied… but robots don’t feel anything, so I wouldn’t be satisfied. But at least I wouldn’t be dissatisfied like what I feel; at least I wouldn’t feel incapable, sad or lacking something or like living in a nightmare…

But I do live in a nightmare… I’m in Causality department of my hospital, and it’s not less than a nightmare. I’m not new to the wounds, the fatal accidents, deadly dehydrations, bleeding, burns, bites, poisoning cases… but here I see the medico legal side of these things… and it’s as horrid as the fatalities themselves. Though my job is to try to keep the victims alive, I do hear the conversations of accompanying people, the police, the medical officers and the victims if they are in a state of talking.

I hear a drunkard father with a stab wound on his arm he says caused by his own son expensing all his money as military pension on prostitutes and drinks and gambling, and speaking of throwing his wife and son out of their house… and filing a case against them, and the son saying that the wound is caused by that man himself…

I hear different stories about a young woman drinking linden from her different relatives, and I hear people misleading police about the burns caused to a middle aged woman.

I see brothers with broken bones and many injuries trying to kill each others in fighting, and filing cases against each other for attempts of killing. I try to be a machine and try to help both parties to survive…

And I do feel proud of my hands when I suture the wounds… when I insert the RTs, it almost never injures the patient… but I feel incapable that alas, I can’t suture their minds, can’t help their minds to get rid of the poison of hatred for their own kins… I can’t even understand what in the universe is making them to behave like this? How people get time to make stories when someone from their home is dying?

And I keep on working, treating one patient after another, like a machine programmed to suture, to insert the branulas, the catheters, RT tubes… and keep on feeling flaccid, paralyzed, something like a loser. I must be totally mad to dream a happy altruistic world when the reality is exactly opposite. There must be something wrong in me, so that I keep on thinking that the situation can be changed… and a violence free world can exist with every heart ejecting love with every beat it beats. Either my concept of a human being is wrong or we’re living in a world of subhuman…

I try to find a solution that’ll at least start changing the situation… then I find the chain of my thoughts broken… the branulas in causality department are damaged, they just gel folded up when attempted to be inserted in the vein, I use the scalp vein set for superficial veins as an urgent measure to reduce the dehydration… there are soooo many things those need improvement… and by now, I’m completely sure about my madness in dreaming my dream world. But alas, this can’t stop me trying for making my dream a reality.

Sunday, April 10, 2011

a fossil of memories

I’m in UHC, and it’s not busy… only few patients arrive there, that too with stereotypic complaints, nothing to stimulate thinking. Other doctors are there and they talk to each other about some topics that never attract me. I sit there tying my hands with my best friend- my loneliness; trying to draw my feelings on pieces of rough paper… examining patients occasionally and then giving medicines to them (the pharmacologist over here is on leave for unknown time).

When I feel dull the sensations of my dream world in which I live become blurred… I keep on trying to keep control over what I think but I lose it often. And I look at the calendar hanging over the front wall telling me how time flies… I was an extremely sincere student once upon a time, a matter of pride for my parents and teachers and a stimulus evoking jealousy in my fellow students. I always and always occupied the first bench, always was the first to get into our college bus and into our class, always was first to examine the slides first to do the dissection first to reach the patient and examine her… and was of the rarest varieties that used to read and then attend the classes hence I always answered questions of teachers. I happened to be the strongest girl in my class and had overtaken all boys from my batch in the fitness test in physiology, and no one could attempt ragging on me when it was so common when I was in first year. And when other girls were requesting boys to break the skull during dissection, I myself was using the hammer and chisel eagerly to see my most favorite organ, and when the brain was out I glanced that I was encircled by more than forty mystified students of my class and they were staring at me as if they were looking at some ghost or something.

I hated mugging up and reading the small readymade answer books… all I read were the big weighty reference books. I was never a topper but was surely in top ten, teachers expected me to write answers like those short answer books and sometimes I had to take the reference books to the teachers to tell them that what I’ve written is correct… I had written an article for our magazine explaining this situation and had won the best article prize for it. I remember of it when some nursing students those I don’t know ask me today, “Are you Namrata Shinde from 2005 batch? We have seen your photo and read your article Maathaache Manogat… We liked it a lot…” and I had shocked all those people who used to think of me as a book insect by winning first prize for Love letter writing. I really had enjoyed the rumors saying that I couldn’t be delicate enough to write something as tender as a love letter, and the prize winning letter was written for me by someone else. Next year I tried to combine science fiction and romance in the competition and got a queue of girls with tearful eyes at my room to congratulate me for my writing… that was the birth of my novel ‘I know you love’. On a professor’s request I had written a drama to express problems faced by young people for representing my college in a competition… my roommate was the only girl who had read it, and boys from my class congratulated me for it. But a big competition started amongst senior students for the lead roles and politician boys of my class took it from me and instead of my drama they played something else; I had no copy of it with me. I lost it for good… and recalled about it after four years when unexpectedly my roommate showed me a bus driver and said, “Look, this man looks like the loafer Raghu in your drama…” I was left in tears.

I have attended some clinical postings alone in my second year sometimes with a batch one year senior to me… I used to literally wander in the college and canteen searching for my colleagues who used to bunk them and beg to them to come to the postings when teachers refused to teach only to one or two students … I never attended parties, never went to watch movies, never attended trips, I didn’t even attend the gathering of my college… I was immersed in my efforts of collecting more and more knowledge… I’ve read Harrison’s medicine and Belly and love for surgery in my second year only… and had read most of the Kaplan’s psychiatry and tried my eyes on big Nelson of pediatrics. All I wanted to do was to become a scientist working on brain.

But things started changing and getting worse and worse… in third year there were almost no lectures and in postings rather than sincerity something else became important. Scoring in exam became a dirty game of politics. It wasn’t transparent… and I hated sordid means. I did have quarreled with one of the lecturers for whatever was going on there… no lectures, declaration of exam just one day prior to it without any explanation about the syllabus, copying… everything was like living in a hell. As there were no lectures, I had no chance to communicate with the teachers in proper. Then I had got shocked to see one of my most respected teachers smoking the public canteen in my college. It was hardest thing my life to accept this realty which was far far away from what is ideal.

And the jealousy I had evoked in some persons started affecting me. I was getting accused wrongly of using my power to bully other girls and of showing off my height and figure and what not by persons who never happened to interact with me and even those classmates to whom I used to always help didn’t stand by my side. I was alone and again got accused of having some kind of behavioral problems… and having some pitfalls in personality rendering me unable to what they called it “mix” with other girls.

It was a blow to my soul, it was improper. I was getting tensed because of it and then I developed some kind of inflammatory disease, was wrongly diagnosed with Rheumatoid arthritis, became a guinea pig for orthopedicians who fed me chloroquine, methotrexate, anti depressants and tons of pain killers as strong as opioids. I was surviving, trying to make as many efforts as I could to reach my dreams… but alas, no one here knew what a scientist is and what they did was either to ignore me, or to pity over me, to mock me or to try to explain to me, “you complete your MBBS then while preparing for your MD entrance examination do your PhD thing.” I contacted to some scientists who suggested me to have some experience with research and this was the hardest thing to do in my college. I still managed to do a project for which I had to contact a local gym, a local video recording company, and had to take lectures of first year students on neuroscience to make them ready to be volunteers for my research.

I became so weak that I fainted while standing to observe a surgery. My parents were shocked to see the changes in me and they attributed them to the toxic drugs I was consuming for that arthritis. I took the drugs for more than a year, developed some itching skin reaction and anemia after that when my mother took me to a big hospital for joints, I gave up the toxins as the doctors over there said that I had no arthritis… after some months I also became allergic to common pain killers like parecetamol. My score in exams dropped near to the boundary of passing in third year, and in final year exam I got that gynecology blow over my soul. The days after declaration of my final year results were the darkest days of my life; my parents who were used to boast for my achievements were terrified. “Your thoughts are nice, but they’re meaningless if you always become a loser because of them,” My mother said to me ten months later that incident.

I survived it though I was a bit depressed, and was unable to express myself in full, and was dumb, it was an extremely traumatizing experience… even the part of my novel I had written in those days is so negative that now I’ve to rewrite it. But I didn’t give up trying for my goal, and then tried to express myself by writing in nature network, and in my blog about my feelings. And I did meet an angel powerful enough to make smile even in that condition. He helped me a lot to get out of the situation. Then I got a chance to do a research project on learning and memory in another university, and I did pass the final year exam to become an intern…

Now I’m an intern in UHC, and its 12 o’clock in the afternoon… the OPD is going to get closed. The doctors surrounding me who were discussing amongst them have left. I’m still looking at that terrible time map called as the calendar. What you say- why have I written all this autobiographical matter? Remember what I’ve written in the second paragraph… “… I keep on trying to keep control over what I think but I lose it often.”

Saturday, March 5, 2011

being a doc

Few days ago people in Walsang had seen a caricature wandering in their village for the first time. Now they know me as a doctor who works in PHC, and I get many smiles and salutes right from the moment I get down from the bus. The kids say, “Look a doctor is walking!” some brave ones come to me and ask, “are you a doctor,” and when I say yes, I see their eyes shining with pride. This’ the glory of this occupation, people learn to put their faith in your hands and they look to you as something special…

It might make you slightly grandiose when you find people waiting for you making queues and depending on you for their health and well being… it would be appropriate if I were some superhuman… but I’m not. I too am a human, and I too fall ill. Yesterday I was on the bus stop for more than two hours but couldn’t catch a bus thanks to my ill health and the crowd and Darwin’s ‘survival of the fittest’ ruling the already crowded buses. I couldn’t attend the morning OPD and I got a permission to come in the afternoon from the MO via my cell phone. And when I arrived here at around four pm I saw kids running into their homes after seeing me and then their mothers coming out and then they asked me, “Doctor where were you in the morning, we waited for you…”

I know being a doctor is not an easy thing to do… it’s a big responsibility. And it’s a thrill to make those people happy and satisfied with whatever resources you have with you. And it’s a big challenge to work in areas with scant facilities like these PHCs (and also something like my big hospital)! And it’s a lot of fun to play angel when you’re just a tiny human… and you get thousands of blessings every time the patients feel better after visiting you……

But to me, something is missing here…. I feel sorry, but this’ not the work that’ll give me complete satisfaction… I want more. I want to make each and every health center to have good health facilities like good medicines in sufficient quantity, good diagnostic tools, good surgical equipments, good transport facilities, and good care. I want every doctor to play angel and not robot. I don’t want this difference like rural and urban health facilities, and rural lying far behind the urban ones. I want every doctor to practice logically if not ideally. And I crave to make the treatments safer, I want every disorder to have cure. I want to make people really happy, even when I’m not there to treat each and every one of them. I want to become a scientist and want to work on brains of us… and also want to make improvement in the health condition of people in the world. Just figuring out what I shall do, and where I shall make a start to achieve it…

Friday, February 25, 2011

diary of ntern....

Humans are weak animals, with a small life and a big mind and huge desires… I feel myself as fragile, a miniscule creature hoping to bring happiness in human life. I love to go this PHC and see people every day and do something that I can, to help them with their health problems… and I face obstacles every day in one form or other those in fact should not arise. This PHC affords being constantly online, it affords the webcams, it affords the decoration it has… and the new decoration that is taking place; can’t it afford a one thousand rupees sphygmomanometer? And there are round needles, no matter what kind of wound it is, and where and for whom you have to use that big bored round needle for applying sutures… why should the people tolerate that extra trauma, only for the cause that they live in a village?

And I see poverty ruling lives… almost every woman and many men I see are anemic. I heard a doctor saying that complaint of weakness the women over here do is nothing but a psychological problem… I thought what’ll happen if he bleeds and his hemoglobin level falls near to five; won’t he complain of constant weakness and fatigue? The iron and folic acid syrup over here is out of stock, now I give the tablets… and they’re going to end soon the pharmacist insists. And I encounter women with backache and weakness in limbs due to compression fractures in vertebrae… with extreme tenderness over spinal cord… they are osteoporotic… leave apart the cementing of vertebrae and other surgical treatments I couldn’t even give them calcium tablets. They refused to attend a higher center- my hospital… and I’m sure they wouldn’t have got the treatment over there also. They can’t afford CT in government hospital and MRI from private hospital is a big thing for them. At least to increase their bone strength to some extent, I advised them to take milk everyday… then they smile at me sarcastically… “If I were a queen I would have got milk,” I remember one of them saying. My knowledge is helpless here… so is me.

And the men are addicted to one or more drugs… especially to the alcohol and the smocking. If not anything else their families will definitely get good nutrition if they stop spending money on their addictions… but who’s going to stop them? Why the government doesn’t ban such things in total, when it’s known that smoking is hazardous to health, it harms even to the non smokers… why the cigarettes and beedies are still being produced? If they start getting profit from selling and producing something like cynide, will they do it? Will they promote suicide by cynide? Then why do they do it with nicotine and with alcohol? Who has given the manufacturers the right to ruin the lives of the consumers? I’m totally clueless… I’m nothing but just an intern physician.

And I see violence. I see adults coming with police cases with heads broken due to fights in families and in rival families… I see women with tender infected injuries they’ve got because of beating by their drunken husbands… and I also see kids with head injuries due to getting hit by a stone by a small sibling or a playmate….. And the cases of dog bites in children are also on rise as the kids go and kick the dogs on face!!! They also hit the pigs, but the pigs don’t bite. What is this? Why? Why this violence… why everyone likes to pick up the stone and target the head of other? Is this a learned behavior from the parents… or is it something deep in genes? I know, I can’t do anything at this level of mine. I want to study neuroscience and want to stop this violence… but I also want to stop this under nutrition and addictions… and these scant facilities… I want to see them happy. I don’t know what I should do to make it a happening… Leave it; I’ve started daydreaming……………………………………….

Tuesday, February 22, 2011

diary as an intern

I’m an intern physician… I’m at PHC Valsang… and it happens to be one of the topmost PHCs in Solapur district. And here are many drugs, I never see in my hospital… though it lacks some fundamental investigation techniques, it seemed to be near perfect to me as a primary health service center… provided that you refer the patients to the necessary higher center when the need is apparent… and this doesn’t sound bad. But…

I hate that ‘but’… but it is there. I don’t want it, but it is there. This polished structure, this cleanliness this cool behavior is now I feel is sheep’s skin worn by bad nasty careless educated wolves…. Enemies of health working as health care workers. I feel it, that these webcams are foolish, morons or idiots… machine things having no IQs….. or maybe I’m an idiot.

As usual today there were many patients, with their usual complaints, and with their own usual theories about their complaints, and with their usual wrong beliefs and wrong health habits. And as usual I try to explain them the things, the importance of minor activities and good health habits and their effect on health… that ‘saline’ (their term for iv fluids) are not energy doses and that (pain killer) injections are not the solutions for every health complaint. And I usually succeed in convincing the patients and making them to understand their health problem at least an outline of it f not in complete… but then I face the complaint of the MO and even of the attending staff and class four servants that I ‘spend’ or ‘waste’ too much time on patients… and the crowd is very big and I’ve to check the patients in fast………..

Today I encountered a cheerful forty year old obese woman, a butcher’s wife (her weight was apparent by her size, though I didn’t actually weigh her). And she was there to tell about the ‘weakness’ of the right side of her body… there was no obvious loss of functions… and when asked about the onset of her weakness, she described an episode of profuse sweating with transient confusion which was followed by the weakness and the weakness had reduced then… she had not consulted any doctor. This was a mini stroke a herald of a catastrophe. I asked her about her blood pressure, and she told me that she was taking one blood pressure tablet for high blood pressure once upon a time which she stopped as someone told her that her BP was normal… I wanted to measure it, and I took her to the MO’s chair. He wasn’t there and I got a chance to examine the only BP apparatus in this PHC… it is fixed to a stand near the MO”s chair. And to my horror, its release valve is malfunctioning! And I got the reason why the MO tells that the BP of every patient I send to him as normal… even that of those having symptoms of angina. I somehow stopped the airflow and her BP was 210/ 150 mm Hg……………… stage two, very high.

I reached the drug store to find some suitable drug for her… only to find out that the ramipril and hydrochorothiazide tablets over here are the dolls decorating the showroom… the pharmacist refused to give those drugs to her. And I asked sir about what to do with that patient, and guess what that lady got- atenolol that too just 50 mg…….. aten 50 for bp 210/ 150??? He said after looking at my shocked face that what’ll happen if our stock of ramipril ends… the patient can’t afford it, so we give this one affordable- atenelol 50 mg! Then why the hell are you keeping that drug in your drugstore… I can’t guess, and can’t understand the logic behind this… the logic behind having the drug and not giving it to the patients who require it. Atenolol blunts the CNS… makes people dull as an adverse effect… and we must give any drug after evaluating its need or benefits and the potential harms it can cause. And if a better drug is available, we must give it instead of some crude one… I really can’t understand the logic behind giving her atenolol when ramipril was available.

And I see them telling a patient to get his forearm massaged at home with a gel after a trauma and when by examination fracture was apparent with no x ray advised and no immobilization was done. And I see infants getting prescription of nimesulide syrups… and I feel what if this’ just a bad dream and I’ll get up and I’ll see that this isn’t true… but it’s not… it is the truth. And I face it, everywhere… everyday and continue to hope that at least at some point of time this’ll change and we’ll live in a healthy happy world.

Am I really mad to dream what I dream? Is it possible to make some improvement? Is it possible to make the health service perfect… to make everyone healthy and happy? Can the world in my dreams exist? I don’t know… but I can’t stop thinking of it and trying for it… as if I don’t think of my dreams, I think nothing! And someone has beautifully told me that dreams can come true, without that possibility nature would not have incited us to have them… and I believe in him.

Saturday, February 19, 2011

ideal Vs Real................ ..........!!

It’s not an easy task to be a good doctor, especially when nothing is known about many things, no specific treatments are available for many diseases, and many treatments those are available are not reachable to your setting… no diagnostic tools are available, and when patients have bad habits like addictions and false beliefs… I encountered today a patient with fully developed rheumatoid arthritis… with Z thumb, and bent fingers, and lungs shouting fibrosis and COPD, coughing and moaning with pain and with a packet of beedies peeping out of his pocket… and was asking me about the cause of nodules over the back of his elbows, and was requesting me to give some “high quality” drug that would cure him. He was emaciated… I wanted to refer him to higher center (the heck, to my hospital!) but the MO stopped me. Anyway it was a question what they could do for this patient… (I guess nothing other than prescribing a RA factor test and ESR and CRP- what if they were positive… and high) He was a regular patient over there, and was an alcoholic along with being a smoker. I had to give him some analgesics and after him I faced another patient brought by his wife, who was looking like his daughter… he was with full stretched abdomen with ascites of high grade and pitting edema over his feet… and she said that he had vomiting of blood in the morning. And he had same kind of vomiting few months ago… but no swelling. He was having liver cirrhosis (alcoholic) and he was drunk at that time also. And I found that ascitis tapping is not being done here. I searched for diuretics… alas, they were also not available. I ran to MO to ask for what to do, and he told me to send him back with some Tonic capsules (Tonic!!!??? He was as if closer to last stage… I would definitely have admitted him if I were in my hospital). I told her to take him to the causality (the emergency sector) of my hospital in case if some emergency arises… and then I caught the assistant of the pharmacist giving gamma benzene hexachloride ointment to a patient whom I had prescribed betamethasone ointment for atopic dermatitis.

What is going on here…? When are we going to get up and start practicing logically if not ideally? I see steroid tablets being given abundantly because the stock is in abundance, and the nimesulide… and tramadol injections for people with chronic trivial low back ache. I accept opioid analgesics if given after trauma or for severe pain. It’s not something that should be given to each and every patient complaining of pain. And nimesulide is totally unacceptable. And health advices like how to protect lower spine from injuries, and how to take care of spine, and to do exercise are not being given at all. And even if they’re told to do so, the smokers and alcoholics are not going to seize it.

How to change this? Where to make a start? Am I too small to think of that? I don’t know… maybe I’m… or maybe I’m confused. Is my dream of healthy happy world a daydream of a fool? Maybe it is; I never say that I’m a sane person. And I’m going to keep on trying, let me see what the future is going to show me…

Friday, February 18, 2011

me at phc

I’m a human, alas, though I wish to be some angel or demon or something supernatural… so that I’ll be able to do everything I’ve to. I go there, somehow… and encounter a big crowd called OPD patients waiting for me, and the MO raising his eyebrows (as the wall clock over there has been set at a wrong time). I get my own chamber, and I’m left alone to speak to, to examine and to diagnose and then to treat the patients. I do have experience with gynecology, I’ve worked in orthopedics (but it’s really hard to handle patients with injuries and joint complaints without the aids of X- ray films), and in ENT… I know surgery, and little quantity of ophthalmology… but I can’t control sweat gathering over my forehead when I encounter pediatric patients, then patients of deep lung infections and heart complaints, and then a tons of types of fevers and skin rashes and scabies and fungi… here I see everything, and I’m the whole and sole and the responsible person for them… I literally have to dig out information buried in the graveyard of my MBBS school memory. And ironically I’ve to refer patients with something like CSOM or DNS or like IUGR to my own tertiary care hospital… I sign the forms requesting them to do further investigations and do the necessary operations… as those things don’t happen in primary health centre.

The pharmacist insists me to prescribe something in her reach… people try to run away from work, no matter if it’s as small as getting up and opening the cupboard to take out the drugs. And they ask me why the hell I’ve chosen this PHC as it’s defamed for you really have to work hard here. I haven’t chosen it, I’ve been allotted, and no matter how exhausted I get I don’t feel my decision of working is a wrong one. I like experiences, I love patients… and as usual I feel tied because of lack of treatments to some diseases, and the hazards of the treatments I give to them… for some patients I do nothing rather than leaving them to their own luck (or badluck).

Today here was a camp day for laparoscopic tubal ligation operation. And there were maybe more than hundred women or girls (yeah, I don’t know what should I call to them when their average age is around twenty and they have two to three kids) waiting NBM since last night for the Civil Surgeon, and he happened to arrive at around 4.30 in the evening. I was shocked to see the en mass administration of anesthesia and the peon lifting the post operative patients and carrying them in his arms to their bedside (which’ a cloth piece laid on floor) … here are no stretures. But it’s good, that they’re doing family planning… in my hospital I’ve encountered many G4 G5 and sometimes G6, G7…

I don’t know from where I should start to do something that’ll transform the picture to close to ideal one… just trying… I really wish I would be some structure with super power!!! Oh my magic stick, where are you?

Wednesday, February 16, 2011

PHC continued......

Wandering is not new to me, but searching some address in a completely strange environment, at a place not given in details in google maps was a bit challenging. With some anxiety and some fear and tons of loneliness and kilotons of curiosity, I reached Walsang- The village of the PHC which has been allotted to me by the DHO. I was walking like a fool, looking at any slightly big house as the PHC… and people were looking at me as if a strange funny fast cartoon character was marching before them. The village was the same as where I’ve spent my childhood, with only few houses with more than one floor and the school and some little private clinics, and open gutters and garbage and pigs. But I encountered about three medical stores which was a bit surprising to me.

And when my legs were about to give up walking, after asking few times to the locals, and after spending almost one hour in searching, I reached a place they were calling as PHC. It was open, and crowded… “Who’s that girl,” I heard a woman asking to a man…

I work in a tertiary care hospital, that too aligned to a medical college- Govt. hospital Solapur… so my idea of primary health centre was something with a standard far below than that of my hospital. And that’s why I got shocked to enter it- the PHC at Walsang… in contrary to my hospital, it’s computerized, and is extremely clean and webcams are recording the behavior of doctors and nurses with the patients… and finger print machines are used for attendance recording… I was pinching myself repeatedly to examine whether whatever I was seeing was true. And I was to have a heart attack or may be a stroke due to excitement when I visited the drug store…

Along with Amox and cipro here septran and tetracyclines like tetracycline and doxycycline, cephalosporins like cefalaxine and cefixime are also available. Of course, higher antibiotics are not always necessary and can cause resistance and toxicity is high especially with the tetracycline group… but they are must when strains resistant to routine antibiotics are encountered. Here in my hospital we pray that the strain shouldn’t be resistant and if it is, we are left with no other choice than telling the patient to purchase it from nearby private medical.

Antihistaminic drugs like cetrizine are also there… but chlorpheniramine maleate stock is in abundance. I don’t understand why they go for CPM when cetrizine has far less CNS side effects… diclofenac and paracetamol are available in my setting also… but diclofenac is sometimes out of stock, here that’s not the case. I almost shouted to see Diclofenac gel in their cupboard. I never see such things in Solapur. I wondered to see a tablet with serratiopeptidase as a constituent… but the other constituent of it- nimesulide disappointed me. Why the hell government is providing something as toxic as nimesulide when it is banned in many countries? One more thing that bothered me was the needles… according to new agenda we use a new needle for every patient, but here the needles are used in ancient manner repeatedly for many patients after boiling it for sterilization. This seems dangerous, when I remember the long queues of patients and relatives waiting for ART drugs in my hospital. And yes, vitamin B tablets are out of stock here, same as in my hospital…

But I liked this PHC… at least the first impression is good. It would be an ideal health center if only few drawbacks it has were removed. It’s as if it’s very close to the health service in my dream world… of course higher facilities like x rays and CT are not available… but still it’s good as it’s just a primary health center. Why my hospital lacks these things like the webcams and the attendance recorders and the cleanliness and the friendliness, why so many drugs are not available here? How can a tertiary health center lag behind some primary one in many things? Why other PHCs are not like this one… why are many of them closed for almost all the time?

I don’t know management much and economics was a big challenge before me when I was a high school student… but it would be very pleasing if I could answer my own questions… I’m here to learn and to use whatever knowledge I have for the patients over here and I’ll do it. But I can’t stop myself dreaming an ideal health service serving the whole world… I want my dream to come true.

Tuesday, February 15, 2011

PHC... and me

I fear sometimes to do something that others don’t… to be an intern that others don’t expect. I’m not a heroine, a Hercules… a fearless monster with extraordinary strength. I’m a normal human, fragile many times due to some unknown inflammation… who’s unable to give up something that her mind calls as being honest to her job! And my job is to be an intern on a way of being a capable independent physician… I must and must do the things and to use the sources as what a good and ideal physician does. I feel there’s nothing wrong in me to wish to expose myself to the extremes of medical practice.

I’m not a studious medico kid who prefers thick stereotyped books over the live experiences in the hospital. I’m not a time saver kid running before the clock to have one more MCQ paper solved in a day’s 24 hours. I run behind the experiences… I just can’t refuse to go to the incomparable monthful of experience of attending a PHC… no matter what and where the PHC is, no matter even if it’ll cost me my hours and make me to travel by bus everyday for a month… My friends tell me, then yell on me, then beg me for not doing this- to break trend of escaping PHC service with the shining notes with Mahatma Gandhi imprinted on it… then they give up and I’m left alone to express my fear to this dead machinely computer screen. The clerk in District Healthscience office doesn’t like me, and I get the PHC far far away from where I live. And then I’m left in complete darkness about the status of it… whether I’ll encounter a live human there or whether there’ll be a big rusted lock telling me some corrupted tragedy… and I feel I’m not prepared to face it. Still I’m going there without knowing the outcome… tensed…. I wish how happy it would be if everything were normal, uncorrupted, like something in my sweet dream world. But this isn’t the dream world and I crave for some live hand on my shoulder telling me that what I’m doing isn’t wrong… I know I’m not wrong.
Let me see what is there…

Wednesday, February 2, 2011

Let them to say what they want………..

They say it’s in vein
To spend hours… in teasing your brain,
To play with words to haunt minds,
To think of the world… existing only in hearts

They say it’s utterly madness
To try to find something…
which maybe completely fruitless
And to consider the world… which affects you not

They say it’s a big flop
To spend your life in searching…
Answers to the endless ‘whys’
And in attempting things… which may cost your life

They say it’s a severe bad luck
To be unable to be practical…
In this ‘Practical’ world
And to foster dreams… those sound irrational

But this madness has its own reward…
What others say doesn’t bother a mad!

She lives life like the spring
Bringing blossom to every mind she meets
Buds are bound to flower…
It’s exciting to watch flowers born as thorns
It’s really funny to live for a cause
No matter, even if it costs you your life

Saturday, January 15, 2011

i insane

I’m not a good student… I don’t sit in the library and mug up MCQ books. I don’t know which common questions they ask frequently in the entrance exam, to be honest, I don’t even know exactly how many and which subjects they’re supposed to ask questions on, what I try to read is everything available about the diseases I encounter in the OPD and my beloved neuroscience. I don’t plan, and I don’t want to appear for that exam. I don’t want to be a physician… don’t want to spend my life in the hospitals trying to offer already available treatments which may or may not be effective, and in trying to fight against the disorders disabilities tragedies and curses with maybe partially useful or totally futile or guess based regime weapons, and in trying to be satisfied for offering the treatments to needy ones no matter what the results say…

I don’t hate doctors… really, and I do salute their contribution in the health care system, because if we remove doctors the system will be totally paralyzed… but I don’t want to be one. A doctor has to be practical (yes, I’m speaking of an ideal doctor… and not about the money making robotic machines devoid of their own brains and alas, also of hearts!). She can’t be enthusiastic- the doctor, can’t be drastic… can’t cross the boundaries. She just can’t be curious beyond a certain limit. And she’s helpless; she has to adjust with the scanty diagnostic facilities and primitive like treatments even though she’s working in a most advanced setup (leave apart something like what I experience here)… she has to see failures, she has to face conditions where there is no treatment… there are diseases with no cure, and there are people who get them, and come to her with great hopes… like a machine, she has to take consent and has to convince the patient about the scant regimes and potential hazards of those regimes, and to tell that to the disease there is no treatment.

When she decides to go beyond the limits and to expand the boundaries, to question the regimes and the pathological conditions and mechanisms in physiology, wants to seek something better and safer…, she’s not a doctor, she’s a scientist. I know a doctor is not supposed to play the god though some people still do call her a god, neither a scientist an idol. But… but… but why to accept the limitations, why to surrender the pathological processes and traditional treatment regimes when you believe that something better can be found out? Why to spend life in prescribing VDRL and then ART to thousands of AIDS patients rather than trying to defeat the HIV in total…? Why to go for AMP or nailing and plating and working on live human’s bone/s as on a piece of wood rather than finding something that’ll deposit natural bone where it was and how it was before the accident? Why to give something as hazardous as steroids or cytotoxic drugs to control inflammation? Why is in cases of fights and crimes, MLC papers and signs and signatures and proofs and photos more important than the fact or facts why the heck their brains became so violent? Of course, there is some answer/s to every why, but alas, none meets my satisfaction…

And I, like some unsatisfied wandering spirit keep on thinking of research while working as a doctor in my hospital… and my mind keeps on hovering between the reality and my dream world…