PLIGHT OF DOCTORS

PLIGHT OF DOCTORS

Medicine is not an exact science. It is a human quest for knowledge and effort to understand and usurp the forces of nature. In a way, mankind is trying to win over the laws of nature.

It is a constant ongoing battle and we as mankind have made a lot of progress. This progress has happened more in the last fifty years or so. Proportionate rapid progress has taken place in other fields like space science, defense technology, information technology and food management.

Humans have therefore raised unrealistic expectations out of medical science. They fail to understand that it is against the laws of nature that we are waging a battle. We don’t even know what exactly makes a human being alive. The understanding is finite. We still are not immortal and we cannot overcome death.

In an earlier era, it was accepted that this is a normal course of life. Old age, disease, and death were accepted parts of Human destiny. Gautam Buddha had realized it too and set out on his knowledge quest because of the same reason. He found his solace only once he attained enlightenment!

Hence, it is pertinent that doctors and patients understand this. Life is finite. We have progressed and to some extent succeeded in fighting some diseases and have increased the life expectancy a bit, but it is still minuscule in nature’s scheme of things.

Due to rapid progress and achievement of economic prosperity, humans have started feeling entitled to having perfect health. They think money can buy you health and life. It’s not so. They fail to understand that they are fighting nature. And they can’t win.

Doctors in their parlance talk of managing a case. Never treatment. “I treat, He Cures.” It is accepted and understood. Doctors should now make their patients aware of these things. Their unreasoned and unrealistic expectations have to be addressed even before they start ‘managing’ a case and not treating it. 

Every doctor who starts managing a case by prescribing drugs or performing a surgery tries to do it to the best of his capability. Not every time it gives the desired outcome. He tries hard. He also doesn’t want to fail. But it’s beyond his capabilities.

There are a lot of other problems too in this field. Not even the developed countries have a perfect solution. We are plagued with a huge population, which does not have the resources to care for itself. The government can only chip in up to a certain level. 

The problems get compounded when too many people start fighting for limited resources. The system gets overburdened. It cannot cope up with the demand. And then it starts crumbling.

The frustration comes out. The media hypes it. The kind of discourse on television these days, makes it sound politically correct to find faults and deficits in an already crumbling system. With political rhetoric and tacit support, people are emboldened to use violence against the doctors. The softest and the easiest target.

These doctors are the same people who are constantly trying to help you in your battle against disease and death. They are on your side. Trying to steer you and take you as farther as possible. Alas, they are also humans! 

#Stop violence against doctors

Love for chocolate

Love for chocolate

A  gift for someone you love

Nine out of ten people like chocolate,the tenth person always lies. 

That sums up how much chocolate is loved by everyone. Chocolate has become the metaphor for love. It is given to express love, celebrate occasions, gifted to someone you love, express gratitude or even as a return gift. In fact there is no occasion for which a box of chocolates would be inappropriate.

So, why is that we love our chocolate so much. Is it some genetic factor, is it in our genes? What makes some people choc-o-holic, to an extent that they are not ready to try any other flavor than chocolate? Try offering it to a die hard fan of chocolate and see if you can persuade him into trying something new !!

Chocolate had been used as early as 1900 BC by Olmecs (Mexico). What started as a chocolate drink has metamorphosed into  a multi billion dollar industry of commercially produced chocolates in different forms; bars, syrups, spreads, ice creams and chocolate cakes.

What exactly is Chocolate?

Cocoa beans are the dried and fermented seeds of the cacao tree (Theobroma cacao). Theobroma literally means “Food of Gods”. After fermentation, the beans are dried and then roasted. The nibs are extracted by removing the shells. Then they are  ground and liquefied to make pure chocolate liquor. The liquor is further processed into cocoa solids and cocoa butter.

It is the varying proportion of the cocoa solids and the butter which gives it the characteristic taste and texture. The active ingredients are in the solids. More the butter, more will be the fats. Pure chocolate is devoid of any milk and sugar. It’s addition makes it more palatable ranging from dark chocolate, milk chocolate to  finally white chocolate.

The Aztecs used to consume chocolate as a bitter, frothy drink mixed with chillies. We are luckier though, with the plethora of options we have. Chocolate triggers the release of endorphins and serotonin, our feel good hormones. It makes us feel happy and elated. It is said to contain more than three hundred different chemicals, but the most important ones are caffeine and theobromine.

A table spoon of unsweetened cocoa powder contains 12.1 mg of caffeine, whereas dark chocolate will contain in a higher concentration- 22mg per 25 mg serving. The psychoactive effects on cognitive performance can be seen with even 9 mg dose.

Why do we love it so much ?

We love it because of the rich aroma and taste, the way it simply melts in our mouth. The rich creamy flavor evokes a wonderful joyous feeling. Its association with love, romance and happiness makes it a part of our celebrations. But wait, the answer is not so simple! 

Letting chocolate dissolve in your mouth produces the same effect as a passionate kiss in the brain and raised heart rate. Moreover, the effect can last unto four times longer!

There are several hundred different chemical in your typical chocolate, but the most notable are the stimulants theobromine, phenylethylamine and caffeine. It also contains a feel good chemical called anandamide, similar to the one found in marijuana called anandamide THC (tetrahydrocannabinol). It also persists for a long time giving us the longer lasting “chocolate high”.

Eating too much chocolate also triggers a different area of brain (parahippocampal gyrus. Orbitofrontal cortex and prefrontal regions) which practically tells the person to stop as it is perceived negatively.

Choc-o-holics vs Non choco-o-holics

Is there is a difference in the response by brain in people addicted to chocolates against those not? Apparently, there is a difference. Certain areas of brain (orbitofrontal cortex,cortex, ventral striatum and the pregenual cingulate cortex) behave in a different manner in these persons. These same areas are involved in other forms of addictive behavior, such as drug taking, drinking and gambling.

Even a sight of chocolate when you are dieting can trigger a response.

Is it bad for me?

Dark chocolate has higher levels of epicatechin levels which are understood to increase physical performance to a small extent. Some studies say that it reduces the blood pressure, but it has been found that the effect is seen only when it is consumed in very high quantities.

Some side effects include heart burn, sweating, trembling and headache. Consistent consumption can lead to kidney stones. Chocolate can be an important source of lead especially in children, if consumed in high quantities. Allergic reactions and  acne are known to occur.

So eating small to moderate quantities does you no harm and might be of some benefit, but eating too much will increase sugar and fat intake which leads to obesity and its problems.

 Final words

Charles Schulz has said, “All you need is love but a little chocolate now and then doesn’t hurt.” So indulging yourself or giving it to someone you love is definitely a thing you must do. It creates long lasting memories and moments which we can cherish forever.

Enjoy the chocolate high, gift it to someone whom you love, share it with friends who make you happy and  surprise someone by sending it to them without a reason.

Keep making your life more chocolatey by enjoying the Theobroma…the food of Gods !!

How much Coffee is good (or bad) for you ? 

 Ultimate idea of relaxation on a Sunday morning is having a good hot cup of coffee and reading the Sunday morning newspaper and lazing around in the house. I am sure many of us like this and is part of the Sunday morning drill for years. Some of you might be occasional drinkers and some of you might have downed cups of coffee during exam days. Or you might be the types who are constantly gulping down coffee at office or maybe a coffee aficionado. 

Whatever maybe the reason, coffee is part of life for most of us. So how much coffee is safe for us or recommended. Is it good or is it bad ? Should you be avoiding it all-together or maybe restrict it. Well let me try and help you out on this.

What does coffee do ? 

Coffee is extracted from the roasted fruit of Coffee arabica bush. It contains caffeine and works by stimulatingthe Central nervous system (CNS), heart and muscles. It improves alertness and clear thinking. Along with glucose the effect is further improved. 

It has other beneficial health effects also. It is known to prevent or delay Parkinson’s disease, prevent Type -II Diabetes and Gallstone formation. It is also possibly effective for some cancers of digestive tract and breast.

How much can I take ?

Each percolated cup contains about 100-150 mg caffeine, instant coffee  about 85-100 mg and decaffeinated about 8mg.

2 cups or about 250 mg is the average recommended dose. 

So average consumption should be about 2-4 cups, although higher doses are more effective for Diabetes and Gallstone prevention. So, sticking to 2-4 cups is most prudent as it will prevent side effects also.

What are the side effects ?

Excessive consumption can cause anxiety, agitation, restlessness, insomnia. It can cause heartburn, acidity, ringing in the ears and irregular heartbeats.

Not to be used excessively in pregnancy and during breast feeding. Should not be used in children, anxiety disorders, heart disease, hypertension and other serious medical conditions.

 

Five things you can do to fight boredom

 Five things you can do to fight  boredom

1.      Listen to your favorite music playlist

Keep a playlist of your favourite songs ready. Select songs which are generally happy and upbeat. Play it up loud and maybe dance to it or start a workout. It will surely help you get out of the down feeling.

2. Pick up Coffee and a book

Grab a cup of coffee and pick a motivating book and read it. Keep your favourite book handy or maybe keep a ebook with you always. Coffee is a known stimulant and book will inspire you. Preferably read from the motivational gurus. It will help.

3. Listen to an Audiobook

Audiobooks are a great way to read. It requires less effort on your part. Put it on with a headphone or just play it aloud. Again goes without saying, choose a positive, motivating author. Don’t read something which is dull and dark!!

4. Go for a long walk or run

Exercise is known to stimulate your hormones and in a short time, they are known to boost your mood and morale. Also,it always good to exercise to stay healthy. So walk, jog or hit the gym.

5. Make a bucket list

     Making up a bucket list is known to make you think about the dreams and things which you wanna do. It will help in conceptualizing your thoughts. In composing the list you will stumble upon new ideas and things you want to learn. That may inspire you to take up something new and push that dull and empty feeling away.

Desperate for Motherhood

The urge and drive to be a mother is the most beautiful and basic desire of every woman. It is said to have strong genetic undercurrents which is manifested by the strong desire to have a baby. Science has not been able to pinpoint the exact mechanism of this phenomenon , but it is like the most fundamental basic desires of humans and animals as well.

Although it is not incorrigible to understand this behaviour of humans, what is perplexing and often shocking to see is the extent to which your patients will go to achieve the aim. This is often done to the extent of endangering one's own life.

As a clinician you are also part of the dream of the couple to have a little one and guide them and help them in reaching their destination. You are also frustrated like them when the results are negative, and painstakingly continue the fight. But when things go wrong and at times horribly wrong to the extent of putting the lady in grave danger, you have to convince them out of this dangerous journey. It is in those moments that you have to sit back and think. Think about the desperation these couples are going through and the amount of risk they are willing to take !!

I then think, is this really needed ? To what extent should you as a human being go towards achieving this goal. There are lots and lots of examples wherein people stay out of marriage by choice and don't nurture these feelings. Then there are those who sacrifice and put this issue away to pursue their dream career. Then we also have plenty of people who are caught in the patriarchal mindset and the desire for having a boy makes them resort to sex determination and female foeticide. 

Whatever may be the genesis of these desires....maybe biological, genetical, societal, material,philosophical, religious or purely psychological, it is really intimidating and disturbing to witness this brut force of nature at work from such a close distance !!

Doctor we trust you !!

          It is a great privilege to be a doctor and practice medicine. The love, trust and respect that you earn from your patients is phenomenal. The opinion and judgement is valued and taken with a lot of seriousness, often altering the course of the disease and the life as well. This has been the norm for thousands of years and medicine has been indeed practiced in families. But things are changing. The automatic trust bestowed by patients on the medical fraternity is showing signs of erosion. It is onto us , the medical fraternity to stop this breakdown.

         Every other day there is a fresh case of hooliganism and vandalism at some or the other hospital. Doctors are being beaten up, man handled and brought to court. The headlines in today's TOI is "Why Pvt. Hospitals push you to buy expensive medicines". A detailed analysis of the commercial transactions follows. It all boils down to the rampant greed of the pharmaceutical companies and the doctors who willingly or unwillingly become part of their business tactics. On the inside there runs a article which writes about the striking doctors in response to the suspension of a senior HOD after the loss of a patient's life.

         So the point is, there is growing sense of mistrust about the medical fraternity. We have to all come together and stop the deterioration in the doctor patient relationship. These values have to be emphasised at all academic meets and educational institutions. Undue perks and previlages offered by the companies have to be stopped. Focus on academic education and not sponsorships is the need of the day. The govt institutions and medical colleges have to lead the way and bring on more standardised healthcare. Violators have to be punished by the medical fraternity itself. MCI needs to do more and not let courts do the final justice. Hospital administrators need to be patient centric and facilitators of healthcare. They have to be there to help the practioners deliver the services to the clientele.

          A coordinated effort by all the stake holders in bringing down the cost of healthcare will help in bringing the trust back. Healthcare can thus become more affordable and all inclusive. The Pvt sector can then take on more patient load and reduce the dependence on govt institutions. The difference in standards in terms of infrastructure and facilities offered needs to be bridged. 

           It is not too late. We are having the solid foundation of values on which we have based our modern practice. So let it not wither away or go down the drain. Let us safeguard the trust bestowed upon us and rise to the occasion. Let's bring back the glory to the profession and wake up to some good news on a Sunday morning !!

      

New Vistas

The best and the worst part of army life is getting posted out. It teaches one of the most important lessons of life very simplistically , "Nothing is permanent in life !"
We are born and conditioned in life with ideas about me, myself , my achievements, my belongings, my home , my friends, my colleagues ....so on and so forth. We gather this baggage as we journey this life and along the way we get attached to these experiences. We start giving so much importance to this cosy environment which we live in that it is impossible to imagine a life without it. One has created a comfort zone  around  oneself in a short span of say three years in our case. Much more in the case of people who never venture out of this zone ever.
Now imagine that you are suddenly uprooted from this comfort zone of yours.  It is really nerve wrecking at times when you know that the time to move on has come but you still don't know where you are going to go. Then suddenly one fine day you come to know the place you are supposed to move to. You suddenly loose that fire and interest in your work.....we call it PONI mood.. Posted out not interested !! Everyone around you will either congratulate you or console you depending on where you are going.
Suddenly it is as if a bond has been broken. Something snaps somewhere. Although everyone will be very nice and will speak all the good things about you and will pack in lovely sendoffs, something happens. It feels like you are not part of the team anymore. You become detached to everything that's going on near you. It's as if you are watching everything from a distance. It can get a bit creepy if you are philosophically minded.  Your frame of mind totally shifts. And it happens to not only you but to the entire family. The kids start fearing and lamenting the loss of their friends. The new school and new environment which they will have to face shortly. Your spouse will be the worst affected because she will be uprooted totally from whatever career she is trying to build !!
And then getting back to the dirty work and the nitty gritty of planning the finer details of your move. You have to get hold of the transporter and get a suitable transport arranged and then strike a deal. And then start packing all your stuff. That's the most heart wrenching part of it all. To see your lovely home turn into a devastated looking mess......as if a tsunami has hit you. It really pains to see what you have built over the last few years suddenly melting into non existence. But you and your family knows that there is no turning back....
The sendoffs and see offs are beautiful traditions which have been meticulously followed and help in buffering the impact of change. They make you feel wanted and valued and boost the overall process of letting go...easier.
You wake up to a new dawn in a new place in a new environment and the next step starts. Acclimatization !! You start adjusting to the new climate, new surroundings, new people and new colleagues. And a new frenzy starts. To get school admissions, accommodation, phone & net connections etc etc..... And in the meantime stay put in a guestroom of the mess. A welcome break from the hectic month which you have endured to get to this new setting. And the lull before the storm which follows once you get a new house which you will call your own for the next few years!! And one will be damn lucky to get it very quickly without the agony of shifting from one temporary accommodation to another. And then once again you start putting your heart and soul into your abode for the next 3 years. Fixing it, decorating it and then enjoying it.
It is amazing how fast the human mind and body is capable of adapting to the new place. That is most surprising and fascinating part of this entire process. It is fairly easy for me to adjust as I keep on doing the same kind of work in same type of work culture, except for some change in the colleagues and a little adjustment is all  that is required. But kids, I found them to take the challenge so very maturely that I found it difficult to believe that they could ease into the new environment so very easily. That goes into developing their personality I hope.
Finding a new job and career options for your spouse remains a major challenge and at times you have to be lucky to get a decent break.

So finally you have come a full circle and a new beginning is made. You gradually become more and more adept at playing this game. But over a period of time it makes you more philosophical and teaches you the guarantee of impermanence in life. So cherishing the journey as it unfolds, building new bridges along the way and to fondly remember the associations formed, make this journey so very rich. The promise of opening up  of new vistas and the wanderlust keep you going and craving for more.......

Rescpect Life

The Nirbhaya episode was a dastardly and cowardly act which had shaken the collective consciousness of the entire nation. It showed utter disrespect to a living soul and what a human mind could do collectively to another fellow being. That such things are possible and humans are capable of doing such acts was a shock to most of the people. Now, that the justice has been done to the perpetrators of this crime, is a great win for the justice system of our nation.
At the same time, celebration and jubilation of this nature is unwarranted. Although the verdict (Capital punishment) will  hopefully deter people in doing such acts, it must not be forgotten that it is ultimately human life with which we are dealing. Celebration of the end of life, in whatever form or for whatever reasons, is not a good idea. It is chilling to hear it on radio and television when people talk about it as if it were a cricket match victory. It speaks how much we have degenerated collectively as humans and as a nation.
We need to change the psyche of the people and the society so that there is no disrespect for the living being and no such acts are repeated ever again.