C&H

So, here goes today's funny of the day...

Cyanide & Happiness @ Explosm.net

He has a point I think... though i'm not sure what to do with the layout.

In other things that move and shake and all that I'm back to my one flu over the cuckoo's nest state of mind. And the immortal words of Ace Ventura ring painfully in my head - It is the mucus that binds us.
But we'll have to do something about the frequent viral infections. Get out of the cesspit of infection you work in, you'd say. However that is not a consummation that will eventualize.
Yes that is MY word. Eventualize, verb, To become an eventuality.
Other options include cod liver oil (yuck), general green leafy vegetables (cysticercosis, here I come) and my top favorite immunity enhancing concoction - Waterbury's Compound. Which turns out has an I love Waterbury's compound page on Facebook.
I'm sure I've mentioned Waterbury's before, 40% alcohol and and eary morning buzz... It's there somewhere.
Anyway me off the get me some of that or brandy.
And for those of you who live in Bangalore, there's a nice little place tucked away behind Richmond Road called Under the Mango Tree. It's good. Go eat there.

Path, Pasta, Pod

So, some many unfinished prematurely done posts are beginning to clog up my thought process. The saved drafts section is slowly growing to near epic proportions. There are posts about music, movies, new year rants, resolution promises and even that magnum opus on the evolution of pornography that I've been planning for many a year now.
The last one of course is never ever going to get published. For many reasons. One my research (purely academic) is never going to get done. Every day I think I have enough material to go forth and wax eloquently but a cursory check reveals some new and often unimproved piece of absolute kink that warrants more investigation. Now if we'll avoid the innuendo and the puns and the general nonsense in the comments for that I'll be glad but then again one can never be sure. Anyway thankfully all is streaming and none is stored. So they can't find me.
Got me a bigger and better iPod recently and have spent the better part of one early morning filling it up and drooling over coverflow. It's not rocket science and seeing the album covers whizz by is never ever going to change music quality but I still choose to drool.
And speaking of drool since when we have very little to actually talk about outside of an absolutely terrible start to the year with respect to work , I decided that my month in Pathology (this one) is going to be spent in the pursuit of updating this place a tad more regularly. Maybe even the porn post.
Pathology is a strange subject. It deals with the dead. In a convoluted not-so-comforting way so does neurosurgery but that'll change in the next many years. I hope. The joy in having the absolute last word is omnipresent in jars of formalin and bits of paraffin. People stare rapturously into bifocal and confocal and fluorescence microscopes deriving pleasure from little bits and blue and pink and ultimately pronouncing life and death judgments. And as I found out today, destressing with Shakespeare. They didn't take too kindly when I picked a skull up and proclaimed in a baritone, "Alas, Yoric! He was a good friend." Or when some technician was heating a beaker full of some noxious looking fluid elicited a"fire burn and cauldron boil."
Tomorrow there promises to be a session on gross anatomy (yeah that's what it's called. with good reason.) of the brain. Where we slice and dice a real thinker to learn how the hippocampus curls in around the dentate gyrus and how the choroid fissure runs in the inside of the brain and how if time and circumstance permit, the perfumes of Arabia will never wash the smell of blood off my hands.
No such humor is not appreciated. Though strangely referring to a malignant brain tumor which would translate from slide to reality as a life expectancy of 6 months, as beautiful is considered standard behaviour.
And of course the jabs at neurosurgeons who never remove the right part, neurologists who never send enough tissue for diagnosis and radiologists who never supply enough clinical data are a part of the daily schedule.
But enough about pathos.
Dinner sometime ago was a tomato and pepperoni pasta.



Straight forward stuff really. Blanch tomatoes, peel and cut roughly. Saute some finely sliced onions in olive oil, toss a crushed clove or two of garlic. Once they're soft, in go the tomatoes and some tomato puree. Add salt and paprika and oregano/basil/mixed herbs. Let it all simmer away merrily till it looks, tastes and smells cooked. Feel free to throw in some pepperoni slices/cut up sausage along the way. Al dante some pasta in the mean time and drain out the water. Mix it all up. Top with grated parmesan.

Bon appetit.

On the days gone by

Ok then. Been a while and all that jazz. Many things have changed since the last post and that annoying blog-in-Hindi option seems to have suddenly appeared, as has a new grammar Nazi, albeit anonymous, who's made mincemeat of my syntax, spelling and inappropriate punctuation. While I shall try to toe the queen's line and be as proper as I possibly can, I've never had the patience to edit more than once so any of the inconsistencies that crop up geographically, grammatically or ecumenically should be forgiven and forgotten.
Life's been revolving around work and a new found passport into the operation theater and the past few weeks have had me going medieval on many a random skull. Yeah so we're in the 21st century and survived the Y2K crisis (which some people made out to be potentially worse than the nuclear holocaust that Nostradamus had predicted) and technology rules our lives but still medieval is what we are while getting to the brain.Yeah that's what we use... it's hard initially as is the skull but does wonders to shoulders and forearms.
The average neurosurgeon therefore is lean, emaciated, unshaven, but has arms to die for... or at least a right arm to die for.
We also apparently believe in the 24 hour validity of both a bath and brush.
Work apart what else is news?
Kabhi Kabhi Aditi is a trippy song. Trippy enough to have on constant repeat and begin a groove to it when it plays in the middle of surgery.
What you say?
Some of us like music when we work. And considering we're all low tech (see above) we use FM. And till a little while ago that was good. Then every station barring two decided to go local. Now while I have no grouse with local music and to be honest while the melodies are catchy and some even excellent musically the lyrics I'm afraid drive me up the wall and get me to the state of wanting to grind my teeth to a fine white powder and replace whatever the man was snorting when he wrote this. So with much cunning I position the dials to Radio One 94.3 since 91.9 will be vetoed by all except the anesthetized patient and begin to scrub for the case. Only to find that some more cunning and devious lie in wait in the shadows to switch to the hottest local station - Mirchi - less than a minute after I gown up for the surgery. It's an unerring regularity with an unerring tendency to piss me off (since this plays at hourly intervals). Anyway 94.3 plays contemporary hindi film and pop music which is how I got to hear the Aditi song in the first place and has the funniest fillers in Prof Ulfat Sultan, Chamarajpet Charles and Rajani Saar. Since it's all accent dependent a transcription will not be attempted and neither in the near or distant future a recording and streaming of the same. Best that you should hear them for yourself.
So that's what's been happening. Bad humor, worse work shifts but a good dreamless sleep after it all.
A parting shot at new music, I shall consider reviewing Sampooran by the Mekaal Hasan Band. Think it's got the potential to be the next good thing that'll never make it big.

Back.

Ok I've had enough of aborted posts. Some five lie incomplete in the drafts folder and it's beginning to look like the death of a blog and one that I swore never to let die.

So here goes. After some many half-hearted lines on small towns, John Butler and his two friends and a bit on Rashid Khan taking Malkauns to a new level, I've decided to start small and wax eloquent about what I know best. And no it's not that you sick mind, I was talking about medicine.So I had some impacted, infected molar with the roots growing all awry so it needed to be yanked out and I had to, after much procrastination, visit the local dentist. Sweet man with all the regular jazz of assistants, unprotected-thyroid-cancer-inducing X-rays and a lifetime supply of 'Outlook' in the waiting room. So last Saturday evening was spent in his company with him going at the old biter with an assortment of scary implements (and bending two in the process). Saturday night was spent in hungry agony. Saturday afternoon though, was spent in prayer to the Gods of blasphemy at Koshy's consuming some incredible beef fry that they serve with beer. But that lasted only little longer than the anesthesia which explains the rest of the night. The next day happened to be apartment checking out day considering the folks have finally gotten tired of living with the fungus. No that's not their idea of me. The old house is falling apart and the only saving grace is that it isn't ours. So the usual house hunting saga happened with us finally settling on an apartment. Now those of you who've been avid readers of this space and hang on and memorize every word would remember that dad had an apartment complex... well it seems while you can't make horses drink water, most would once led to a stream or some similar water body.
So we found an apartment and once the interior designer has decided that the upholstery is the right shade of blood red and is finally satisfied with the cool inlaid saree on the cupboards we shall shift. Will have to remember to take the Balinese menstrual cloth that she's put in one of the rooms as a curtain and sentence it to purgatory.
managed to rip the sound track of Unreal tournament and put it on the pod, if I have already mentioned some technological achievement of this sort, I beg for forgiveness.
But getting back to our medical story - what connects a tooth extraction, burning feet and high fever the next day? House would go infection. It's not auto immune and certainly not Lupus and god forbid a tumor. But yeah the feet have been doing the hot coal routine for the past day or so and it's driving me up the wall. Much rumination went into it's etiology and after denying access the the zebra diagnosis of Gopalan's Burning Foot Syndrome (yeah I know it is cool too) I've settled for post infectious radiculoneuropathy.
All that's left to do is to load up with some legal trippy meds and kick my feet up. Suggest you do the same.

On the afterthought, to do justice to the many posts that didn't see the light of day Rahid Khan does make Malkauns a tad more magical than it already is, John Butler Trio is trippy music, if at Madikeri or Mangalore eat at Eastend (Biryani) and Costa's (Neer dosa and any curry you want) respectively.
And check out the Hero 849. Cool?

National...

... Institute of Mental Health and Neurosciences offers 3 seats every year for Super specialization in Neurosurgery.
I join on the 1st of August.
This blog and maybe many patients might die over 3 years. Not because I want them to but because I may not be able to do too much.
But yes I will be a neurosurgeon.

MMM

As life dawdles along at a pace mostly set by forces out of one's control, we attempt to blog again. We'll kick things off with the usual quote from the QDB.
In our anal retentive manner here goes :
So this doctor goes to the bank and when asked to sign a cheque reaches into his pocket and pulls out a rectal thermometer. He begins to attempt a signature when he realises his error and mutters, "Damn! Some asshole's got my pen."

That one done with, a random saunter through the campus in the intolerable heat of this afternoon found yours truly in front of a Littmann stall. The makers of probably the world's best stethoscopes are offering a small discount to buy more such acoustically enhanced devices. Turns out that there's a new one in the market. An electronic one. With noise cancelling. Like the Bose headphones I've spent half my adolescent life drooling over. Noise cancelling stethoscopes had to be the last straw till further perusal of the brochure revealed that one can record up to 6 tracks of heart sounds. Then they can be beamed across using IR or some such sperm immolating radiation to a computer. Then the sounds are converted into a phonocardiogram and played back at half speed or double or just analysed by the software. Of course volume controls are present as are soft ear pieces and the trademark Littmann diaphragm. Just when I was thinking that they couldn't do much more...
Read it all.

That's just about all we have time for but before we go here's the parting quote.
Since the invention of the Internet, the rotation of the earth has been primarily fueled by the spinning of English teachers in their graves.

Adios and kudos to technology.

Darwin Revisited...

I remember many moons ago having dealt extensively on the laws of Darwin and how simple observation of turtles, mutant or otherwise and the fact that de-tailed rats did not beget rats in detail it was decided aboard the Beagle off the coast of the Galapagos that stupid people ensured our survival by killing themselves in the absurdest of manners. The Darwin Awards.
And many moons ago I also remember waxing eloquent on the sorry state of an auto driver who had a bottle stuffed where the sun apparently didn't shine.
In a strange amalgamation of these two we present two absolute cretins who graced the Emergency last night.
Names have been kept confidential since I don't remember them but with all due respect for privacy you pervs don't get to see any pics.
Ladies and Gentlemen, if you've all digested your meals I'd like to present exhibit A.
Moron child of the decade. Was playing at a car repair shop with other moron children of the decade. So these representatives of the not-so-full-decks decided to fool around (like they were capable of anything else) with the high pressure air hose. Threatened, hopefully in jest, the initial moron child, with introduction of the hose where, you got it, the sun don't shine. Now I think it was survival instinct that made the protagonist of this story get into some kind of scuffle, which ended with him developing a rent in his scrotum. Just the skin. Now this bit of the skin is continuous with that of the anterior abdominal wall the deeper layers are not and are attached in and around the groin. So if this layer is inflated at 60 psi, in a matter of a few seconds moron child develops subcutaneous emphysema that freaks everyone in Casualty out before someone decides to take a good history.
So ends story one... nothing exceedingly untoward, the boy recovered and is under observation. but like dealing with the mafia, a slip could have landed the hose in deep shit. And the boy.
Exhibit B is a tad more stupid.
But before we launch into the gory details of this expendable specimen of the race one has to ponder why is it that we as surgeons, and on a broader scale as doctors subjected to events and people who force us to keep a straight face when all we want to be doing is rotfl. Much as I detest that word, it does manage to describe what we'd like to be doing, in the most insensitive manner and thus bringing the hounds of hell on ourselves.
Exhibit B was wheeled in to Casualty and placed in a discreet corner, not 20 minutes after exhibit A's spectacular entry. This one at a glance appeared to be your average peri-pubescent imbecile with two legs, a penis and what appeared to be a toilet brush sticking out of his nether. On closer examination we found he had 2 legs, a penis and a toilet brush (with the handle in the inside) sticking out of his nether. Turns out that his friends told him that it was a fun thing to do. Loosely translated, of course, from "mazaa aaega".
A great mind once said that stupidity is a problem that'll solve itself if we took the safety labels off of everything.
A greater mind said that every new and improved idiot proof product will give rise to an new and improved idiot.
On a complete aside a small voice says that the chom problem is just about beginning to take care of itself.

Trauma and the like

Damn it's good to be on a keyboard again. And a nice Toshiba laptop at that. Now I'll let you all imagine that I struck gold for a bit. ... . I didn't it's a friend's who's kindly left for a two week trip to to Seattle to settle scores with certain gates that didn't let him through to whatever he wanted to do. And he plans to buy himself some slim, trim Vaio or some such. So here I am Toshiba-ing away. I can feel the beginnings of a bad Toshiba joke bubbling away but I'll spare my small but significant sane side the agony.
It's almost a month since I landed up in Chomland and my take on it sadly is unchanged. My Jane Goodall feeling persists as does my intense displeasure at the vagaries of the weather and the people. Had someone asking me a week ago if I'd learnt hindi from watching movies considering "in the south" they don't take too kindly to hindi. If only they knew what chom meant... So I had to politely in my stingiest voice point out that much as we might not like it we are taught the national language in school. I then proceeded to daydream about punching their shocked faces in.
C'est, they say, la vie.
But on the upside, summer's starting soon.
That's not the real upside, my pigeons, which according to Wikipedia incubate their eggs for 18 days are coming to the end of that period.
Which again reminds me of this nondescript shop at Kadrenhalli Cross in good old Bengalooru that had some emaciated, marinated birds boldly advertised as teetar tandoori. Now I'm not quite sure if that's a parrot or a pigeon and almost anyone I ask has a tendency to avoid answering the question by breaking in to song. You must have heard it, "teetar ke aage do teetar..." It's only the thought of June back home that's keeping my from going on to some homicidal rampage. For those of you who play chess and unreal tournament, the next time you play the board game, capture 6 or seven of your opponents pieces continuously and then in the deepest voice you have say, "killing spree". Thank you bash.org for that.
Ok to point of it all is that I've suddenly realised a few things. One, that trauma is a good place to be as long as you're on the other side if you get what I'm saying. Oh on a small aside, when I told someone that I was going to be working in trauma they asked me why I would encroach on a psychologist's territory. It took me a while to figure that a traumatized person needn't have been in an accident.
Back to the points in question. Trauma/ER shifts are excellent for many reasons. The whole I'm a surgeon, I save lives line that I borrowed from Grey's Anatomy and use to evoke alternating awe and disgust from the world at large, is largely true in the ER. The golden hour, though a fine theory, is rarely followed in the real world. Patients land up usually at 55+ minutes which as one can imagine gives us five or so minutes to do what we can. Which at least here is quite a bit.
The adrenaline rush apart, once the shift is done, there's absolutely no concept of a follow up. Which I love. Every shift has new patients, no wards where there's a chance of seeing patients for days or weeks on end, no discharges or case notes to constantly update and thus no boredom.
Yeah I'm insensitive.... Sue me.

Monkey Business

So I spend most of my days surrounded by monkeys. Real monkey monkeys and chom monkeys. To the extent that I now feel a bit like Jane. Goodall not Tarzan. "Choms like chimps have personalities too. They may all look the same the first time but soon one realizes that each has it's own identity. See this one's called Raj..."
No it's not so bad. But a little exaggeration hurt only the boy who cried wolf. But I am surrounded by specimens. Close encounters happen every other day. Some heart warming some decidedly scary. Like take for example this little runt who works across in the pediatric casualty. Five foot nothing, juvenile and his hair is in the same state of disarray every day. And by the same state, every single strand is out of place in the same angle, so to speak, every single day. And he's mad. Been around for a couple of years in pediatric casualty. QED perhaps.
Or another guy in medicine who saw me condemning a patient to acrossness (more about that) with flourish using a parker ink pen decided that I deserve better and should be gifting me a sheaffer sometime today.
Or people who randomly accost you while roaming lost in the bowels of aiims to show you the way, or those who'll bump into you while you have an 18G needle because they couldn't care less.
The past few days at the job have raised many a lofty thought on health care that in retrospect I think are meaningless. It's bad enough that I now realize that a single health care policy wouldn't work in this country, I now think that it won't even work in a single hospital.
AIIMS is the premier medical institute in the country. At the apex of it all. Does it make sense for it to have a casualty and accident and emergency services? Shouldn't it be a tertiary referral institute. And only do stuff that "lesser" institutes can't. Chitra in Trivandrum and SGPGI at Lucknow already function that way. But we have a casualty. Then shouldn't we be doing it justice. Or be doing the patients justice considering we don't have a choice regarding the presence or absence of emergency services. On an aside their presence is what brought me here so I shouldn't be cribbing.
As one enters the casualty one sees in big bold letters a board that states that it is a policy in this hospital to not admit patients once all the beds are full. Which they almost always are. So no matter who it is, and delhi is filled with politicians of all shapes and sizes, if there are no beds then there is no admission. So a substantial number of patients are "acrossed" to Safdarjung Hospital. It's pretty hilarious once you get used to it but till then you, like me can feel bad about the 2 patients an hour that Safdarjung has agreed to admit if sent from the institute.
But we have a 24 hour coffee shop and a General store that will procure anything (from mats to sleep on to USB LAN cards). We have half a dozen CTs that run almost 24/7, central lines for free in casualty, ventilators if required, good patient load and frequent resuscitations. Some of whom survive to be acrossed or icued.
It's a good hospital. And I'm learning to like it.

And to make the title valid this here are the lyrics to Bebot by the Black Eyed Peas. (Goofy, if you're reading this, enjoy!)

Eventuality.

Ok here's a warning. This isn't a funny post. And today I'm not amused. Just Quiet.
Lost a grandparent this morning.
And it's been a grandparent losing week from what I hear.
Well to be fair, she wasn't someone I was close to, considering I used to meet her about once a year and in the recent past with even rarer frequency so I'm not devastated or anything. At the same time the morning was spent getting my dad a ticket to head to Vizag (as I'll always call it, along with Bombay, Madras, Calcutta and Bangalore) and then driving him through mind-numbing traffic trying to make the GoAir departure. And apparently that airline does exist and fly since he's reached.
Mind numbing traffic does do wonders. Completely blocks any semblance of thought and strangely can also be a time for quiet introspection and rationalization if looked at another way. Like sandpaper... can smoothen a rough surface and roughen a smooth. No, I just wanted to use that somewhere. But that isn't the point. The point is though I've learnt to deal with death in a clinically detached way at some point of time what it has taught me is to treat life with a reasonable amount of respect. The fact that life is ephemeral. That no amount of medical knowledge and surgical technique and bio-medical engineering can change that. That life will slip from one's grasp at a moment's notice.
And no one can do a thing about that.
All we can do is try with what we learn over the 12 odd years of structured medical education and that random classroom called medical practice.
But medicine and dealing with life and death is just one aspect of what's been running through my head. As I said this was a part of my family (reasonably close genetically at least) that I've lost and though this doesn't affect me as much as it would perhaps the people closer to her, what it does do is sharply pull the rug of comfort from under my feet.
The immortality complex that we develop along the course of our rather long education is something that cocoons all that are near and dear. We ostrich when we hear of their problems and refuse to acknowledge the fact that they grow old and a step closer to the end. Events like today's are sharp reminders of the inevitable and also augmenters of a helplessness that should be fought. For one's own sanity if not anything else.
So how does one wish that nothing goes wrong with the people one cares for knowing fully well that something will...
I need a stiff drink and some sleep. Night all.

What Ails Ye

www.indiangyan.com is a site that I came across about ten minutes ago while exploring a concept that I'd heard about. Onion (Allium cepa) it turns out is an aphrodisiac. Not just a regular one, the second best. Second to what you'll discover shortly. It's also been stuffed into mummies (the Tutankhamen kind, you perv), been the longest running tear-jerker for most housewives, though Ektaa thinks she can beat that record; sliced, diced, saute-ed, fried but never ever consumed before hitting the sack for some handkerchief-pandkerchief with the significant other when chocolate has failed.
The last thing I can imagine that's a turn on is sulphur breath. Horny, sulphur breath at that too. Anyway for those of you who're interested here's the excerpt from the aforementioned gyan site.

Onion is one of the most important aphrodisiac foods. As an aphrodisiac, onion stands second only to garlic. It increases libido and strengthens the reproductory organs. The white variety of onion should be peeled off, crushed and fried in pure butter. This mixture acts as an excellent aphrodisiac tonic if taken regularly with a spoon of honey on an empty stomach. The powder of black gram when dipped in the juice of onion for seven days and then dried, produces a mixture called kanji. This also acts an aphrodisiac.

More here.

Now if that bad enough the more perceptive of you would have realised is that at the zenith of all randy devices, more potent than rhino horn and tiger claw and the extract of a bull-elephant's prostate is Garlic. Allium sativum. The reek that chinese food gives you is apparently due to indigestible allyl methyl sulphide that seeps into the blood and then has to be gotten rid off by the lungs and skin. Leaving you smelling simply peachy for the better part of a day. The vampire myth is thence by simple extrapolation explained. That isn't the point.

This is. And if you don't feel like scrolling here goes.

Garlic is a natural and harmless aphrodisiac. Even Dr. Robinson, an eminent sexologist of America considered it so. It is a tonic for loss of sexual power from any cause, Sexual debility, impotency from over indulgence in sex and nervous exhaustion from dissipating habit. It is said to be especially useful to old men of high nervous tension and diminishing sexual power.

So Dr. Robinson lived a happy garlicked life, no longer bothered by the impotence of over-indulgence and the nervous exhaustion from dissipating habit. What in God's name is a dissipating habit? It had better not be what I think it is.

So all this came about when I realised that I didn't have any friends from school. Not from high school where I think I have the socially acceptable number of friends and acquaintances and voodoo doll needle stickers, but from kindergarten. Where apparently lifelong friendships take root, etc.
It turns out that my caretakers at the time (I'm not mentioning names here) used to fry a few cloves of garlic in good sesame oil and rub me down with the oil prior to a hot bath and feed me the fried cloves.
Every single day.
So I was the reeking randy four year old. No wonder no one stayed in touch.
More general garlic blade here.
Enjoy.

The Grim Irony...

... or how I may never see the light of heaven.

Despite all arguments that there may not be a heaven (though there may be a hell) or there may not be both and we all die only to be reborn as boll weevils or salamanders, or we just die and like Mozart, decompose or like Newton, disintegrate, let's assume for sake of argument itself and for sake of this post there exists a heaven and a hell, ruled by God and the Devil... respectively.
And that each of us has a personal heaven and hell, not the generic boiling oil-pearly gates pictures that some of us have been led to believe. For instance my heaven would involve wine, women and song and hell would be a joint filled with goody-two-shoes dressed in white with harps playing Coldplay or some such. I'm assuming the drift is being got. So this post deals with how contrary to everything I try I'm just not getting to my heaven.
Those of you who've seen the movie Constantine, where Keanu Reeves tries to play a exorcist who's sentenced to hell because he attempted suicide but was revived and the Good Book says that all suicides attempted or successful are condemned to eternal damnation without relief, would have realised that the movie was a waste of time. I didn't and am probably one of the ten people who actually dug (digged?) the movie. Anyway so he decides to become an exorcist to do God's work on earth and send every wayward demon back into hell so that he maybe allowed entry to heaven. Of course he also realises that if he fails, he's going to go to 'a prison where half the inmates were put in by him.' Life's a bitch, init?
In a very similar vein doctors I do believe have been sentenced to purgatory the minute they enter the hallowed halls of medschool. No amount of reviving dying people, wading through body fluids, staying up days on end, for pittance of a remuneration is going to change that.
Why? Simply because no amount of slavery can condone our inherent or developed insensitivity to the world at large. Our patients are the single largest source of humor in our lives. Well most of our lives, I have the Provider to give close competition. The jokes that get cracked when a patient is anaesthetised, being operated, in the midst of the OPD, being given CPR (yeah even then), while being discussed; are sinful in the average person's mind. That collective idea of sin overshadows the collective goodwill that we may ever get. The average person is often referred to in my book of life as the muggle or mudblood. Which in itself ensures a year or two of the rack. Let me show you how it works.
Take for instance the auto driver who was assaulted by 3 people for asking for '1 1/2 meter' post 11pm. He had a bottle of brake fluid (empty) stuffed into his nether. When he came to the hospital the first reaction was that he'd have put it in himself. The next reaction was that every nurse, ward boy, anesthetist who was involved in this man's surgery was laughing their heads off. Now if that wasn't bad enough his case with photographs and the bottle itself was presented at conferences and generated equivalent amounts of laughter there too. I could see the Devil ticking off names.
Or how one gentleman sauntered in to my out patient one morning and began to wax eloquent about how he was an Ayurveda specialist attached to ESI or something and he had this one wonder drug that would cure all kinds of colds, allergies, skin conditions, etc on daily consumption for 45 days. So after patiently listening for close to ten minutes at the advertisement I ventured to ask him what his problem was and he replies in the most sheepish voice I've heard, "Hernia." And I almost fell off my chair laughing. Not openly and though my initial response wanted to be, "Why don't you take your pill and see if it resolves after 45 days..." I ended up keeping a straight face and advising surgery.
Or the 23 year old with erectile dysfunction who was advised to watch porn and wank, or the 30 year old complaining of sterility when he hadn't been staying with his wife. Or the... these just go on.
So i wonder in the face of such terrible odds how can we ever be forgiven...

Nee Sandman?

All we read or get to nowadays is stories of how the kids just ain't right. And that some one's getting a face transplant. The last one got rejected on account of ugliness I think. It's interesting how medical research is funded. The first knee prosthesis released over a decade ago were simple hinge joints. In other words, they moved only in one plane and around a single axis. And cost the usual GDP of a tin pot little African country. The rich old men who could afford to both play golf and get their knees replaced realised that post getting enough metal in them to set of detectors in all airports except the ones in Bangalore, Delhi and Hyderabad, they couldn't play golf anymore. Not that golf is a game that requires one to be in the pink of health and prime of one's fitness but the issue here is simple - the swing, in golf, to be completed perfectly, requires a small amount of rotation in the joint. Now, the knee is easily one of the most complex joints in the body and though primarily a hinge, it does allow enough rotation to make Woods a Tiger on the fairway. It is also historically an extremely important joint and has been immortalised in the Tamil greeting "nee eppudi irruke". Digression apart, rich old men fuelled their rich old money into material research to give rise to this.

Miracle of modern engineering. And that's why as Chris Rock says we'll never find a cure for AIDS. Because then drug companies will go out of business. Then maybe they'll bring small pox back.
That apart been reading two incredibly creative and entertaining comic series - Fables and Sandman. More on them later. But this is a legend I read - every night as we tuck ourselves into bed, the Lord of Dreams comes along and sprinkles sand in our eyes. This makes us sleep (duh!) and the sand is what makes us dream. This also is why we wake up with a gritty, sandy feeling in our eyes.
So I did wake up with something that felt like sand all over my face for a long time. Maybe I need to start earlier. Circa 1980 when teak was actually available. So then the Provider decided to get himself some teak furniture that would look good and outlast us all. And in the midst of all the wood work were two beds. With proportions that required a custom built mattress (80"x30" - we were a tall thin race apparently). The headboards were out of a single piece of teak some three feet across, worth the GDP of a TPLAC (tin pot little...) in present day. And the years rolled on with little or no change outside of us becoming a tall not so thin race and the Provider's taste in wood changing. Albeit slowly but surely.
Then one fine shopping expedition a gargantuan bed with an intricately carved head board but with more acceptable proportions was procured and yours truly inherited the teak. The new bed though wonderfully carved is a dust magnet and if one is allergic the night is spent with the Sandman battling the Dust bunny. But that's not the story, is it? So the teak device was my place of somnolence for many a moon till I realised that I was waking up with the mother of all back aches every morning. And not because I was sleeping funny. Or anything. Investigation revealed that though the cool headboard was teak, the bed itself was plywood (incidentally invented by Alfred Nobel's dad). And teak lasts twenty years. Plywood on the other hand twists and turns with time and warps like the gravitational field of a small star.
The result is a morning-after back ache. The cure is to take the mattress and use it to soften the floor and enjoy a restful night or two. That's when the sandman came along with me waking to a faceful of dust. The legend we began to believe and dreams were in technicolour.
Till it all fell apart. The dreams, the legend and my mattress which was bought circa 1980. Made to order to fit the bed. It says Dunlop on top, like the tyre and over twenty years the rubbers becomes mud. Like the book says, "... and dust ye shall be." Looks like the folks got conned and got an adult rated mattress.
So it's now the not so soft floor. But I'll live. Looking for someone interested in buying the carved monster so that's one less piece of junk I have to deal with.

But on an aside on tyres, what do you do with 365 used condoms? Melt them down and make a tyre. Call it Goodyear.

Bail-ey me out of here

The days draw to an end in the space-time continuum (yeah I picked this word of Wonko's blog where he waxes ad nauseum about continuing on some continuum or the other and gymming at the end of it) as my exams get far too close for comfort. It is in times like these that one resists every temptation to read Revolting Rhymes or The Lord of the Rings or the transcript of the Matrix (all of which, in a moment of weakness, I put onto my ipod to peruse at will while listening to the Supreme Beings of Leisure). Instead, having delved through the oft mentioned textbook of surgery, I decided to do a last minute sprint through the bible of all surgical trainees - Bailey and Love's Short Practice of Surgery. It's not short and I won't tolerate any practice jokes. Will join hands with a lawyer and practice on you.

The book has always been a favourite. Not because it's british and has large illustrations that significantly reduce the amount of text to be read. Not because at the bottom of every page footnotes exist outlining the life and times of the person who lent their names to the many eponymous conditions that often attracts medical students. But simply because it almost feels like reading PG Wodehouse or Stephen Fry ever so often. Examples follow.

What's 'yaws'? - Syphilis.

On pruritus ani - In case of pinworm infestation, children should be made to wear gloves since they may reinfest themselves by scratching and nail-biting. Parasites lost, parasites regained.

Or when the books warns against proclaiming brain death in a patient who's hypothermic - No body should be declared dead unless it's a warm body.

So I'm morbid. Sue me.

For the amount medical students have to read at all points of time in their lives it's a relief and a joy to see a book that makes life just a little more enjoyable.

Of course one has to tolerate lines on the line of, 'So Bailey's your new Love?' But it's a small price to pay.

For those interested in other such moments of joy feel free to refer to Robbin's Pathology (where he speaks of congregating amyloidologists and thyromaniacs and quotes Isak Dinesen's 'What is man, when you come to think upon him, but a minutely set, ingenious machine for turning, with infinite artfulness, the red wine of Shiraz into urine?' at the beginning of the chapter on Nephrology. )

Again I reiterate my nerdish claim. And also plead exam-induced insanity but there I know I'm not the only one. Got this message from a colleague at a similar point on the space-time continuum - 'You've been building castles in the air all these years. It's not a bad thing. Now is the time to build foundations under them.'

This incidentally is also the person responsible for putting the idea of forwarding service messages.