flutter by a helicopter

hi all,

reporting back a lot late. sorry busy with many mnay things.

ours is a quaint little town where not much happens that can amuse you or raise your eyebrows or make you gasp.

But something did happen yesterday.

i was on my regular 4 km morning walk today morning whan i spotted a few heads looking at some big thing. Naturally i did what anybody else would do. go there. thats it, I went there and to my surprise saw this firey red chopper nicely perched in the big ground in the centre of the town.

I wondered how did this come here. No political leader was suppesed to visit. Moreover the elections are over. So now these people are not going to see our face for the next couple of years, until they shamelessly come begging for votes again!

People were inquisitively looking at the chopper, a first close look for many of them ( including me!). there was a fire engine and an ambulance as a standby. three policemen were 'guarding' the flying machine.

On enquuiring with the onlookers the whole story was revealed.

It seems that the heavy industries minister of our state, along with his family, took off in the choper a day before from kankavli, around 300 km south of dapoli, to go to mumbai, the capital of our state.
the chopper was caught in rough weather, and due to sudden darkening the pilot could not see. The chopper started drifting from its course. They were trynig to land in a safe place, when they found out our ground and perched their helicopter there.
The minister and the family left for mumbai in a car, and the pilot stayed back overnight.

The poor policemen and the firemen had to stay put near the chopper for the whole night, guarding the machine and the makeshift 'helipad'.

This incident gave some food for gossip to the localites and now this will be churned and churned for days together.

The pilot left late in the morning after some refilling.

The helicopter has reached its hangar.

But gossips wiil be here to stay for a long time to come!!

see you soon.

Till then, good bye!!!!

myths.

hi all,
sorry for not writing for a long time. was pretty busy with many not so pretty things!!
patients come to me with all sorts of questions. most of them stem from myths that are circulating from generations together:

1)The spectacle number increases due to watching TV: its an age old myth. my parents have told me the same. though its a good excuse to shy away unrelenting kids from TV, its the biggest myth i feel. what i can agree to is that,TV watching taxes your eyes a lot and thus the person has lots of difficulty and strain while doing other activities like studying ( which hardly any kid does willingly), or reading etc.

2) don't look at the light once u have been operated for cataract: this cant exactly be called a myth. in the olden days cataract surgery was barbaric if you compare the techniques with today's techniques. large cuts and thick sutures. the patient would genuinely have difficulty looking directly towards light. but people have taken this too far. in my area, my own patients, even educated ones, sit secluded in a room, with the goggles on even a month after surgery, with all the doors and windows closed and curtained! and these same people seek permission for watching TV!!
now the latest techniques of cataract surgery allow u to resume your normal life even within two days of surgery. but old habits die hard!
further, everybody in India has a strong phobia of getting operated in summer. again it was valid in the very old days when patients would have to lie down in one position for days on together, not to move their head at all ( with sand bags cushioning the head from both the sides), and they were not allowed to have a head bath for at least two months!!
now after a phacoemulsification surgery patients can have a head bath after 2 days. there are no restrictions on movement. but still the old adage stays " no cataract surgery in summer. u will loose the eye."

3) i don't know about mega/metro cities like mumbai, pune etc. but in semi rural and rural areas, people still relate a tooth extraction to a cataract or an eye problem. its not true. but i can reason for them. the teeth and the periorbital area are served by the same nerve ( various branches of trigeminal). so a patient having tooth ache can sometimes have pain AROUND the eye ( not the eye per se'). may be that's why this feeling gets generated.

4) in India most of the time any ailment in females including cataract is related to a family planning operation. the poor tubal ligation is held responsible for anything and everything that the female might suffer after the procedure. this is no the truth. Tubal ligation is absolutely NOT related to any other ailments.

there are many more myths which need to be busted. there are many things all of us need to know. i will keep on writing as and when things come to my mind

i sincerely request all to have a look at two blogs by my friend Dr Manish Jain. the links are there on my blog ( rendezvous.doctors and rendezvous.bell the cat). serious readers will get a beautiful insight into many things related to medicine and bureaucracy.
till then
c ya!!

is your doctor a schoolo drop out!!

hi all,

have u ever thought of asking your Doctor his or her credentials? at least, have you tried to take a look at his degrees? surely you must have at some or the other time.

but what about those people who are illiterate, or may be literate but ignorant.

In the past few years of my practice I have seen that people here are least bothered about the skills and knowledge of the person whom they call 'doctor'

this anecdote dates back to around a year ago:

I operated upon an elderly lady for a cataract. The operation was successful and she had good vision post operative.

i was talking to her relatives after the surgery. the subject drifted to schools, education system and syllabi's.

I told the patients daughter that I don't know what changes have been made is the syllabus as its been 19 years that I have left school.

So what should she ask.

"so you did not learn after 10 th standard?"

if you come to know that your doctor is actually a school drop out, you would faint on the spot.

but this lady showed no remorse for getting her mothers eye operated from a person whom she thought to be school drop out. for her any person who successfully does any sort of medical work is a doctor.

here they call the optician a doctor, the local medical laboratory technician is also a doctor. well, the opticians and technicians conveniently show their 'inability' to bring forth the truth.

to continue the story further:

"no", I said, " I have done junior college after that and than further education to..."

before I could complete my sentence, pop came the question," so you did go to college. what have you done. did you do a B Com or a BA?"

for this lady college only meant B Com or BA.

I was left wondering at her ignorance and lack of knowledge.

I sat through half an hour and explained her the medical education system. how much she understood, is another part!!

This lack of knowledge and ignorance if what helps quacks to establish their flourishing practices. The fact, that people are not ready to learn, that they are happy in their ignorant world, is what helps these quacks more!!

'Advantages' of Surgery

whenever a person recovers vision after a successful cataract surgery, obviously he or she is happy.

but reasons for happiness can be different!!

I had a patient who was blind in both the eyes due to a dense fully mature cataract.
his health had deteriorated. he wouldn't eat and drink properly for the fear of having to visit the toilet frequently, for which he needed 100% assistance.
he got operated for both eye cataract removal and lens implant and had good vision post operative.

he was happy, i was happy. i saw his health improving every visit. i would now meet this villager in the mornings during my morning walks.

after a few days, i met his son, and asked about him.

the son reported that he is ill and has been admitted to the hospital.

i was aghast. it seems that after the surgeries, he was in excellent health for a few weeks. he had been a chronic drinker and had quit around two years ago. i reckon it was more to do with his inability to go to the country liquor bar, rather than abstinence in its true sense.

after he started seeing properly, he resumed his regular visits to the liquor shop.
his drinking increased to unacceptable limits. in fact, now i presume that whenever i use to meet him in the mornings during my walks, he actually would be on his way to the bar.
this guy always used to say that he is very very happy , thank me profusely, and would tell me how much i have helped him get his 'life' back!!.

Now, do you see the reason for his happiness for having got his sight back!!

now he is recovering. but you never know when he will be spotted on the 'morning walks'

see u soon!

The 'WADI' culture. perfect example of local self government>

hello all,
each village in india has a gram panchayat. ( the village's governing council, following the Panchayat raj concept given to India by mahatma Gandhi.)

in the kokan region of maharashtra where i practice each village is divided into small hamlets of around 20 to 30 houses, known as a WADI, all under the aegis of the gram panshayat.

if u peep into their social structure , you will find the concept of Local self government exmplified beautifully>

here are a few examples:

1) a marriage is decided by the consent of all the elders of the wadi. the whole wadi celebrates the marriage and acts as an event management body. there are no caterers, no pandal contractors, no halls or marriage palaces booked! the marriage is solemnised in the courtyard of the brides house. each house hold in the wadi is given a specified duty.
for example: if one group is looking after decoration, the other is looking after cooking the food, while another group is busy arranging accomodation for the guests ( which is done in the different houses of the wadi itself ).

it is a social obligation that every house hold HAS to follow. if any house hold does not do so, they are declared out cast.

marriages within the WADI are discouraged

the best thing: compulsory HIV and HBSAG ( hepatitis B) testing is imposed on the bride and groom befor marriage. The tests are conducted in the local government hospital.

2) nearly each members owns some farm land, which is traditionally cultivated to grow rice in the monsoons. all the work is done in a group.

a time table is made, and accordingly one member from each house is selected. the whole team goes to one farm and finishes the work in one day. next day its someone anothers farm, so on and so forth!

3) one to two members from each house work in mumbai or pune. its compulsory for atleast one outstation member to be present for major festivals like Ganpati, Holi etc, as these are celebrated within the WADI as a group, apart from individual celebrations. again there are strict work protocols and timetables to be followed and targets to be achieved.

4) most of the times the disputes are settled in the monthly WADI meeting. the decision of the council of elders is binding, and the erring party is asked to pay a fine which goes to the WADI developement fund, thru which monet is spent for things like festivals, get to gethers and necessary public works.

i have seen this working for the last 6 years.

recently, in the wake of the swine flu epidemics, all the WADIS in all the villages of the DAPOLI tehsil have met and decided on the following:

1) relatives, family members coming from outside dapoli, will not be allowed to come home if they have symptoms, and they will be subjected to quarantine and testing at the government hospital

2) all hotels, resorts and individual tourist businesses ( there are many, as dapoli is a fast developing tourist spot), will be kept absolutely closed till the 30th of august.

allthis has been decided without the authorities asking to do so. it has been a spontaneous decision.

hats offf!!!

see you soon

vangelis

hi all,

know whos vangelis. a greek musician.

listen to his two beauriful creations. enjoy




most of us will never ever forget this one

hi all,

here's a great piece of national integration.

see this sikh singing in excellent and crystal clear marathi.

take care!

Life with swine flu around

hey all,

swine flu is rampant all around me mumbai, thane, pune, satara, mahabaleshwar, sangli, kolhapur. till now it has not reached me. but wait till ganpati. the hoards of people coming from mumbai will bring it with them, that too kilos and kilos of virus load. wanna see where I am! take a look below.

just started me thinking. schools closed, theatres, multiplexes, parks colleges, all closed.

okay. i can sit at home and still have a days meal for days together.

what about the vegetable vendor, the bhelwala, the milkman, the bhangarwala in mumbai.

for how long can they wait.

they cant!

they are still out there on the roads, on the open, doing their jobs and relying on god to protect them.

if they give in to the fear and stay at home, who will earn bread? what will happen to their wives and children.

for these people life can stop, but life cant wait, isnt it?

any way. take care.

c u soon!!

fear of surgery

any body would be afraid to undergo any suergery. Its natural. how ever minor it may be. i have under gone a minor surgery few years ago. inspite of being a doctor, i had had butterflies in my stomach.

in my practice i have seen many types of reactions to fear and anxiety. some patients keep on talking, and some remain absolutely quiet. some keep on eating, and some prefer to remain empty stomach. ( they are afraid their gut will give away due to fear.)

on the other hand, some patients are very cool about the whole affair.

there are two funny things that I have observed.

1) patients who claim to be mentally 'very, very' strong, and have an air of confidence around them, are the ones most likely to have cold feet while entering the operation theatre. they look as if they are heading towards the gallows!

where as patients who confide that they are hell a lot scared, are very quiet and calm during surgery.

may be, once the patient has confided with the doctor about his/her fears, he/she feels secure that the doctor will now take due care.

2) second amazing fact is that i have seen patients who were absolutely fine during the first surgery are scared much more during the second surgery. why?, i dont know!!

there was one 84 yr old grandpa, a retired primary teacher. his daughter is a practising dentist in mumbai and he stays here in Dapoli.

he was very cool and co-operative during the first ( right eye) surgery. even during the left eye surgery he was very cool, quiet, jovial and was in a good mood.

after 2 days he called me to his house for a cup of tea.

he showed me a note. he said that he was very afraid during the second operation, so much so that he was sure he was going to die while the eye operation was going on.

so he had kept a note in his pocket which said: " i am old and i am very much terrified about the operation. if i die during the operation due to heart attack or any other reason, please dont hold the doctor responsible. he is a good man and he has taken utmost care for my well being. please leave him alone after my death"

I still havent forgottrn that crumpled 'death' note.

now that grandpa laughs it off whenever he meets me.

but both of us will never forget the 'note'

Arrogant Ignorance

ignorance, many a time, makes the peson arrogant. i have seen this happening in my practice day in and day out.

i regularly get patients with corneal ulcers. a devastating infection of the clear part in front of the eye. if not treated in time the patient loses the eye. ( sometimes it has to be removed completely).

aggressive medication is the answer. with the advent of newer generation eye medicines, these conditions can be handled in a far better way than yester years.

i had one such patient. a village head man. uneducated. but the headmanship had gotten to his head.

" hey kid, ( i am 34 yrs old), can u treat this?"

"i dont want trial and errors ", he said, "can you or can you not?"

this old man had had this infection for the last 8 days. he had not seen even the village doctor, forget an eye doctor.
he had tried local remedies which included rose water, alum water, cows milk, cows urine, some herbs and shrubs. he had even gone ahead and put lime in the eye to 'kill' the germs. ask any eye doctor, what devastating effect lime has on an eye!

i told him that the only answer was complete removal ( evisceration ) of the eye as the condition was beyond repair.

"hows that possible, you fool. you dont know anything!"

"all the shrubs, cows urine etc. has damaged your eye sir." i told him.

"impossible", he retorted. " how dare you blame the age old remedies ? you cant treat with your chemical poisons. tell me that. you incompetent fellow. I will see how your practice thrives in this area. i am going."

some days later i came to know that he went ahead to mumbai. spent 10 thousand rupees and finally underwent an evisceration.

so why didn't he listen to me?

The answer is quite simple.

the fact that i came to practice in a rural area all the way from a mega city like mumbai, made him think that i dont know anything in my field, and thats why i was incompetent and have run away to a remote location.

this just shows an inferiority complex these village people have about themselves. they just cant believe that some body can come from a city and live them. how can somebody offer good service to them. they are villagers and not city dwellers.
they really have some funny kind of complex.

add to it the illeteracy and the innate arrogance, we have a nice cocktail here.

albeit, such intances have been rare, but they have occured.

C U soon !!

They are really Honest

Its been 6 years that I am practising ophthalmology in a rural setting. Peaple here may not be rich moneywise. but they are really honest, i mean most of them. u r always bound to find dishonest and mean creature any where on the surface of the earth. Its the percentage that counts.

this happened 4 years ago, when i was new in practice. ( i still am).
a friend of mine referred to me an old lady operated for cataract at a chritable clinic. she had got operated at a far off camp and could not go for her gkasses one month after surgery. he asked me to give some concession.

i examined her, and wrote down the prescription for glasses. "how much should I pay ?".

i asked her to pay just 10 rupees as a token.

she dug into her wallet and brought out a crumpled 10 rupee note.

but for that note, the wallet seemed to be empty.

she stayed 10 Km away from my clinic.

"do you have enough money for the bus ride back home ?" , I asked.

No was the reply.

"how on earth will you go home"

"walking". she replied as a matter of fact withou any qualms about it.

I felt shattered. that lady had given me all the money she had and was ready to walk 10 km ( approx 6 1/2 miles) back home.

inspite of her protests I returned her the money. she told me she would come back and pay me the next day. i told her not to worry. its okay, she need not pay.

2 days later, i was not even thinking of her, she came and paid me 10 rs.

i asked her, why she had come all the way again, when i had told her she need not pay. also she had spent 20 rupees on bus ticket to pay my 10 rupees.

the answer left me stunned:

" dear boy, for you it may be just 10 rupees at stake. but for me its my honesty at stake. i can go without food for a day, but cant have peaceful nights sleep when i know that i owe you some amount, however meagre it may be"

i did not know what to think, what to say.

They are really Honest, these village people!!

stumped

this anecdote was told to us in a meeting by a fellow ophthalmologist!!

he had an elderly village lady as a patient. she had advanced cataract in both the eyes. he advised her surgery in both eyes, for which, naturally she was not willing at that moment.
"lets wait till it becomes fully mature. thats how they are done. i know.", said the lady

my friend told her" no need to wait that long granny. now a days with advanced technique, we dont wait that long. u see, times have changed"

and guess what she quipped.....

" yes my son, times have really changes!!. u see in our times we used to eat at home and visit the loo outside the house. in ur times, u eat outside and go to the loo bang in the house!!. i cant come to terms with this!!. good bye."