FUN FLOWCHART TO HELP YOU CHOOSE YOUR SPECIALTY !!!

So, what's your pick???

MEDICINE AS A LEARNED AND HUMANE PROFESSION

People have always asked me what it feels like to be a doctor. That "oh-so-noble" profession that everyone keeps referring to. When you introduce yourself as a doctor, people's perception about you automatically changes. It's like..... you are someone to be revered and respected; the adulation and at times, awe are all part of the package. But is this what being a doctor means??? I think not....... Read on.

Becoming a physician has meaning far beyond completing medical college. It is the entry to a way of life, the one characteristic common to every true profession. It may sound old-fashioned, but the learned professions are really "callings" from which the members cannot separate their lives. There are no "part-time professionals", at least in this profession, having accepted such a calling, one is bound to live it or leave it. A physician can also be a good spouse, a good parent and a good citizen of the community; however, the role of a spouse, parent and citizen, is inextricably intertwined with the calling of being a physician.
Medicine is not just a science, but a profession that encompasses medical science as well as personal, humanistic and professional attributes. The process of becoming a physician and being committed to lifelong learning requires that an individual possess the scientific base not only to acquire and appreciate new knowledge but also to see new ways for applying it to patient care. Every physician must delight in learning the new, correcting the old and perfecting the future. Much of what medicine now accomplishes depends on large-scale testing of procedures, interventions, vaccines and new drugs.

Being both professional and caring is an acquired skill. A physician can diagnose and prescribe in a technically correct and scientific, but insensitive way. The patient may be made better, even cured, but still feel unsatisfied with the interaction. In these cases, patients are likely to ask the questions:
1. Does my physician really care?
2. Does what happens to me matter to the physician?
3. Does my doctor show sensitivity and compassion beyond mere technical ability?
Patients want and deserve compassion and understanding. They want their doctors to be interested in them as individuals who seek advice, as well as relief from pain, disease and suffering. They want to sense that they can safely share their deepest thoughts and their most heartfelt confidences with their doctors. In short, they want to value their physician as a trusted friend. My own experiences during my rural internship have shown that a kind word is all that is needed in allaying part of the fear and anxiety associated with visiting a doctor.

Patients also expect to be kept informed while they are receiving competent professional service. As a caregiver, it is the sharing of oneself that is so very important. To some, it may seem odd to talk about caring as a learned skill, but it is just that. In studying to be a physician, one must learn both compassion and caring. Easy, supportive interaction with patients and others less fortunate, is a skill that comes readily for some and with great difficulty for others. In learning how to demonstrate compassion, Kahlil Gibran taught us: "You give but little when you give of your possessions.....it is when you give of yourself that you truly give". The giving of oneself with ease, with grace and with meaning is, for most persons, an acquired skill. Sometimes a deep sense of awakening within is required to release the innate sensitivity and compassion that perhaps have not been expressed since childhood. Nevertheless, these traits remain imperatives if the aim is to become a "complete physician".
When patients seek medical attention, they entrust their doctors with their very lives. The physician must earn such complete trust. Technical abilities and skilled treatment of disease alone do not suffice. Patients must believe that their physicians care about them as people, not just as patients. Physicians, in turn, must understand that they do far better as professionals if they err on the side of being human with their patients
A particularly difficult time comes as physicians deal with patients who become old, frail, dependent, crippled or cognitively impaired. These are circumstances from which the most sensitive among us truly learn what it means to give of ourselves. Sometimes we may find once again that our patients are the "best teachers".

On second thought, I really can't define what being a doctor encompasses..... because it is something that goes way beyond mere "definitions"..... for me, I guess, it's a way of life...... as said before, something that is inextricably intertwined with my very being.....

Adapted from: Cecil's Textbook of Medicine

!NCREDIBLE !NDIA

Amidst all the hullabaloo of the ongoing Commonwealth Games..... the corruption, the lackadaisical attitude of our authorities and the absolute debacle (that it was gonna be, but so far hasn't been.. THANKFULLY).... I thought I'd share my version on why India is truly Incredible and why we are "like this only" !


Amul, at their very best, yet again !!!

 We Indians are so cynical that, had those nincompoops (at the Commonwealth games) done at least a respectable job (at not only organising the CWG but also "hiding" the "under-the-table" business of theirs), we wouldn't have made a big deal about it as, the "supposedly brilliant" end-result is what would've mattered to us!!! Because, obviously, everyone in India knows the "what, where, why, how and when" of CORRUPTION..... we are like this only !!!
Anyways, back to my anecdote on why this country never fails to amaze me.
I'm currently preparing for my entrance exams and study at a library a l'il distance from home. The lib has a huge ground facing it and, according to my sources, there's a huge fair organised there every year during the Navratri/Dussehra festival. Currently this fair is in its "construction/organising" phase and I get a direct view of the frenetic activity happening there. Now this is your typical Indian "mela" replete with all sorts of see-saws, merry-go-rounds, giant wheels, mini-shooting range and what not. I guess you get the point....and am sure you've been to at least one such mela in your life ( the last time I went to one such mela was during my rural posting in Internship around a year ago, what fun!!!.....but that's another topic altogether ).


The Ferris-wheel in its "preparatory" phase with the "mango-people" working relentlessly 


Now getting to the point....... actually observing a mela take shape is, truly, a fulfilling experience, I must say. The amount of hard work one puts in, is truly undervalued, at least in our country. Just watching those puny little men from some remote village in north India sweating it out in the Mumbai sun, assembling that huge giant wheel and that huge "dome-of-death" ( or whatever that motorcycle-stunt thingy is called ) from scratch , piece-by-piece, WITHOUT A MACHINE...... and that too for what.....some measly 150 bucks a day..... WHO DOES THAT?.......... The "common man" in India.....the "aam-aadmi" or "mango-people" (as popularised by some Bolly movie)..... it may not be much of an experience, the way I've described it. But day in and day out watching these "invisible", "behind-the-scenes" men work really hard, so that the other "common-men and women" of our country have a great time, represents the true spirit of India for me. Despite inadequate lighting post-sun down, these men are still at it, working on that sheer monstrosity called a "giant-wheel" (which could very well be called India Eye by me, akin to the London Eye or Singapore Eye or whatever eye...have you). That is the "spirit" of this wonderful country called India.


Lo behold ! The Ferris-wheel all ready ! Also, don't miss the "dome-of-death" behind


And what astonishes me further is...... this library that I study in, is less than 50 feet away from this "site of action"..... and we are continuously exposed to the "din" outside..... and yet Indian students preparing for God-knows-which entrance exam continue to study, oblivious to that construction outside, maintaining an inner calm, not complaining..... but continuing to do what we do best..... EXCEL AT EVERYTHING WE DO WITH WHATEVER LIMITED RESOURCES WE HAVE !!!
And that's my !NCREDIBLE !NDIA for you.....
Kudos to the mango-people...... JAI HIND !

My WAVY BIRTHDAY WISHLIST !!!

Today's morning-walk along the Worli Sea-face promenade.....felt different for me. The eerie silence of the waves alternating with its humble roar, lashing against the shore..... the humid weather..... the cloudy sky...... my jogging shoe sole giving way..... yeh baat kuch hazam nahi hui.

I realized, then, I would be turning 25 tomorrow..... and, was this a hint from the one up there........ ???
I started making a wish-list of a different kind.....inspired by the waves.
Here goes.....

I wish I never again, feel like worrying and keep thinking about the lovely sea-waves which keep coming onto the shore one after another, breaking off.....but knowing that, that's the way the calm and powerful sea expresses its happiness.
I wish I never worry about the sand on the shore, which has to see so many waves being destroyed on the shore..... they are not destroyed, in fact they are totally accepted by the sand with all their characteristics, just the way they are.
I wish I never worry about the short life-span of the waves..... each moment of it, is spent with such joy, so freely.
I wish I always stay as expressive and happy as the waves, and be as calm and powerful as the sea, and get someone as firm as the shore, accepting me for who I am (I am fortunate enough to have such people in my life, already).
I wish all possible ways of running away from problems are blocked and many new avenues of solving them are opened.
I wish the coming year repeats all the happy moments of my life a thousand times over and gives me more such moments.
I wish all my dreams and aspirations are fulfilled and many more such dreams are born in my mind.
I wish myself..... a very HAPPY BIRTHDAY !

Teenage Angst: I AM VJ

I am sharing a "beautiful" poem from the book, "Chicken Soup for the Teenage Soul on Tough Stuff"..... I have modified it a little..... but the entire credit goes to the original poet, Krysteen Hernandez (I don't know who she is, but if you're reading this..... Thank you)

I read this poem when I was going through some really difficult moments in my life (more about that, on another blog-post)..... and the fact that this poem rightly described my frame of mind (at that time) in the most simplistic way, really stood out, for me.

So here goes...... I call this poem:      I AM VJ

I am a poet writing of my pain,
I am a person living a life of shame.
I am your son hiding my depression,
I am your brother making a good impression.

I am your friend acting like I'm fine,

I am a wisher wishing this life weren't mine.

I am a guy who thinks of ending his life,

I am a teenager with a lot of issues rife.

I am a student who doesn't have a clue,

I am the guy sitting next to you.

I am the one asking you to care,

I am your best friend hoping you'll be there.

My tryst with CANCER

Another day, another case.
This blog-post speaks of a man's "need"..... a need to get "diagnosed" first and then the need to get treated and the need to lead a normal healthy life..... Alas! That was not to be ! Read on.......
This patient's case is slightly peculiar because he presented with varying symptoms. I was supposed to present his case, but never got the chance to.....

The Violet Ribbon- "Support Hodgkin's Lymphoma Awareness"

This man was a poor construction-site worker from a remote village, and came to our hospital with complaints of swelling in the neck, fever, weakness, breathlessness, facial puffiness, abdominal complaints and various other non-specific complaints. He was admitted to our hospital 4 months ago to undergo a biopsy but backed out, for reasons best known to him.
Since I examined this patient in detail, I knew his clinical history..... he had multiple shotty lymph nodes all over his body (basically, a generalised lymphadenopathy). My provisional diagnosis for the case read: "Multiple enlarged lymph nodes due to ???Hodgkin's Lymphoma (possibly stage III B) with a severe degree of anemia and anasarca"
Now when I say, a severe degree of anemia.....his "Hemoglobin" levels were 3.2 gm/dl (normal level for an adult male as per Indian standards: between 12-16 gm/dl). Multiple transfusions later, he developed a cardiac overload, which he did recover from. Ideally concentrating on his primary disease, he should have undergone a "biopsy of his neck lymph nodes", but he was scared (?) of this procedure and even though I explained to him that it was a "harmless" procedure, he wasn't convinced. The patient's brother was basically running from pillar to post, just to get a "certain" diagnosis for this patient. My professors suspected a form of "Lymphoma", but a confirmatory test was required in the form of a biopsy, so that he could be referred to a centre offering "Specialised Cancer treatment" (since those facilities were unavailable at my teaching hospital). Since the patient was unwilling to get any form of procedure done on him (while his relatives were more than willing), he was asked to get "discharged". He actually did !!!
Around 2 months later, I was enjoying a "mini"-party with some close friends and just outside the venue..... this patient's brother spots me, and actually recognises me, and then addresses me as "Dr." (I was just a final year student then, but such "occasions" actually give you such a "HIGH"). I remember this patient well and I asked the relative how my patient was doing. I was in for a shock now.....
My patient had expired a week ago...... he developed a severe anaemia again and was admitted to the Rural Hospital in his village. But this time, no amount of transfusions or symptomatic treatment could help him...... his lymphoma, I guess, turned too aggressive......he died from a cardio-pulmonary arrest due to an extremely severe degree of anaemia ( I was told, his Hemoglobin was just 1.7 gm/dl !!! ).
So that party turned out to be exactly the opposite- a cause for celebration..... turned into a cause for mourning !!!
Patient deaths wouldn't affect me so often (more on that on another blog-post), but what happened here shouldn't have happened and in fact, shouldn't happen to anyone...... this man died for the lack of a diagnosis, a fear of the unknown and basically, according to me, his own foolishness (for lack of a better word).
But as my internship progressed and as my rural postings came to an end, I realised that this man's case was not an isolated instance. In fact, in the villages of India, thousands of such deaths go "undiagnosed" !
And we talk about "HEALTH FOR ALL" !!! Wow !

My tryst with HIV/AIDS

So, I am back after a "mini"-hiatus (thanks to all the "BOOKS" that have been keeping me really busy). So I read recently in the papers about a Kolhapur village "taking back" an HIV+ widow and her child (see link below). One of the causes I was actively involved in, and want to be involved with in future is PLWHA (People Living With HIV/AIDS), especially widows and children. So, here I share a detailed account of my "tryst with HIV/AIDS"....the HOW and WHY, for my association with HIV/AIDS in general.
This case is from my final year, in MBBS, when we were posted in the Department of Paediatrics, and were actively involved in Case-Discussions. This one case I distinctly remember, because I was lauded for my efforts (at case-presentation) by my Professor......and more importantly because the boy's face is etched in my mind till today.
I'm presenting it to you the way I presented it back then.....I guess it'll also give you an idea on how we present cases! It might seem BORING to some, so a WARNING at the outset.....read only if you really are keen on knowin' what happened..... details are (medically) authentic because I have retained the case-discussion notes till today! So, here goes:
(OBVIOUSLY, no personal details revealed----- patient-doc privilege, you see)

The INFORMANT in this case is my patient's GRANDFATHER.
Master V, 9 years old, residing at K village, K district, studying in the 2nd standard and 2nd issue of a third-degree consanguineous marriage presented to our hospital with:

Chief Complaints of: Cough since 8 years; fever since 1 month

The patient was apparently alright 8 yrs back. Symptoms of COUGH began at the age of 13 months.....intermittent in nature, with a crescendo-decrescendo pattern (gradually increasing and decreasing although not having completely regressed). Cough is associated with whitish expectoration about 2 teaspoonfuls in quantity. The intensity of cough increases at night. There are no relieving factors.
Since the last month, the patient has been complaining of fever which is, again, intermittent in nature. The fever is not relieved by medication and it is increased at night. Fever is not associated with chills or rigors.
There are associated complaints as follows:
1. Breathlessness (on and off), which he experiences on walking a little distance.
2. Relatives have noticed that the patient has stopped talking since the past one month, although he can hear and understand what is being said.
3. The patient has developed weakness in both his lower limbs since the last episode of fever. He walks with difficulty and with pain in both lower limbs.
4. The weight of the patient has also decreased due to loss of appetite.
5. There is a history of ear discharge since the past 4-5 months, which has stopped at present.
6. There is a history, of a vomiting episode yesterday. Vomiting was non-projectile, bilious in nature and vomitus contained only food particles.
7. There is a history of passage of loose stools (on and off) since the past one month.

There is, however, no history of:
convulsions, rash over the body, dysuria or frequent hematuria, contact with an open case of TB (Koch's disease), haemoptysis, haematemesis or e/o worms in the stools.

Other RELEVANT PAST HISTORY:
The patient is a known case of HIV infection diagnosed at the age of 13 months, and currently not on any form of ART (Anti-Retroviral Treatment). Patient has had recurrent Lower Respiratory Tract Infections and bilateral ear discharge, since then.
Both his parents have died of "UNKNOWN" causes, as per the Informant.
There is no significant history regarding any hospital admission or surgery in the past.

Family History:
The patient is a second issue of third-degree consanguineous marriage. His father died in 1999 and mother in late 2000. Patient's elder brother has no similar complaints and is non-reactive (i.e. doesn't have the HIV infection).

Birth History:
Full-term normal vaginal delivery, at HOME. Patient cried immediately after birth. Perinatal period was uneventful. There is no history of NICU (Neonatal Intensive Care Unit) admission or any major illness in the neonatal period.

Socio-Economic History:
The informant (grandfather) is the guardian of the child (both his parents are dead, as reported previously). Grandfather is literate (but has studied only till Class III). The patient lives in a pucca house; no history of over-crowding. Sanitary facilities available at home. Tap water is available from a common tap catering to around 10-12 houses in his village.

Dietary History:
The patient consumes 1150 kcal and 30.8 gms of proteins a day, during 4 meals in a day.
The expected intake is 1950 kcal and 40 gms of proteins a day.
Thus, there is a dietary deficit of 800 kcal and 9.2 gms of proteins, per day.

Anthropometric findings:
Height: 102 cms Expected: 122 cms -----Under the 3rd percentile.
Weight: 12 kgs Expected: 28.1 kgs -----Under the 3rd percentile.
The patient is severely malnourished with evidence of wasting as well as stunting.

NOW, normally I would present the examination findings, general and then system-wise examination (i.e the Cardio-Vascular System, Respiratory System, Central Nervous System and the Per/Abdomen findings)..... but that would be Greek/Latin for a majority of my blog readers.....so I'm sparing you the torture.

By now, you may guessed the "WHY" part..... the kind of "trauma" this child faced for no fault of his !

His *&%$%@#@$$@$%$$@ father went and @#$#%$% a CSW (Commercial Sex Worker) without a condom (or "protection" as its popularly known)..... then transmitted the infection to his wife who then transmitted it to this kid. Yeah, I'm playing the blame-game here and why shouldn't I ???

But after a year, I passed my MBBS examinations and was then posted as an intern, to the TB & Chest Medicine Dept. of my teaching hospital ..... and REALITY struck me in a "LIGHTENING" sort of way..... every third (or so) patient who walked into our OPD was HIV +ve and came in for DOTS treatment (Directly Observed Treatment- Short course chemotherapy)...... because Tuberculosis was (and still is) the most common opportunistic infection in our country in PLWHA..... and our government provides FREE TB treatment to our patients at government hospitals.
And now, thanks to HAART (Highly Active Anti-Retroviral Therapy)..... the life-span of PLWHA has increased..... but still, knowing that you have HIV/AIDS and yet facing the onslaught (of recurrent infections and thence ill-health), just like my innocent patient, V, did.... defines TRUE COURAGE for me. Kudos to these brave hearts.


"V" must not have lived long (no follow-up, a common patient issue), because he wasn't on HAART and his grandfather wasn't very genuinely interested in taking care of him..... coz he ( V ) was just an additional financial, emotional and SOCIAL burden on him..... (stressing on the SOCIAL-stigmata part here)..... and that is the "harsh" REALITY !!!
So that's "HOW", I got involved in a cause that is dear to me..... no details on how I actually am involved with the cause, because I don't wanna be a brag-n-tell @$$.
That's my "tryst with HIV/AIDS"..... and this article is dedicated to my aforementioned patient, "V"..... wherever you may be, my dear..... GOD BLESS YOU !

Here's hoping the HIV vaccine becomes a REALITY soon.....

LINK: http://epaper.hindustantimes.com/Publications/HT/HM/2010/08/14/INDEX.SHTML
{Read Page 8 of the e-paper}

Strange encounters with the "alcoholic" kind !

So, a long-due act was recently passed in the state of Maharashtra. The Maharashtra Medicare Service Persons and Medicare Service Institution (Prevention of Violence and Damage or Loss to Property) Act, 2010 was passed by the Maharashtra Assembly on the 9th of April this year. What this means is that, any individual (or group, for that matter) found attacking any doctor or medicare personnel, will attract a (minimum) fine of Rs. 50,000 and imprisonment for three years and it will now be considered a non-bailable offence.

You might be wondering what the aforementioned tidbit has to do with the title of this post??? Read on.....
This happened during my Internship.....when I was posted to the Dept. of Internal Medicine. As I've (tirelessly!) mentioned earlier about the workload at this district hospital I trained at(because of the paucity of residents.....Interns work like Residents- read "bakras").....I'm not gonna delve into details (for your benefit). This was peak season for admissions (hospital-admissions, mind you) and I was handed over the Male Medical Ward as per my rotating internship programme. There were around 27 patients under my care (and only me, alone!!!) during this period. We were required to see the patients on admission, write their case-history, medicine orders (everyday that they were admitted there, that too twice a day), do blood collections and other minor procedures (like catheterization), etc etc. (hope you get the hint). All this and 27 patients to top it all, sure took its toll on me. And one day, I missed out on seeing one of the patients. After our rounds (with the Senior Consultants), I realised my folly. So, that evening I went and apologised to the aforementioned patient. Fortunately, the relatives were very understanding. As I was about to leave, I heard someone abuse me....(specifically using the word "doctor", and I was the only doc around). I didn't heed....but then the abuses went on and on....and all the patients and relatives in the ward (mind you, this was a general ward) were aghast. I turned back and went to see what the problem was. Believe you me, this patient looked like he was hardly in his senses (diagnosed with "Alcohol-Withdrawal Syndrome") and he wasn't under my care (as in, he was admitted under another Unit), so I began to walk away. But the abuses didn't stop, and now this degrading attitude of his, really began to piss me off.....after all I hadn't spent the past four and a half years studying Medicine, to listen to people like him, abuse doctors like us!!! So I asked him what his problem was, sternly. He actually had the audacity to hit me....though I ducked at the right moment and was spared of his wrath (unlike "first time in labour"). Taken aback, I called the security guard on duty.....but this delirious man wasn't in a mood to give up and went on about how "you doctors" don't give a damn about poor patients....how that patient suffered (which was absolutely untrue) and the like. All this while, his poor wife was a silent bystander to this drama and now even she tried to "console" him. But I really don't know what strength "ALCOHOL" gives people.....three security guards later and his wife holding onto him couldn't stop this guy's attempt to pounce on me. I really didn't understand the reason for his wrath against medicare personnel in general. A few seconds later, the patient's doc (Resident Doc of that particular Unit) came in. He ordered for some tranquilizers. Two shots of Diazepam didn't do the trick. Finally after a lot of attempts to pacify him and a lot of violence on the part of the Resident Doc (yup, have to do that at times), Chlorpromazine and Phenargan, both potent drugs.....did the trick. He conked off. Further probing revealed that his wife was used to this drama at home and often wound up getting beaten up. And yet, she supported her husband.....I was at a loss for words. The next day, this patient was discharged (Against Medical Advice- DAMA).....and it seems he couldn't remember anything about this "interesting" incident !!! Woah....!!!

And so this is one particular "breed of patients" we see on a regular basis at Government Hospitals..... this man hadn't realized the damage that alcohol had done to his brain, liver, kidneys, heart and virtually every organ in his body.....I hope you do, before its too late. . . . . !
P.S.: And on similar lines (as my previous "labour story"), this "man" visited me again when I was in the Surgery OPD.....with his kids having multiple abrasions and contusions, saying they had fallen while playing.....whether they had really fallen or were "made to fall" is an entirely different story.
Sordid state of affairs, I must say. . . . . !

GOLDEN YEARS at my ALMA MATER

Continuing the series on Videos......this one also has something to do with Internship.....and a whole lot more !!!
In sharp contrast to the video posted before, this one's more about the good times at my medical college......a sort of collage of photographs (and memories attached to them) with some soothing Bollywood Music in the background.
NOTE: Please excuse the gross spelling and grammatical errors in the video......coz even though I feature in it, I haven't edited it !!!
Watch, and share some of those memories with me. . . . . .

GELCO: INTERNSHIP UNCUT

This video I'm posting, is created around the life of a Medical Intern (portrayed in a very humorous light). The characters, situations and locations shown in the video are not fictitious.
Although the work that I've done during my internship, in my college-attached District Hospital is nothing like how its portrayed here (as in, it wasn't limited to blood collection, catheters etc.....but much much, much more); the video does give one, a perspective on the trials and tribulations, the red-tape and juz plain BS that an Intern deals with.......just to get that oh-so-coveted "COMPLETION" and his hard earned "measly" stipend !!!
Watch.....and you shall be enlightened (and entertained) !!!
It's not easy becoming a DOCTOR in this country.....thats all I can say !!!

BHOPAL GAS TRAGEDY: Justice Delayed.....Justice Denied !

On December 2,1984 at around midnight, there was a leak of Methyl Isocyanate (MIC) gas from the Union Carbide India Ltd. (UCIL) Pesticide Plant in Bhopal, resulting in the exposure of this toxic gas to over 5,00,000 people.....and there you have the largest industrial disaster to date!
The earliest reference to the Bhopal Gas Tragedy that I can gather, was from our Science textbooks in Secondary School. Obviously, at that time I hadn't realized the magnitude of the problem (what with the text matter limited to a few lines in our textbooks).....but now, reading various articles on the net and in the newspapers have actually opened my eyes to the great disaster that it was.
Estimates vary on the death toll; some say around 3,000 and others around 15,000. Others estimate that around 8,000 died within the first few weeks and another 8,000 have since died from gas-related ailments. And the foibles continue, what with epidemiological reports showing eye problems, respiratory difficulties, immunological disorders, neurological disorders, cardiac failure secondary to lung injury, female reproductive difficulties, etc. among those affected and birth defects among children born to affected women.
So what had happened exactly?
The UCIL factory was established in 1969 near Bhopal. It produced the pesticide "Carbaryl" (Sevin). In 1979, a "Methyl Isocyanate" production plant was added to the site. Now, MIC is an extremely toxic gas, which can cause damage by inhalation, ingestion and contact in quantities as low as 0.4 ppm. Proper care must be taken to store MIC because of its ease of exothermically polymerizing and its similar sensitivity to water. MIC, an intermediary in carbaryl production, was used instead of less hazardous but more expensive materials (other manufacturers like Bayer made carbaryl without MIC, though at greater manufacturing costs).
On the night of December 2-3, large amounts of water entered a tank containing 42 tonnes of MIC (during cleaning work; while some claim due to bad maintenance and leaking valves).....causing exothermic reactions and pressure changes leading to a release of large volumes of toxic gases into the atmosphere. The gases flooded the city of Bhopal, causing great panic as people woke up with a burning sensation in their chests. Thousands died immediately from the effects of the gas and many were trampled in the panic.
Various factors complicated the issue.....Besides the poor maintenance and various "money-saving" approaches adopted at the plant, the problem was made worse by the plant's location near a densely populated area, non-existent disaster-management plans and shortcomings in health-care and socio-economic rehabilitation.
Over two decades since the tragedy, many civil and criminal cases remain pending in US district court, Manhattan and District Court, Bhopal against UC (now owned by Dow Chemical Company) with an Indian arrest warrant also pending against Warren Anderson, CEO of UC at that time. As the UC boss, Anderson knew about a 1982 safety audit of the Bhopal plant which identified thirty major hazards. Rather than fix them in Bhopal, only the Company's identical plant in the US was fixed. Neglecting these hazards in Bhopal caused the deadly explosion.
On June 7 2010, seven former employees of UC (all Indian nationals) were convicted of causing death due to negligence and were sentenced to two years imprisonment and fined Rs. 1 lakh (approx $ 2000). All were released on bail (surety of Rs.25,000) shortly after the verdict. APPALLING, to say the least !!!
Surveys and laboratory analyses from water sources around the plant still show contamination of the ground-water (with pesticides). A recent analysis (by BBC) actually showed traces of Carbon Tetrachloride (a liver carcinogen) from a water sample taken from a hand-pump located within a 3-km radius of the plant.
And the main reason why this incident was almost completely ignored for the past two decades is because it had nothing to do with celebrities or well-known politicians or their kith & kin.....but with the "aam-aadmi" (ordinary citizen) of this country.
Kudos to us all!!!!

References: http://en.wikipedia.org/wiki/Bhopal_disaster

The Sights, Sounds and Smells of MUMBAI

NOTE: This is a blog version of my previously published article in our College Magazine. It's normally the other way around (i.e. print version of a blog), but hey.....it's my blog after all! So, here goes.....

As soon as you enter the street, a cloud of brown dust covers your face and before you have time to recover, you are toppled off your two feet. Welcome to Mumbai- a little sadness, some hardship, but loads of happiness and wonderful feelings!
Mumbai, the city where I was born, brought up and where I live. I am quite familiar with its sights, sounds and smells, if not entirely. It is the city I love: it lures me when I am not here. But I still have something to complain about- a perfect combination.
Mumbai, right from Churchgate to Virar, is a land of miracles. A land of extremes, a land of contrasts. The richest people lying on mattresses of money, live here. The poorest people lying on the muddy streets, live here. People flaunting their Versaces and Armanis, and people who only have a metre of linen to cover their body. People moving around in their chauffeur-driven Mercedes Benz rub shoulders with those (un)fortunate enough to have only their two bare feet to move around. There are people who live at Marine Drive in their ultra-modern homes and then there are those who live at Marine Drive on the pavements. Again, a land of contrasts.
The tallest of skyscrapers, the neon lights, the colour, the money, the richness of Mumbai drapes a cloth over your eye till you open your eye to the small huts; the darkness, the poverty, the hunger of Mumbai. It's all here and we all have to live with it.


There are people all around you, pushing you to the limit. They will push you and push you and push you some more, till one day your lungs cry out for space. In this city that never sleeps, even morning won't give you solace, what with the incessant honking of cars bringing you back to the real world. And when the morning paper arrives, you read nothing but bad news. Get ready to go the office, jostling for that inch of space on the packed local trains. In the evenings, come back all sticky and tired from work, wanting some peace and quietude. You expect peace at home, but then you probably haven't heard of television and the barrage of ethnic serials doing the rounds today!
But notwithstanding all this, this city has a lot to offer. If Mumbai didn't have the charm, would it attract thousands of people from all over the globe to come and try out their luck here? Mumbai has the glamour and lavishness, like a gold foil covering a stone. But even this gold foil is attractive enough to bring and more importantly, keep people here!
Mumbai might not be the best city in the world but which other city can compare with its extremes and contrasts? Mumbai might not be a New York, London, Paris or even a Shanghai, but it still is good enough to make me live in it, love it and sleep every night believing in a better dawn. . . . .

LOVE STORY OF A MEDICO !!!

This is one of those funny messages I received.....which actually sounds too good to be true! Many of my colleagues may (or may not?) have read this.....so for the benefit of my non-medico acquaintances, I am posting this.....just for laughs!

PLEASE NOTE: ANY RESEMBLANCE TO REAL-LIFE MEDICOS IS PURELY CO-INCIDENTAL.

So, here goes.....the "LOVE STORY" of a medico:

I was in Class XII
She was in Class XII

I got admission into MBBS
She got admission into B.Sc

I was still doing my MBBS
She got an M.Sc.

I was finishing my MBBS
She got a Ph.D

I completed MBBS
She got married

I was preparing for my MD entrance
She is the mother of two children

I am doing my MD
Her daughter is in Class I
I completed my MD

I opened my own Hospital
Her daughter passed Class XII

The greatest Irony: Today is my engagement
And her daughter is my fiancee!!!

THERE'S ALSO A HINDI VERSION OF THIS (though, slightly different), which I am gonna share (Please EXCUSE the Bambaiyya Hindi,you staunch "Shudh Hindi" loyalists out there):

Main 12th mein tha
Woh 12th mein thi

Main MBBS kar raha tha
Woh B.Sc kar rahi thi

Main MBBS kar raha tha
Woh M.Sc. kar rahi thi

Main MBBS kar raha tha
Woh Ph.D kar rahi thi

Main Doctor ban gaya
Woh Doctor ban gayi

Uski Shaadi ho gayi
Main PG-Entrance de raha tha

Woh do bacchon ki maa ban gayi
Main MD Gynaec kar raha tha

Bacche paanch saal ke hokar school jaane lagein
Main MD Gynaec ban gaya

Bacche tenth pass ho gaye
Maine Hospital shuru kiya

AFSOS ISS BAAT KI HAIN ke:
Aaj uski TUBECTOMY hain aur meri ENGAGEMENT

!!!

FIRST TIME IN LABOUR !!!

We, medical students, have something called "clinical postings" everyday (starting from our second year in MBBS).....where we're supposed to attend OPDs (as observers), have case-discussions, learn minor clinical procedures and observe major ones, etc etc.... So, this was the first time we were posted in the Department of Obstetrics and Gynaecology. Whilst waiting for our Professor on the first day, curiosity got the better of me and I ventured near the labour room.....(as you shall find out later, CURIOSITY does KILL the cat!).....Lo behold! What a sight.....A single intern busy working on an episiotomy suture surrounded by a bevy of screeching ladies.....and the moment he saw me, he yelled out, "Hey you, get me another pack of Catgut". The look on his face said it all....I was the proverbial "bakra" (scapegoat)! Now all this suture material lingo was Greek to me at that time. So, I yelled back, "Sir, I am a second-year student"! Miffed, he replied, "Okay, do you know how to record a patients blood pressure....go and record that lady's BP". Now, this was something we were taught very well in the first year and I thought why not put it to good use here! So I went ahead and got the sphygmomanometer and got to the aforementioned "lady's" table. She was a hefty woman in her late twenties.....lying on her back with her legs spread wide open (almost a lithotomy position, in medical parlance). I went ahead and began tying the sphygmomanometer cuff to her right arm.....(I may have tied the cuff a tad too tight!).....she winced a little.....I didn't mind.....and went ahead and began inflating the cuff. I moved towards the leg-end of the labour table, unknowingly. Meanwhile just to comfort her a little, I asked her..... (AND NEVER EVER DO THIS TO A WOMAN IN LABOUR, even out of courtesy!) in Marathi (the local language there) "बाई, तुम्हाला त्रास होतोय का?".....loosely meaning, "Lady, are you in some sort of pain?".....What happened next, completely shook me!!!.....I don't know how, but she just KICKED me in the groin.....and asked, " आता सांग तुला त्रास होतोय का?" (Translation: Now tell me if you are in some sort of pain?).....Too taken aback and with an aching groin, I just got out of there that very moment, still trying to figure out what had happened exactly. On my way out though, I did notice a snicker on the interns face and a glistening look in his eyes (As though saying, take that you incompetent @$$).....
{ PS: (UN)FORTUNATELY......during my internship, I happened to see the aforementioned "lady" again (SECOND time in LABOUR, I guess!).....although, she didn't recognize me, I made a run for the nearest exit! }

AND that is also when I decided I am never gonna specialize in OBSTETRICS!!!
A lesson learnt the hard way!

OPENING NOTE

Well,after a lot of social networking and micro-blogging on Orkut, Facebook, Twitter and what not, here I am, finally, on.....BLOGGER!!!
So let's get to know me.....I'm a doctor (the medicine kind), just fresh out of med. college and an aspiring PG-candidate. An avid reader of books (besides thousands of medical texts, fiction as well as select non-fiction), a freelance writer and also having dabbled in a bit of social work-cum-teaching (English to differently-abled children), that's me.
Enough said 'bout me........so, what's my blog gonna be about?.......Anything and everything......take for example, some great moments at my alma-mater or memories of my rather gruelling-yet-interesting internship or relevant current events that tickle my fancy!
So, welcome to my world.....here's hoping you enjoy reading my blog!