LEARNING ABOUT FATHER THROUGH YOUR SON! A TRIBUTE!

LEARNING ABOUT FATHER THROUGH YOUR SON!  A TRIBUTE!

“It is a wise father who knows his child.

But maybe it's a very wise child who takes time to know his father.” - ANONYMOUS

My 28 year old dropped in during breakfast time this morning to show me a letter from his grandfather, my father.

My thoughts flashed back to my late dad. We lived in a modest home in a small town. My father was always strict with my sister and me. He was a regional probation officer who dealt with rehabilitation of juvenile offenders.

He always seemed to have time for us as he used to sit at study almost everyday during  school days; he was always knew all our lessons and the answers too!

He paid through his nose for my music classes and ensured that a happy music teacher got me through the entire grade exams of Trinity College of Music, London.

He retired when I was in V standard in school (out of 11 standards). He took on 4 jobs at a single time to see me through the best medical college; he turned down some of the government colleges where my marks qualified me to study free because he wanted me to study in the prestigious CMC Vellore- which I did subsequently paying a fee.

Every Sunday, I had to memorize that week’s particular prayer by heart before breakfast…. No prayer- no breakfast!  Such was the strict moral upbringing. 

He did not look happy when I did not get the first rank in school, nor when I told him I passed in MBBS in second class ( it did not matter that no one passed in first class in the entire university!) He had a high standard and was a hard act to follow...... Many a time I had wondered whether I could ever impress him! 

Back to the present now….. my son today came accidentally across a letter from his grandfather written in 1985 in his own handwriting in an inland letter; my mother had signed it too in the end. He proudly flashed his grandfather’s first birthday letter ( addressed and posted to him!) – so different from the cards of today!

How did he write such a letter to a one year old on his birthday? Did he know that this letter would one day reach his grandson after 28 years ? And be discussed in among family and friends?!

There is so much for me to learn from this letter about life and love… from a father who is no more!

“Our dear grand son,

Today is your First Birth Anniversary day. Pattiammal and I give you a warm hug, sweet warm kisses and wish you a Happy Birthday and wish you many happy returns of the day. We pray God to keep you to grow in the fear and wisdom of the Lord.

You are a member of the All Saint’s Church, Puthur, Trichirapalli. Your birthday was announced in the Sunday service on 12.5.85 and all the members prayed for a Happy Birthday to you and wished  you many Happy Returns of the day.

We wish you all good luck,

From loving grand parents  “

CHANGING PATTERNS IN PATIENT DOCTOR RELATIONSHIP

CHANGING PATTERNS IN PATIENTS AND PRACTICE

Today unusually I was in the out patient block seeing patients. I have been quite busy over the past few months. Doing many cases daily forces me to see most of my out patients in a room adjacent to the operating theater.

A mid thirties smart man walked in to the room and for convenience I will call him Joe. Joe was well dressed, a fit and articulate young man. He announced that he had an anal fistula. He came to the hospital last week and ordered on his own an MRI of the wrong end of his gut for confirmation. His ordering MRI on his own surprised me as this is an expensive test and a fairly new one to most of the surgeons ;…… also how did  hospital do this without any doctor authorizing it.

I assumed by now that he was an IT (Information Technology person from computers) man…. well informed folks these are. By now, Joe wanted me to read the MRI x rays and tell him if this necessitated an operation. This was most unusual as you normally pay the doctor to examine you first, and then to advice you!

As  a medical trainee from Christian medical college and later on, as a surgical trainee from the same alma mater, I was always trained to ask, “ What is your main problem?” “Fistula in ano”, said he and looked at me in wonder as if I was a moron!

When I persisted, “How does it bother you?” He said, “Not at all”. Now it was turn to look at him and return the compliment. He further surprised me saying that he did not want me to touch him and examine him , but just to look at his x rays and give an opinion! What an extra ordinary request!

I explained that generally I needed to examine him first for an opinion…. “No … no … no examination, just your opinion,” was his comment. Well, I decided to take him to the x ray suite and show his films to the radiologist for his actual comments.

The walk to the radiology was an eye opener for me. Joe had initially consulted an Auyervedic practioner for many years before seeing doctors. He had consulted even a colorectal surgeon for this ailment and when he advised surgery, he did not trust him. Well why should he trust me I asked….He had also googled me before coming. He had no belief in doctors. The reason?....His father who had suffered from stroke was not treated well by a well known neurologist. Joe also added that the doctors who had seen him for the present complaint never had enough time for him.

By now we had come to the end of our walk and arrived at  the x ray department. As luck would have it, radiologists were away at lunch and a young radiographer opened the x rays on the console panel and I explained patiently that the condition was a mild one. Since he had no symptoms, he might well use medical measures initially. I then offered to wait for the radiologist to return from lunch so that we can discuss with him also for a final opinion.

By now Joe appeared totally satisfied and said that he was happy with whatever I had done for him. He in fact said that no further opinion was needed and thanked me much for my time.

When I look back at the situation, I do not see an enlightened IT person. I just see a young terrified man who is scared that his surgeons have no time for him, that his doctors make mistakes in diagnosis. I wonder if the fault was really on his side or the physicians who saw him earlier. One is trained to inform and inculcate confidence in patients. This may take time, explanations and a great deal of patience. I know Joe may have upset his surgeons by his questions due to his anxiety and past experience with physicians. Had I not walked with him to the department of radiology, I might have completely missed it too!

He does not want surgery now but medications;  that  is all the advice he needed along with enough time for him to digest. He appeared satisfied…. Did he? Only time will tell!

Who knows… he might even let me examine him next time!

Goodbye Joe!

( Picture is "The Norman Rockwell image of the doctor-patient bond) 

Bhuhari’s Café

Bhuhari’s Café

I reached the station at 7.30 pm exactly 2 hours before my train…. the price one pays for anticipating traffic jams in Chennai.

I had a choice of spending the time in the beach as suggested by the cabbie or wait for the train. I opted instead to visit the café which I last ate in 1975!

Bhuhari’s Café is right opposite to the central station. It used to be the jaunt of all medical students who used to go from Christian Medical College, Vellore for exams to Chennai for the examinations. The moods used to vary – sometimes pensive, occasionally happy that the theory, viva went well. And we did this year after year from second to the fifth level exams. It was not an exotic place - just what we could afford as medical students.

The favorite dish those days used to be “ Chicken Biriyani- quarter plate”  for Rs 3.50 and “Chai” (tea)for Re 0.25. Today ,when the taxi pulled up in front, the usher waved me to a new air conditioned posh area. I ignored him and walked on to the main dining hall.

“Quarter plate of Chicken Biriyani followed by Chai”, I said. The waiter looked at me strangely and said that it was all in set plates now. And no tea nowadays only juices! As I waited a while for the food, I looked around. Mostly middle class customers- almost everyone with chicken biriyani!

My plateful arrived after about 10 minutes and the food was the same. …very homely and good. No wonder the place was popular even now. The bill came to Rs 110 per plate , keeping up with inflation.

As I was leaving, I told the waiter that last time I was here in 1975 as a medical student; the place was still as full. He told me that the hotel was started in 1960 and then I realized that  by now, I had spend nearly 75 minutes there …. just with nostalgic memories. I called up my childhood friend Jebsy from Trichy …. He agreed that it is always great to take a step backward in time .

Those were wonderful days!

Who are you trying to fool?..........

Who are you trying to fool?...........

I had to take the early morning bus from Chennai to Vellore last Saturday. So the cab was taking me at 4.30 am from home to the bus station.

The driver was muttering that I could have driven to Vellore rather than take the bus. I patiently explained that I could not get one of my two safe and favorite long distance drivers and hence the bus journey.

Lo behold, we saw a government bus which had taken off from the bus station  rolling away from Chennai. My cabby raced and pulled up in front, stopping the bus for me. I hopped in wondering how it was going to be travelling unreserved after a long time.

Surprisingly only a few passengers in the bus. Nice reclining seats and it was cool. I looked at the conductor for the ticket, but he generally ignored me; so I trotted off and took the seat in the third row.

In front of me sat a well dressed lady in thirties with a little girl and a big tall boy. The boy was older and sat on the left side of the bus and the lady with the daughter on the right side.

After a while the conductor came along and despite the noise I heard him laugh when the lady said something to him… I thought  what a friendly guy!  After a while of some casual conversation, he asked the boy to go and stand against the markings on the door. And then it hit me that the boy was being measured for height. He was too tall.

The lady had then to shell out the adult charges for the boy. Conductor then came to me in the next row to give me my ticket. When he went back to his seat, the boy winked at his mother and shrugged his shoulders ; both had a good laugh.

It was obvious to me that the mother for a few rupees, had tried to fool the conductor.

What sort of an example was she setting for her children? She was obviously a middle class lady who easily could have afforded the normal rates for her brood. What sort of adults will they be when they grow up? Do not parents realize that children are like sponges absorbing the good and the bad from parents all the time?

I still remember what an LKG teacher told us in UK when Pravin started school; the child learns at home and comes to play in school. There is a lot of truth in that statement. We talk about corruption, bribery and wonder what makes us crooked- well obviously bad upbringing is certainly one mighty good reason!

www.lapsurge.org

A Visit to Passport Office- A Novel Experience

 Passport Office, Coimbatore, PDG Kuriachan                                       Clean corridors in Section 2

Abundant Waiting space for public in Section 3   &; Transparent cublicles of Senior Passport Officers                          

A visit to the Passport Office - A Novel Experience

"Enthusiasm is excitement with inspiration, motivation and a pinch of creativity"

I had to go to Sri Lanka for a meeting as speaker next week. So I happened to glance at my passport and had a shock. It expired in another one week after my travel date; any foreign travel requires 6 months validated passport.

So naturally takkal passport reissue was the choice. I went on line and applied for one on a Saturday not really hoping to get a reply soon. Back came the response saying appointment was at 1030 hours on the next Monday less than 48 hours away!

I rang up my friend and the youngest Rotary Governor Kuriachan. He was very helpful and rang up   some folks and said that I would get everything sorted out the same day. I have had several passport experiences in the past- crowded corridors, long noisy queues with no really directions posted on the passport offices. … lots of touts. And officers who never look at you more than once except to make sure that the picture in the photo is really you!

So not expecting much, I showed up on time with all the necessary documents at the passport office near the airport in Coimbatore prepared for a long day. The difference was striking. The building was classy and the security at the gate was smart and demanded to see my appointment slip. I walked through and the first thing that hit me was the entire complex was air conditioned. No sweaty crowds. People standing in orderly queues while young men and women -  uniformed  and polite explaining patiently and in low tones what the forms needed were and how to fill them up.

The chairs were clean and orderly; not one speck of dust anywhere. The whole complex was partitioned into three different areas with a door opened by electronic lock . Everyone was identified by a token with a number, I was asked politely to go the next section for the document verification. There were many usherers who politely guided the customers to sit down in comfort and fill up the forms; were helpful when there were queries by the innocent public. This section had fully furnished seating arrangements with abundant space. One could wait anywhere in the lounge like in the airport and see on the monitors the status of your token and which counter you are expected to go next.

There was a nice Xerox printer for photocopies where the lady insisted on paying back my one rupee out of the five rupees for four copies to be made. When I  met at the counter for verification, a  young woman conducted the actual interview..... there was plenty of politeness, clarity in conversation and no waste of time. She verified all the relevant details of passport, cross checked with my records, typed them on her computer form which she read out to me on the computer console. She again showed me how it would look on the passport by spelling out all the names every time. She took a digital picture, took finger prints and uploaded everything to the server .... all in record time without hurrying me!

By then my curiosity was aroused. I had to know how the change had come about. The passport office had undergone so much transformation in the past three years since my last visit elsewhere. How was this possible? The usherer informed me that the passport officer was walking closeby. I met him briefly and told him how proud he should be of his office.

He surprised me in stating that the office was run by only six government officers who were at the very last control of the passport. Outsourcing had been done to Tata Consultancy Service (TCS) . TCS had provided the building and nearly 40 young men and women who were so orderly , patient, polite and methodical with all the public. Yes, he was proud of his office; and he  invited me to a cup of coffee  which incidentally costs only Rs 5 per cup served in a clean cup and saucer to all officers and public alike.Mr Kumar also told me that passport unlike driving license and pan card is a document of the government which it allows you to have!

The last stop with the passport government officials was in two sections with the officers sitting at right angles . There interview were very transparent and quick. The last verification was by two senior passport officers  who said that I would receive the passport by courier within 24-48 hours. As I was exiting , much to my surprise a feed back form was given asking me and everyone else to rank each service. I waited for a while watching others;almost everyone ticked all columns uniformly as excellent. Such was the satisfaction!When I had come home, I received an sms stating my new passport number and the tracking number for the speed post... so much efficiency despite so many thousands of passports every week!

I could not believe how the changes for achieving the excellence had come just over the three years since my last visit. The mind set of everyone here, be it government officials or TCS officials was just to make the experience in the passport office for everyone a pleasant and rapid experience. There was so much politeness, purity, plenty of curtsey… it was unlike any other government office I had ever encountered.

I am not going to ask why all the offices not change like this..….. I just know that this change was very welcome and the change was achieved from within the department. I believe that most government offices would see this as an example to follow and change for the better. As for the youth- the TCS officials…..each knew what he or she had to do, and did it well. There is so much hope for India and the youth!

That night I had to take a flight out of Coimbatore and a fleet of politicians were sitting in front of me in the fuselage. They were showing each other their individual visiting cards printed with a huge picture of their esteemed leader. One of them was using the mobile phone as the aircraft was taking off; the others noted  this and seemed not to care……. Such was the anticlimax!

So as I mused on how there is hope for a bright future on the private sector and the government sector, the politicians who rule us need to change as well. I believe in the common good , but the incident during the flight did not mar the happiness and the pride I took in visiting my passport office and my brief interview with the passport officer Mr Kumar.


The sky is the limit for some people.... if you aim higher, nothing is impossible!  I can see it in my passport!

www.lapsurge.org

AN UNFORGETTABLE SURGEON

Aristotle said, “Bashfulness is an ornament to youth”, but he would have thought twice had he encounterED Muthu.

Muthu Raman came a year ago to Global Hospital , Chennai and said he wanted to work with me . He qualified in surgery about 8 years ago and spent some time in Kerala ; I remember asking him why with me….. his reply was kinda vague except that he wanted to stay for a year and have exposure to basic and advanced laparoscopy. Anyway we needed a junior surgeon in the unit and he was qualified for the job.

Always short sleeved, with his shirt tucked in, he was a tall lanky lad, quiet and smiling.His notes in the mornings were always neatly written even when I reached early for rounds.

A few days after he joined, I asked him to write up a chapter on prevention of obesity for the public; he wanted to take a day or so. 2 days passed by and he gave me a paper. I was astounded by the clarity of his thoughts and the richness of his English. This was obviously of excellent schooling; that is how I learnt he studied in Monford. I had come to respect him and his English.

Surgeons especially the ones in training usually want to be in theater to scrub with us; and do as much “ cutting “ as possible. He was different. When there was work to do in the wards, Muthu was with the patients, comforting the ones with pain, or talking with the families of patients. I do not ever recall his wanting to push his way during surgery; but if he differed in opinion as to the treatment, he always gently made his opinion clear. When he was scrubbed in theater, I was sure that all patients in wards and out patients had been well cared for.

He differed from many of the young surgeons in never trying to impress me with his knowledge or his skill. His love for patients and his care for the family members were legendary. There were times he spent hours with the families when he could easily have gone home. Home… that reminds me, he resided in the hospital campus and made himself available 24 hours a day,365 days. He was always the first one to arrive in casuality ward when called for major trauma. When there was work to be done, he did other departmental work whenever the patient needed it.

His relationship with the xray specialists and anesthetic colleagues was exceptional. They in turn always obliged him at odd hours; he spent a lot of time in the departments collecting results to ensure patients spent minimal time in the hospital. He was popular among other surgical colleagues for lending a hand whenever needed. The nursing staff and paramedical staff too got along well with him- he was always smiling and was so soft spoken. I do not recall his ever being loud or pompous… surgeons generally are!

As time went on, we needed more surgical help in the department. When the less experienced surgeons requested more pay, he declined further hikes in pay, saying he was getting enough and wished for no more pay! 

Like Bournville chocolate, he had “earned” respect from patients and their relatives … they used to stand up for him whenever they saw him passing by in the corridors.

He qualified in FIAGES examination thus specializing in laparoscopy; and helped with numerous live workshops in Global Hospital, Chennai and in other states.

2 months ago he quietly mentioned that he wanted to be relieved from duty on 11 december; he explained that that was the day he joined one year ago. All the kings horses and all the kings men appealed to him to stay back. It was not for taking on a much fancier job or a hiked up pay, he was leaving; it was just that he wanted to work with tribals in the remote rural hospitals. He had desired for experience in advanced laparoscopy and now was able to take it to the tribal communities................... What an idea ji !

He even vacated his room on the exact day without being asked to do so and shifted to a lodge to make room for his successor. At his farewell, there was not a single doctor or nurse or administrator who did not feel the loss.

We presently live in an environment where basic values such as kindness and compassion are not often given the importance they are due. Self glorification and arrogance are often seen in abundance and considered the order of the day to be popular. The present era has witnessed law suits for trivial reasons on doctors not to mention the  mindless murder of an obstetrician yesterday. Here was a young man who put others before himself, who loved his doctoring, who treated others as he would have liked to be treated.

He will always be an unforgettable character for the right reasons. He made the place richer by his presence and association.