My Blog:)

Hey everybody! Welcome!
There's a lot to life and there're a dozen million ways and more to discover it!
This is where I share all of my experiences and views.

A myriad of hues which blend into perfection, or well almost there about, that's life ... No wait, i've got to change that definition!!!... Now that's life!!! ;P... Es mi vida!

Sunday, September 13, 2015

The Sands Of Time...

It gushes forth, a harried flurry then a steady drizzle.
Yet as I peek though the hourglass , my mind is at  a standstill.
 The last few grains trickle by unflinched.

A journey into your mind

Into your mind i peek,
Yet I  hear not the speak.
The myriad oddities you do utter,
While you smile and mutter.
I know not what goes on out there.
Boiling in your minds inner lair.
But as I look into yonder,
I can't help but wonder,
Oh dear boy, what is it that you need,
To my medicines will you not heed,
And yet you battle each day,
To understand or to be understood I can't say.

Through the annals of history I pore,
You're story so unique yet shared by so many more.

From Bleuler to Schneider,
Sure our knowledge has grown wider,
But yet not can I tell,
The voice will be banished to hell.

But m'lad,
This is the journey we embark upon,
For every night has a dawn.
And so it shall be,
The caverns of your mind one day light shall see.

Sunday, May 24, 2015

Saturday afternoon in a quaint town!

Growing up in a big city, I always had my weekends packed with the myriad of mundane that we metropolitan dwellers are acquainted with.
And so, since the time I've shifted to this quaint little town , nestled in the belly of this hot, fire breathing land, the first question I ask of the locals is," What do you do here on weekends?"
... I get a general matter-of-fact shrug and a 'you know ...' look! The answer though remains elusive.
But of course, there's this big beast called google which has intruded all our lives, and so be it the charming countryside or the bustling city centre , we're doing much the same thing. Selling our souls to the internet!

However, on this charming afternoon, following a stirring session with Dr.A, a bunch of us headed down a different path.

A few scrapes and grazes and a little more uphill effort later we were there, atop College Hill!

The view from atop the hill! 

                                                 Ah! Cheers to the friendship!

                                                           Conquering the fear!

                                            A quintessential modern hazard! The Selfie!

                                                     Sai ! The cutest member of the trek! :)

                                       A moment to ponder , looking down from up there!

                                               That's the whole bunch of us!

                                           The kings and their scepters after the conquest!

                                        Celebrating new friendships! :)

                                                            ... And that's how high I jump! ;)

Sunday, May 03, 2015

The Lost Sheep Of Modern Medicine

In the mad rush of today’s outpatient department , even as I noted the duration of his cough and enquired about the tremulousness of his hand, I could , feel the ticking hands of the clock breathing down my neck.
The corridor outside my tiny room was overflowing with the sick and the needy, ebbing with tales of pain and sorrow. They sat there pleading to be heard, hoping to be understood, and above all, praying to be cured. I felt overawed by this sheer deluge that was now at my doorstep, people, families from far and wide were here, having battled long queues and prolonged waiting lists running into months just to obtain this appointment.
Would the next few minutes they spend with me put a name on their suffering, or would they still be wandering in the dark corridors of ambivalence, oscillating between hope and despair.
 The next few minutes, that is all I have to understand this person’s elaborate story spanning a third of his life, a story of his pain in the arm , and how he lost his job, that of how he was previously the sole bread winner in a family of six, and the repercussions this had on his state of mind and how that in turn worsened his pain , and how he had taken up the bottle in a means to end  his sorrows and how all of this had lead him to today where he no longer recognized his wife.
The wife sat beside, holding back tears that were threating to flood my calm clinical mind. I empathized with the family, I put myself in their shoes, the rather uncomfortable, and worn out shoes to the already aching heels.
How could I bring a glimmer of hope over their furrowed brows? I had a dozen more questions in mind, both clinical and humanitarian. The differentials were stacking up in the back of my mind, yet they were vague and fuzzy, I need to pore over some more details, some old reports, talk to the daughter, I needed more time!
 I jolted back to the reality of my crowded OPD. The next patient was already peeping through the flimsy curtain.
I deftly jotted down the history, the details afforded to me by my brief yet thorough physical examination, I noted that there was no acute emergency, at least none from a doctor’s and medical point of view, ( I tried not to think of the fact that for the stricken family, the gravity of this situation of theirs was no less than an absolute emergency ) . I noted the differential diagnoses that I had arrived at and I moved on to the management plan.
What diagnostic clarity I lacked for the want of time to delve deeper into the history, I tried to make up with the help of the wide array of diagnostic tools I had at my fingertips, the laboratory investigations, imaging modalities and molecular level tests. I picked the best ones for my patient and handed it to them along with the usual slip for a review appointment.
The patient’s wife looked at me confused, how could these tests, whose names she could barely pronounce, help cure her ailing man?
I tried to explain to her how this worked, and she seemed reassured, her faith in my white collared coat, in the degree hanging on my wall and above all in the legacy of my profession had helped ease her doubts.
And thus I made it through a long day in the out-patient department.
Yet I couldn’t block out the gnawing thought at the back of my head. Was I doing justice to my patient?
Are we, the modern clinicians doing justice to the legacy of our great forefathers? Are we giving ourselves sufficient time to delve into the history?
In the halls of our great medical schools, it is often said that history reveals 90% of the diagnosis. That is a resounding number, far better than any PET or PCR.
It is not merely the story itself, but how the story is told, what is mentioned and sometimes, more importantly, what is omitted, that leads us to the diagnosis.
An anonymous quote sends out this ominous warning. “A doctor who cannot take a good history and a patient who cannot give one are in danger of giving and receiving bad treatment!”
Not just the history but a thorough physical examination, will tell us most diagnoses without having to drag our patient through a battery of tests.
To enunciate my point, merely looking at the nails of a patient can help us diagnose Cyanosis (which is indicative of a respiratory compromise), Obstructive Lung Disease, Inflammatory Bowel Disease, Infective Endocarditis, Iron deficiency anemia, Liver cell failure,Psoriasis and Renal failure.
The beauty of the physical examination is that it can be performed anywhere and is the fastest modality in an acute emergency setting. If done right, it can help the doctor literally scan a patient from top to toe in a few minutes, and voila! Here’s the diagnosis!   
But unfortunately these time tested medical practices have fallen by the wayside.
So why then are we denying ourselves these crucial tools? Those that have been honed and handed down to us over the centuries.
Is it the numbers that is pushing us down this road? The need to see more patients, to write out more prescriptions and ultimately to reach an agreeable number on the balance sheet?
Is that what is eating into all our time? The precious minutes we owe to our ailing patients. Each extra minute spent with one patient, is a minute less to see an extra patient. Is this the eternal tug-o-war of quality vs quantity?
It’s often the bond that a doctor establishes with the patient, that’s the most important determinant in how well the patient fares. This rapport that is at the crux of all our treatment strategies takes time to be established. Are we then able to give them this time? Given time, the patient himself will tell you all you need to know about his illness.
It has been observed that most patients feel reassured ones the doctor palpates and examines them. The mere act of looking into the patient’s eye, examining them and offering a word of comfort, has done us good for centuries up until now.  
Moreover bedside discussions have been at the epicenter of medical teaching, and there is no reason to abandon it. Seeing a sign demonstrated on the patient, auscultating a murmur, these are irreplaceable, even in the era of the internet.
To quote William Osler, one of the clinicians par excellence, “He who studies medicines without books sails an uncharted sea, but he who studies medicine without patients, does not go to sea at all.”
Technology and its advances are no doubt very important to the development and progress of medical science. CT, MRI and 3D printers have allowed us to view the human body like never before. Yet they were never meant to, and they cannot supersede the basic history and examination sequence. It’s here that our clinical acumen and the armory of investigations will aid in putting the final puzzle together.
In other words, trying to arrive at a diagnosis without a decent history/clinical examination is like trying to predict what a picture puzzle will look like when a significant number of pieces are missing.
Ours is a profession that deals with life and its myriad complexities. It therefore takes another human being to feel the pain, touch the wound and heal it.
 Plato the renowned Greek philosopher rightly said, “The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.”
Tests and drugs will most likely cure the patient’s physical ailments, but will we heal the mind?
It’s the daily interaction with the patient, the physical presence of the doctor, the empathy in the physician’s eye that, the primeval bond that forms between two beings when one helps the other, this is what is at the heart of our profession.
 But has this era of corporatization of healthcare, cutting edge investigations and other modalities, meant to aid us, curtailed our inherent instincts of sitting at a patient’s bed side. Floundering in this vast sea, are we treating then the X-ray or the patient?
The ancient Chinese wisdom proclaims, “It’s easy to get a thousand prescriptions but hard to get one single remedy.”
I wonder if in this nearly mechanized world, will the empathy in medicine, the art of eliciting a history and the clinical examination die out altogether.
 Are we, the clinicians of this era the ‘lost sheep of modern medicine’? And is it time for a relook?

Thursday, September 11, 2014


This story was written in the summer of 2013 as an entry for the annual Deccan Herald Short Story Competition.

As she nuzzled against me, I felt the warmth of her little body, the slow breathing

synchronising with mine. Her almond eyes tightly shut, her somnolent mind led

for a walk amongst the stars.

I remember the very first time I held Maya to my bosom. My blood was still

throbbing following the eight hours of intense labour. I was drained, parched and

broken. Yet true to her name, those little fingers, as I entwined mine with hers,

wielded a magic wand. No sooner than did I peer into those brown eyes, that I

was healed. My baby.

The tiny steps she took, were momentous milestones in our lives. Her tiny feet

traced a path the lit its way into our hearts. First a coo then a call, our little girl

was growing up fast.

It came as a bolt from the blue. One day my little girl was jumping and playing

about, walking into walls, losing her balance on the bicycle even as her father

held her, and the next day she was tripping down the deep caverns of sickness.

It was a Saturday afternoon that we’d taken her out for an ice- cream. She’d lost

her incisor, and after a bout of sobbing, a few negotiations with the tooth fairy,

we’d all stepped out. The first sign was when she declined the ice-cream. Never

one to say no to anything sweet, my little one ,a trait that she’d inherited from her

mother, I put it down to her childish whims. Her headache having been attributed

to playing all day long in the sun, I put the tin of ice cream in the freezer.

The Sunday morning, I’d woken Maya up, only to find her listless and lethargic.

It took her father and me a whole lot of coaxing to get her through her breakfast.

But even her favourite story, and Polka her stuffed pig couldn’t afford much

success as the day progressed. Finally, she surrendered to sleep in my lap, early

that evening. As I put her to bed, I noticed she was running a fever.

Adversity brings forth a startlingly different response from each person. When

we are stirred to our depths, shaken, jolted, what simmers forth is the myriad of

emotions that exemplify life.

A diagnosis of leukemia, is still, very much an ominous announcement. And

when it strikes as close as your very own four year old, a bitter chill scorches

through your insides, one that words hath failed to describe.

X-rays and scans, tubes after tubes of blood being sent back and forth, and stark

white envelopes holding within, your fate. As you wait anxiously in the doctors

office, and he looks poignantly albeit with a scientific detachment, to pronounce

the verdict... the claws of fear, the mind numbing chill.

Yet barely a moment later, I was lucid. My analytically trained brain, having

devoured the facts was running its mental checklist. On the other hand my

husband had succumbed to the one human flaw, emotion. Overwhelmed, his

strong paternal fa├žade had caved, and sobbing uncontrollably he clutched our

sick yet confused daughter.

To explain to a four year old child how an illness, and in particular cancer works

is a challenge. One that takes not only the explanatory power of a doctor, but

also the reassuring capacity of a parent. Yet no amount of scientific knowledge

on my part could satiate her.

I held her, I hugged and kissed her, and I whispered a silent prayer in her ear.

In my own search for an answer I had transcended the realms of science, the

boundaries had seamlessly blended with those of spirituality, a quest for an

answer in the beyond. A vague journey had begun.

What followed was months of multiply tiny battles. Battles against malignant

cells which had invaded my baby, battles to keep my retching, toxic toddler

going, battles I faced against and with my husband, as we watched our only child

on the brink of complete destruction. A battle which you fight both within and

outwardly, much like the chemotherapeutic drugs, which destroys from within to

fight outwardly –the malignancy. Ultimately, in this lethal tug-o-war, where there

is a blind distinction between the elements that make you and break you, its

anybody’s guess and blind faith that you need to tell you which side it is, that’s

going to make it.

And much like all great battles, I fought this too is no less an arena. A Paediatric

Cancer Chemotherapy Unit is the Azkaban of our real world. As you watch sick

children being wheeled around, tubes running in and out of their tiny bodies,

anxious parents sallowed by fear and sadness, subconsciously you sink.

Yet at the same time, you stand together united by the same harsh fate.

If it is empathy that I felt on one hand, on the other my whole being resonated

with one question, “ Why me?”

It’s a question each one of us will ask at some or the other point in life. And that

day was my turn. I fought with the universe for answers, I cussed and cursed,

I swore, then again I swore off yet many other things, I threw wagers, forged

negotiations, pleaded, fell to my knees, implored, prostrated my self, give me my

little one back.

Nevertheless she fought with childish fervour. That gave me hope.

She made friends with the nurses and doctors, the other kids, she made her

father and me read out endless stories, narrated them over to all and sundry.

She tried to learn the name of her medicines even, and being unable to grasp

those sharp names, she made up sweet kiddish monikers for these lethal toxins.

Each chemo cycle was like the long up hill, the week in between an insufficient

breather. We had our little triumphs and tribulations with each fresh blood count.

The three of us striving to protect our cocoon in the face of an opponent that had

swallowed millions.

But with each passing day, we passed from the bleak to the bleaker.

One such night, in the dark as I held her hand, and watched her shift around

in an uncomfortable sleep, groping for me in the darkness, she took my hand

and asked, “ Mamma, am I going to become a star?” ... her childish reference to

Alas soon after one balmy afternoon, even as I watched my husband tell her and

Polka a story, I felt her squeeze my hand, just as she fell beyond the veil into an

eternal slumber.

The first few days after a devastating loss, the mind develops an unknown

strength. So it was with me. Even as I whispered a teary adieu, I had enough

lucidity to carry out the nitty gritties of the after procedures.

But as time goes on, you let your guard down, the memories the storm had

brushed aside in a heap begin to unfurl. Every pin that held your tattered

existence together gives way, you fall by the wayside, in a futile heap.

The cold bleak winter of my life followed. I lived amidst the gaunt shadows,

withdrawn, the blinds down on all windows. I shrunk into my own den, shunning

the world, refusing to be touched by the warmth of the rays.

I was alone. Endless conversations followed in the darkness, with darkness.

It was an unlit meandering path I chose to take , and I walked alone.

Because its only in the immediate aftermath are there people to help you. But as

times moves on, its up to you to pick up the pieces, its up to you to heal.

As the months went by, my husband resumed work, he had begun to heal. I

grappled in the darkness.

I shunned all help; my journey had to be alone.

The voice grew louder,

The darkness deeper.

Echo after echo resonated my pain.

The caverns are haunted,

Not very much unlike how I’m taunted.

My despair is resounding.

My insides are gnawed at by a hollow something.

I see no respite,

I see no light.

Eighteen months that had gone by had taken with it a life time.

Nobody could replace my Maya, my baby girl.

Then one fine day, coaxed out of my den, I stepped into the sunshine.

My hapless husband wearily eyed me for signs of healing. I was unmoved by the

exuberance of the tiny humans around me. My armour of despair, still intact.

Then, “Are you my mummy?”, the shrill voice of a little girl spoke.

As she entwined her fingers with mine, the icicles began to thaw.

Little Leia was snugly asleep. Polka the pig was her favourite toy. And her

favourite bed time story was that of her Big Sister who walked amongst the stars.

I would heal.


Friday, September 05, 2014

Book Review: The Mistress Of the Throne

An insight into the intriguing lives of the Mughal dynasty, especially their women and in particular their daughters... The Mistress of the Throne is a semi fictional memoir of  the unsung princess Jahanara and how she played a defining role in shaping India's history from behind the veils.
 A powerful, independent and strong character, born  perhaps about 500 years ahead of time, her remarkable life, her vision and her sacrifices appear to be the less chronicles aspects of what undoubtedly was the Golden Era of the Mughal Rule.
Her unparalleled love for her eccentric family is remarkable. As an adolescent she was thrust into the forefront of royal responsibilities soon after her mother , the legendary Mumtaz Mahal breathed her last, yet this Persian beauty wore the title of Shah Jahan 's Empress and that of a foster mother to her siblings with grace and dignity.
The melancholy of her own life not withstanding, she was the will behind the Taj Mahal, thus immortalizing her parents' epic love story. Her architectural vision also lead to the design of Delhi's famous Chandni Chowk, whether this was a tribute to her own lost love I do not know.
The book also delves into the bonds shared by Emperor Shah Jahan and Mumtaz Mahal's children, their early lives and how it shaped Indian and Mughal history eventually.
Mistress of the Throne by Dr. Ruchir Gupta is a very interesting read, a book as mesmerizing as the times and the woman it chronicles.  

Thursday, July 24, 2014

To Write InVerse

The blue sky, the bird and the butterfly,
In all their cerulean glory, for my attention do vie,
I strain my brain to not give a grain,
Putting to work all those years of train.

Teasing me with a sweep and caress,
The evening breeze seeks to ease my brows creased with stress.

Yet I persevere, hard and fast,
But I do fear my will won't last,
Alas, I have been at this for the day past.

Yet, to my master, I implore,
The myriad distractions shall you ignore!
Dear, hippocampus , I've a lot of work you see,
Do, I can't , all that which would set my spirit free.

And so despite the finger itch,
I must put in the next stitch.
Yet, I see how you're writing without a glitch,
And now the urge to have me read has reached , a fever's pitch.

Ah well, about physiology, (for now), the devil may care,
For I will pick up that pen and lay my thoughts bare.

I write, frigid and terse,
And out flows this rusty verse.

*to all the connoisseurs out there  :I do apologise for this is unintentional.
I very rarely do rhyme,
Not much more than  rosemary and thyme ;
The writing bug , occasionally I choose to nurse,
The result is this piece of poetry inverse! 

Saturday, May 24, 2014


I woke up this morning to the very reassuring news that govt MBBS doctors in Karnataka are to see a salary hike , and it will now see them cashing in on 60K a month!!

Yayy that's great news for my clan! And even more so for "MY CLAN" i.e. all those fresh MBBS graduates (read #babydocs, #jrdocs, #jrs) at the mercy of mankind, coursing through all of Dante's hells to arrive at the ultimate prize ... a PG seat!
( associated perks : fulfilled ambition, reinstilled sense of self worth, a job and a salary, recognition, a SPOUSE!!!, ... and I've also heard whispered in some corners 'Happiness!!')

And so as we course through this phantasmic journey, unmindful of the endless night duties, the thesis terrors, the next quest for DM/Mch and other what nots that will follow in the post PG life...!

As the rest of the world scales great heights ( specifically with regards to their bank accounts), we trudge along the dreary path where exams are mile stones and any, ANY, known pleasure is a potent stumbling stone, akin to that dreaded Snake on 99 that can barf you all the way back down to 0 on the game board :\

The journey is a thankless toil, a bootcamp, a nightmare all combined and magnified a hundred times...
You think I'm exaggerating , well here's an insight;
At ages 23-26 heres what "My Clan" is doing:
8am to 8pm reading and re reading all that was taught over a span of 5 and 1/2 years .. which is actually an amalgamation of everything that manking learnt from Hippocrates'(the Father Of Medicine) era to what the NEJM (or for that matter some other journal in some far corner of the world ) published as of this morning!.. this Ladies and Gentlemen is what comprises our"COURSE SYLLABUS"!

A far far cry from the happening lives of our peers! #nonexistentSocialLife
But hey, saving lives is no easy feat eh?!?
But yes none of us look as 'fab' trying to do so a la Jackson Avery...

That said Greys Anatomy has made this profession of ours more glamourous in the eyes of the lay man. Then again, the very famous 'On Call Room' of Sloan-Grey Memorial is not a reality in our day to day lives, nor do we run into a McDreamy or a McSteamy very often !!!( two questions absolutely everyone asks me when they realize I watch Greys)
Unfortunately Shonda doesn't script our day to days!

And as the rest of the world breaks new barriers, we are further bound and tied down by new legislations, malpractice insurances, bonds,QUOTAS, licenciating exams and the lot!
All as we try to follow our passion to learn more about this magnificent machine, the human body!

Yes, the general public is very distrustful of doctors, and definitely I accept not without reason , there are a fair number (that I've seen in my very short career thus far) who are in it for reasons that they shouldn't, and hence the apprehension is understandable. But by and large, there is a vast majority who are truly passionate and work very hard day and night! #truePassion

Yes eventually we might be able to afford that all elusive BMW #loveTheBMW , but that's after spending a good part of our twenties being largely broke (and perennially hungry) ;) ... #by2Coffee

And thus we work our way through countless books, solely focusing our attentions on Messrs. Harrison, Bailey and Robbins , adding 'dysdiadokokinesia' to our vocabulary, learning the 'idiosyncrasies' of life, and fighting the every day battle against- '5 and 1/2 years to become a hard core cynic'  (as a popular daily newspaper termed the MBBS course ), all because we will one day learn enough to qualify as 'good doctors' and serve the society.
 All because we truly love what we do!