Myopic Musings

E-day

2010-09-07T18:01:00.004-05:00

While walking back from work this evening, something struck me as being remarkable. I spent an entire day seeing patients in my clinic from 9 AM to 5 PM without once needing to use a pen! And I realized that because I forgot to carry a pen with me this morning and didn't miss it once in the day.

Many hospitals and clinics are incorporating electronic medical records including charting and prescribing. Notes are completely electronic, communication between nurses, front-desk staff and physicians is via electronic messaging, referrals and prescriptions are also e-scribed and e-signed. With the security of a provider's password, a lot of important communication and therapy is taking place. It didn't strike me as amazing till I realized that I didn't need to sign a single prescription or hand-write a single instruction note for a patient today. Everything was printed and/or sent electronically.

While it makes health information relatively easier to access and circumvents the need to develop special skills to decode physicians' scribbling, there is almost always an excess of documentation and mandatory tags that follow the note that sometimes buries the real essence of a physician's note. The Center for Medicare and Medicaid (CMS) has announced special incentives for practices and clinicians who demonstrate "meaningful" use of EMR. It is believed that it will make documentation lighter (no paper), cheaper in the long run (perhaps), more transparent, increase sharing among different providers that in turn can decrease medical errors and deaths. For instance, when seeing one of my geriatric patients who has moderate dementia and does not remember his or her allergies, EMR makes it almost impossible for me to prescribe a medication he or she is allergic to. Without EMR, a provider who missed reviewing the allergy list on some specific page of a thick paper chart could easily prescribe a medication that can eventually lead to wasteful emergency room visits and unnecessary admissions. That is one of several ways in which EMR hopes to reduce medical errors and improve health care delivery.

One of the cons of EMR for physicians is the learning of computer skills and smart ways to document efficiently. For some, EMR documentation may need them to stay longer at work in the evening. Also, it may result in lower patient satisfaction if the physician seems too busy with typing on the computer as he or she speaks with the patient, and this may ironically result in lower online 'health-grades'.

Best city to live in?

2010-04-24T23:44:00.004-05:00

I am definitely not talking of Philadelphia, in the suburbs of which we currently reside. I am presently attending a national conference in Vancouver, Canada, a place I have heard a lot about, but am getting a chance to experience first-hand only now. In fact, other than the United States, this is my first entry onto foreign soil. I have not even started the tourism around here, but I already seem to like the vibes I am getting. Neat and clean, friendly people, great downtown and restaurants. I do not hear much about crime yet, but I am sure it cannot beat Philadelphia and Camden, amidst which we are nested currently! In fact, Vancouver and neighboring Calgary are among the best cities to live in according to several sources I have read. Forbes in 2008 ranked it number 4 (with a quality of life index of 107.4) behind Vienna, Zurich and Geneva, and it is the only North-American city in the top ten.

So far, I was impressed with free luggage trolleys in the airport (unlike $5 ones at Newark), $70 rental for 4-days on our mid-size car (unlike $70 for one day in Detroit, America's car city) and from medical standpoint, far less visible obesity than many places I have been to. I haven't picked up on the nuances of the Canadian accent yet, but the personalty of the city and its people have impressed me much. More later!

One Last Wish

2009-09-29T19:44:00.006-05:00

"You want to be connected to this machine though you may never come off it or be able to talk or eat anything?" My patient connected to a ventilator and with multitudes of wires and connections all over her body, looked me in the eye and nodded her head. I looked at her in frustration and bafflement.

This was a patient of mine who was in the Intensive Care Unit (ICU). She had extensive lung cancer which had spread to other areas of her body. Her best survival at this point was 6 months, only if she remained free of infections. Yet, she wanted to remain attached to the ventilator, and did not want comfort care or end of life discussions. I was unable to understand her need to being awake with an uncomfortable machine connected to her, not being able to eat, not being able to talk, and living in a nursing home. 'Such people are a complete waste of resources', I fumed inwardly.

As we frantically searched for a ventilator facility to transfer her to, she developed more complications - an infection of her bowel, potentially needing surgical evacuation. The surgeons we consulted balked at the thought of operating on this patient with such a poor prognosis. They recommended medical therapy and we prayed that the infection would wall off with the antibiotics we were giving. Through all this my patient had to bear multiple abdominal exams on an exquisitely tender abdomen, multiple CT Scans, nutrition through deep IV lines and their changes. Once again, end of life care was approached as we were skeptical she would pull through. The family of my patient, comprising of 5 sisters and a brother staunchly supported her decisions. And my patient, through all this, while mournfully staring into my eyes each day as I examined her, remained strong in her wishes to remain on the ventilator machine.

One day, I noticed a man sitting at her bedside and a wan smile on her face. I had stayed late that day and asked the nurse next to me who the man was. The nurse told me that it was my patient’s boyfriend who visited her everyday at this time. After he left I walked in and asked my patient somewhat brusquely: "What does he think seeing you in this condition everyday?"

She signaled to me to get a sheet of paper and in rambling handwriting wrote: "That is my boyfriend of 18 years, whom I can’t imagine a life without. I have had this cancer for 5 years but I came here because I could not breathe anymore on my own. I would have died if you had not placed me on this machine. I know I can’t make it on my own. By staying on this machine if I can get to see my love even one more day, then it’s worth it. I am not ready to leave him just yet."

I was sobered. I felt apologetic about my attitude. Even as I tried my best to get her to a ventilator facility, my thoughts were more mature. Young physicians like us sometimes forget that people are complex individuals and they have a personality beyond their disease. The reasons behind human decisions are manifold, some of which we don’t necessarily understand. Our job is not to coerce patients into our way of thinking or disagree with their decisions, but to continue to make our patients as comfortable as they can be. Just as we respect the wish to die and provide comfort care for people with a terminal diagnosis, we need to respect those who want to fight death and live beyond all reason.

Jai Ho!!!

2009-01-11T21:24:00.017-06:00

Hurray! He did it! A billion prayers answered. An Indian composer wins the prestigious Golden Globe best composer award for the first time. It's ARR's tribute to India and Indian music. I was lucky to catch the live presentation of the 66th annual Golden Globe awards on TV last Sunday and all the anticipation ended in jubilation. I was so proud to see the entire audience, the who's who from Hollywood and from other film fraternities around the world, give an impromptu standing ovation to our "Mozart of Madras" as he walked up the stage to get his award. And then each time a Slumdog nomination or award was announced, the inspirational song "Jai ho" played in the background.

I would not say that Slumdog Millionaire is Rahman's best work. It very well ranks with the top music he has produced in the last 15-16 years. But he needed this film to catapult himself and India to a global level of recognition. In fact, in the 2 days since the GGs, I have heard at least 4-5 people I work with, actually evincing interest in his work and talking about his music for the film. I think that is simply remarkable. Soon, they will be able to pronounce his name well too! (They called him AR Roman or some such thing at one of the award ceremonies.)

2008 was indeed a fantastic year for ARR. Before we could have enough of one album, he came up with another chartbuster. Jodha Akbar, Jaane Tu Ya Jaane Na, Ada, Yuvvraaj, Ghajini, Slumdog Millionaire... wow! And what a way to start the year! I can see many more awards coming his way in the next few months. An Academy award too perhaps; watch out on February 22, 2008. Another billion prayers for the musical genius please!

And from reading a million news articles on ARR in the last 2-3 days, I can tell you somethings that you probably didn't know:

That Shahrukh Khan was offered the part of Anil Kapoor as the host of the 'Who wants to be a millionaire', but refused because he was busy with Om Shanti Om. He apparently regrets it now! First, he missed Lagaan, and now this.

The award winning song "Jai Ho" was composed by Rahman for Yuvvraaj, as a song for Zayed Khan's character. Subhash Ghai felt that it did not suit the movie, and agreed to let ARR use it for Slumdog instead.

Mallfluenza

2009-01-01T22:15:00.009-06:00

That's right! Fatigability, severe joint pains, headache, dizziness, feeling of impending doom.... I had all these symptoms this afternoon as I returned home after a 4-hour shopping mall outing with my wife. I believe the 'pleasurable' excursion was long overdue, and we were initially excited to find what great deals everyone has been talking about. But what a way to begin a year!

Just entering a mall, any mall, small or big, causes some blurring of my vision. All covered with artificial lighting, a really jarring combination of colors and styles. The miles and miles of walking and turning into aisles. Don't even ask about the pressures of finding the best price between stores and amongst the heaps of clothes, shoes and bags. The irritating banners all over the place, one bigger than the other; but each less informative than the other. One said: "all items $4.99 and up", with the latter two words in small print, about 1/100th of the size of the first three. Another shouted: "Up to 80% off". Then the BOGO scam: Buy One Get One deals. I sincerely sympathize with store managers who arduously scale up prices to 200% one day prior to the sale only to give the gullible shoppers half-off. And if you're finally done with your selections, at the check-out counter, would they ever forget to ask you to enroll for their credit card if you want another 15% off? One generous lady even wanted my e-mail id so she could send exciting offers about the latest bath and body products. I courteously declined.

All this prompts me to go on the internet for all my shopping needs and urges. Already, I shop for electronics, books, some groceries and sometimes shoes and clothes online. You can often make the best decision in lesser time, be certain of good quality by reading customer reviews before purchasing, compare prices at different stores and have it delivered at home comfortably.

Memsahib

2008-12-26T23:15:00.007-06:00

"First impressions are lasting impressions". Or perhaps, "Don't judge a book by its cover". From our first experience at this Indian restaurant in Baltimore, MD, the second statement wins handsomely. As we strolled through the streets of Inner Harbor Downtown looking for a nice place to dine, we were not greatly impressed by the shady streets and parked old cars around Lexington Street. But a first-rate experience awaited us when we least expected it.

The usher-waiter was genuinely courteous. The seating was splendid and comfortable, the decor inside was ethnic and soothing. The menu at dinner was exquisitely unusual. You get to choose one of two starters, one of three main course options, one of two dessert options, then tea and papad. No extensive looking menu-cards like some other places where you get different vegetables in similar tasting gravy. I don't particularly remember what I liked the most, but the bhelpuri, the nan (bread), the kheer were all very well-made. And then we felt like eating some yoghurt (not on the menu), they got me some just like that, and did not even bill for it! To top it off, they had a huge display screen (check the picture below) that streamed some of the latest Hindi film songs, that more than quenched my thirst for Bollywood chartbusters. Overall, easily the best Indian dining experience in the USA so far for me. So don't forget to include it in your travel plans to Baltimore.

Nutrition and Malnutrition

2008-12-14T13:32:00.004-06:00

From being Indian, the only malnutrition I knew is protein-caloric under-nourishment with kwashiorkor, protruding bellies and skinny, sickly limbs. But from living in America, the only malnutrition you need to know is protein and caloric overloading, protruding bellies and oversized hips and thighs. It is omnipresent, almost taken for granted. Less known is the fact that obesity has the potency to kill like cancer from smoking does. The current generation will be the first in history to NOT outlive their parents.

Last week, a 44 year-old male patient in the Intensive Care Unit succumbed to death after suffering from a fever of 101-103F for 15 days. He had an abscess on his buttock that was being treated with multiple antibiotics. There were 6-8 specialists on the team who were trying to decipher the source of his fever, day after day, week after week. He was on the lung ventilator, heart monitor, urinary catheter, feeding tube, peripheral intravenous and central venous lines and several cooling blankets. His 'numbers' kept creeping downward, with his kidneys, heart and liver also showing signs of deterioration. We could have sent him to a University or tertiary center for multi-disciplinary care. Why were we all so helpless? It was his weight: 520 lbs. He wouldn't fit inside any CT scanner in the area. Not in our hospital, not in our city or the state. Perhaps only 2 machines are available to accommodate such a size in the entire US: Mayo clinic, MN and some South Carolina university hospital. We even called the Philadelphia Zoo to find out if they had a scanner they used for large animals. Finally, due to our inability to determine the cause of his fever, we had to let him go. Each of his last days was a mixture of hope for a miracle and despair and frustration, for the family and the medical team.

You probably know that 66% of US is overweight (defined at Body Mass Index >25) and almost half of those overweight can be classified as obese (BMI>30). Here are some startling facts about obesity you might not know:

In 1963, the average 10-year-old American boy weighed 74 lbs; girls 77 lbs. Today, the same boy weighs 85 lbs and the same girl weighs 88 lbs.

Obesity is linked to the top 10 causes of death, depression, absenteeism (school and work), lower marriage rate and lower income potential.

Only 2% of children consume a “healthy” diet (as defined by the US Department of Agriculture) on a daily basis.

25% of American teens drink 4 colas a day!

20% of all ‘vegetables’ consumed in the United States are french fries and/or potato chips.

Cal-utopia!

2008-08-30T11:29:00.010-05:00

Above is a snapshot of the wonderful memories we have of our Southern California vacation. This one is of the Laguna beach along highway 1 traveling from San Diego towards LA. Relatives, friends, driving, paragliding, swimming, canoeing, tandem biking, boogie boarding and variety of foods: in all, an exciting week.

Amongst other things, trying 'animal fries' was a first. They're basically french fries with American cheese and diced onions and some other spices, and are a special non-menu item at one of the fast-food joints of the area. So you'd order them only if you've heard about them from someone. Well, now you have. Not the healthiest, but well, just try 'em.

Then, for being uninitiated (or rather uninspired) in tech-gizmos, we were quite shaken by the Nintendo-Wii that my cousin introduced to us. So, our plans of visiting the Hollywood and Universal studios were quashed by the desire to spend countless hours with the 'Wiimote'. And well worth it, I must say. Quite a revolution!

India and the Olympics

2008-08-16T07:54:00.005-05:00

A couple weeks ago, I was on vacation when I read the headline on the internet: "Even God can't help India: Supreme Court of India". But obviously excited by the hair-raising headline, I scrambled to read the details. I was curious to know how a Supreme Court judgment, one that should be unemotional and logical, could be so pessimistic and depressive.

As I read on, the report said that the SC judges BN Agrawal and GS Singhvi were reacting to the Indian Government's reluctance in amending a law that could pose stringent hindrances to politicians who overstay in their subsidized accommodation at New Delhi or other state capitals, sometimes long after they have completed their political roles. It won't be surprising to hear that a politician's family is still using Government accommodation while he is serving a prison sentence for having someone murdered when he was a CM 4 years ago!

The report further mentions that "the governments have become non-functional", and that "even God will be a silent spectator as He will be helpless". What does this mean to all of us? Something we all knew for the last 20 years? Or something that completely trashes the glowing image of India we'd all like to carry in our hearts no matter where we go?

All along, even as we complained about India and the politics, the population, the illiteracy and the crime, we were always proud that India had something remarkable that is unique: the diversity, democracy, multilingualism, rich cultural heritage, age-old traditions, etc. But what are we making out of all that?

Then, we have the Summer Olympics. A great coming-together of all nations, where countries like Cuba, North Korea (and probably Myanmar too) are not only competing but winning medals. Kudos to Abhinav Bindra for getting India its first individual gold. One solitary gold medal for a country of 1.1 billion. Well, its not about winning, one might say. But are we even competing in more than a handful sports? How does China create a fabulous opening ceremony like that AND rank on the top with almost 30 golds? Can India even imagine hosting an Olympic Games in the next 50 years?

Where Weird Things Happen!

2008-05-10T09:24:00.007-05:00

I love Wisconsin: I spent 3 of my best years there. In a way, I have come to consider it my home away from my home country India. But two recent incidents have me covering my face in shame and shock.

First, in Necedah township, police officials found a 90-year old woman stored in the only toilet of the house, with the children of the house being forced to live with the unbearable stench for 2 months since her death. In their defense, they said that 'God would raise their mother from the dead, and that they and their children prayed for days in hopes of that happening.' In the mean time, the children were using the pail for the bathroom and coerced into not telling anyone about grandmom. The parents face charges of causing mental harm to the children and obstructing justice. Child Protective Services (CPS) have seized the children from their care.

Second, 2 weeks ago, a peculiar couple in northern Wisconsin took the country by utter disgust when they failed to seek medical attention for their diabetic daughter (Type I Diabetes) who was suffering from a life-endangering complication of the disease. And she died at home! Died from something that was completely treatable and correctable by prompt medical intervention. They claim to have continued to pray for their daughter in a 'show of faith' but refused to take her to a hospital. They have been now charged of second degree reckless homicide. There are several complicated issues to this legality. Medical ethics in this multi-cultural country have agreed to honor religious and personal faiths, and such things as alternative and herbal medicine, chiropractics, reflexology, etc, even if it does not meet scientific criteria to be approved by the FDA for treatment. Then, whereas adults have the complete right to refuse any form of life-saving treatment (as long as they are mentally competent enough to make such a decision), children are bound by law to receive emergency treatment even if that means over-riding the wishes of their care-takers. That includes receiving blood transfusion and emergent surgery, say, in case of accidents, when parental approval is immediately not available or possible.

Where nothing ever happens

2008-05-08T14:12:00.013-05:00

Ravi and I visited Charleston, WV for a conference. My initial outlook was rather snooty. After all, I was from a large city, complete with high rise buildings and cursing drivers. I looked upon Charleston as a place where nothing ever happened.

We completed the conference on a Sunday afternoon and watched the speedy emptying of the hotel we stayed in. We asked a rather Marilyn Monroesque receptionist about places to eat. My initial impressions were reinforced when we found that most good restaurants were closed on Sunday afternoons as they were family owned. As hunger pangs assailed me, I told myself- 'whoever heard of restaurants being closed on a Sunday afternoon? This can only happen here!!'

Ravi came up with an idea- 'Lets get to the State Capitol, there are sure to be restaurants there'. I had no arguments to offer, and I knew he wanted to add one more Capitol pic to his kitty. He pacified me with a banana and some random biscuits. We drove the short distance to the Capitol.

Surprise of surprises, the Capitol was deserted, as rest of Charleston was. Angrily I stared at the gold domed building as we drove towards it. Ravi was more optimistic - 'maybe there is something in the front, we seem to be at the back of the building'. I had no such illusions.

As we drove to the front of the Capitol, my anger was suddenly forgotten at the beautiful sight ahead of us. The Capitol sat on the bank of a river, cherry trees dotted the bank at the bases of which there were memorials. At a lower level there was a small path for walking or biking and stone steps led further down to the water. On the other bank were picturesque homes, surrounded by trees and the green lawns of which led into the river. There were small boats dotting the river- a couple sunning themselves, another reading a book. In the horizon, a quaint old bridge was visible. The scene was one of perfect idyll, and as I rejoiced in the peace, I realized though we had slowed down to a stop, nobody honked at us, instead the cars went around. Soon we found a spot to park right by the Capitol and took a stroll on the little path near the river.

The hunger pangs returned, and didn't seem to appreciate the scenery as much as we did. As Ravi clicked a gazillion pics, I stopped a young man taking a walk to ask him about restaurants. He spoke to me at length about the delightful steakhouse, the delicious seafood place and finally said rather reluctantly after being pressed for greater culinary delights than the ones he had told me about - 'there is this place called Bluegrass Kitchen which serves some vegetarian stuff for brunch, which is close by.' I pounced on that, and thanked him for his time (a good 30 minutes), contrasted him in my head with the type of answer I would have gotten in my busy, large city.

At the cafe, I got another pleasant surprise. The place was eccentric and had a cheery outdoorsy feel to it. One end had an open brick wall, decorated with multiple unframed paintings of various dogs. There were also antiqueish lamps, a beautifully painted Gecko and other knickknacks. On the other end was a brightly painted wall, decorated with embroidered rugs. The waitresses were chugging lemonade and were in jeans and T-shirts and scarves. Our waitress informed us that all the vegetables and meat was farm grown and they made their own cream and cheese. After waiting for a short time, our food arrived and was excellent, and had a tangy flavor with turmeric, black pepper and paprika for spice. Crowning everything was the most delicious and heavenly lemon meringue pie I had ever eaten in my short life.

Vetoing my idea of packing several of those fabulous pies, Ravi reminded me about the journey home. As we drove, I silently thought about how hastily and presumptuously I had misjudged this quaint little town. Here, I had found perfect peace and a bustling, busy world seemed far away. Here, I re-encountered hospitality and friendliness which I had lost touch with. And here, time seemed to stand still with no one being in a rush to push it along, as nothing ever happened anyway!

Election Euphoria

2008-04-22T16:47:00.006-05:00

They keep talking about the astonishing amount of money being poured into the Iraq war. Well, the money that Senators Obama and Clinton are spending on their Democratic party primaries for the last one year is only adding to that. Never before have such obnoxious sums of money been spent for getting the nomination to stand for the national elections. Not to mention the tireless amount of energy and television time spent on covering each and every heave and sigh of their existence these days.

I neither understand the US electoral system nor the intricate policy details of the several candidates (nor do I want to). But I do have a pair of eyes and ears, and a functional brain to process bits of information on the internet and TV from the political campaigns. Today, the day of the Pennsylvania primary for the Democratic party, is crucial. Hillary Clinton must be on the edge of her seat waiting for the results that could make or break it for her.

Hillary Clinton probably suffered from the worst level of complacency, given that there was no other candidate close in competition to her up until recently, when things changed dramatically. I admire her commitment, her experience, her determination. I also feel the media has been unnecessarily biased against her lately, publicizing every single gaffe to death, interpreting leads and trails as it suits them, doing the exit polls to death. Bill Clinton would perhaps do better to take up some environmental cause to improve his chances of getting a Nobel prize, instead of helping Hillary win.

Barack Obama, like he claims to be, is like a breath of fresh air, aiming and claiming for a change. A magnetic personality, if you have listened to his speeches, he draws you to whatever he says like no one else has. What people say about his lacking experience is not without truth in it. 92% black voters vote for him. Yet, they want to deny the fact that race could play a role in electability. I really don't know if there is anything different in the policies of Clinton or Obama. Once we have a nominee, I think they would line up in tandem to voice the same proposals. It wouldn't matter then that Clinton supported the war in Iraq (some 6 years ago).

John McCain spent the least money, had the fewest debates, hugged and shook hands with strangers to the minimal extent possible. He is no accomplished orator. But remember that elections are never about oratorial skills. How else would you explain Bush winning against Kerry or Gore? But he is smart. Once the Clinton-Obama see-saw is over, he might just pick Condoleezza Rice to be his running mate, and get those undecided women and black votes in his kitty: play the race and gender card together!

So, who is going to be the most powerful person in the world, come January 2009? I have my preferences, but I don't get to vote. Something tells me a short-tempered white old man named McCain will lead US (I mean, United States) into the next decade.

Capitol Tour

2008-04-15T21:55:00.006-05:00

That's the collage of the Capitols I have visited so far. The ones at Washington DC, Austin and Madison make it to the top 3 in terms of size.

A Slow Death

2008-03-08T20:13:00.004-06:00

I surged ahead with ecstasy! The laughter of the child ringing in my ears, her hands having a free rein on the smooth polished surface of the wall. Oh! I reveled in the freedom and danced among the riotous colors. My bliss at the unending array of possibilities was overwhelming. Where would I go next? What would happen next? These questions hovered tantalizingly in the air… the possibilities were endless.

“Oh my God, the walls!” a harsh shriek cut me short, the crayon fell off the child hands, as she stared fearfully at its mother….

I awoke again, tempted by the churning ideas, million thoughts in the girls’ head. What can I write, the girl thought. My spirit was rejuvenated by her lively ideas….a half formed story, a poem….the possibilities were amazing!! The girl put her pen to paper and started giving me shape. I heaved a long contented sigh…. ah, release at last.

“Today’s essay will be on Raja Ram Mohan Roy. Please look at page 93 of your textbook and read the chapter, and write a detailed essay about his services to our country.”

I am in the humming of her wordless music…an off key beat….a suddenly inspired pirouette, a graceful unconventional twirl. And yet, “all these modern steps don’t impress me. You are here to learn so that you can have your arangetram soon. So start practicing hard.”

“What happened to new ideas?? Why are you so blank…come up with a creative solution- a beaten to death theme won’t help us make this deadline,” the boss walked away. The girl looked blankly at his retreating figure.

At the mention of me, I stirred and laughed hollowly. I am an empty shell, long deprived of the nourishment that I needed to survive. I am buried deep beneath the layers of regimentation, conventionality and inflexibility. No matter how hard I am searched, I remain elusive. My loss is reflected in the drabness of daily life, in the vacant stares of youth, in the dull existence of elderly.

The death of creativity is complete.

Responsible Alien

2008-02-24T20:10:00.006-06:00

I am an alien, that's for sure. I just have to determine if I am a non-resident alien or a resident alien. You guessed it! I am trying to do my taxes for last year, and I keep putting it off to the next weekend. Soon, the time will come when I can procrastinate no more. 2007 was a special year for me. I graduated from school, got a job, got married. But the aftermath of these special events have come to haunt me now. In case you were wondering, the married life is going on fine, thank you! But its just that these special events have made doing my taxes my worst nightmare. A student for half year, married for half year, multiple locations, multiple W-2s (couple from my wife) have my head spinning at the moment.

So last weekend, I got to trying TurboTax online. At the end of an excruciating hour of filling forms, I realized that I am due to pay a few hundred dollars as federal tax. I trashed the attempt. Now, I've got to get people, I think. Meanwhile, I can't wait to get back to work Monday morning. Sweet Mondays!

Wah Wah Rahman!

2008-01-25T15:03:00.000-06:00

The music of Ashutosh Gowariker's next film (after Lagaan and Swades) released a couple weeks ago. A.R. Rahman brings to us his absolute best in Jodhaa Akbar. After hearing the album, I thanked God for the fact that Rahman composes so infrequently, giving us some musical marvels to revel in. I am a self-confessed Rahman fan, but even then, I am generally fair in my assessment of which one of his is an average, good, great and simply superb album. Based on the first few rounds of my listening to Jodhaa Akbar, I think every song in the 5 (+2 instrumental) song album is a top scorer. That can be said of very few albums, which is why I think JA ranks right up there with others like Lagaan, Taal and Roja. The second rung would be the albums of Zubeida, Sapney, Rang De Basanti, Guru, Pukar, Rangeela, The Legend of Bhagat Singh, Saathiya and Swades. But again, this is only MY opinion. Try listening to the songs of JA: they will grow on you.

There are some fascinating features of Rahman's compositions in JA. He has used some relatively new voices: Bela Shende and Javed Ali; fresh and full of verve. The latter's love ballad Jashn-e-Bahaara Hai is beautifully sung, of course, with some wonderful lyrics by Javed Akthar. I hope it is picturized as well as it is composed. The instrumental versions of both songs have their own identities rather than being carbon copies (without vocals) of the full songs. Then, the ease with which Rahman has included different styles: there is a bhajan and a qawalli, appropriate instrumentation, some new sounds. I find it quite arduous to pick my favorite among the five.

Many music directors nowadays come up with great songs, hummable alright, but make it repetitive, like Himesh Reshammiya doing his nasal high-pitched twang much too often. You may argue that even Rahman repeats his tunes occasionally, but he has repeatedly shown maturity and ingenuity in composing for different kinds of cinema: historical films (Jodhaa Akbar, Bhagat Singh), period films (Lagaan, Zubeida), youthful (Yuva, Rangeela, Taal), always trying to match his music to the script. He employs the well-known playback singers even as he explores lesser known but mightily talented newcomers (Chinmayee, Madhushree, Naresh Iyer to name a few). You could have Udit Narayan and Alka Yagnik sleep-walk through their parts within minutes (saving time and/or money) and make a hit song, or else you could record with new untested voices that give that unexpected thrill and exuberance to the mindful listeners. Rahman does both these with the same elan, and comes up on top.

Tipping FedEx

2008-01-21T10:41:00.000-06:00

Despite running the risk of sounding like many many other tennis lovers, I think that lately Roger Federer has been losing his magic, his perfect shots and his stronghold on men's tennis. The first week at the Australian open tennis was about a new surface (Plexicushion), a lot of long tough matches, 5-setters ousting favorites and more. World No.1 Roger Federer is the obvious favorite to win his 4th title here next Sunday, but it may not be that way. Or may be it will. A new phenomenon called Janko Tipsarevic (from Serbia) almost spoilt Federer's dream run on hard courts (40 consecutive wins) last Saturday. In spite of winning the final set 10-8, Federer generated generous discussion about not being invincible any more. 'He's human!' said one news report!

Two years ago, Federer was perfection plus elegance personified. To watch him play his best game was like watching a concert in action, with all the right moves and right notes! Not any more. If you saw him at the Australian open, you'd agree with me that he is making more errors, less winners, looking more vulnerable then ever before. But again, it is almost absurd to expect him to play the perfect game for ever. After all, he has held the the No. 1 position for a record 209 consecutive weeks (that's 4 years in a row). Over the last year, his fiercest competitors: Nadal, Djokovic and Nalbandian are posing tougher challenges, their matches with closer scorelines. Federer, often his own coach, has a way of learning from his losses and beating his nemeses, like he did to Rafael Nadal on Hamburg clay last year.

I do hope Federer wins more slams and Masters' titles breaking whatever records there are remaining to shred, nevertheless, the golden period of his tennis career is probably coming to an end. But Federer always loves to surprise his critics. His ardent fan here definitely hopes he does.

Janko Tipsarevic (Serbia)

It's all about portions

2008-01-07T12:47:00.000-06:00

"When you're trying to lose, it's actually the decrease in calories that's more effective," says Helen Thompson, a registered dietitian with the Center for Human Nutrition at the University of Colorado, and director of America on the Move in Colorado. However, exercise can help with weight loss. She notes, "Maintaining weight loss is tied to exercise." Why does fasting not work? Your body is a very efficient machine, and when you fast, it actually wants to conserve energy so it can function with less calories. You really tend to lose fluids, even if you are drinking water. The pounds tend to reappear on the scale once you stop the fast.

Personal success stories like one of my professors at work make it clear that dieting indiscriminately or exercising aggressively never succeeds 100% in reducing that pot-belly. 'It is all about portion-size and addiction control', he said. No matter how much he ran, he didn't see his pant-size drop till he practiced reduction of his daily portion sizes. And mind you, he is one who runs 20 miles a week and even trains for the Ironman Triathlon. Some say eliminating the whites in your food, or at least minimizing it helps: the white bread, pastas, rice, potatoes.

One of my patients with a BMI (body mass index) of 42 wanted to know if she could be given alli (Orlistat) to help her reduce her weight. This woman has other co-morbidities like fibromyalgia and arthritis that prevent active participation in physiotherapy. Add to that, her reluctance to watch her diet. And then, the holiday season, which everyone thinks is the perfect excuse to not think about one's health. Anyway, alli works by reducing the absorption of fat in the body, and one can reportedly reduce about 5% of initial body weight. But alli alone won't cure obesity. Ditto for those considering bariatric surgery for their excess pounds. Diet and exercise remain the foundation stones of weight loss, and healthy living.

People, take a moment to go to the CDC website and watch how the obesity pandemic has spread its tentacles over the entire US. Watch the color coding of the states change from 1985 (when obesity information was first analyzed) to 2006. It is fascinating how the human race is becoming dangerously fatter with every passing year. FYI, let me inform you that West Virginia (where I work) is ranked No. 2, second only to Mississippi, both with >30% prevalence.

Kho Na Jaaye Taare Zameen Par

2008-01-06T17:21:00.000-06:00

Very little preaching, simple and realistic situations, lots of great acting and a touching subject. Aamir Khan's Taare Zameen Par dwells on dyslexia, bringing our short attention span towards the common fate of dyslexics in our competitive world today. The main message of this movie was to make everyone understand that every child has his or her own niche. Come to think of it, its absurd to imagine that 100% of children read, write, think and calculate the same way as they graduate from one grade to another. Brain cells have an exponential growth curve from birth to early childhood, and trying to model every single child the same way in the formative years may result in hampering the expression of their natural talents below full potential.

Its unfortunate that the exact etiology and diagnostics of this disorder is still elusive. What is even more unfortunate is that in reality, teachers and parents might not be able to understand and detect this problem in their children in order to give them the deserved attention. In India more than in the US and other countries, children are forced to follow a pattern and be part of a certain rat race to fulfill parents' definition of being successful. Happiness is considered no barometer to justify what you do for a living. Then, like here in the US, many children with moderate learning disability are labeled with ADHD (Attention Deficit Hyperactivity Disorder) and Bipolar Disorder and and put on multiple medications at tender ages. I don't know what the right answer is! What I think we need are non-pressurizing parents, devoted and sharp teachers, and caring and responsible doctors, all working together on these kids.

Well-Doll Clinic

2007-12-09T20:51:00.001-06:00

No! I am not getting trained to treat stuffed toys, like the giraffe you see in the picture! This is from an unique event held 2 weeks ago at my hospital, when children came in with their favorite toys that had imaginary illnesses, broken bones, cold, chest pain, etc. We had to 'treat' these patients in a comfortable and amiable environment, allaying any fears they might have about the visit to the doctor. This exercise involved the kid to assume responsibility of the toy's health and to help them understand that the 'doctor' is indeed a helpful and genuine person. We were given colorful band-aids, alcohol swabs, syringes, tongue depressors to introduce the children to the gadgets used commonly at a doctor's clinic.

The half-hour we spent there had its share of interesting moments. Whereas most kids came with complaints of 'boo-boo' in a limb or cough and cold, some had symptoms of heart pain (!) and bleeding from the nose, etc. They were most excited about receiving the splints (made from tape wrapped around tongue depressors) for broken bones, or getting an injection for decreasing the pain. Personally, I enjoyed the interactions with kids, some of whom were imaginative and wild in their explanations of problems, and others who were visibly anxious and tentative about the doctor visit. Most children had sex-specific occupational identities about a man being a doctor and a woman being a nurse ingrained in their minds. During this visit, they were encouraged to think that even girls could be doctors, and men nurses.

Prodigal Artist

2007-12-02T20:28:00.001-06:00

Did you ever understand M.F. Hussain's depiction of Madhuri Dixit as a Goddess? No? Neither did I. I thought it created more controversy than spread the message of beauty and art. But I might be wrong. Well, I am no student or sharp connoisseur of the art of painting, so I gladly give Hussainsaab the benefit of doubt.

On the other hand, have you ever, when at an art museum, looked at what might be called abstract art and thought: 'Well, even I could do something like that'? Yes? Well, there is definitely something in there that you probably cannot re-create. I was just reading an article in a London daily (Daily Mail) that put a smile on my face. Its about a 2-year old Freddie Linsky, who started his career in painting at 8 months of age with ketchup (yes!) and has since graduated to using acrylics. He gets tremendous appreciation and encouragement from his mom. He is allowed to mess up his place when he is working on a project. How you wish your mom had allowed you to do that when you were a toddler and not curbed your talents! And guess what, his prodigal work has been selected by a gallery at Berlin for display. I am sure you will enjoy the entire article. Some interesting excerpts of his interview are below.

Freddie is said to favour the "spot and blotch" technique pioneered by the American abstract expressionism movement in the 1950s.

The young artist is said on Saatchi Online to have "dedicated his whole life to art".

His mother wrote: "Freddie W R Linsky paints over and over, making us curious to know what is going on.

Alien Species

2007-12-01T23:02:00.000-06:00

My idle mind wandered to figure out why many American advertisements featuring animals were portrayed to be 'Unamerican', and mostly British! The lizard of Geico (more correctly the Madagascar Day Gecko) speaks flawless British accent, as does the elephant housewife in a commercial for one of the renowned room freshener brands. Then, there is an irritating bee in the Nasonex ad that speaks a totally confusing accent, probably originating from the Middle-east. Are the ad agencies stereotyping the animal species as being alien? I really don't see a reason, except to add a tinge of fascination to the whole animal concept.

Talking about animal ads, I hate the cheek of the 'Happy Cows' California Milk commercial that depict the Wisconsin cows to be shivering in the snow, looking to migrate to California. My 'Dairy State' of Wisconsin lost its No. 1 position in milk production to California in 1993, though it narrowly continues to be the No. 1 producer of cheese in the country. The New York Times report mentions about Wisconsin: 'Cheese is the state’s history, its pride, its self-deprecating, sometimes goofy, cheesehead approach to life.' Wisconsin boasts the nation’s only “Master Cheesemaker” certification, for its most accomplished veteran makers (there were 47 as of April 2006) and one of the earliest cheese-making education programs, at the University of Wisconsin.

Entertainment Redefined

2007-11-14T20:21:00.000-06:00

Was I jobless, plain bored, idle or what! I was flipping TV channels while having dinner tonight, and hit upon MTV. Quite optimistically, I thought it would provide me some flimsy entertainment for the 30 odd minutes during my favorite meal of the day. It turned out that I would have rather spent that time writing about some other nicer topic on my blog. But here I am penning my experience of less than 10 minutes ago, watching a series called 'A Shot At Love' with Tila Tequila. I won't blame you if you haven't heard of either the program or the host. Well, if you have, you may reconsider acknowledging that fact.

This is a path-breaking reality show where the hostess Tila Tequila (no, she was not born with that last name!) is a self-proclaimed bisexual, and has 14 straight men and 14 lesbian women vie for her in an epic battle through 10 episodes. I am quite sure I won't be watching the entire season, but today I did witness the bunch of guys and girls trying to gobble a pair of bull testicles and a penis down their throat to win Tila's heart. Not only that, the winners of that ordeal had to down a glass of blood, a heart and a pair of eyes (forgive me for not being curious about which animal's parts they were provided) to prove beyond doubt that they were worth Tila's time in a jacuzzi later that evening. The unbelievable explanation Tila gave for this test of strength was that because she travels around the world so much, she wanted to make sure her sweetheart could make do with any kind of food.

This is prime-time television for you, and dinner time for me today. Wow! Correct me if I'm wrong, but I thought MTV stood for Music Television!

Gloom Barabar Doom

2007-06-19T10:08:00.000-05:00

That's how I would describe the latest Amitabh-Abhishek-Preity-Bobby-Lara Dutta starrer that released about 5 days back. I actually did advance-booking to catch a late-night show of this joke of a movie. There were about 50 other sufferers with me in the theater that fateful night.

130 minutes was the total length of the misery, of which 40 minutes were spent in reiterating the title song in different forms, with all the main characters trying their best to out-dance the others. Big B definitely took the cake, with an outlandish hairstyle and some of the absurdest costumes I've seen him wear. As the credits rolled at the end of the movie, I distinctly spotted the 'story development' credits right at the top, for a movie that really had as much story as the bedtime story my two-year old niece hears. The only commendable aspect of the movie was the music by Shankar-Loy-Ehsaan, that is first-rate both in quality and popularity.

It disappoints me to see Amitabh Bachchan wasted literally as an 'item boy' in this Yash Chopra production, even as he delivered a performance par excellence in the other movie I saw last week. Cheeni Kum (directed by R. Balki, and easily one of the best movies I've seen in the past year) saw the Amitabh Bachchan and Tabu in beautifully etched out roles, ably supported by veterans Zohra Sehgal and Paresh Rawal, not to forget the child artiste who played the cancer patient.

It was disheartening to see movies like Kabhi Alvida Na Kehna rake in money for its producers. Gauging the crowd at the theater that evening, I am hopeful Yashraj learn their lesson this time around, and not take their audiences for granted.

The Great Indian Walmart

2007-06-15T08:48:00.000-05:00

Which was my favorite experience among the lot? The '5-second darshan and push everyone around you' experience at Tirupati; the 30-minute traffic snarl at Bangalore airport arrival lane at 12 midnight; or being one among (I am guessing) over 10,000 shoppers at the Saravana store, T-Nagar, Chennai.

Tirupati, the most visited place in the world, is a world-renowned place of worship and you most certainly expect crowds on each day that the Sun rises in the east and sets in the west. But our visit was special. Ex-CM Chandrababu Naidu decided to have his 'Mahanadu convention' at Tirupati at the same time, and this made everything difficult during our darsanam. For the first time, there were queues to get out of the temple after offering our prayers. My mind wandered to think what would happen if there were a stampede right there as we exited the temple premises.

Everyone knew Bangalore as a beautiful city of gardens, pleasant weather and helpful people. Now, I know Bengalooru as a place where you need at least an hour to get to any place, no matter how close it is. Bangalore was never planned to be a metro like Chennai, and now it seems that it cannot handle the pressures thrust upon it by the IT personnel influx that only seems to be increasing with each arriving flight (by what I saw at the airport that night).

One surprisingly magnificent experience was shopping at Saravana stores, where I happened to enter to buy some essentials. 7 floors, over 1000 customers on each floor, over 100 attendants on each floor, mind-boggling variety in almost everything you can think about: fruits, sarees, shirts, suits, shoes and chappals, plastics, steel, toys, cell phones and more. There is even a superb canteen that caters to the shopper's hungry palate. All prices are well below regular retail stores, so you always get the best deal for any product. What's intriguing is that the store is maintained to handle the madding crowds, check shoplifters, service and returns, very very efficiently. It seems there are people who arrive at Saravana straight from the Chennai railway station and return to their villages directly after their shopping spree, their hands full with those typical jute bags they doll out for bulk shoppers. That day, I got out in a short while, but I promise to return to have a better and longer rendezvous with Saravana.

Final Flourish

2007-06-14T09:53:00.000-05:00

Athletic, romantic, picturesque, multi-cultural, friendly, progressive, intelligent… Madison in Wisconsin, my home for three years during my Master’s studies, is all this and more. There could be no words to express how much I am already missing being there, my lab, my home, my roommates, my entire day. Madison changed a lot about me, mainly for the better. I lived through uncountable moments of laughter and thrill, fun and frolic.

What made my final stay in Madison very memorable besides good times with friends and well-wishers was the opportunity to witness a concert by Bharat Ratna Pandit Ravi Shankar. I never really had a chance to hear him ever before in India or in the US. On the 17th April, just as I was leaving Madison for good, Ravi Shankar accompanied by his daughter Anoushka Shankar performed at the newly renovated Overture Center in Madison downtown. For me, it was a dream come true to hear undeniably the most popular performing Indian classical artist. I was more curious to know how Ravi Shankar could deliver at the age of 87. Lots has been written and said about his music, much acclaim, and plenty of criticism to go along with that too. Yet, I was thrilled to experience first-hand, what many non-Indians consider as the best and predominant expression of Indian culture and music.

Glamorous pamphlets (if I can dare to call those information booklets that!), heavy security checks and an enormous buzz greeted us at the entrance doors. Past that, I was pleasantly surprised at our seating that was in the 6th row from the front in an auditorium that seated over 2000. We didn’t need the binoculars that I took along to catch a glimpse of the artists from close quarters. Still, I did not lose the chance to use them to get a clearer view of Anoushka who was glittering like no other classical Indian artist I have ever seen on stage!!

Anoushka staged the first half of the performance with Tanmay Bose on the tabla and Ravi Kullur on the flute, all highly creative and talented, but only one who ran the show from the beginning to the end. If I was impressed with her playing skills, I was in complete awe of the confidence and pizzazz that she oozed. And she played Puriyadhanashree and Keervani ragas, both that have counterparts in Carnatic music (called Panthuvarali and Keeravani respectively), and both my absolute favorites. After a short break, we were finally treated to the Maestro’s music for which we had all been waiting for: Ravi Shankar entered to a standing ovation from the audience. He played a beautiful khayal in Behag followed by a thumri in Mishra Kafi. Whereas he took some incubation time to display his toned flourishes, it was well worth the wait.

If there were any complaints in my mind, it was only that we couldn’t hear them for longer; and the fact that their music is an abbreviated (or abridged) version of the true presentation of Hindustani classical music, made to suit the Western audiences’ tastes. The world already knows all the greatness about Ravi Shankar. Now, all eyes and ears would be on Anoushka as she takes Indian classical music to even further beyond what her father attempted.

Not Hibernating

2007-03-29T14:24:00.000-05:00

Its cold here in Wisconsin, but I am not hibernating. True, I am busy with other things, and have been thinking of writing something for over a month now. But each time I really sit down to it, I lose the enthusiasm to write. Its funny that whenever I am really busy and anxious with work, I am most excited about writing in my blog, and when I think I have all the leisure time in the world, I don't feel like sitting down to write something concrete.

The other day, I was in a hurry, as always, to get the bus back home from work. You really don’t know how much I love to catch a bus as it leaves the bus-stop! There is one distinct sense of satisfaction when I do manage to do that. But an equal and opposite sense of frustration when I miss it! Anyway, as I was taking the elevator down from my 6th floor lab to the first, I was halted at the 3rd floor. How irritating is that! Especially, when you are in a hurry. Then, to add to my over-sensitive nerves, a 300-pound lady enters and cracks a ‘funny one’ at me. Then, she presses the button to the 2^nd floor. That was it! Any decency and etiquette I had learned over the years was melting into nothingness. I respect a person’s desire to use the elevator, after all, it is public property. But to use it to go from 3^rd to the 2^nd floor is not only waste of her time (I am confident she waited for over a minute to get in) but also of MY time ('coz I missed the bus and had to walk home eventually).

OK, I might be seeming much too insolent at this point of time, but the fact of the matter I am getting to is that life here is getting just too comfortable. Everything can be done at the touch of a button. As we gloat about progress in science and engineering, we don't realize how much we bloat on account of that. Obesity seems to be the result of many factors, foundation of some that are laid in early childhood, in the very atmosphere you are brought up. It is not an infection, there are no medicines you can take (unless you consider Relacore and other such pills) for instant betterment. There is definitely a role for the genes, but the dominant factor is lifestyle. Why do we brush aside poor eating habits (over- and improper-eating) and poor activity routines when we are kids? Oh, he’s just a child. He’ll grow up fine. Look at those chubby cheeks.. so cute!!! Even as adults, we refrain from considering this condition as a disease. While we are fast finding cures for cancers and resistant bacterial strains, we are fast losing ourselves to this prettily disguised, yet, formidable opponent.

I was reading somewhere that obesity can be prevented by inculcating certain simple habits at childhood. Breastfeeding, eating veggies and fruits (you’ve heard it over and over) and eating together with the family can all help in regularizing food habits. In fact, I remember how when I was a kid, my whole family (my parents, sister and I) would come together for each meal, inspite of the fact that my mom also worked and my sister and I were in different schools. We were together for only half-hour at lunch, and perhaps a little longer at dinner, but the feeling of eating together was wonderful. Those memories seem quaint and quite unimaginable now. Like one of those Karan Johar movie captions: 'The family that eats together stays together'.

Believe in You

2007-02-10T16:17:00.000-06:00

Who has not experienced trying times at some point during their journey of life, times when one wonders why their hard-work is not paying off, why all odds are turned against them and why there is nothing really they can do about it? Life really seems like a vicious circle of misplaced situations and torrid results. It only hurts to look around you and see others in seemingly better situations. At such times, I hear my parents' voices telling me to “try your best and leave the rest to God”. Life is full of ups and downs, twists and turns. What goes down can only come up!

How else do you explain the manner in which Shilpa Shetty came out of sheer oblivion to become the most-talked about entertainer of the past month, owing to her classy conduct (or rather her tormentors' behavior) on Celebrity Big Brother? Or how Sourav Ganguly defied his harshest critics to make a stunning comeback in international cricket, when even most of his ardent supporters wouldn't dare to imagine him in the World Cup team later this year. After his performance against the West Indies recently, this might just be a strong possibility. Another inspiring story is that of Serena Williams in the recently concluded Australian Open tennis championship. Lack of match practice, injuries and a low ranking did not deter this gutsy woman from thinking big, believing in herself when almost no one did. Did you see her thrashing of Maria Sharapova 6-1, 6-2 in the finals? I wish I had!

Here's some of the advice I used when I felt down and out:

Talk to your parents. They sure believe that you are no loser in life. You are unique and you are special.

Talk to a close friend. Most good friends like to play the intent listener and help in some way.

Take pride in your past successes and draw inspiration from them. You can do it!

Read inspiring stories and biographies.

Believe that it is never too late for anything.

Try not to compare yourself with others around you. You don't know their real story.

Enjoy practicing your hobby.

Remember you'll truly appreciate the 'good' only if you experience the 'bad'. There's probably something you can learn from your hardships.

And however philosophical it might sound, finally, there is no one thing that is cosmically significant in the larger scheme of things. Just move on!

Frozen Finally!

2007-01-31T00:43:00.000-06:00

Global warming is on everyone's mind. Its on every talk show on TV or radio. And quite often, you will hear President Bush being blamed for the effects of global warming too! Due to the El Niño effect, it has been predicted that 2007 would be the warmest year so far. Nevertheless, not many in Madison are complaining about the late beginning of winter this year. When I spoke to our hospital shuttle driver about 2 weeks back, he said he couldn't care less about when the Madison lakes would freeze this year. He seemed thrilled to envision a scenario in which they might not freeze at all.

But some of the more adventurous and enthusiastic Madisonites would beg to differ, and among them are the cross-country skiers, ice-fishers, the snowmobile-riders, ice-sculptors and the kite-fliers. A lot of the culture of Madison depends on how thick the sheet of ice is. Madison was the host of the now defunct 'Kites on Ice' fest held annually on the frozen Lake Mendota (see picture below). Teams from all over the mid-West and other parts of the US and Canada convened to compete in a kite-flying test, replete with music and fanfare, with the participants and the audience cheering as they stood on the frozen Mendota. I was fortunate to have witnessesd this truly fine event in 2005, that was thence discontinued because the “weather situation in Wisconsin became too iffy”.

Just as everyone was speculating whether the lakes would freeze, on the night of January 20, Mendota lake froze, it seems, in dramatic fashion as it always does. There has not been a year in the past 150 years of record-keeping when it has not frozen, and this year had the second-latest freeze date (compare with January 30 in 1932). Now, everyone (in the Limnology or Climatology departments or anyone who is just interested) is watching if the record for the shortest time of freeze is going to be broken. And when you compare the longest duration of freeze (161 days in 1880-81) to the shortest (21 days in 2001-02), you cannot but wonder what would happen one century from now. Would it have happened if they had elected Al Gore in place of George Bush?

Super Sunday

2007-01-21T23:19:00.000-06:00

As always, also this morning, I strolled into my balcony with my morning cuppa. Madison received a whopping 5.9 inches of snow through the day (second only to 6 inches on January 21, 1998), thus preventing timely clearing up of the snow from sidewalks and roads. It was a pleasure to watch from my balcony as the snow flurries drifted slantingly towards the ground, almost as if it were a world lacking gravitation. It was most certainly dreamy! The worldly worries of having to scrape the snow off my car or my sidewalk didn't bother me much. Well, that's because I don't have either!

Who goes out on a snowy Sunday morning to the lab to work? I do, not always, but this morning, and I am glad I did. As I set out, all decked with layers that Wisconsinites are always encouraged to drape themselves in, I didn't realize that the journey to my place of work would be more than another mundane excursion. Okay, my bad that I presumed that buses would run late on a day like this. It is times like these that I curse myself for being 'minute-wise, hour-foolish', so that I get some additional time to check e-mails or surf the internet aimlessly for few more minutes. It seemed like the holiday route bus-driver took his job almost as seriously as I do, and drove past the bus-stop at quite the right time, even as I scampered a few minutes late! So, anyway, I decided I can do with some walking. 'Its not that far', I thought, and 'Its good for health, too!'. To dampen the efficacy of my intellectualization of this exercise, I saw a bus pass by in the opposite direction , easily 5 minutes later than it should have. 'That's the Murphy's law in action', I thought. But lately, I have come to believe that everything happens for a reason. Perhaps, He wanted me to take to the path by foot.

The feeling of walking on virgin snow-covered paths was a mixture of childish and sinister pleasure for me. Occasionally, I turned back to look proudly at the trail I left behind, a path no one had ever walked before, at least this morning! Soon, when I was a few blocks from home, I joined a bunch of kids noisily making a snowman, or at least something that looked like one. I had never done it before, and I thought there is never a better time than NOW. I excitedly offered my services and could see myself regress 20 years in age as I joined these kids. 15 minutes later, I was richer with another first experience of its kind. As I bade my new buddies good day and good bye and continued my walk, I felt a unique sense of relaxation and happiness that rejuvenated me for a wonderful day at work. There were passers-by who were skiing, some snowboarding, some just throwing snowballs at each other. Truly, sometimes these simple pleasures of nature far supersede any artificial joy rides. Then, as and when I peaked out of my lab window during the day, the view of a white and pure landscape livened me even more (as in the picture below). On my way back that day, I didn't wait for the bus. I decided I didn't need any!

Stretching It Too Far

2006-12-10T09:42:00.000-06:00

Two days ago, my friend Brad and I had a heated argument while working out at the gym. Brad insisted that I spend some time stretching before commencing our run on the track. He said he had always felt more comfortable that way. He even attributed his better running record than mine to my non-adherence and callous indifference to stretching protocols. In my defense, I quoted what I remembered about reading that stretching has been shown in research studies to be of no significant benefit in preventing injuries in sportsmen, and perhaps, even to be related to higher risk of injuries. Stubborn as we both were, we failed to consider each other's points of view (even though we verbally confessed that we did!) and ran our own ways around the track. I realized later that neither of us were totally right or wrong in our assessment of the requirement of stretching during a workout.

Firstly, stretching is often confused with warming-up, the latter being the performing of the activity in a slower and gradually accelerated way. Whereas warming-up has been considered to be of help in improving performance efficiency, all the studies that showed stretching to be beneficial did not consider the confounding aspect of warming-up in their plans. Stretching obviously contracts and relaxes the muscle fibres to its maximal extent, thereby increasing flexibility around a given joint. This may be important when indulging in sports that require good flexibility like for gymnasts and figure skaters. When not needed as in running, excessive flexibility can cause muscle instability and decrease total force production. Even sports medicine scientists agree that the benefits of stretching in causing subjective improvement in performance is something that cannot be quatified by research. One of the reasons why Brad felt compelled to stretch each time could be that stretching induces production of hormones called endorphins that are natural pain-killers produced by the brain. This is probably responsible for the 'runner's high' that athletes experience and that scientists and doctors have failed to reproduce in lab experiments. These are the same endorphins that are also linked to the effect of placebo in controlled experimentation.

So finally, what's good and what's not with stretching? Stretching techniques can be of several types: ballistic, dynamic, static and propioceptive neuromuscular facilitation (PNF). Repetitive bouncing movements as in ballistic is definitely not recommended whereas dynamic stretching that mimics the activity to be performed in an exaggerated yet controlled manner can be as useful as warming-up. Static stretching of muscles by holding them at the point of discomfort is a popular method and useful if done for limited periods of time and severity. PNF requires a partner and involves both agonistic and antogonistic muscle groups (eg. biceps and triceps) and produces the greatest benefit in flexibility. Thus, stretching can help maintain flexibility which declines with age or inactivity due to an injury. Also, stretching may be more safely performed after exercise, when muscles are warm. As a final word, I have come to believe that like most things, stretching is good as long as done in moderation to suit the kind of activity done. Indeed, both Brad and I never imagined this topic to be as equivocal as it turned out to be!

'Mean'rashtra

2006-12-04T01:01:00.000-06:00

Land of Shivaji, land of Ambedkar. The very land of the father of our constitution is now burning. Following the tasteless act of the beheading of an Ambedkar statue in Kanpur, Uttar Pradesh, there has been a unimaginable surge in communal rife in Maharashtra. Specifically strange considering that the place of the inciting event and place of subsequent riots are separated on the map by a distance of over 1000 km. Many believe that it is a politically motivated exercise to garner the crucial support of the Dalit votebank and some consider this to be the the outcome of bottled up anger and frustration of that community over previous discriminatory incidents. Either way, this exposed the worsening situation in Maharashtra, the incapable and fickle government, the unrest among sections of the population. It is hard for me to believe that Pimpri, one of the most peaceful areas in Pune, was struck by mobs of stone-pelting and shop-burning. Shops, schools, offices remained closed for at least a day in most places in Pune. Who gained anything out of all this? Who pays for all that damage, loss of property and disruption of the civic system?

What Babasaheb Ambedkar said repeatedly in his writings and speeches was: "We must shape our course ourselves and by ourselves... Political power cannot be a panacea for the ills of the Depressed Classes. Their salvation lies in their social elevation. They must cleanse their evil habits. They must improve their bad ways of living.... They must be educated....” I fail to see even an iota of effective education in anyone connected with this whole incident. Neither the ones who desecrated the statue, nor the ones who rose up in retaliation to burn trains and buses nor the politicians who watched silently mired in their own factionist goals. I wonder how many how of them even know any intricate details of the life and teachings of Ambedkar. Is it surprising that even as we talk of India becoming a super-power, only 6% of the Indian population graduates from school (Rajinder Sachar committee report)? Its common knowledge who the people involved in these revolts and mob activities are: jobless persons, those who have no fruitful ways to channelize their energies and who take this as the only opportunity to be heard. They have no vision for themselves; definitely none for their community or their nation. Apt and ironic to quote one of Babasaheb Ambedkar's bête noire, Mahatma Gandhi who said: 'An eye for an eye will make the whole world go blind.'

Subway Expedition

2006-11-29T19:07:00.000-06:00

“What kind of bread would you like?” I was asked by a rather stern looking lady at the Subway restaurant with a tone of routineness and a glance of expectation of an even more routine response. But being a person who just landed on American soil about 2 days prior to this event, the question sent me in a tizzy. The most I'd heard or imagined about was white and brown bread. Not willing to display my ignorance on matters of the bread, I shot back with a question: “What are the breads you have?” At this moment, the lady raised an eyebrow and realized that she was dealing with a rare challenged customer. She pointed to a chart displaying the 4 or 6 types of breads – Italian herbs, whole-wheat, etc, etc. I muttered something to her that looked innocuous enough to be tried for my first time.

But life is a garland of several battles, and I was reminded of that when she came up with “And what kind of cheese would you like?” I felt a cold sweat drench my neck and palms. Gauging my continued incapacities in choosing my sandwich, she quickly pointed out to the different cheese varieties, names of which I barely followed as she hurriedly enumerated in her Southern accent. I picked the first one – cheddar I suppose, again one that seemed harmless and insipid. By this time, I was hungry, cold and sweaty, and wondering when I would finally be able to get a bite into something edible. The lady on the other side felt a similar level of impatience.

Anyway, when it was time to decide the vegetables that I need to put in my sandwich, all I was worried was that there should be no trace of meat in my sandwich, lest all the hard work put in so far would be wasted. I pointed excitedly at the capsicum slices. The lady was not impressed. For that matter, she didn't understand what I was trying to tell her. Then, I tried telling her to make my sandwich spicy, and to add some green chillies. She gave me a blank face. She called out names of some veggies I had never heard of, and I wondered why my convent education didn't help me in this day and age. Finally, I hit the jackpot, and out of sheer desperation, I said: “Please make a sandwich with no meat, just the way you would make it for yourself!” Phew! I later realized that this masterstroke saved me the anxiety of choosing a kind of sauce for dressing the sandwich.

After what seemed like endless mental travail, I dug my teeth into this cold, dry, raw, conglomeration of vegetables huddled inconveniently within 2 slices of a cold, hard, vapid fancy bread. Homesickness struck me that very moment. I couldn't help reminiscing about my mom's traditional and tasty, yet, healthy cooking and the dosai and sambhar I ate every other day with no tedious question and answer sessions. Sometimes, I thought, life is easier with fewer options to choose from. Today, I may think differently about having choices and about seeking novelty, but this incident does bring forth funny memories of a different world.

Citizen Of The World?

2006-10-30T01:09:00.000-06:00

My father was the only one among nine siblings from his family to have moved out of Chennai to make a living in the northern city of Dehradun, then in Uttar Pradesh, now in Uttaranchal, soon to be in Uttarakhand. As he reaches the culmination of his successful career, he has tracked back to Chennai. Needless to say, he has taken to life there like a fish to water, including attending a classical concert each evening at a venue that is no more than a stone's throw away from home.

Mom, on the other hand, breathes and dreams Bangalore. Having spent all her pre-marriage years in Bangalore, she never runs out of stories detailing the magic of Bangalooru, its people, the gardens, etc. There is that distinct glow in her eyes and an unbound enthusiasm whenever she makes plans to visit Bangalore. She often laments the fact that she does not derive the level of satisfaction when bargaining with the Marathi thelewallah as compared to the Kannada vegetable vendor!

My sister has been all over the country, setting up her house wherever she went. But even as she moved from place to place, she finally found her calling in Pune, where she now raises her children and runs her clinic. She, too, has soaked the Puneri culture and rattles off instructions to her patients in Marathi as if that were her first language. She doesn't consider herself an outsider no more.

Then, consider my aunt in Manhattan, who thinks there could be no other city that even comes close to NYC in terms of livability, all this inspite of incidents like the WTC crash and the forever orange alert. She savors the independence and comfort NYC offers and trashes even the faintest idea of living anywhere else. I hate her audacity but love her panache thats so typical of a Manhattaner. Secretly (not any more), I envy her easy access to the Central Park, the world-famous museums and the Broadway theater.

So where do I belong to? I wish I could say Dehradun or Pune, places where I spent almost a decade of my life each. Or perhaps Madison, that I have begun to love and feel one with during the last three years. I have at some point of time or the other, always sensed each of these cities to be my own, so much so that setting feet on its soil brought forth a unique sense of security. But each time, I move on laden with pleasant memories of a warm past relationship. 'Where do you see yourself 10 years from now?' A favorite interview question: I wish I knew...

Not spoony about this one!

2006-10-16T23:34:00.000-05:00

Sure, you’d agree that there are burning issues in the world today waiting to be solved: the Iraq war, North Korea nuclear tests, polio eradication and obesity. But that's not to deter these researchers to perform a systematic longitudinal study researching a very common occurrence, a problem each one of us has faced at some point or the other, but rarely gone beyond lamenting and complaining about. Hats off to these guys who are path-breakers in the field of 'spoon' research. I'm talking about a paper published recently in the British Medical Journal about disappearing teaspoons!

Initially, I found it really amusing and a little absurd that anybody would waste time, money and manpower on such issues. But then I thought about research in general: the whole idea of research is to ask difficult questions, to scientifically explore the causation and thereby find solutions to problems. Its an answer to the intellectual man’s inherent and incessant inquisitiveness. As I analyzed this more, I became appreciative of the fact that schools (in the US and UK among some other countries) encourage this culture among students and scientists. Indeed , the sky is the limit for us to ask perplexing questions and find ways to research them. Why, then, shouldn’t we rightfully know where those teaspoons go from the spoon shelf? Why did I never think of doing a study like this?

Somewhere along this train of thought, I was thinking about the education system in India. There is no doubt that there are advantages in our system that has been producing top quality engineers and scientists who now lead many companies and institutes around the world. Keen sense of mathematics, multi-lingual capabilities and resourcefulness are all ingrained in most of us like nowhere else. But out-of-the-box and novel thinking lags behind in our priorities. For 12 years of schooling, most of us are burdened with heavy bags, homework and unrealistic expectations, to be the winner of a rat-race of sorts that leaves the real essence of life unexplored. Even hobbies are forced onto children by their parents with a vengeance of some kind (for all the things they themselves probably never attempted and achieved)! In all this, there is a huge possibility that one ends up without exploiting one’s special talents in trying forever to be just like everybody else.

To sum up the interesting results of the spoon study, they found that “the half life of the teaspoons was 81 days. The halflife of teaspoons in communal tearooms (42 days) was significantlyshorter than for those in rooms associated with particular researchgroups (77 days). The rate of loss was not influenced by theteaspoons' value. The incidence of teaspoon loss over the periodof observation was 360.62 per 100 teaspoon years. At this rate,an estimated 250 teaspoons would need to be purchased annuallyto maintain a practical institute-wide population of 70 teaspoons.”* Incredible!

*MSC Lim, ME Hellard, CK Aitken, BMJ 2005; 331:1498-1500

Kingmaker

2006-09-30T11:28:00.000-05:00

An inspiring story I read recently was about a teacher in Patna, Bihar (the poorest, most illiterate and one of the most populous states in India) who trains students to take the entrance examination to IIT, the most prestigious institution in India. So what’s new about that? There is already a well-thriving industry that coaches you to ace the test. There’s probably one in your neighborhood too. Well, this one’s different. Maths teacher Mr. Anand Kumar started the ‘Ramanujan School of Mathematics’ to help fulfill dreams that he himself never managed to realize in his life and career. He selects 30 of the most eligible students from over 5000 applicants. And eligibility depends not only on their intelligence and talent, but importantly on their family background and financial status. One place in today’s world where your monetary assets don’t boost you undeservedly. These brilliant brains come from some of the most impoverished families, who without guidance may never have achieved what they are capable of. They have truck-drivers and daily-wage workers as parents, and bunch of siblings who have never dreamed of going to school, let alone excel in academics. Here, they're given food and shelter, some superlative training and insight, and the platform to become role models for their families and community. Each year since its inception, the number of students ranking in the top of the list has been increasing, and a significant proportion come from the lower castes. To me, this is a glowing example of what needs to be done on a larger scale to bridge the caste system in our country and to give the best possible opportunities to those lacking access to them. But where do we find more motivated and selfless humans like Anand Kumar?

Reading this makes me feel trivial and insignificant. What am I doing? What am I contributing to the world, to my country, to my society? Everything was offered to me on a platter: the best clothes, the best schools and education, the best of vacations. Am I utilizing my opportunities to the maximal extent? There would be many who trade their right arm to be in my position of fortune. To some extent, I do think we all tend to become complacent with our work, with our goals. Someone said: 'Always be satisfied with what you have, never with what you are'. I try never to forget that.

Better Safe Than Sorry

2006-09-19T23:50:00.000-05:00

My friend recently wrote one about sex education in his widely-read blog, based on personal experiences and state of present day schooling in his home state. We were all gently poking fun at his ignorance and immaturity about those things during his growing years, when all of a sudden, I was drawn into delivering an impromptu lecture on related matters, not at the level kids at seventh grade get it, but at a more contemporary level, a more practical discussion of the arcane topic. I was the only erudite doctor amongst these talented scientists and engineers and felt a natural responsibility to take the lead in what could be called my expertise. Soon, I was drawing charts of the female hormonal cycles and talking about 'safe' days and the 'rhythm method', options of abortions and emergency contraception pills (ECP). Talking to them, I felt that someone our age cannot afford to be insouciant about the biology and its practical ramifications for any eventuality that may arise.

Earlier today, I was looking to update myself with the state of ECP in the US, since everything associated with abortion and life-issues is huddled with so much controversy. ECP are nothing but high doses of the regular contraceptive pills (combination of the hormones estrogen and progesterone) that should be taken after unprotected sex or a failed form of contraception like the tearing of a condom or in case of a sexual assault, to prevent pregnancy. In recent years, the popularity of the progesterone-only pill (known as plan B in the US) has grown mainly owing to its fewer side effects. These have to be taken within 72 hours of intercourse and they work by preventing or delaying the implantation of the egg in the uterus, whether or not it is fertilized by the sperm. To some, it might seem like a form of abortion since the ovum may already have been fertilized, but in reality, there is no growing fetus until it is implanted successfully. In fact, the majority of natural abortions (or miscarriages as they are known) are due to chromosomal abnormalities or improper implantation of the embryo. These will occur irrespective of any intervention. ECP, however, should not be confused with Mifepristone, a drug that is given in high dose to abort a first-trimester fetus, well after implantation. Whereas pro-life groups consider hormonal contraceptives immoral and abortion-like (that it prevents pregnancy), the pro-choice factions fear that soon, breast-feeding could be considered an abortion method (that it renders the woman temporarily sterile) and immoral!

Of the 300,000 sexual assaults occurring in the US annually, 25,000 result in pregnancy and 90% of these are preventable had there been better awareness about and easier access to ECP. Also, nearly one half of America's 6.4 million annual pregnancies are accidental! It was only on August 26 this year that the FDA approved the universal sale of the 'morning-after pill' over-the-counter at pharmacies to girls aged 18 and above, whereas those underage still need a doctor's prescription. Some controversial questions, however, remain. Like does encouraging the use of emergency contraception lead to increase in unprotected sex and hence, to increased incidence of STI (sexually transmitted infections) in the community as a whole?

Of Heroes And Idols

2006-09-11T01:24:00.000-05:00

Today was the final day of the last Grand Slam of the year in tennis: the US open at Flushing Meadows, New York City. I have always been a tennis enthusiast, and have also been playing it for the past few years. To me, this year's event was noteworthy for a number of reasons: a crowd favorite for two decades, Andre Agassi playing his last singles tournament; a super-stunning and equally talented Russian blonde Maria Sharapova winning her first US open major; the continued domination in the game of the one man who has all the answers, Roger Federer adding one more to record books; and a legend and an enigma in herself and an inspiration to millions, Martina Navratilova, 50 years young, winning a record 59^th slam.

I am no fan of Andre Agassi, and could not bear to hear his emotional rant after losing his 3^rdround match repeatedly telecast as part of a promotional advertisement all the way through the tournament. But the fact remains that his career in tennis over two decades has been awe-inspiring. It tells the story of a man with a passion for his sport, who has been at the No.1 ranking as often as he has been ranked below the top-100. Though his match-winning streak may have waxed and waned throughout, his popularity with the game-lovers never once abated. They always believed he would bounce back. And he did, to be the only one of his time to have won all 4 major slams. His tenacity, never-die attitude and the unique camaraderie is something that can only be appreciated.

Then, you have this 6'3” tall Russian teenager, who enters the court with a look on her face that gives away nothing, and a dress that would give any top-notch model a run for her money. If you saw Maria Sharapova in her Audrey Hepburn-ish black costume, you'd know why everyone, Russian, Indian or American were rooting for her. But not for that reason alone. She had the requisite tools to eliminate, rather annihilate the top 2 players in the world before rightfully holding that winners' cup over her pretty head. And when you hear that her parents migrated to the US when she was 9 only so that she could get the best training possible while still trying hard to make ends meet, you realize why her success story is so special. And today, it is not about the 1.7 million dollars she took home with her. Its about her sheer hard-work and single-minded determination to succeed.

Roger Federer is an unbelievable player. He is the one everyone loves to love. He is the best the sport has seen in a long while, probably be the best ever. He has clearly dominated men's tennis for the last 3-4 years, amassing 9 majors so far, 5 short of Pete Sampras' record 14 titles. When I watch him play, what amazes me is his calm demeanor as he hits the most effortless-looking cross-court backhand I have ever seen or as he varies the pace of his shots so superbly that his opponents look on rather stunned. I wonder if he has ever banged his racket in despair or shouted expletives in anger. Not that he would never have experienced it. The guy seems so unaffected by all the adulation and expectations and so very modest and humble about his tremendous achievements. In this era of power game, his opponents consider themselves fortunate to have taken even one set against him! For instance, he lost only 2 sets on his way to the crown, one set each to Americans John Blake and Andy Roddick. And did you know he can speak in 5 languages: French, German, English, Italian and Swiss?

Finally, if there is one tennis player who deserves a standing ovation for a sterling career, its Martina Navratilova. I remember watching her when I was five, winning her favorite Wimbledon title, one that she won a record 9 times. Today, she won her 59^th overall Grand Slam title (10^th mixed doubles) partnering Bob Bryan when she is just one month shy of being 50 years of age. She had previously announced that this tournament would be her swan song. Here's raising a toast to some exceptional athleticism and spirit that one may never see again in one's lifetime.

Kurai Onrum Illai

2006-08-30T23:30:00.000-05:00

This famous song composed by Rajaji (C. Rajagopalachari) is a favorite among many classical music connoisseurs. It has something to do with the lyrics of the song that is quite distinct from most other carnatic kritis in that it does not exhort the Lord to help and protect us. Instead, it says that the person is content with his worshipping of the Lord inspite of His absence. ‘Kurai Onrum Illai’ means that ‘I have no regrets’. The words in Tamil are very lucid and easy to comprehend by the common man. But the main reason most of us remember this song is because of its soulful rendition by M.S. Subbulakshmi. I believe that she was among the first artists from India to be invited to perform at United Nations in New York in 1966. Here’s where she presented this special composition including a benediction verse in English.

Nowadays, every artiste worth his / her name plays to the audience’ requests for this song. I have heard many sing, and cannot but mention that the MS rendition supercedes all other attempts. If you have heard it, you probably know what I am talking about. When MS sings, it not any more about the language, the words, the raga or the tala alone. She takes you to a plane that’s higher than intellectual or musical satisfaction. You can almost feel the devotion in her voice, the empathy in her tone and purity in her breath. And I didn’t realize this overnight. I remember as a child, my father used to sing praises of her and could talk endlessly about her concerts that he had attended. To me, these conversations were rather repetitive and pointless. I was a student of music and quite diligent at it. Even so, I didn’t quite understand the intricacies involved, the ‘bhavam’ and the rest of it that my father pointed out each time I practiced. Even when I got the opportunity to visit MS at her home in Chennai, to sing in her presence and to seek her and her husband Sadasivam’s blessings, little did I realize my good fortune. She has been bestowed with all the awards and honors that a musician can possibly ask for. But the person I met that day was as simple as can be, with a large heart and unsurpassed humility. Today, I look back at that day, and am filled with pride for having such moments in my life to talk about.

After almost 2 years since her death, to most of her fans, MS amma still lives on. To me, she was the most traditional woman in all respects: in her attire that became representative of her style, in her almost complete submission to her husband and in her single-minded devotion to her craft. Yet, she was a pathbreaker and a pioneer, with mighty ambitions and lofty ideals. She was solely responsible for popularizing the Meera bhajans, the Annamacharya kritis and numerous devotional and religious hymns. Can you imagine any other voice chanting the Venkatesa Suprabhatham every single morning at Tirupati temple and countless homes around the world? I wish I could say otherwise, but the truth is that without her, romba kurai irrukku.

Independence Day Charade

2006-08-15T23:17:00.000-05:00

59 years ago, India freed itself from the tyrant rule of the English Queen, to signal the beginning of a new era. Most of us would never know how it was to be under a foreign rule, and only learn about the atrocities from history books. Yet, we unanimously feel the pleasure and pride of this independence, being able to elect our own government and to play a critical role in law-making. This year, lately, there has been a spate of terrorism-related events that have marred the comfort levels of the community in general. There was unprecedented security measures as the PM delivered his I-day speech today, full of stern warnings to the terrorists and motivation to the citizens to face the threats bravely. He won a lot of applause for demonstrating his tenor. Yet, I am uneasy at all the politicking involved with I-day and its celebration.

I am closely following one disturbing news item that came into prominence some days ago. That about finding decomposed bodies of new-born female babies in a well behind an ex-army man’s house in Punjab. The couple have been not only illegally determining the sex of unborn children and performing abortions, but also brutally murdering the female babies 3-6 months after they are born. Where is this scenario are we talking about independence? Are we worth our independence?

When my friends and I watched a recent Hindi movie ‘Matrubhoomi’, we initially found it absurd, since it was about a village that had no ladies whatsoever! Older ones had died, infants had been drowned in buckets of milk. Soon, the men were left without any woman to marry and procreate. Amidst all this, the plight of this one girl who was secretively nurtured by her father for 18 years can be safely left to your imagination. We watched with open mouths and prickly goose bumps the events that followed. What we saw that day was probably an exaggeration of the condition in interiors of Punjab and some other northern states. Did you know, for instance, that there are on an average 798 females for every 1000 males in Punjab, sometimes as low as 500-600 in some places? Unarguably, the worst sex ratio in the world. That’s no fact we want to be proud of on this day.

India needs desparately to break away from the shackles of hollow tradition and blind misbeliefs. These benefit a select few temporarily and harm the entire country almost permanently. The dowry system, gender inequality and caste politics need to be done away with completely. Till that happens, there is no rightful pride in watching the Independence Day parade.

This Day That Year

2006-08-09T21:42:00.000-05:00

Yesterday was a milestone. Three years ago, this day, I left the comfort of my home and parents in Pune, India to come to the US to build a career. Besides being a roller-coaster ride in professional and personal life, these years have taught me a world of things.

For one, I have learned so much about so many things I never knew or never bothered to learn. Computers, cooking, ice-skating, molecular biology, languages, love, independence, travel, history, people, tolerance, accents, …. those are just some that come to my mind. My learning curve has been steep and I have nurtured a really good sense of inquisitiveness about a variety of things. I feel a part of this has been the effect of staying and interacting with different people. I have been lucky to find some really good friends and colleagues, most of whom have taught me something just by being with me. They all come from different religions, varied backgrounds and diverse interests, hobbies and ideas. Imbibing even a little from each person has made me a better and richer human than I was three years ago.

Salad days never last forever. I have come to believe that every era of our life is special and it is irreplaceable by any other. There are the childhood years, and there is college life. And then one gets serious about career and marriage, etc. Through it all, I feel the most valuable aspects are our memories and the relationships we make during that period. We might move away from family and friends, but the moments spent together remain etched in our minds. It is vital that we savor each moment as it happens, not hoping that things could be better than they are, and strive to make each day special.

A lot of people have made my journey so far very worthwhile and exciting, and without naming each one of them, I thank them all and wish them happiness and success in their every endeavor. If you are reading this, you probably too have played a part and I owe you my gratitude.

Rx Ananda Bhairavi 1 capsule prn

2006-08-04T00:49:00.000-05:00

Okay, so that resembles a physician's scribble. But the scientists and musicians at the Raga Research Center, Chennai aim to prove that this prescription is indeed therapeutic for a hypertensive patient. Like Sankarabharanam is for the psychiatric patient. Or Raag Ahir Bhairav for one with indigestion.

As a doctor, I often see patients with hypertension grope with 4-5 medications, and still have an unpredictable outcome. I wonder what music therapy can do in these patients. I don't see music as a part of specialized or critical care. But it might be interesting to incorporate music in primary care practice, say, for instance, in patients with a strong family history of hypertension, to add a musical form of treatment in addition to the less-salt and more-exercise regimens.

We have all heard at some point of time about the healing power of music. We have all probably experienced how good music helps alleviate languor, worry, anxiety and anger. Music therapy has been part of the age-old Indian science of Ayurveda and forms an important part of Hindu texts like the Vedas. Its just that for this to have some impact on a field as scientific as medicine, it needs to be validated with experimental data and stringent clinical trials. The Raga Research Center, headed by violin maestro Kunnaikudi Vaidyanathan, are attempting a comprehensive research study that involves musicians, psychiatrists and physiotherapists, to study the therapeutic effects of ragas. There are interesting possibilities that music stimulates the pituitary gland whose secretions affect the nervous system and many physiological processes.

A recent study showed that Indian classical music produced the largest fall in heart rate as compared to other international forms of music (including Beethoven, Vivaldi and Red Hot Chili Peppers), and these effects were most evident in those with musical training. So, the next time you have insomnia, trust some soulful Bageshri to put you to peaceful sleep.

Much Ado about the Veto

2006-07-20T00:35:00.000-05:00

The big news today was about President Bush vetoing the bill that would have expanded federal funding of embryonic stem cell research. This was of interest to me since I work in the field of biological research, and also because I happen to be at an institute that is the leader in stem cell research, UW-Madison. Dr. James Thomson, director of WiCell was the first in the world to isolate stem cells in 1998 and lay the foundation for further research in this area that aims to find cures for diseases like Diabetes, Alzheimer's and Parkinson's. Stem cells retain the ability to shape themselves into different organs depending on the stimuli given, and may be able to replace the dead brain cells, the destroyed pancreas or the failed kidney. The WiCell Research Institute at Madison was selected late last year by the National Institutes of Health to establish the federal government’s first National Stem Cell Bank that includes a support of $16 million over the next 4 years.

The stem cell research that is opposed by Bush and his right-conservative faction is that involving embryonic stem cells. Adult stem cell research is not part of the cut-down and although it lacks the plasticity of embryonic cells, there have been successful applications. Embryonic stem cells are derived from human eggs that are fertilized in-vitro, and not the eggs fertilized inside a woman's body. These eggs are donated by women voluntarily, and these are eggs that would have gone to waste anyways. Bush equates cells of the fertilized embryo to living human cells, and to what extent that is true is a matter of your belief and opinion as to when life actually starts. It is an extension to the abortion row that continues to divide the citizens and voters of this country.

US scientists are wary of losing opportunities of stem cell discovery to Asian countries like China, Japan and South Korea which have more permissive policies for such research. However, by far, US funds more stem cell research and has more stem cell lines than all other countries put together. For instance, total US funding is in excess of 200 million as compared to South Korea that comes a distant second with $60 million. Moreover, I read that whereas the NIH funds only around $24 million, private agencies fund more than $200 million. The veto does not affect this private funding a wee bit.

Critics of embryonic stem cell research say that not much has come off from the past years of research. There have been reports of disastrous consequences of stem cell transplants where cells grew into a brain tumor that killed the patient. Proponents might tell you a heart-wrenching story of a loved one that succumbed to a disease that lacked a cure. Undoubtedly, developing cures for these diseases need decades of labor-intensive research, and stem cell research is yet only in its infancy. A lot is expected of it and a lot is foreseen. Statistics can tell you about the burden of those diseases on federal spending through Medicaid and Medicare. By aiming to find cures, not only are we progressing in science and technology but also saving millions of dollars of future expenditure on rehab and palliative care. I doubt there is one straight-forward answer to it all, but debate and discussion can help people understand the other's point of view.

Let me end with a funny line by Conan O'Brien on the Late Night Show tonight. You needn't be an expert on American politics to figure out 'Who would be the biggest enemy of Bush? Two gay (illegal) immigrants doing stem cell research!'

Fahrenheit 451

2006-07-16T13:50:00.000-05:00

This book by Ray Bradbury is about a dystopian world imagined by the author at a time when reading books and intellectual, individualistic thinking are discouraged, and homes with books burnt by 'firemen'. I put down some striking lines I came across. Some with deep meaning, some ironic and some real weird.

'Those who don't build must burn.'

'The good writers touch life often. The mediocre ones runs a quick hand over her. The bad ones rape her and leave her for the flies.'

'When I was younger, I shoved my ignorance in people's faces. They beat me with sticks. By the time I was forty my blunt instrument had been honed to a fine cutting point for me. If you hide your ignorance, no one will hit you and you'll never learn.'

'The folly of mistaking a metaphor for a proof, a torrent of verbiage for a spring of capital truths, and oneself as an oracle, is inborn in us.'

'And on the either side of the river was there a tree of life, which bare twelve manner of fruits, and yielded her fruit every month; And the leaves of the tree were for the healing of the nations.'

WMD (Weapons of Mc Donaldization)

2006-07-14T11:50:00.000-05:00

Over 99 billion served worldwide. Or so says the giant hoarding at a neighborhood McDonald’s fast-food restaurant. What I’d like to hear though is how many they have killed. No, really, I am serious. May be I am being unduly harsh on McDonald specifically, but we can include all its kind and its competitors in the statement. One of my co-worker’s husband had a heart attack recently at the age of 26. Boy, was that shocking or what! No prizes for guessing what his diet was like; burgers, French fries and coke, day after day, every single day. And he is not alone in leading this lifestyle. Have you noticed how every customer at McD’s is asked: ‘Would you like some fries? Anything to drink?’ Even if someone was intending only to satiate his transitory hunger, he would be cajoled into buying these ‘necessities’. Good for the marketing mind, not so good for the over-burdened heart!

Together, they have revolutionized the eating habits of the western world, and sedulous efforts are on to raise the ‘Mac index’ of the eastern world too. We know how ‘hip’ it is to visit a McD’s in India. It is considered a form of ‘American culture’ that many are willing to adopt blindly. The irony is that the western world is gradually waking to the benefits of vegetarianism and healthy food, while India, for instance, is fast falling in the same trap that will ruin whole generations and take much time to recover from. But that might not quite happen. Whereas here in the US, it is the minorities and the relatively poor that are targeted with prices of food as low as a couple of dollars; in India, it is still the stage for the relatively affluent classes. Obesity is an alarming epidemic in the US, with 65% adults being over-weight, 30% being obese and 5% being morbidly obese. If you are curious to know where you stand, you might consider calculating your BMI (Body Mass Index). Divide your weight (in kg) by the square of your height (in meters). Under 25 is normal; 25-30 is overweight, 30-40 is obesity and over 40 is morbid obesity.

I cherish the fact that I am a vegetarian. Though that was meant to be for religious reasons, it is reassuring to hear the health and goodness of being so. It is associated with lower cholesterol (animal fat has more saturated fatty acids, except fish oil), heart disease, hypertension, diabetes. I recently read that such a diet can also help insomniacs in regularizing their sleep patterns. Including lettuce and broccoli in your diet is not all that bad, is it?

But here’s something striking to ruminate about: Indian doctors recently met at a conference to discuss the exceedingly high prevalence of hyperhomocysteinemia (high levels of homocysteine) in vegetarian Indians, and a cause of early onset coronary heart disease and stroke. This results from a deficiency of folic acid, B6 and B12 vitamins found in greens, milk and eggs that are excluded from a vegan diet.

Can you digest these?

2006-07-03T15:44:00.000-05:00

I have read all its biology and I have read the mechanisms. Yet, I was baffled. Reading the BBC Health capsules recently, I was rather shocked at the hard facts about the HIV-AIDS pandemic that our world is facing during the last decade or so. Even as they say that the AIDS’ spread has begun to peak, the magnitude of the problem is far too over the board. Although in terms of percentage, India, UK and USA all have around 1% of the population infected with HIV (many notches below an alarming 18.8% in South Africa, which means that 1 in 5 in South Africa is infected!), India houses the most HIV-infected persons in the world, accounting for 2/3rds of the cases in Asia. In absolute values, that’s about 5.7 million cases (according to a UN report). Regionally, southern India is worst affected, with 50% of the prostitutes in Tamil Nadu being infected with the retrovirus.

Another aspect of this horror story is that India also lags behind in meting out treatment to the HIV-infected. Whereas China that has almost the same number of infections is able to provide anti-retroviral therapy to 25% of its cases, India stands at a poor 7%, much below than even the Asian average of 16%. However, things are probably beginning to look up. With the biotechnology boom in India and a lot of international drug companies willing to set up base and invest in R&D and production of generic drugs, we might hope to provide the majority of our sick with cheaper yet effective drugs.

India spends 29 cents per capita on AIDS prevention and treatment, which is below the amount necessary to mount an effective resistance to the epidemic. For instance, Thailand that spent 55 cents per capita has been able to control the disease to a great extent that once threatened to trounce it completely. In terms of the enormous population, India still has a huge deficit of funds towards this cause. The Bill and Melinda Gates Foundation has pledged $200 million to the ‘Avahan’ project to deal with AIDS awareness. This is only part of the philanthropic efforts of the US software giant towards health issues that include development of vaccines and drugs for Malaria and TB (which are the other two of the ‘trinity’ of health problems of the developing world, in which too, India is the leader). Amongst all this, it pains me to hear about a 15-year old in Gujarat who immolated himself because he could not bear the ostracism faced due to having HIV-infected parents. I get reminded of the subtle message Shabana Azmi publicized many years ago in a TV ad: ‘HIV choone se nahi phelta hai, isse to sirf pyar phelta hai’.

I miss her...

2006-06-29T23:44:00.000-05:00

She is 8000 miles away from me. She doesn't even utter my name. I don't think she even cares about me. She is happy out there, in her own world. She probably doesn't know I miss her so much. No, I am not grieving about my departed girlfriend, or nursing a broken heart. One should never run after three things in life: trains, buses and girls! (You've heard that one before, eh?) You lose one, and there comes another right behind. I vouch for that each morning.. no, not a girl, when I invariably miss a bus to school. Whom I miss the most right now, right here, is my darling niece Jo. Ya, she is this most adorable lil' girl of my sister and she turns one this Sunday.

I have not seen her yet, in person. And today, when I received some of her photographs and videos where she walks for the first time and flashes her two-toothed smile, I wished hard I could be there close to her. Thankfully, my sister captured those moments for me on camera. I would have seen those video snippets some 20 times already and can't have enough. On her first birthday, I wish my niece a really cheerful and healthy life ahead and all the blessings I can shower from across the seven seas. Even with her parents and two sets of grandparents constantly doting on her, I hope she somehow comes to realize that she has this uncle who really misses her so very much...

Boy! Are we rude?

2006-06-21T17:53:00.000-05:00

The results of this latest survey from Readers’ Digest caught my eye yesterday. A survey of the metros of the world showed that our very own Mumbai was ranked at the bottom of the list. In plain words, ‘aamchi Mumbai’ is the world’s rudest metro. Quite an irony when Time brings out an issue the very same week extolling the role of India and Mumbai in the world of tomorrow and as leaders in IT and whatnot. I don’t necessarily mean that politeness and leadership go hand-in-hand. Well, for one, they might be two different coins altogether. While Mumbai has London and Paris for company in the rudeness department, what surprised me was that New York City topped the ranking with an 80% score for politeness.

One could think that high density of population, fierce professional competition and a hectic lifestyles would translate into caddishness. In more ways than one, NYC and Mumbai are quite similar, and many would vouch for that. I have probably spent an equal amount of time in Mumbai and NYC, and that’s about close to 10 days in each. Besides bursting at its seams with people immigrating in search for jobs, they both boast of great communication infrastructure, multi-cultural societies and ceaseless economic activity. Why, then, does a NYC shopkeeper thank his customer more often than a Mumbai tradesman? The reasons could be many and varied. The first thing that occurred to me, possibly to justify the Indian behavior, was if the so called New Yorker politeness could be mere lip service. Does the New Yorker really care more for his customer than his Mumbai counterpart, or is he just perpetuating the good ol’ American tradition of ‘How are you…… Good!’ to one and everyone. But that’s another story day. Really, how many in India care about thanking and acknowledging the bus-drivers or the janitors for their work when they see them? ‘They’re doing their job…What’s great about that; I am doing mine!’ True, but does it hurt to mouth a few words that might go a long way in increasing job satisfaction? And that reminds of this Hindi movie where Sanjay Dutt believes that the panacea of all problems is the ‘Jadoo ki Jhappi’, a hug. Well, we need not go far enough to hug each and every janitor we meet (that would be a no-no!!), but a little ‘thank you’ here and an appreciative nod there would be great.

Talking of politeness, I got to thank my roomie Pratap who incessantly insisted that I write a blog. I have never seen him so goal-oriented about anything! First of all, I had to overcome my lethargy of thinking about something appropriate to write and then, writing something that would readable, at least by me. There were other challenges like naming the blog and setting layouts but I rose to them remarkably. You have to remember that I am a doctor (Yes, of the human body) and whereas most of my professional friends rarely go so far as to check their e-mail once a fortnight (can you believe that one of my friends doesn’t even have an e-mail id; or perhaps she didn’t want to share it with me!), I have perhaps outdone many of them in terms of computer awareness and technology stuff. Gloat, Gloat…..