Blissful Life

When you apply skepticism and care in equal amounts, you get bliss.

Author: akshay

  • Photograph 51, Bangalore Little Theatre rendition

    In my 6+ years in Mysore, I’ve seen around 6 plays. 2 plays that I don’t remember, and 4 times “Madhyarathriya Thiganegalu” by Rangayana.
    Come my second week in Namma Bengaluru, I witnessed a 1 hour 30 minute spectacle called “Photograph 51” by Bangalore Little Theatre. Oh, where do I start about this heart warming, yet insanely funny and intellectual play?
    The venue was JRD Tata Auditorium. There were scientists and senior citizens taking up majority of the seats. The stage was set as a dimly lit Chemistry lab. The story of Rosalind Franklin.
    “The play is about the race to solve the structure of the DNA and the role of Rosalind Franklin who provided the critical evidence for this. For a long time, she never got the credit and this play highlights her efforts in science at a time when the doors of science were not open for women.”

    The introduction by the director and his daughter set the tone for what was about to come. Photograph 51 is that image of the DNA taken by Raymond Gosling and made the mystical thing a little less mystical.

    As soon as the cast walked on to the stage, the narration started, by none other than the actors themselves. This is one of the many exciting things about the play. There is no narrator. But there are many narrators. And they are all part of the play as well. The narration is sometimes weaved through dialogues. The fourth wall gets breached many times, but what do you call the wall between the narrator and the actor?

    Then there is the wit. If I were to put the play in one genre, I would choose comedy over history, feminism, and science. But it is not a comedy play. The wit never bothered the story. Wit was always self-contained either in soliloquies or in quick exchanges between the actors.

    There is love. There is passion. There is heartbreak. There is reality. This play is a must watch.

    And for that matter, they are performing it one last time on 29th September in Bangalore. Head over to BLT’s website for more information.

  • Understanding the 1/5 Unconstitutionality of Aadhaar and What You Can Do About It Today

    What is the difference between a monarchy and a democracy?

    I am Tipu Sultan. I rule the kingdom of Mysore. I ensure that my kingdom flourishes. In order to ensure that, I will make certain rules. I will punish those who do not follow the rules. Welcome to Mysore.

    We are the people of India. We will decide what happens in India. We will elect representatives among us to make rules for India. We will keep changing these representatives. We will ensure there is social, economic, and political justice; that there is freedom of thought, expression, belief, faith, and worship; that there is equality of status and opportunity among us; and we will promote among ourselves fraternity assuring the dignity of each of us and the unity and integrity of India.

    Which of these places would you want to be born in? Mysore or India?

    I was born in India. I was not born when India was in hundreds of pieces and ruled by different kings. Neither was I born when India was under the British emperor. I was born after Indians came together, said “enough is enough” and claimed India for themselves, and having drafted for themselves the Constitution of India, decided to live by it as a democracy where justice, liberty, equality, and fraternity will prevail. Thank goodness I was born in a democracy.

    Here is a picture of the constituent assembly. Whatever they discussed while drafting the constitution is available on the Loksabha website. Reading through the constituent assembly debates is in my bucket list as well. 

    Anything more than incremental change is hard. Except during revolution. During revolution, change is the norm. India’s independence from Britain was a revolution. Because of our experience with monarchy, we chose democracy as our governing moedel. A strong constitution is fundamental to the survival of a democracy. We drafted a strong constitution taking inspiration from various strong democracies. We set that in stone. We set our democracy in stone.

    The beautiful thing about principles is that well-thought principles rarely need to change. For example, Mahatma Gandhi made truth and non-violence his principles. He could live his entire life on those principles. It is principles that give rise to many of the organizations we see around us. When the principle dies down, the organization too. The way we operate, the rules we follow, the things we do, everything can change. But the principles won’t. Indian constitution defines the principles of our nation. Whatever happens in our country should be in line with the principles laid down in our constitution.

    Think about it for a second. The constitution is the foundation of our democracy. If we do not uphold the constitution, we are destroying our democracy, we are giving up on all the principles that the constitution stands for. Hold that thought.

    The constitution alone is not sufficient to run a country. Which is why the constitution allows for setting up of legislative, judiciary, and executive branches for the democratic government. Legislative to write laws. Judiciary to read laws. Executive to execute laws. (Like Unix file permissions). And there is clear power separation between the branches on who can do what.

    The distinction between branches work well when everyone is doing just what they are supposed to. Law gets passed by legislature that from October 1 people should ride their vehicles on the right side of the road. Police fine or even arrest people who are riding on the left side on Gandhi Jayanthi. They are produced before the court and the court gives them the punishment prescribed in the act.

    Things get murky when the constitution is involved or invoked, though. Vrinda Werkijal who was arrested on October 2nd, goes to the court and says “It is my constitutional right to ride on the road as I please. Rather than punishing me, you should strike down the law that says I can’t ride on the left side.” Then the court would be happy to point out to Werkijal that there is no constitutional right to ride on any side of the road and put Werkijal in jail.

    But, imagine the law was about free speech. Say UP passes a law tomorrow that says people should not use the word “beef” in the state. Abhish Mathew could go to the court even before he gets arrested and argue that the law is against the fundamental right of freedom of speech and therefore should be struck down. Easy peasy.

    Wish everything was so black and white. Many laws are huge. Huge in terms of the components in it. Take Aadhaar Act itself. It has 59 clauses spread over 8 chapters. And many of these are complicated compounded sentences with multiple sub-clauses. When an unconstitutionality claim on such a thing is claimed, it will indeed take months of litigation and thousands of human hours to decide on constitutionality.

    In short, there is only one argument against aadhaar: it ensures surveillance while claiming to ensure welfare and does not even ensure welfare.

    Let us imagine. What does it take to decide on this case? Even for a person who is not influenced by politics and not corrupt, it takes deep and philosophical understanding of:

    • the constitution
    • how surveillance damages democracy or how privacy is important in democracy
    • the disproportionate power that entities with access to big data obtain
    • the technology that is running behind aadhaar
    • the reality of welfare delivery in our country

    Unfortunately, superficial understanding of these won’t do. Someone with superficial understanding would say things like, “hmm, aadhaar will help catch terrorists”, “hmm, we can save money by removing fake accounts in the PDS”, “hmm, you don’t have to worry about surveillance if you have nothing to hide”.

    But if you go read the critiques of aadhaar, you can hear deeper perspectives on how biometric authentication is probabilistic and how arbitrarily a threshold setting configured on a software can either declare you undeserving or deserving for your fundamental rights; on how design choices enabled illegitimate enrollment which has lead to ghosts and fakes in the database – the very thing you set out to weed out; on how democratic voices are stifled in a surveillance state; on why Rajya Sabha is indeed a part of the parliament; and so on.

    Relevant section from Supreme Court judgement on Aadhaar’s constitutionality

    So, why would someone feel like aadhaar is unconstitutional while others don’t? Why is it 1/5 unconstitutional? You know the answer, don’t you?

    If you would like to spend more time crying over spilt milk, read from page 568 onwards of this PDF file.

    What you must do now

    As a citizen of India, it is in your own best interest to ensure that the democracy continues unharmed. The best way to do so is to elect representatives wisely. That is not an everyday choice though. But you do have a choice every day to engage with the government. For example, ministry of electronics and information technology has invited feedback on a draft personal data protection bill. The bill is riddled with issues. First, read analyses of it. Here are a few links:

    Looking at loopholes in sections of the Bill pertaining to data ownership, RTI and more
    Loopholes pertaining to empowerment of children, consent and surveillance State
    India’s data protection draft ignores key next-generation rights

    Then, write to the ministry with your comments.
    Through Ministry directly
    Through Maadhyam

    Be a good citizen. Live in a strong democracy.

  • Why Jacob Vadakkanchery’s Arrest is the Best Thing for Naturopathy, AYUSH, and the State

    There is a lot of context needed here.

    To begin with, Jacob Vadakkanchery is a self-proclaimed healer naturopathist from Kerala who goes around asking people to believe that modern medicine is harmful for health. His arguments are so basic and trying to respond to an argument he raised had me writing a 1200 word blog post in Malayalam explaining what science is and whether medicine is a science. He was arrested in the second week of September by Kerala police for asking people not to take Doxycycline prophylaxis (in the aftermath of the floods) under at least section 505 of IPC. Section 505 is one of those sections which exist owing to the “reasonable restrictions” over freedom of speech and expression in the interest of public order as per Article 19 of the Indian Constitution. It punishes people who spread rumors that are likely to disrupt the society unless they are based on reasonable grounds.

    I, am an HIV physician and general practitioner of modern medicine. I have previously worked in a hospital where Ayurveda was regularly practiced alongside modern medicine.

    Now, let us get to the matter. After Vadakkanchery’s arrest, there was a discussion in my circles about how it was wrong for the state to run Government naturopathic hospitals on one side and arrest people for taking stances against modern medicine rooted in naturopathy on the other side.

    Isn’t it true? If you recognize natruopathy (or AYUSH) as a valid system of medicine by opening hospitals and offices for the same, are you not also paving way to firm believers in those systems to make everyday statements that insult families of cancer victims, make doctors and hospitals look like villains for providing standard care, and makes those who think question the role of scientific temper in our discourses?

    Many times the prescriptions of modern medicine are directly contraindicated by the principles of alternative medicine. How is it that the government is allowing two such opposing systems to exist together? What is the government trying to tell people? Whom should a person go to when they get sick?

    Here are my thoughts.

    It is not the government’s responsibility to tell people what to do. Actually, the government does not have any power to tell people what to do. The government’s role, in a democracy, is to abide by the Constitution which is written by the people for themselves and “govern” the state. So let us leave the government out of the question.

    How did we end up with such systems, though? I think the answer is simple if we try to understand what these systems are and what they represent.

    Self-preservation is a fundamental drive of all living things. Humans must therefore have started thinking about the art of staying alive from the beginning. What humans also tend to do is form theories based on what they see and understand. We form theories for everything. In fact, what we call science is a continuous reforming and refining set of theories based on observations. But these theories are limited by what we can observe and imagine is happening.

    Our imaginations become more accurate representation of reality when we can observe more closely and in more detail. That is how science keeps growing. The idea that there might be something that transmits diseases from one person to another was imagined by observing people living together getting the same disease one after the other even before the invention of microscope. Later, when we invented microscope, this imagination became observation. Then we moved forward imagining things which a microscope could not show us. That is how science happens.

    In that spirit, Ayurveda is a science. Or to put it more correctly, Ayurveda was a science. From the set of observations that could have been made centuries ago, whatever could be imagined was indeed science at that time. AYUSH is a set of outdated imaginations based on observations that does not include all that can be observed with the state of affairs right now.

    Now here is the most important sentence I am going to say. Outdated does not mean wrong altogether. If that is the case, the medicine I am practicing today in India is already out of date by a few years compared to Western world and I am completely wrong to practice that medicine. That does not make sense. It is okay to use the best of what is available. In HIV, there is a medicine called TDF which has a lot of side effects on the kidney and has been replaced by TA in the West. But it’s not yet widely available in India. So, should the 1 million people who use TDF not be using TDF? Absolutely not! Oral rehydration solution is an invention that is absolutely stunning. But for simple diarrhea, drinking plenty of fluids might just be enough. So, if I do not give someone ORS when they have diarrhea instead ask them to drink plenty of fluids, am I making a mistake? No.

    Similarly, AYUSH makes sense for people who do not need modern medicine and for people who cannot access modern medicine no matter what. Take a close look at the clauses I used.

    “People who do not need modern medicine”. A lot of conditions do not need modern medicine as a must. A simple cold with cough, a simple cut, obesity, psychosomatic illnesses.

    “People who cannot access modern medicine”. When I was working with SVYM near Mysore, I became acutely aware of this. For populations of about 20,000 there simply is no surgeon available. The two obstetricians who are in different towns in the taluq have to coordinate with each other to ensure that when they take a Christmas vacation with family, the 20 ladies who are expecting do not suffer. Do not even ask me about how the on-call system of doctors could run. AYUSH practitioners are a luxury for rural Indians. MBBS doctors – an Utopia.

    This is the context where AYUSH and modern medicine do not just exist together, but are forced to work together.

    These are not the only reasons though. There is an element of human touch that goes missing in medical practice now. This leads to people seeking comfort from people who give that touch. Homeopathic medication might be placebo. But if placebo is the only medication that works for a particular condition, and if modern medicine practitioners are not able to give that placebo, then why not homeopathy? If in one 30 minute visit to an ayurvedic practitioner I can get relief from my headache, my grandmother’s knee pain, and my child’s cough, why will I visit someone else? Where is the modern medicine family doctor?

    It is in this context that government opens its own naturopathic centers. This context, though tiny by definition, includes a large population of our country. Therefore, it is very important that we define this context well and nurture the continuum of care when there is a change of context. For example, a pre-diabetic who was being managed with lifestyle changes by an AYUSH practitioner will need a modern medicine consultation when they become a full-blown diabetic. At that point, it must be possible for the AYUSH practitioner to understand their limitations and refer them to the modern practitioner. At the same time the doctor at the modern medicine end must be sensitive about the context the patient is coming from and be willing to accommodate and include the system that the patient has easy access to in their prescription.

    This is not happening now and cannot happen as long as practitioners of different systems do not understand their strengths and weaknesses and are not willing to collaborate on behalf of the patient. Where there is no trust and understanding, there cannot be collaboration.

    When people like Jacob Vadakkanchery go about stating ill-based arguments against vaccine and doxycycline, they need to be stopped, arrested if need be. If they are not stopped, it would be ignoring all that human beings have achieved in the pursuit of science.

    Only when the enmity ends can people begin to learn about each other and understand each other’s strengths. The enmity can end in only one way. AYUSH will have to accept that their role is in a limited context. They will have to learn their limitations and refer patients to modern practitioners before it is too late. And modern practitioners will have to understand the issues in their practice and make use of AYUSH practitioners.

    This is not a natural collaboration. It needs to be forged into place. Some organizations like SVYM may have been able to do it successfully. But it is in the best interest of the state to enable this collaboration to emerge at a national level. Pitching one against the other is not going to work. And that is where Jacob Vadakkanchery’s arrest is the right thing to do.

    What to do with BM Hegde though?

  • Healthcare With Smartphones?

    Imagine this. You are a 36 year old lady working as maid in two houses, not supported by an alcoholic husband, and mother of two school going children. Your husband had a wart on his genitals and now you have it too. It is not particularly bothersome, but you are not sure what you should do about it either.

    You think it would be a good idea to go to a hospital, but which hospital? Which doctor should you meet? Would they judge you? Do they charge too much money? Is it going to hurt? Whom do you even ask these questions?

    Enter our app.

    You will be asked a series of questions in your own language. The questions get more and more specific as you answer them. They will also be read out to you in case you can’t read. By the time you have answered about 10 questions, the app knows what your problem is.

    The app has been fed with a well designed set of protocols/algorithms that need to be followed in each situation. It has a curated collection of resources (hospitals, clinics, labs, lawyers, etc) which are guaranteed to give you quality care without judging you or making you feel uncomfortable.

    The app might suggest you to get over the counter paracetamol for a fever it thinks is not serious. But for your wart it is suggesting that you consult a dermatologist near you.

    You can book an appointment with her through the app at a time convenient to you. Your data will be passed on to her with your consent. Later at the clinic you can start from where you stopped.

    —

    Information is strength. Knowledge is power. As a doctor, I have witnessed countless situations where patients struggle because they did not know the right room number or doctor’s name. What the app does is eliminate those knowledge barriers by presenting trustworthy and relevant information in a friendly interface.

    The possibilities that this idea brings are endless.

    It can be tied together with a call center where people who do not have a smartphone can be given service.

    A subscription based service that gives discounted rates for various medical tests and consultations can be introduced.

    Micro-insurance schemes cab be brought in.

    Transgenders can be employed as distributors of the app to otherwise hard to reach strata. They can be given additional training to be able to work more or less like ASHAs in the community.

    Otherwise hard to navigate healthcare facilities can be easily navigated. (Think of how easy google maps has made walking around an unknown city)

    —

    The bottlenecks:

    Affordable healthcare providers. Whom do we have?
    Government is cheap. But what about quality and comfort?

    It might be possible to tie up with private companies under Corporate Social Responsibility to fund the charges at private hospitals. But the costs can become too high too soon.

    An intelligent mix match of services public and private using a friendly application can solve this in my imagination.

    And that is what I am working on now! Ping me if you’re interested to join forces.

  • Reimagining Kinnars (Hijras) as Health Workers for Reproductive & Sexual Health

    Supreme court struck down section 377 a couple of days back. India is moving forward in the right direction. There is still a lot of work left to do.

    We see kinnars (hijras) working on roads asking people for money. They are “strange” humans in other people’s mind and when people look at them all that comes to their mind is their gender issues and sexual connotations of those.

    This strangeness might be the reason why people are unwilling to give them jobs. Could we turn this around?

    Reproductive and sexual health is a topic that is absolutely neglected in our education system. There is plenty of embarrassment in discussing topics related to sex as well.

    What if, then, we put them both together? What if we empower kinnars by giving them training and other resources required, to go into the community and work for reproductive and sexual health? Like ASHA workers they would promote health. They can even distribute interventions like condoms.

    This is a positive change in many ways:

    • The kinnars themselves gain a better understanding of health
    • This can become an income generating opportunity for them
    • The perceptions about transgender community can slowly be changed to a positive one
    • Otherwise hard to reach strata of society can be reached

  • Bridges, bridges, everywhere

    I’m a Bangalorean now. I have a metro card as well. For about a week now, I have been talking to a lot of people and reading (also searching for 1BHKs around IISc). Turns out there are not many secrets in answers to “What to do in life?”

    There were a few points that made sense and helped me gain immense clarity. I’ll list them down.

    Immanuel Kant: Mark Manson’s post on him is a nice read on the kind of moral philosophy that we can have. It is slightly complicated but boils down to “strive to be the best, if not you’re doing injustice to yourself”.

    Remember it was the same idea that propped up earlier with reference to Gita.

    In fact, Priyanka Chopra lists down 12 rules in her breaking the glass ceiling talk which sounds similar as well – be fierce, fearless, and flawed.

    Stoicism: Talking about fears, Tim Ferris made a really nice TED talk on defining fears and defeating them. He gives an excellent tool to practice stoicism. And stoicism is an absolutely useful “-ism” in times of uncertainty.

    Bridges: The place where I have to go to isn’t really somewhere that people frequently go to from my place. Therefore, I have to build a few bridges to that place. The only issue is to differentiate bridges from hangouts.

    Money: There are a few important lessons about money.

    One is that money saved is indeed money earned. If you can decrease your expense, you won’t need a huge income.

    The other is that money created is a measure of value created. If you are building a product and want to know if it really adds value to the world, just count how much money has been generated by the product.

    Integrity: When we talk, we need to walk the talk. This doesn’t mean you stop talking about anything that feels important to you. It means that you should keep pushing. Talk, then write, then do, then do more, then do maximum, and then keep doing.

    Bed bugs: Bed bugs are really pesky pests. Do not try to adjust with such annoyances. Overcome them.

    Failure is not a choice. But success definitely is.

  • What Next?

    I am privileged. I was born into a higher middle class family in Kerala. I have not been discriminated against based on my family’s religion/caste/colour/whatever. I am male. My parents are both alive and work in public sector. I even had access to internet at a very early age. I was allowed and assisted to dream.

    Precious copy of my life plan (written after 10th standard)

    My father is a doctor. I became a doctor. Natural. It was not incredibly difficult. I did not have to fight unfair situations. I had plenty of help.

    I think it is because of my excellent background that I am able to even recognize these privileges.

    Consciously or not, much of my life’s philosophy is influenced by this. My obsession with free knowledge, is a good example. I may not be able to erase the advantages I already have, but I try to avoid relying on them.

    There is no point in beating myself too much either. I am not responsible for my privileges. But I am accountable. Having had all this, if I do not make the best out of them, I am wasting them. When life gives you lemons, make lemonade. But what if life gives you apples?

    I have a few straightforward options.

    • Become a specialist/super-specialist doctor. Work in one or two hospital(s). Make a lot of money. Help a lot of people.
    • Go back to SVYM. Help build a resurgent India.
    • Join some other organization/hospital/research project which can benefit from a clinical doctor.

    None of these are mutually exclusive options either.

    Yesterday I was coincidentally discussing with dad a verse from Gita which has many different interpretations.

    karmaṇyēvādhikārastē mā phalēṣu kadācana.
    mā karmaphalahēturbhūrmā tē saṅgō.stvakarmaṇi৷৷2.47৷৷

    Specifically, it is the last part we concentrated on. “You should not not do your duties.” How do you know what your duties are, though?

    Every person plays multiple roles in their lives. They would have multiple roles each inside family, work, society, and any other sphere of their life. There are duties in each of these. Is there any way you can prioritize one above the other?

    I have never been good at prioritizing things in the past. I usually get distracted by the most visible task and forget rest of my duties. I sometimes am able to note them down and come back to them. But this is fixable.

    24 hours is what everyone has per day, on Earth. There are indeed people who get a lot accomplished in that 24 hours. If they can, so can I. I will have to organize my time well and get disciplined. And more importantly, I will have to choose the right commitments.

    That is what we are coming to, aren’t we? Commitments. What are the right commitments for me now? What should I do next?

    I keep reading “A Guide for Young People: What to Do With Your Life By Leo Babauta” now and then. The gist is this:

    The idea behind all of this is that you can’t know what you’re going to do with your life right now, because you don’t know who you’re going to be, what you’ll be able to do, what you’ll be passionate about, who you’ll meet, what opportunities will come up, or what the world will be like. But you do know this: if you are prepared, you can do anything you want.

    Prepare yourself by learning about your mind, becoming trustworthy, building things, overcoming procrastination, getting good at discomfort and uncertainty.

    You can put all this off and live a life of safety and boringness. Or you can start today, and see what life has to offer you.

    Lastly, what do you do when your parents and teachers pressure you to figure things out? Tell them you’re going to be an entrepreneur, start your own business, and take over the world. If you prepare for that, you’ll actually be prepared for any career.

    Is this advice for me? Am I already at that point where I should be knowing what I’ll be doing and who I am? At the end of my final MBBS, I thought the one year of internship will be the time when I finally understand what I will do with my life. But I was wrong. During FHM, I got a few ideas on the kind of life I do want to pursue. I am sure I will not be going back to a university in a few years. And then there are a few preferences.

    I sort of want to do things that create massive impact. That is why I got bored of clinical work. It was the same thing happening every day. Sick patients, some diagnosis, some treatment, some outcome. At the end of the day, not much has changed in the way things are.

    I want to do creative things as well. I do not want to be remembered for things I did. I want to be remembered when people use things I built.

    I love internet. It is a technology that has immense potential. I want to utilize it.

    I love computers. Computers (including the small ones called smartphones) are all over the world. Sooner or later they will take over the world. I definitely want to be a part of this take-over.

    I love teaching and learning. I want to help people learn all they want to. Knowledge should not become monopolized. 

    I believe I am good at a few different skills – programming, writing, clinical care, teaching. I want to do things that utilize all my skills. If I do not utilize all the skills I have, I am wasting those skills. That would be running away from “duty”.

    In fact, I have a few ideas in my mind which are aligned with all these preferences. I want to build free software (free as in freedom) that bring the power of internet and data science to healthcare. I want to enable people (especially the ones in healthcare) to achieve more through the use of technology. I want to make sure this immense power (of technology) does not get accumulated in a few hands. And I want more people like me – I want to ensure there are hundreds of thousands of people with me who do things like me (or better!).

    These can’t happen if I am alone. I need to connect with people. I need to build on collective strength. I already know a few people I would love to work with. Almost all of them are in the Silicon Valley of India. What makes perfect sense for me to do next is – move to Bangalore and start talking to people. That’s what I am going to do as well.

  • Way Forward

    On 30th of June, SVYM organized a one day session on careers after MBBS at Vivekananda Memorial Hospital.

    Interns and/or final year students from Mysore Medical College, Bangalore Medical College, Hassan Institute of Medical Sciences, JSS Medical College Mysore were among the ones who were in the audience.

    After the SVYM video, it began with introductory remarks by Dr Chaithanya Prasad, the director of VMH.

    Then Dr MA Balasubramanya talked about administrative careers after MBBS. The gist of it was that as doctors, we are already administrating. There is no running away from it. We should embrace that reality and go forward with it.

    Dr Kumaran K took the audience through the story of his life in research and thereby had them thinking about how to pursue a career in research.

    Dr Ravindranath motivated the audience to take up surgery as a career and showed various alternatives to the MS degree to become a surgeon – majorly about options in various other countries.

    Dr RK Nair talked about his passion for emergency medicine and how to go about it as an Indian.

    Good lunch in between, and then a snippet on Fellowship in HIV medicine.

    Dr Dushyanth P who is the technical lead of SVYM’s palliative care talked about careers in public health and palliative care.

    Dr Seetharam MR and Dr Kumar GS and the audience brainstormed on the direction where healthcare is headed or should be headed.

    Later the participants were taken on a walk around the SVYM Saragur campus and the interactions continued over various tourist spots in and around.

    Downloads

    The presentations [Powerpoint, Google Drive]
    Recording of Dr Kumaran’s talk [Soundcloud, audio]

  • First PEP – Days 7, 8, 9, 10, and so on…

    Well, I lost count.

    I didn’t miss a single tab. But I have, as usual, missed on writing the experience.

    There are indeed some highlights.

    First, a house surgeon and his friend from my college came all the way to Nugu and our hospital after reading my posts. I guess I put enough philosophy in his head that he comes back and joins here later.

    Then, I’m making good progress in my thesis work, interviewing patients about their perspectives on how they became sick. I have interviewed three patients till today. Each interview gave me a completely different story. I have even moved to Asha Kirana hospital asking permission to interview patients there.

    Also, Amazon made three deliveries. My favourite book – The Emperor of All Maladies, my favourite stethoscope Dr Morepen ST 01, and Tripti Sharan’s Chronicles of a Gynaecologist. (all affiliate links) 

    Finally got a hard copy. Horror stories one after the other. Chronicles of @triptisharan200 pic.twitter.com/0Y3D1LFwLf

    — Akshay S Dinesh (@asdofindia) May 17, 2018

    I started managing my tasks with any.do, and it’s going well till now.

    Somehow, I’m on a streak!

  • First PEP – Days 4, 5, 6

    Days fly by as usual. It’s already day 6 and I’m wondering what I did on day 5. (I slept all day).

    Day 4 – Monday, 30th April

    I had general OPD duty. In essence I was jobless almost the entire day. I sat in the injection room and saw some 10 patients.

    This morning I had tried to swallow the LPV/r without any water. It wasn’t a very good idea as one of it got stuck to the throat and I almost had to do Heimlich on myself.

    It’s the day we went to Nugu and savoured garlic bread and churmuri prepared by all the ladies.

    Busy kitchen at the ladies’ place
    Not conspicuous: Ram struggling with pepper powder in his eyes

    On the way back Kishan & Suchitra ran out of petrol. So I had to empty a 1 litre bottle of water into my throat and fill petrol in it. Swathi and I went on a scooter ride after about an year today.

    Day 5: May day

    All I remember of this day is sleeping all day. I tried to get some useful work done after waking up in the evening. But having finished dinner, I slept again.

    Ah, ah. I also sent an email to the canteen manager regarding the legality of “cooling charge”.

    Day 6: May 2, Wednesday

    My first shift in the new ED. I spent half an hour with the new defibrillator. Skanray as they call it. Sankar Ray as I call it. Sliding out the adult pad for getting the paediatric paddles was the most interesting part. Still wondering whether the whole machine can act as an AED.

    Only 3 cases came to the ED today. One of them was a lady in labour and I sent her straight to labour ward. The lady with fracture of leg? Straight to x-ray. The sad one was the man with MDR-TB, diabetes and cellulitis of a limb, had to send him to Mysore as well.

    The computer network in the hospital was in partial disarray today thanks to the lightning and thunder last night. Oh, man! Yesterday there was a bolt of lightning and ear-deafening thunder right outside my window; I thought I died. One can only imagine how the poor electronics must have felt.

    The thunderstorm is back tonight. I came to the hospital to finish this blog post as the power supply keeps getting disturbed in my room. And there it goes, another strike on the radio station above us. I sure will need an audiology check-up soon.

    Earlier when I was in my bed, I felt my calf muscles ache. Myalgia is an early sign of acute HIV, you see. Had to brush up on the basics of acute infection. Also had to read three studies on the failure of PEP in health care workers. Seems like the right regimen wasn’t chosen or there were adherence issues in most of the cases. I might also have been part of a world record by receiving PEP at around 15 minutes which I think is the earliest anyone has ever received PEP.

    I might be having some minor reaction to the PEP as I feel abdominal discomfort (in the form of flatulence) and feel like the stools are coming out faster than usual. But apart from that, the pickle in the canteen is making me eat very well.

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