Blissful Life

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

Author: akshay

  • A Lot Can Happen Over Coffee

    Yesterday, I met two scientists. One is a neuroscientist about to join Yale, the other, her husband, an immunologist in NY.

    And they changed my perception about how I should pursue my higher studies after MBBS.

    No, the meeting wasn’t a coincidence. I’d never be in CCD on any given day unless someone invited me over there. But the events that led to it, was undoubtedly a long chain of logical but random choices (even involving a confessions page in facebook).

    So, what was so earth-shattering about this meeting that my career plan has to undergo a complete overhaul?

    ***

    Here’s a slightly modified transcript of the conversation:
    (KI = the neuroscientist, AG = the immunologist, ASD = me, SSB = my friend)

    KI: So, how are you liking MMC?

    ASD: To answer that, I’d have to go back in history. Till about the end of grade 10, I was going to be a Professor of Mathematics. Because back then, I liked and understood the subject really well. But at the end of grade 10, I decided that I had to do something relevant and of importance to the world (not that Mathematics is pointless). I decided I’d do MBBS. And after MBBS, I’d choose IAS and enter social service; or do DM in Neurology, so that I’d be doing some research in brain and cognitive sciences later on.

    And then, at the end of grade 12, I had a real chance to pursue Computer Science and Mathematics. But then I stick to my ill-logic of practical importance, and choose to satisfy my curiosities in CS and math as a hobby while I become a doctor.

    And what makes me confident about this all encompassing polymath style approach, is the over-confidence that my study technique lends me. I believe that even in a fact-oriented subject like Medicine, when you go deeper with your understanding of the concepts (sometimes hypothesising on things) you’ll have made facts intuitive, thus avoiding the need to memorize them, and at the same time making you very good at the subject. That’s why I started learnlearn.in and I’m just waiting for the results.

    So, in short, it doesn’t matter to me, the college. I like it, because I’m in it.

    AG: So, you thinking of developing a brain-machine interface, or the like? You know what, the research on all those is going full swing right now, and probably by the time you reach there, it’d all be over. They’re mapping out all the connections in the brain, and the US government has given nod to a $300 mn bill already for the ‘connectome’ project.

    ASD: Okay! But that’s so going to fail.

    AG & KI: If you look at it, it’s much like the human genome project. They’re just trying to figure out the connections as perfectly as possible, and once we have it, possibly we’ll end up with a whole lot of applications of it. You know how the CNS pharmacology is not based on our knowledge of the brain, but on pure luck.

    ASD: Okay! I meant it wasn’t going to solve consciousness or intelligence or anything. For health, of course, yeah. So, tell me your stories.

    KI: I did my MBBS starting in 1999, while AG started in 1996. Towards the end of it, I realized that writing an entrance examination after graduating, and then getting into post graduation rate race, was so not going to happen for me. But, I also knew that to get into research positions abroad or in India, I needed to have something in my c.v. So, I went to the National Centre for Biological Sciences in Bangalore during my internship and stayed there for 3 months, doing their work, closely learning how the entire system works. And I convinced the director there of my commitment to do science, that they wrote a recommendation letter for me.

    And with that I could join a neuroscience research team. In essence, when you apply to universities, they ask you what you have already done, because they need some way to separate the grain from the chaff. They need to find out who is really committed to doing this, who is capable of doing this, and who knows what they’re going to do.

    But that’s not an excuse to neglecting your academic performance in college. They really aren’t waiting for a guy who took 5 years longer to finish medical school just because he was interested in doing much cooler things. They want someone who is good at whatever he does.

    And, you gotta compartmentalize your academic studies from the things that you learn for your research interest. Because they could well be at odds with each other.

    And then +swathi sb comes in after finding her lost scooter key.

    SSB: Sorry I’m late. I know you’re talking about career. I wanted to do something in public health, for the poor who are suffering. So, does this all apply for me?

    AG: Well, we aren’t pretty confident about that sector, and there are people who’re better qualified to answer that. But still, there are a lot of ways you could help the community. You needn’t necessarily be working at a rural setting, because that’d only make you a practising doctor in rural areas. You could gain experience while working as the doctor for NGOs that operate in rural areas. That’d fetch you insights into how things work or doesn’t work there. Then maybe you can use it to do some work from the cities.

    SSB: Okay. Forget about me, continue your story?

    KI: Ha, so I did some work on astrocytes, the glial cells. Now, to do my post-doctoral work I’m joining Yale Medical School.

    ASD: Wow! The Yale?

    AG: Yes, the Yale. Like I’m joining Sinai for getting some clinical practice.

    ASD: Okay, you haven’t told us your story.

    AG: Ah, I finished MBBS, like she already told you and then I went to Bombay to stay with my mother. While doing MBBS, I had done some studies in P&SM, and with only that experience I went to the nearby Tata Hospital. And I didn’t know whom to meet there. So, I went to the Director directly, and told him “Sir, I’m a medical graduate. I am interested in doing research.” And he was amused. He talked with me for a while. And then he wrote a note.

    I took that note to the lady it was addressed to. And she was an immunologist. They were working on genetics and stem cell therapy. And I worked with them. And I was among the team which discovered a therapy for ADA deficiency, which was also first of its kind.

    ASD: That is the example for stem cell therapy in biochemistry.

    AG: Yeah, so you know how important that was. And then I was thinking of doing some stuff, when I stumbled upon the much cooler stuff that one of my colleagues were doing there. He was trying to make changes in dendritic cells that’d enable them to better identify cancer cells. And then the T-cells would be able to identify them and kill them naturally. So, I’m working on it, now.

    ASD: So, what progress are you making on it?

    AG: In research, you usually do not make any perceivable progress in a short term. That’s, maybe, one disadvantage of it. But you shouldn’t really get bogged down by that. You will build on someone’s work, and then someone else will build on your work, and maybe credit you. That’s how progress is made.
    And if you ask us whether we’ve made the right choices, we are not old enough to say so, but so far so good.

    ***

    Thinking of it, my idea of doing a DM in Neurology is stupid, when all that I want to do was research on the brain. The most natural thing for me to do is, after MBBS, to join some institute where they do some actual research on the brain.

    And so is it going to be.

  • Two Ways to Go Crazy

    Yesterday was a Sunday entirely different from the hundred before it. I did two things.

    Quizzing
    8 hours of questions and answers (and excellent guesses) with my partner – Shruti parimoo
    General Quiz #1: At NIE, Mysore. We reached about an hour early and talked about neuroplasticity, and the like. Then, the first round started. There were about 14 teams and about 24 questions. Some of them:

    What does the following cartoon represent? (Of course it wasn’t this easy in the actual event)

    feet-to-meters cartoon no. 1

    Whose old logo is this?
    http://media.gizmodo.co.uk/wp-content/uploads/2013/01/18afup0k2v6oqpng.png
    Cricket question.
    “I would say the difference between the two side is the fielding. England
    are an all-round good fielding side. I do believe that India have
    few…3 or 4 very good fielders and … X”
    Fill X.

    Which phrase in English owes its origin to the fact that density of water at 0 degree Celsius is 0.93 g/cu cm and that of water at 4 degree Celsius is 1 g/cu cm?

    And, we didn’t get selected for the second round.
    But we watched it along with very active others.

    Dry round – a lot of questions based on “pounce and bounce” format (That is, after the question is read out, every team has a chance to write the answer and “pounce” on it, getting +10 for correct and -5 for wrong; and then teams who haven’t pounced will get the questions in infinite bounce format)
    List it – to list all the 13 individual olympic medal winners of India, all the 9 movies of Ranbir Kapoor, and all the Shiva temples based on 5 elements.
    Short Visual Connect – A set of images on the screen, find what connects them.
    Long Visual Connect – A long set of images coming one by one, find what connects them at the earliest. This one was about Raghu Ram

    Having been only to quizzes where the quizmaster rein and the participants open their mouth only to answer or “pass” this first quiz in two years was mind-blowing, not blowing, mind-expanding for me. I’d never thought quizzes could be fun too (and not just exciting)

    And then General Quiz #2 at SJCE Mysore
    Here’s where I got really surprised. Not just that all the teams who participated in the previous quiz was here, one of the QMs at the previous quiz was a participant, and one of the participants there was the QM here.
    For now, this is the longest (5 hours) and the most interesting (unlimited fun) quiz I’ve ever been to.

    Questions have all been uploaded to slideshare here.
    The preliminary round was much easier (in terms of the number of questions we could answer). My personal favourite would be:

    What is this? 😀 (See how the big circles are linked)

    And all the 9 teams participated in the second round (which turned out to be a wise decision, because the teams left out would have to watch from outside the rest of the quiz)
    In the second part, I started with a -5 for pouncing. I said “simple majority” where it should have been “The common parlance for the minimum number of members of a deliberative assembly (a body that uses parliamentary procedure, such as a legislature) necessary to conduct the business of that group and its requirement is protection against totally unrepresentative action in the name of the body by an unduly small number of persons”

    And a lot of questions later, including one that looked very similar to this tricky graph question I found from Quora, the Sheldon Cooper round started.
    We had to give the Latin phrases for the descriptions. And Shruti absolutely rocked.
    So did she in the round about books, and also the Southpark round.
    The LVC about Cricket stumped us, but those about buildings were easily solvable.

    And then it was late night, they had already began singing songs at Jayciana outside. So it was time to find out the winner, and as there was a tie between KP‘s team and the other awesome team. It couldn’t be resolved even after a few questions, so everyone left in a jovial mood.

    But here is a way to conduct quizzes that I’ve never experienced before. Find excellent questions. Pose them. And let everyone have fun. Get up from the seat. Argue with the QM. Argue with other teams. Go touch the projected image, just to see if the texture gives any clue. Look for clues in all the words spoken by each member in the hall. And successfully spend a lot of time into something that’s well worth it.

    And, Rock Music
    If I had returned to hostel straight away, it would have been an above average Sunday, but not an exceptional one.
    There was some kind of musical show to be expected later in the night. So I stayed back to join my friends. And after the fashion show, beauty pageant, results of previous events, etcetera, it started. A sexy male voice attracting crowd like shit does to flies. +Akshaya Fadnis and I climbed inside the VIP section with the first song. And within minutes we were right next to the stage. And the crowd was going crazy. The music would awaken even the comatose. Hands would not agree to stay down. And the rhythm shook the whole body.

    After being completely lost in that experience, I spoke: “Buddha calls it meditation, we call it rock music”

    Now, that tranquillity was thanks to Underground Authority.

    And that was a Sunday truly worth its name – Sunday. 😛

  • Things You SHOULD Learn from M K Gandhi

    I woke up today morning reading this on Quora: What are the biggest mistakes of Mahatma Gandhi?

    The answer tells that the British were comfortable with Gandhi heading India, and that complete non-violence was probably a big mistake. Two things.

    1. Non-violence works in international affairs. Especially after the second world war.
      This must be self evident. Today’s wars cannot be won with weapons. It is won only through diplomacy.
    2. Non-violence works even better in interpersonal affairs.
      This goes without saying. Getting angry and not cooperating with nasty people is how we’ve learned to do it. But that is violent. A better way to do it would be by helping the nasty earnestly, and sternly but politely making them a request to stop being nasty.

    But that’s not what surprised me. When someone pointed out in the comments that Gandhi had also told that non-violence is better than cowardice, the answerer said: “Well this shows that he was totally confused“.

    People, it’s not just fine to change your convictions with time, it is sometimes necessary to do so.

    That is one great lesson from Gandhi that not many have heard of or practise. He conducts experiments with his life. And he corrects himself when he’s proven wrong. Like his U turn on milk, he just needs plenty of reasons.

    We form most of our convictions in childhood. The same childhood when we are not even eligible to vote. And amusingly, we carry these convictions to our adult life, unquestioned. Think of it. Would it be clever to make the same choices in food, clothing, dreams, hobbies, and lifestyle as those you made when you were much younger and more stupid?

  • Graduation day, socials, ethnic day

    While skin posting reached its relieving end, without me taking out even the magnifying glass in that cubicle with 50 people packed inside, three events occurred on subsequent days.

    Graduation day:
    2k7 batch went out with summer dreams 2013. Dr Antony, Dr Abhas, doctors everywhere. They made a beautiful video about their life in MMC and danced to their contentment while we had good food and slumbered.

    Socials:
    I’m yet to talk with the juniors about what happened there. But in the hostel there was definitely innovative hazing methods.

    Ethnic day:
    Now this was fun. Thanks to more than a week of bugging hard work by class representatives and others Sammilan, though it was never called so, went so well at hotel ruchi. I was the DJ playing the right songs at the right times except when I muted the sound for 15 seconds just when the sexy lady part of Gangnam style was coming up.

    Everything went so well – titles, games, food, ramp walk. Fadnis and Deepthi became the ethnic couple.

    And the dance hall was simply superb with the closed room heating things up. People sweating and dancing and enjoying the night in ways that never were.

    BTW, the MMC&RI confessions page has started on Facebook.
    And it’s OBG posting for me from today.

  • Weird Dream

    I am in Mysore Junction Railway station at 8 AM, trying to cross the track to the first platform. But there’s a local train which is blocking my way, so I decide to get inside and get outside at the other side. But as soon as I get inside, the doors close and I’m trapped, along with two girls and an old man who also wanted to go out. They’re waiting for the next stop to get down, while I get to know that the train goes to Kuthuparambu (which is very close to my home, comes after Mattanur, the place I got to get down for my house) and reaches there at 10:30. Since it was Saturday, I thought I’d go home and come back on Monday, and fall asleep. When I woke up, I see that the train is already at Mattanur, and instead of going towards Kuthuparambu, it turns towards my place. I’m extremely happy and want to let everyone know…

    And then I wake up, prone, on the examination table in the hall. Aquib’s pointing towards loose stools on the bed and laughing at me, while removing his gloves. And then the professor starts taking class, about rectal examination. And that’s when I realize what’s happened. I call Sneha and ask her whether they did a rectal examination on me while I was sleeping. She said “Yes”. And bam I slapped her. I was so angry that when Hema ma’am came and said they thought I’d not mind, I just didn’t listen, but went to the professor who was teaching and said him “They did rectal examination without my permission while I was sleeping. That’s absolutely against medical ethics. And there’s even pain in my rectum now”. And the next thing I see is a PG coming inside with sheets of paper and taking statements from Raziq and all others about what happened. And that’s when I feel sad about it and later I go ask Sneha and Swathi why they didn’t ask my permission. They say they didn’t ask Nandu permission in the previous class, and then I remember I had missed the previous class. And I was feeling so sorry for everything…

    And then I actually wake up, prone, on my bed in Room #28.

    Dream within a dream. Double Dream. False Awakening. Not Inception.

  • IFMSA – Introduction To It

    The academic society is brisk with activities. It is IFMSA’s chance to talk in pathology hall today.

    A worldwide organization with its hierarchy. Medical counterpart of IEEE.

    Says US is the place for standard research. That IFMSA gives exchange student opportunity to foreign nations.
    That WHO gives internship opportunities.

    Registration is like 1000 rupee per year. Gives a card that is valid in cafe coffee day.

    Mission statement is to offer future physicians exposure to global situation.

    To facilitate medical research, exchange, etc.

  • The Difference Between Interesting Things and Useful Things

    How many times has this happened in your life?

    You’re travelling in a bus, and the person sitting in the first seat at the front suddenly puts his face outside and looks at something. Within milliseconds, people sitting in the window seats in the 5 rows behind him do the same. And in the next few milliseconds, others who can’t just turn their head and see outside, stand up and do so.

    Sensing and responding to changes around them as quickly as possible, gives monkeys a survival advantage. And there’s a monkey carrying out its survival trick hiding inside all of us. He guides our senses towards all stuff that’s different from the normal – a cool new gadget, random shit facts, photoshoped images uploaded in facebook, utterly useless questions on quora, the gap that a broken tooth leaves, a friend’s new haircut, uncovered body parts – any stuff that’s new. These are the interesting things.

    Unfortunately for us, interesting things most of the times aren’t useful things.

    Books, subjects, exams, practice, revision, exercise – things that happen everyday, the normal things. They are what turn out to be useful in one’s life.

    It’s only been a fraction of a second since that first person turned his head. You still have a choice – whether to turn your head or not.

  • Fall on four limbs

    Neonatal ICU. There are two of them. One in Cheluvamba, ground floor. Second in Kid’s Hospital, top floor. NICU-2 is called Sick Baby Ward, and is more airy. But either of them houses the tiniest kids on earth.

    Caution: Before touching any baby, use GermX (contains sterol kind of alcohol, probably) to clean your hands. Now, before you touch another baby, use GermX again. And this is in addition to the dettol+soap handwash that you’ve got to do before even entering the ward. Anyhow, I’ve decided that it’s unethical to touch any kid unless it’s essential for learning.

    Pre-term babies invariably end up here. And their feet would be the smallest imaginable.

    Photosensitive babies would be blindfolded. At times, there’d be the phototherapy unit shining bright UV light at them.

    Not to forget the sensors. There’s temperature control. And whenever it goes below the set – 36.5 or so, it’ll beep. BEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEP.
    So does the heart rate monitor. Oxygen Saturation. IV Infusion rate. Everything.

    Talking about IV infusion, you should know how tough it is to find a vein and put a needle inside those tiny arms. The doctor who was doing that was later recruiting new babies (neonatals) into the ward. Mother complaining of jaundice. But the baby was pink instead of yellowish. So, no jaundice. But the kid showed us some reflexes.
    Keep your finger on its lips, it’ll open the mouth and put the tongue out. Suckling reflex.
    Hold the baby by its chest and belly, facing down, and it’ll extend all the limbs, in anticipation of falling down. Parachute reflex. And it stays till you die. Yeah, the last time I fell from cycle I fell with my hands and legs down and not even a mote of dust on my clothes.
    And the most dazzling. Hold the baby upright and suddenly let it fall back to your hand below. It’ll show surprise by dilating the eyes and extending the arms. Moro reflex.

    And the 3 questions you can ask a newborn. Have you passed meconium (first stool) within 24 hours? Have you passed urine in 48 hours? Have you started taking feed?
    3 Yes, your systems are perfect.

    Going to see autopsy tomorrow.

  • 4th Term

    Apparently, third term is over.

    And with that came a new fervor for learning.

    Posted to paediatrics from yesterday, Feb 6, a day after I turned 20. Though we missed all the days of OBG posting, I’ve attended both the days of paediatrics.

    Day 1:
    When you take a case, why is it important to know the age? 😛
    Hemolysis at day 1 is different from that at day 6.

    And how is child case history different from adults?
    There’s an entirely new spectrum of diseases that can occur.

    Day 2:
    Immunization.
    The nurses welcome us (just me and Fadnis) warmly and give us a box of used vials to play with. We arranged them in the order they should be administered.
    Age 0- BCG (0.05 mL for kids born in hospital, and 0.1 mL for kids coming from outside, is what the nurse told. And the vial said “0.05 mL for kids upto 1 month, 0.1 mL for kids above 1 month”. You can guess why the rule of thumb works) Live attenuated freeze dried Bacillus Chalmette Guerin IP (IP? Dad replied via sms. Indian Pharmacopoeia. BP would be British. USP would be US) For subdermal use.
    OPV – Oral Polio Vaccine (20 doses bottle. 1 dose = 2 drops = 0.1 mL)
    Hepatitis B Vaccine. Live attenuated. For Intramuscular use.

    Age 1.5 month:
    OPV
    Hep B
    DPT (Diptheria, Pertussis, Tetanus) Intramuscular.

    Age 2.5 months: OPV, Hep B, DPT

    Age 3.5 months: OPV, Hep B, DPT

    Age 9 months: Measles (Right shoulder. Should see whether intramuscular or subdermal)

    And I forgot the rest.

    The intramuscular DPT and Hep B are given in the anterolateral of those small thighs as deep as that small needle (23 or 26 something) goes. The quadriceps was becoming very prominent while administration.

    BCG very superficially in the left deltoid area. The kids would be too small that they don’t even cry for more than 2 seconds.

    And a pregnant mother was being given Tetanus in the deltoid.

    No OPV was given today because the Pulse Polio Programme is happening next week and it would be overdose.