Sunday, September 11, 2011

It pays to lie!


There is truth in this: It pays to lie.
For:
Being  truthful is a costly affair!
How often have I paid -in tears, sighs, banknotes and kind;
only to learn  that a lie was a lot less grind...
For:
Lies have shades-half, quarter, white and grey;
Truth is dark even by day!
People love colours, love to live lying and live lied to...
For:
Living
a life of lies is much less of a yoke
than
Dying
in an eternity of penalizing  truths!   


Truth finder (pastels on canvas)

Thursday, September 8, 2011

Illumination




The day breaks.
Life begins to brew
its karmic concoctions
in spicy double takes.

Slivers of streaming sunlight
refresh a haunting face.
Just ignore that unbidden clue,
Life is a teasing malaise.”

The swishing silk and tinkling bangles
mock and laugh in abandon;
blow a dying ember to life...
“Omens, please be gone!”

What can come of nothing far?
But the kiln is warming up too...
to Time’s imprudent athyachar.

It hots up fast;
the sun above, the kiln before;
And then there is one
 within,
fast singing through....
No more running.
The  runaway has
hit a dead end too.

Life lurches,
 its Cocktail a-pour...

Suddenly,
there is someone at the door.
Only now,
it isn’t a stranger
but someone I have known ever before!


Friday, August 19, 2011

After I die -- Dot? Comma?



After I die,
Their streaming tears and saddened hearts
vainly may fan the embers
of a long-gone part.
“Time to let go, soul,” to myself  I cry;
“Thank Life, you died a samurai.”

After I die
in company of many a cherished dream;
as keepsakes my dear things may remain-
armchair, fountain pen, shawl or ring.....
A moment, an event; small talk or laughter
recalled for days long after.
“I’m not there,” I rue; wishing Time never flew.

After I die,
so will a hundred phrases:
“Work till drop dead.”, “Always.”,
“Tomorrow.”, “Forever.” and “Rat-race.”
A thousand orphaned notions, flailing, fade:
poor, un-sung hangers-on; dead with the charade.
After I die, my
“A 100 Places to visit before you die”
“A 100 movies to watch before you die”
“A 100...........................before you die”
books, shall triumphantly outlive
the heart that had rejoiced in their provocatives!
Pastels on paper




Doctor's day : ce-liberation? (prose)

Some of the babies and twin pairs I have delivered......


July 1st; 12.05 a.m:
The cell phone by my cot innocently blares the ring tone “Kal Ho na Ho” transporting me from the blissful realm of dreams to wide eyed, adrenaline pumping reality. At this hour, I know it could mean only one thing-an emergency on the way.
‘Madam, this is your patient Muthamma’s mother. She is in labour I think.” And so the saga begins. Muthamma arrives in auto and I in the ambulance almost simultaneously at the doors of the hospital. What Follows in the routine encore of any labour room world wide.-Muffle-scream-wince-push-sweat-I just can’t-Why not caesarean?.... Only at the end of it all does the staff have any time to wonder that the dialogues could have been more befitting from the doctor as much as from the patient! Muthamma is then shifted to the wards, with a smile and a cuddly bundle.  I exit outdoors to the early morning traffic on the highway which is already in full force. The ambulance transports me back home.
            I decide to catch some shut eye before the shower just as “Kal Ho na Ho” blares back.(I had set the song ‘Har ghadee badal rahee hai roop zindagi….” as my ring tone because I loved the optimism in the song. But now I have an entirely new interpretation of the song. The ‘kal ho na ho’ phrase is so apt. It has mercilessly erased the distinction between night and day transforming a week into a rapid blur of patients, examination, labour room, operating theatre…My caller tune is another revelation. Sometime ago it was “Ghunguroo ke tharah, bajtha hee raha hoon mein..” Until I realised that the patient’s were only too willing to bajao the ghunguroo further. Now it is “Ek din uth jayegaa maatee ke mol…” as a warning to those who attempt to push me beyond limits!)
“Madam, are you available this morning?” A male voice. It must be a patient’s husband. They still do not understand that they have to call the clinic for appointments.
“Yes.”
“Where? Same place?”
“Yes.”
“Time? Same time?”
“Yes.”
“OK.” The line goes dead. I always wonder what a casual listener would make out if given a transcript of that conversation. It could even be the kind you could put in a magazine inviting readers to complete the scenario of a story! The exciting possibilities and suggestions it offers tempts me to write one immediately too! But for now I just can’t. Two more but less provocative calls later, I give up on sleep.
        The morning out-patient is another routine. The patients are all waiting in full force, some even glaring or looking at me disapprovingly as I am late by ten minutes. “Must have over-slept” was that their silent voice I heard or my own delusions?
 The whole motley is present. The medical ventriloquists( http://shanyashas.blogspot.com/2011/02/ventriloquism-in-medical-practice_23.html), the shoppers ( medical term for patients who, when advised any kind of surgery, begin their journey from one doctor to another assessing their skills all the while pretending to hang on to every word. What they are really working out is the economics and the absolute necessity of the surgery unmindful of the gravity of the situation) and the second opinion seekers (these are patients who consult doctors in elite hospitals for fancy fees and THEN go to other places, to clear all the doubts that they had and could not consult that doctor for the inhibition of being ‘free’ in those five star hospitals and with those busy doctors!) are all there in generous numbers.
Then of course there are the genuine patients. Those who want a child as desperately as those who don’t, the droughts and deluges, the adolescents and post-menopausals…..and of course in our populous land, the pregnant patients. Their range is widest-some fifth time pregnant in as many married years and yet others just staying married between their pregnant years!
I mange to live upto their expectations-a welcome smile, admonishing only gently or following it up with  pacifier-dialogues, juggling my poor grey matter to match that face with that name or enquire about a cousin or a sister who had delivered four months ago. But I fail miserably when one saunters in saying, ‘Doctor the problem for which you treated me has recurred.”
‘I’m sorry. Let me see the previous records.”
“Oh, I have not brought them.” I know better than to ask why. The standard reply in my part of practice is-“we shifted our house and then I lost the records.”
“What were your complaints?”
“Oh the very same then as it is now.” I am defeated on two accounts. An unsuccessful treatment and a memory that has deserted me even as I struggle to recall what this patient’s previous complaint was. As an after thought I ask, “When did you say I last saw you?”
“I didn’t. Since you are asking, you had seen me about eighteen months ago….”was the sheepish reply. As medical students we were expected to have good memories but not one of our professors had ever told us how long we were expected to retain any sort of information about a patient!
It was three in the afternoon as I bundled off the last patient, with a fast fading smile and a growling tummy when “Kal Ho na Ho” chimed again!
“Madam, I am Ramya.” I would know her even if she had only said hello. She was a perpetually tensed expectant mother. By this time, I was so used to getting her calls at such odd times and places as in the toilet or while operating or at 1 am(can’t stake claim on ANY time or space as mine) I grunted a greeting. I was to do a caesarean section on her on the third July.
“Doctor, can you prepone that C-section for today?” Again not an unusual request.
‘Today? You should have called me much earlier. I have to inform the operating theatre, the anaesthetist, the paediatrician….’ I whined.
“Yes doctor. But my husband was very busy and was not sure if he could be free.” Or the daughter-in-law and mother-in-law did not want to miss any of the TV serials till 3 p.m. Note also that the husband’s time and job take precedence over mine. However I must admit she is a shade better than the others who finish viewing even the ‘Crime story’ or ‘Crime diary’ on TV till 11p.m and then come asking for emergency consultation!
‘OK. Will four o’clock be all right? You could come to the hospital right now you know.”
“I will come…But please do the surgery after 4.30.”
“OH!” I don’t ask her why. It is because Rahukalam on Tuesdays is between 3 to 4.30 p.m! (I have the mnemonics grand-dad taught me for calculating Rahukalams-Mother Saw Father Wearing The Turban Soon…Monday: 7.30 to 9.00p.m; Saturday: 9 to 10.30 p.m; Friday: 10.30 a.m to 12 noon; Wednesday: 12 noon to 1.30 p.m; Thursday: 1.30 to 3 p.m; Tuesday: 3 to 4.30 p.m; Sunday: 4.30 to 6 p.m) 
            As I step into the hospital lobby, I realise it is past lunch time and ask for a cup of coffee from the next door canteen. The tepid beverage is a uniquely secular concoction-tasting like tea if you imagined it was or like coffee if you wished it was!
            Much to my mounting tension, I deliver Ramya by Caesarean, the baby with the sex of her choice. I have encountered scowling faces though not outright rebuke when I have delivered a girl when the whole family craved for a boy or less often the vice-versa. I am indirectly made to feel uneasy; as if I had any say in the sex of the baby (I idly wonder what if it was really the case? The obstetrician to be held responsible for delivering a baby not of the sex of their choice! A wonderful clause to the already existing long list of medical negligence!) The colour of the toilet tiles, the stain on the nurse’s uniform, the constantly coughing fellow patient all come under acute observation when the desired sex baby is not delivered. These grouses are the basis for claiming discounts in the final bill at the time of discharge!
            I can’t hope to go home yet as the evening round of out-patients are already waiting, impatient and oblivious to the mice in my tummy. By the time I finish seeing the last of them it is half past eight and I realise that I am yet to have the first meal of the day.
            It is not just doctor’s day today, I realise as I get home. It is also mother’s day, wife’s day and daughter’s day. Son wants help with his essay, daughter with her project, mother wants advice on some medications and hubby is hungry-it is his first meal too! I juggle at the fridge door and hob, in-between calls from a patient who wants me to spell out the medication for tummy ache-just in case, as her family is travelling. “And oh, something for diarrhoea, body-ache, fever and any other thing you can think of doctor?” Yeah. Hope I remember to charge you for phone consultations too when you come the next time!
            As I climb into the bed almost asleep, I realise I have not looked at my cell phone that was alerting so many SMSes throughout the day. The inbox is flooded with greetings for the doctor’s day-medical representatives, some colleagues, friends, patients…. I smile as I go through each of them. Finished with it, just as I am about to set it beside my cot,”Kal Ho na HO” chimes again.
“Shantala madam? I am Shilpa’s mother-in-law. She seems to be in labour. Can we bring her to the hospital?”
“Yes,” I sigh.
I look up at the clock-It is 12.05a.m, 2nd July, beginnig of another doctor’s day!


Cat nap (pastels and charcoal on paper)



Monday, July 4, 2011

Making dreams






An impatient chestful
of teeming dreams,
rearing to riot a skyful
with fairy-tale themes.

Skeins of deathless strands
of passionate golds and silvers;
nodding bright-hued fronds
of sequins, beads and glitters;
sun rays, stardust and moonbeams;
Begging to be woven, blended in seams
On a thousand beams of tireless looms.

Plit-plat; plit-plat, plit-plat;
Dart a million dreams,
drunk; singing and dancing
on and out of the illimitable beams.
A few grow wings,
laugh, flap and fly away.
Yet others remain chestlings,
Wishing, waiting for another day.

Smiles-tears; triumph and fears.
But they also served
who only birthed and waited,
For I am my dreams-
all of the fulfilled and the blighted!


  

Sunday, July 3, 2011

Crow of a soul


Mother always did such things. She worshipped animals-the dog, cow, snakes and elephants; deified the plants and trees-the Peepul, neem, basil and prayed at every shrine she ever passed. Her faith was touching, her ignorance embarrassing and the persistence irritating. She too failed to recognize that she had raised a rationalist despite or rather because of her orthodox ways. For the love of her and for fear of hurting her, I remained silent, not clashing with her ways. Now, this once, for the last time, I had agreed to do what she would have wanted...
            Mother always thought about her life after death. She had wished that after her death, she be accorded all the right rites that would enable her to attain redemption from the cycle of birth and death. Much as I lacked faith in such ceremonies, I was obliged to perform them. I owed it to her-as an acknowledgement for single handedly struggling to make me the big man I was today. Being her only son, I was determined to say the goodbye the way mother had wanted.
            The last lap of the ceremonies involved feeding the crows. A ball of cooked rice, mixed with til was offered as food to the crows. It is a belief amongst us that crows impersonate the souls of the ancestors. If they fed on the offerings, it was presumed that the ancestors were contented and happy with their scions. I had scant belief in this.
            The balls of rice waited patiently for the crows. I was amused. I had never imagined that I would one day spend long hours waiting for that humble crow! There were times when I had to shoo tens of them off from my roof when they came pecking at the pickles that were being dried on wicker mattresses. The believers were beginning to murmur. “Did we do something wrong along the way? Is the soul not propitiated?” they began to wonder, noting the absence of the crows.
            That was when I saw her. A woman in rags with a baby hoisted on her waist, standing at the gates with a begging bowl. I hated them. Begging was another form of laziness. These people would rather beg than sweat it out....That was an unresolved argument I had with mother all too often. “If you don’t want to give alms, then don’t. However, don’t admonish a beggar. Don’t give them unsolicited advice on employment when they come begging for a morsel. Just be grateful that we are on the other side of charity.   We can never fathom the lack of self-confidence and battering of ego these people go through. So desperate they are, selling their souls to quench their basic needs...What right have you over their bankruptcy?” She would gently sermon giving away alms generously.
            About to send away the beggar I recalled mother’s words. What would she have done now? Fed and clothed the duo. Not worrying that the beggar would return for more the next day, making it a habit. She would be ready with alms! “We are all beggars, albeit of different wants, in the eyes of God,” she would smile. I did not want to disappoint her on her last journey.
            I ordered some alms to be given to the miserable woman in rags. Even as the beggar, beaming at the haul, turned away, a large group of cacophonic crows swarmed down on the rice offering, devouring it in no time.
Dramatis persona (water color on paper)


Wednesday, June 29, 2011

The dissection hall




            The apprehensive silence mutated to a mesmerized muteness as one after another, the shrouds were jerked off the bodies. There must have been about eight or ten bodies-for there were nearly one hundred and fifty of us, being assigned sixteen to one. Eight students to each side of the corpse give or take three or two students or half or three quarters of a semi dissected cadaver.
          The trance of seeing the cadaver for the first time was broken by the harsh and rather conceited voice of the tutor who wanted to get done with taking the roll call of a hundred and fifty freshers, number after number. He went about assigning the cadavers to the batches with an air of doing the utmost good to the lowest down trodden. Another of tutors, albeit less stern faced trooped in and in a booming voice, which probably would have echoed in that large hall if it were not for the assortment of the living and dead, proceeded to instruct.
          If any of us were expecting to be guided about the maiden approach towards studying the cadavers, and almost all of us were really so, we were in for a major misunderstanding. "All of you open your Cunningham's manuals and start reading. From page one to eighteen," was all the pearls of wisdom we were worthy of, on that first day in medical college! As stern and sterner faced 'guides' settled around the only table at the entrance of the dissection hall, the greenhorns were expected to quietly pore over the first few pages of the manual.
          And was it an experience! Not being able to raise our heads and look around-not half as eager to evaluate the equally scared peers as to have a good look at the motionless bodies on the cold, steel table before us! Yet gradually, one by one, either casually or as if referring from the book, we got the real first glimpse of 'our' bodies. For me it was neither a scary nor an awe inspiring experience. Probably because I was so ignorant that I hadn't given a thought as to what to expect in a corpse! Though it did not abhor, it indeed was an inquisitive scene.
          Whatever ideas of the dissecting room we had, it could not be as distant from the real view of what lay before us.  All the cadavers had been duly processed before being provided for dissection and the processing left them not different from the dried twigs of a tree- black, stiff and the greatest relief- not half as intimidating as our tutors!
          Our guy was all of four limbs and as yet a totally undissected "fresh' cadaver. As months would roll by, as he would gradually impart to us what the anatomies of the human body was, he would gradually get dismantled limb after limb, organ after organ until...And that is the memory I have of him today- fourteen months post dissection- a mere limbless torso, skull sawed and brain removed; chest cage ripped apart at the breast bone and the heart and lungs a far cry from what they were in life! His face is another undying memory. His jaw was half open revealing a neat line of teeth with two or three missing members, the skin of his face was drawn tight against the underlying facial bones and it gave him a curious expression- which was then  beyond my comprehension. 
         Within the next forty eight hours, three or four then-brilliant-now-miserable students scooted from Medicine and joined Engineering-whatever branch they were offered lapped up most gratefully. It included one boy who had fainted in the dissection hall and three others who continuously threw up until they were assured that 'dissection' would never again be mentioned in their presence, the rest of their lives!
          And finally after two days of reading and re-reading Cunningham's we got down to the brass tacks of dissection. And I must confess that the first twenty three pages of the manual were the toughest comprehension passages I had or may ever read! When they said dorsal and supine for spread eagle, anterior or posterior for just back or front; lateral for sides it was just about understandable. But medial, sagital, coronal, axial were all as Latin or German in pronunciation as in comprehension! The description of movements as abduction, adduction, flexion, extension added to the mounting tension. Surely, reading the first few pages was a humbling experience for one who sat pretty with eighty two percent in English in the twelfth standard!
          If you thought that the dissection began from the head and completed with the toe, you are wrong. We started with the palm, proceeded to the breast- for the lack of which in our specimen, we had to make do watching another batch dissect their bosom, then the forearm, axilla, thigh-all in a disorderly order!
          The first few days we wore rubber gloves and rubbed shoulders and tempers to get hands on training of the palm. The gloves were either too large or small, not to mention the trauma of wiggling the corresponding fingers into the un-powdered stuck up sacs. As the dissection went on we dissected each others skills and knowledge too and not exactly related to medicine. Good old Cunningham who kept constant company with three volumes over eighteen months was ubiquitous- on our laps as we sat studying on the stools, on the steel table and even on the corpse itself!
          As we dissected the palm, we were expected to identify the palmar aponeurosis, the fascia reticularis, the palmar arch, the median nerve and many other tongue twisters. Thus reading and seeing or imagining the structures that were being dissected, I found myself staring at people's palms in all public places-the bus stand, library, while shopping, the flower vendor-the list grew. And the next week when the time table on the notice board said, Dissection- The Breast, I was mortified! Imagine ogling at lemons, oranges and water melons in public! And also by the end of two weeks all but a handful of us had done away with the gloves. Now we really felt the tissues sans the interfering rubber. And that was when the skin of my palms started peeling.
          No medical student can ever recall a dissection theatre without the pervasive formalin. It is this acrid liquid that is used to preserve the cadavers and is the culprit reducing them to skin and twigs appearance. Huge tanks overflowing with gallons of formalin house the cadavers during the after dissection hours. And on Monday mornings, when the bodies are hauled out and laid for dissection, the fumes come on in full revelry stinging eyes and irritating the nose. The smell so persists in us long after leaving the hall, that by the end of the term it lingers on within us like a fragrance of togetherness! The palms' peeling off is no longer as hotly discussed as the course of the ulnar nerve or the boundaries of the inguinal canal. By the end of a year, even lunch is being discussed and shared in the Anatomy hall!
          Nagaraj, our dissection hall maintenance man was in fact the first person probably all of us had met and felt obligated to befriend him at the earliest and to continue the rapport. He knew where we would get the set of human bones (we all needed to purchase one set each for the study of Human Osteology- The study of human bones). He even had begun supplying sets which came at a slightly lower price, though no one had the reason to ask or the inquisitiveness about the source of his bone sets. He not only supplied whole sets but also supplemented the bones that were missing from our sets, of course for a price.
          As I once juggled with eight bones of the wrist (the carpal bones), none larger than a goose berry, deciding what each one was, and more confusingly, if all of them belonged to the right or the left or if they were assorted, Nagraj appeared as a messiah. Thumbing through them he began placing one by one, easily ranting off their names- Scaphoid, lunate, triquetral, pisiform, tapezius, trapezoid, capitate and hamate! And lo! All of them nestled so beautifully that I could imagine the muscle, tendons and skin over them completing the picture of a neat right wrist! (I later learnt a mnemonic for it- She Looks Too Pretty Try To Catch Her- obviously made up by some mischievous starved male?)As freshmen, being already intimidated by the volumes and intricacies of our books, hearing him so fluent in anatomy made up our minds as to who would be the correct person to approach at times of internal assessments and major exams.
          What started as a handful of students approaching him for help gradually waxed in numbers and by the end of three terms, I suspect there was not a single student in our batch who had not approached Nagraj for some sort of assistance. And Nagraj too had enough smartness to encash his services for currency. He was more sought after than our tutors- for which the latter were relieved or envious I could never know.
          I had often been intrigued by this man running the corpse show in our dissection hall for so long. He was probably in his mid thirties and his family even lived a few meters from the dissection hall, in a small shed which probably was unauthorized, yet they were allowed to. He would haul the bodies out from the formalin tank single handedly, and drop them back in there every Saturday afternoon. I marveled at his ability to place the same body on the same table on Monday mornings.
          As ours was a government run college, we were naturally entitled to all the unclaimed bodies in the nearby government hospital. It was Nagaraj's duty to collect the body from the hospital when intimated of an unclaimed one. He was prompt to process and add it to his tank collection. With the advent of private medical colleges and the demand for bodies steadily on the increase he was over-enthusiastic, and he paid for it once.
          My eyes didn't miss his faux paus though I suspect he kept the incident out of ear shot of the H.O.D. He had  brought a body from the hospital (so he claimed), and having shaved it, was in the process of treating it with formalin when he received news that the unfortunate dead man indeed had relatives who were, at this very moment, entering the far end of the college campus and were making it to the dissection hall! The news galvanized our man and he set about his damage control measures!
          A new white shroud had materialized and the body was respectfully wrapped in it. Some ally of his had darted off to the flower market and had bought generous strings of colourful garlands. And finally the cortege left the courtyard of the dissection hall. A handful of mourners following a horse drawn closed cart (Tonga) that carried the corpse as a whole packet of incense sticks wafted off a heavenly fragrance. Had it not been for Nagaraj's blunder, the dead fellow could not have had a better send off.
          But there were some people, who for some strange reason thought that they could serve the society better than just lying inside their graves after their death. One such generous soul or body was of a doctor's who had donated his body for bettering the knowledge of his junior colleagues. Though he was dissected with utmost reverence and gratitude, a few unkind words were sometimes heard. It was rumored that the study of his body was an anthology of anomalies that could be possible in the human body. The good doctor had lived his life in an aberrant body!
          At that time, the dissection hall of the Anatomy department seemed to be yet another of the compulsory training in the course of medicine. However, looking back today, I realize there were so many untaught, but naturally learnt lessons in those eighteen months.
          Forbearance, the mother of all virtues first sowed her seeds here. We had to put up with an assortment of batch mates from day one till the completion. The girl who grabbed scalpel and forceps from others' hands, the slow gentleman, the not so bright midget, the icky dragon...Being in the same batch was the only common reason to work with and not against each other, the latter indulged in after dissection hours! Today I can tolerate the most boring or tenacious or sloppy patient because I started learning in the dissection hall.
          Dissection also taught perseverance. We had to understand the intricacies of the body before getting down to dissecting it. Understanding the greater sac-lesser sac, arguing about the cornea and sclera, and discussing the formation of the arches-all contributed to cracking the mystery of the body bit by slogging bit. If the concept was not clear, then any amount of dissection could not show us what we wanted to see. (`The eyes do not see what the mind does not know' is another favourite adage of the medicos) So today I know not to give up on a patient- at least till I have exhausted my acumen, referred books, browsed the net, discussed with peers and did everything possible to get to the bottom of a problem.
          And the greatest, most important lesson for the life of a doctor- respect of the human body. We owe it to those corpses who lay patiently tutoring us the marvels of the Creation, the beauty of the architecture and reverence to the most awe inspiring creation-the Human body!  
After showers....(Pastels on paper)