Monday, November 23, 2009

Simple Management Principle at work!!.

Anyone travelling by Indian railways will wonder at the sincerity of the waiters in the pantry car.You hardly ,if ever, see them sitting casually.It defies simple Indian logic that a host of public sector employees should work their guts out for their salaries.I don’t deny the fact that there are public sector employees who are committed and do their work with sincerity but this is certainly not a norm.You even see the waiters trying to convince the passengers to order something.I had to get to the bottom of this.It could very well hold the key to a major management issue.
A little research gave me the answer.I believe the waiters have a nine percent haul for the sale of the day and no steady salary.Each individual takes home a packet of around three hundred rupees a day.That is a little more then a daily wage worker who earns half the money in the same time.When they don’t work their lot is less ,could even be naught.
The driving factor here is the money…or rather livelihood ….as it is for people from all walks of life……
What a life!!!!...Brings to my mind the word’s of the Master-‘Man does not live by bread alone…..’

Sunday, November 22, 2009

INCREDIBLE INDIA!!!

This is a 48hrs journey to Delhi and back to attend the thanksgiving service for 40 years of EHA.
A simple ceremony,inspiring …
The journey back was in Tata-Muri ,jam-packed as usual.
Two things that struck me from an observation of my colleague during the journey….so much for the mineral water bottles and the strict instructions to destroy it once it is used..the urchins seem to make a meal of it….they collect the bottle ,fill it with ice-cold water from the station water-coolers and sell it to the passengers in the general compartment for five rupees each-I hope the common sense behind it will take him or her to heights of business glory in the coming days.
I found myself leaving the water-bottle with great care on my berth….hoping it catches the eye of the genious.
The station at Daltonganj was flooded with village folks working on leaves,sewing them together to make leaf plates out of them….apparently they travel all the way from their village every night to make use of the electricity which obviously is a non-entity in their villages to work on at night …they sell these leaf plates in bulk to a whole-sale agent who supplies it for weddings and pujas across the states or may be the country too…
This country of more than a billion people,this sort of ingenuity ,hard work and the ability to beat the odds would have given them rewards in mullahs in a richer country,say the west…..but this is India….there is a smarter person for every smart person on the street…..This is what makes this country incredible!!

Thursday, November 19, 2009

Winters -Brrrrrrr!!!

The winter's come in .
So it seems-today is a bundh and I still have to make a quick trip to Delhi and back in a 48hours time.In JKD where the temperatures go up to 49 degrees in summer,my fingers have started freezing.
DO I like winters ,I don't actually know.I guess it depends on the situation sorrounding it.
Last several winters,I have been travelling all over and have been to colder countries,but the thrill of seeing new places ,having new experiences and the adrenalline that goes with it somehow leaves me unqualified to answer the simple question-do I like winters?
I like the sun as much as the next person around i like the winter sun more,I like the snow and the feel of it.I get fascinated by the ice crystals during winters that drip down ,frozen from the hanging cliffs ,in a sub-zero temperature.
I like the crackling fire wood in the fire-place and the warmth of that hot drink that warms the bones ,slowly bringing it to life..i like the warmth of the winter hearth with the family at it, in absolute peace...reading ,whispering ,playing,a camaddarie that is often difficult to manage on easier days because every one is out-doors.
I like the winter sun and the way everyone seems to discuss the leaves on the trees and the shimmer of the winter sun on the valley....the light and shadows, the dramatic and sudden view of the endless landscape which ebbs and flows before your mind's eye with Elgar's symphony playing on the wireless and ofcourse I like the orange trees which bend to the weight of the oranges ,almost touching the ground at times....oranges everywhere...in the trees,on the ground....in my hand ...and in yours !

Tuesday, November 17, 2009

The healing power of the pure!

What a beautiful message in the chapel today from the most unlkely source-a meek staff nurse!It was restating the gospel we have heard a hundred times over but came forth with clarity from a pure heart-not an extra word,not an extra intonation just a pure simple message....crystal clear.
How rejuvinating and beautiful it is to be in such a company even for a little while.

Sunday, November 15, 2009

FRAGILE !!!

I got a mail from my sister the other day.She has just lost her mother-in-law.She was a pillar of strength for my sister and the family.She said one thing which struck me .She said she was still fragile!!
Our chidhood was a protected one .I had not seen death in my family till I was in my late twenties and that was of a dear uncle,well-loved and truly missed.Life was one picnic with the greatest struggle being the exams one had to sit through and occasional skirmishes with friends in the boarding school.
I literally grew up in Tumbagara!
In Tumbagara,a small village with a hospital which I guess is all it can boast of even now,I learnt the ABCs of life....I saw life in all it's gory detail....lived it,lost it,found it and perhaps ...somewhere along the way it struck me that this was actually life ....
..if ten years ago my sister would have used the word 'fragile' to describe a state of mind it would have gone over my head...now I sort of understand.
Fragile!,what a beautiful word!
My sister used it to describe her state of mind.
Travelling back from England,the airport authorities put a picture of a set of crystals with the word as a label on my guitar,
I thought it was beautiful!
I found myself using the word to describe my exceptionally talented and well-loved cousin who's not been keeping too well.
What a beautiful word-….-‘fragile’....,.....liable to break ......,handle with utmost care.....it's precious!

Tuesday, November 10, 2009

A trial post.

I am just trying out my hands in putting photographs into my blog to see how it works!!

Monday, November 9, 2009

Jharkhand's contribution to Indian cricket!!

India was at the brink of becoming world champions in cricket (BCCI ranking)and predictably,has lost the series to Ricky Ponting's Australia.Now an australian player Shane Warne has put the blame squarely on Jharkhand's blue-eyed boy Mahendra Singh Dhoni's captainy.
What's with Dhoni,a simple boy from a small town middle-class family sailed smoothely to captain the gentlemen's game with a lot of poise,and a definate level of cool-headedness and intelligence.We cannot really say India played badly.The players had their days!
I remember when ,a few days after India lost the world cup(T-20),and there were a lot of flaks being thrown on the cricket team,Dhoni coolly sailed into Ranchi with a brand new H2 2009 Hummer with some of his team mates.My old mother wanted to know what the budge was all about,my brother was patiently explaining to my mother how the captain of the cricket team which had just lost the world-cup had bought a car worth Rs.one crore .This car apparently is used by the US army and one more bollywood actor Sunil Shetty owns one.
This is just one more news item in the feature page of the newspaper and it passed off as a coffee table conversation in most homes.

Friday, November 6, 2009

Strange Request!!

A typical middle class lady wanted to enter my office.She actually asked for my permission to do so!She wanted to know if her husband could get a job of a surgeon in the hospital.He was apparently working in Gaya.
I asked her what his qualification was and she proudly said ISC.
She reiterated that he could do all the surgeries and would duely produce the certificates!
Strange request this!!

Happy Birthday to me!

I spent my 38th birthday doing the rounds of the government health institutes in the district of Latehar.The reason being to get permission for PHC visits for the nursing students as per their syllabus.I always get something out of these visits because there is so much about the Indian health system ,which is fascinating in it’s ability to improvise for short-sighted gains.
The government has started this fascinating coupen system for below poverty line patients,the money is handed out to the poor antenatal mothers who access health facilities when they are in the family way.The doctor incharge of a PHC lamented that on one of his routine visits to one of the villages ,he asked the villagers why the children were not immunized and they were quick to respond that no money was being doled out for it so they would not bother.
The government health centre has been equipped with expensive medicines.The villagers on the market day just walk into the out-patients routinely with vaguest of symptoms ,the doctor says with the intention of getting some medicines which are free of cost which they sell at half the price in the market or better still use it to equip their bags with..By the time a genuine patient walks into the OPD with some emergency the PH Cs have run out of those all important medicines.
What I learnt was there are two sides to every coin .This culture of looking for short-sighted gain ,is imbedded very deeply in the psyche ,has taken up mammoth proportions, and is seen in almost all walks of life in India.
This was interesting,I had most times looked at corruption from the other side of the table and was vary of the government run institutions but now this was a different take altogether……

Lessons of Life!!

There are a few lesson life teaches you that leaves an impact.I have a few junior doctors working with me,youngsters who have seen a lot less of life than I have.In these last few days, I often find myself taking my life lesson of the years out of my kitty and sharing with them.This was not so five years ago.My juniors were much more world-savvy than I am and were friends I literally grew up with.They used to label me 'naive' then, I wonder what they would think now-most of them have moved on in life and must have got savvier by dozen.
The other day,I found myself giving my juniors a lesson from life I had learnt first hand ,as well as vicariously about patient management.
Every now and then we get an over-anxious set of relatives and equally over anxious set of patients who literally leave you flaggerbasted.My juniors came to me to discuss one such patient.They clearly looked harassed.Ten years ago I would have put the lot in a slot but years have taught me that nine out of ten it is God giving you a second chance.
During my tenure in this hospital I remember a time when an ordinary caeserian section was done on a patient.The bystanders were tough and demanding.I am a physician ,so was watching the whole drama un-fold before me while my colleagues beat their head out trying to make sense of the situation.The surgical site was clean ,the sutures were out ,the lady would not budge,she persisted on a stomach ache and the relatives were an angry lot demanding that the senior surgeon in the campus(an exceptional surgeon by any standard )was summoned.He examined the patient thoroughly-there seemed to be nothing wrong.A straight X-ray of the abdomen was done nothing was amiss.The patient was labelled a case of post-partum depression and sent to a higher centre.
Two weeks later the relatives were knocking at our doors demanding compensation ,a swab had been left in the abdomen and was detected elsewhere,operated and removed.By God's grace the patient was doing well.The hospital paid the compensation and the case was closed.
The senior surgeon who happens to be a man of God ,in his practise of over 30 years has a record of never having had any complications in any of his surgeries.He did not do the surgery but he missed the finding.
Later on he went back to the case on his own,and he came back with a resounding lesson on life.He detected seven times when God had actually given them a chance to have a re-look at the case and how each time they as a team had missed out.
I remember another time ,in a hospital where I was getting trained ,a lady was admitted with complaints of a chronic headache,the registrar who was looking after the ward was at a wits end with the demands of the bystanders and the ladies un-ending complaints .It is an extremely busy hospital with the bulk of the patient being medical and an OPD of around 3000 a day.It is a 250 bedded mission hospital.Suddenly an old man was standing in the middle of the out-patient ground and was pouring kerosine over himself .He threatened to burn himself in the out-patient if the senior physician ,a man of great repute did not see the patient right then.The consultant,a humble man of God was quick to respond -the lady had a severe pappilloedema-this story had a sad ending the lady succumbed to the ailment a few hours later but the old father was very gracious in that he said that he had wanted the senior physician to examine his daughter,he had obliged and he was grateful.
Nothing as dramatic has happened to me first hand by God's grace ,but it has taught me the importance of reading the sign of times in different situations in life,it's taught me to stand-still in all the crisis times of our lives ,it’s taught me to respect a patient and the relative's opinion,to give due weightage to their anxieties,but most of all to try and listen in all situations to that still ,small voice which says-‘This is the way walk in it.’

Tuesday, November 3, 2009

LEVITICUS 23

EHA celebrates it's spiritual week .The portion for the very first day was Leviticus 23.A call by God through Moses to celebrate the festivals of the Lord.What amazing lessons in learning to study the mind of the Lord.Every festival,with a clear-cut vision and an agenda ,a prophetic call to move forward with our heads directed towards Jerusalem,celebrating the festival of the pentecost as we march onwards to the feast of the trumpets.Right from the festival of the passover to the feast of the trumpets ,an intricate web of design placed by the creator ,a blueprint for every child of God ,Moses had asked for it.....it was given...it was given the exact blue-print...may God give us the clarity and the grace to fall in line with the agenda so that we can continue the journey till such time and be partakers in the coming feast of the trumpets.