Living Your Dream

Before, I make my way back to the hospital, I thought I'll just give you a chance to listen to the demo recording of my new song 'Living Your Dream'. Listen to the low-quality mp3 here. Just tell me if I should proceed to adding the drum and bass tracks to this.

One grave point to note: I'm singing in the demo. Therefore, just neglect the finesse (the absence of) of the vocals and just judge the melody. I'll get my band's vocalist to sing it if reviews are good.

‘Living Your Dream’

[modified on 14/08/04]

After what seemed like eternity
I redeemed some dignity
Head held high, beaming face
I saved myself from more disgrace

If you want to know why

A few years back, I recall
On a rainy night in fall
I discovered a hidden charm (which)
Saved myself from more harm

I wanna tell you why

I won't get paid for this
But it's something I can't miss
I want to run and scream
Nothing like living your dream

It was a busy day
I missed a movie today
A routine With my best mate
And more of this I can take

If you want to know Why

Because Now, I have realized
A dream, from the day I cried
And it gives me what I need
Without which I would bleed

I wanna tell you why

I won't get paid for this
But it's something I can't miss
I want to run and scream
Nothing like living your dream

Living Your Dream

‘Living Your Dream’

[modified on 14/08/04]

After what seemed like eternity
I redeemed some dignity
Head held high, beaming face
I saved myself from more disgrace

If you want to know why

A few years back, I recall
On a rainy night in fall
I discovered a hidden charm (which)
Saved myself from more harm

I wanna tell you why

I won't get paid for this
But it's something I can't miss
I want to run and scream
Nothing like living your dream

It was a busy day
I missed a movie today
A routine With my best mate
And more of this I can take

If you want to know Why

Because Now, I have realized
A dream, from the day I cried
And it gives me what I need
Without which I would bleed

I wanna tell you why

I won't get paid for this
But it's something I can't miss
I want to run and scream
Nothing like living your dream

Hypoglycemic tremors and ego clashes

After about 2 years off, I have re-started working at the hospital. As a voluntary trainee in Orthopedics. I'm totally enjoying it. I'm already getting to assist major surgeries!

I have this problem. I get tremors when I'm hypoglycemic and I can't control them. Today I had trouble in cannulating a patient because of this. Normally, it should have been over in a minute. But I wasted a couple of cannulas.

Apart from that, the patient I tried cannulating had tortuous veins with a lot of kinks. All the regular veins have been used up due to prior cannulization.

One question in general. Do peripheral venous valves affect cannulation?

I really wish that we could get rid of ego problems at the hospital. Yesterday, a suspected case of Osteosarcoma turned up at the OPD. The unit chief decided to post it for open biopsy. But a very well respected associate professor, from another unit, advised against it to the M. O. posted with the duty of doing the biopsy. He said that the soft tissue swelling and vascularity might lead to alarming bleeding. He suggested an FNAC or true-cut biopsy instead.

Totday morning, during rounds, the chief was discussing this and I said the opinion was changed after the suggesting my the other professor. He clearly was offended and said that he was the chief of the unit. Therefore he, and not anyone else, decide what was to be done. He asked me to not mention such things in the future.

I am a fool to have mentioned it. But I thought this other professor is valued high by the whole department.

AIDS Vaccine Still Years Away

"Despite minor progress toward developing an AIDS vaccine over the past few years, efforts still fall short of what is needed to develop an effective preventive vaccine, researchers said here Monday. At a press briefing during the XV International AIDS Conference here, Seth Berkley, president and chief executive officer of the International AIDS Vaccine Initiative (IAVI), said, “Only a vaccine can end the epidemic. Yet vaccines were not even mentioned in the opening session.”

I'm very suspicious at a headline story in a local newspaper in India which claimed that a microbiologist in India's premier medical institute - the All India Institute of Medical Sciences, New Delhi has invented a vaccine which is about to be available commercially! I can't imagine why such newspapers consult with some expert before publishing such stories.

Army rations rehydrated by urine | New Scientist

"Would you eat food cooked in your own urine? Food scientists working for the US military have developed a dried food ration that troops can hydrate by adding the filthiest of muddy swamp water or even peeing on it. The ration comes in a pouch containing a filter that removes 99.9 per cent of bacteria and most toxic chemicals from the water used to rehydrate it, according to the Combat Feeding Directorate, part of the US Army Soldier Systems Center in Natick, Massachusetts. This is the same organisation that created the 'indestructible sandwich' that will stay fresh for three years (New Scientist print edition, 10 April 2002). The aim is to reduce the amount of water soldiers need to carry. One day's food supply of three meals, weighs 3.5 kilograms but that can be reduced to about 0.4 kilograms with the dehydrated pouches, says spokeswoman Diane Wood. The pouch - containing chicken and rice initially - relies on osmosis to filter the water or urine. When two solutions of different concentrations are separated by a semipermeable membrane, with gaps that allow only water molecules to pass through, the water is drawn to the more concentrated side." Read more >>

This is ugly to read about! I pity the US Army. First, they have to fight for something imaginary. And while doing that, they have to eat their on excreta.

Commitment during internship

I happened to be engaged in a very interesting conversation with a friend of mine last week. We talked about the commitment shown by interns in doing their work in our hospital. We actually compared us with the new set of interns. And we both seemed to think that the present lot is very insincere in their work and a lot less committed than we were.

We, being the perfectionist-workaholic kind, strived to do everything right during our internship. We set high standards for ourselves and kept on pushing ourselves harder to get even better. We tried being nice to the patients, greeting them and interacting with the bystanders. We tried to be like a family member of theirs, always wearing a smile and being cheerful. In return, we got a great response from our dear patients and we took pride in it.

We always used to obey our seniors and carry out all orders without even a second thought. This meant that the seniors (ie. residents) always enjoyed working with us. This too has been highlighted in their comments at the end-posting reviews. This is not to mention that we enjoyed impressing our professors with some quality work and used to get high grades on the end-posting assessments. Altogether, we were like med-geeks.

Now, two years after we have done our internship, two batches have completed theirs and the standards, at least from our point of view, are capitulating. These days the interns don’t do their ward work properly, don’t know the details about their own patients; forget the rapport-bit. They also think that preparing for the pre-PG entrance is the only thing that matters and internship is a farce. This ideology leads them to inappropriate behaviour with their residents. I could go on and on about this. But, is there a point?

I am wondering if we are being too harsh. Or maybe we are deluded by our own high held impressions about the way we did our internship. Or maybe we were the more dedicated ones from our batch and therefore, we cannot compare ourselves with the other batches. I hope one of this is true as otherwise, my dream to see the day when teaching hospitals are trusted and respected by the public will remain like it is; as a dream.

For once, I would love being a pig...

I was mentioning about a friend who developed a prodrome after being in contact with a patient of Leptospirosis. Thankfully, the tests have returned negative. He has returned home after being clinical diagnosed as having Infective Hepatitis.

I've been slugging it out with my HTML lessons. Although I'm improving considerably, I'm sleep-deprived and beginning to develop neurotic tendencies. When I was watching the TV other day, I almost thought I had turned psychotic. I had, what I thought, a hallucination. I was eating breakfast with CNN on the telly. There was this promotional about its sports show 'World Sport'. And when I took my eyes of the TV for a split second I heard this "... you can't miss this show!" I know you are not getting it. What I meant by can't is that it was said in the British way. It was no hallucination. Some effort the CNN guys are putting in to woo the viewers in the the post-colonial nations!

One strange feeling that is seeping over me is a desire to become a pig. Not any darned pig, of course. I would give up all of the rest of my life; rest meaning the part I haven't been talking about, for becoming a piglet like the one in the picture below. For those still not getting the point, I love Cats - specifically Tigers and a certain breeds of Lions! The only disgusting part of the photo is it's source; NewsIsCrappy.com. It's a pity that these people find such cute stories unattractive.

Too many things to do

I know people who have a hard time finding hobbies. I find it hard to understand why because I think that there are so many things to be interested in. For the same reason, I always get my hands full of things which I want to do, but find it hard to manage allotting the time I’m going to spend doing them.

Life is busy being a doctor all by itself. It gets harder if you are doing your residency somewhere. Thankfully, I still have a lot of free time before I start doing that. And right now I’m finding it hard to find enough time to do all the things that I want.

I’m currently doing these activities round the clock - reading two books, watching movies regularly, posting in couple of blogs, learning a programming language, designing web pages, maintaining the ones I already have, watching sport on TV, spending time with friends, posting in a couple of help forums for fellow PG (read resident) exam aspirants, solving crosswords, writing new music, chatting with friends online.

I would love to start working in a hospital to gain some experience and earn some money along with that. The list is getting bigger and the hours are appearing even shorter. I have a big problem developing here. I hope I can restrict myself to some sane limits. But I how I wish I could find time for all of these and many more to come.

Here is a very ‘new’ looking word that I came to know thanks to my YourDictionary.com word of the day.

Rumint(Noun)

Pronunciation: ['ru-mint]
Definition 1: (Nonce word) Intelligence based on rumor or false information.

Usage 1: Today's word is part of the intellibabble emerging from the ever-expanding business of spying. "Human intelligence," spy information from human sources, is clipped to "humint," information from electronic surveillance is "elint," while wiretaps produce "sigint," signal intelligence. In gathering "int" about Saddam Hussein's weapons of mass destruction, President Bush and the CIA apparently fell victims to rumint, human information from a highly unreliable sources close to informant Ahmad Chalabi.

Suggested usage: The US intelligence agencies are often unwitting victims of émigrés who wish to please them by giving them the information they want, whether accurate or not: "The CIA reported an outbreak of anthrax in the Caucasus based on rumint from a disgruntled émigré." Clearly today's word is a nonce word concocted on the spur of the moment for a specific purpose and will probably soon vanish, but why not have fun with it while it is here: "Mom, where did you get your rumint that I was smoking behind the school today?"

The Antiretroviral Combination story

The news about the combination pill containing generic version of three antiretroviral drugs being as effective as their expensive counterparts is all over the internet. For me, this is not at all a surprise. Back in the days of the Anthrax scare, the prophylactic drug of those times Ciprofloxacin used to be upto 10 times cheaper and as effective when it came in the generic form from manufacturers in India. Besides, the BBC has been reiterating the claims of the Indian companies in it's programs about the AIDS situation in Africa.

The facts are staring at you. The US administration should take notice. I hope the people concerned will forget whatever has happened and help the needy in the epidemic stricken nations in Africa and Asia.

In addition to that, I've been wondering what the actual combination is.

In addition to being cheaper, drugs like Triomune -- which contains GlaxoSmithKline's lamivudine, Bristol-Myers Squibb's stavudine and Boehringer Ingelheim's nevirapine -- are simpler to use since patients need to take only two pills a day.

FDA Drug and Device Approvals: July 1, 2004

The U.S. Food and Drug Administration (FDA) has approved leeches as a device for skin grafts and reattachment surgery, an oral HIV-2 antibody test with results in 20 minutes, generic dimenhydrinate injection for motion sickness, and a new device for the treatment of heart failure. The European Commission has granted the CE mark of approval for cetuximab in the treatment of metastatic colorectal cancer in the European Union (EU).

Very interesting reading indeed! The leeches might be very interesting to work with in a case of DVT! And the Oral HIV tests would mean a lot in the third world countries.

Commitment to patients or oneself?

Today I got a call from my friend informing that he might have contracted Leptospirosis, which is fondly known by the names of 'Weil's Disease' and 'Weil's Syndrome in this part of the world. Shocked as I was, I asked him how it had happened. He said he thought he got it from a patient in the hospital he was doing residency. The patient, a known case, was spitting blood out and needed resuscitation. My friend had to do his duties despite of the fact that gloves weren't available at that time. In spite of the fact that the resuscitation was in vain, my friend had his hands smeared with blood and unluckily for him, he had some fresh abrasions to help the spirochetes on their quest over another human body. There are two points that I wish to discuss about this issue. One is the lack of proper facilities in Government hospitals in India. This kind of scenes are going on in hospitals all over the world in developing countries. The Government fails to provide enough gloves, syringes, needles, drip sets, IV fluids, sutre material to suit even baseline needs. Therefore, there are times when, being committed residents/interns, we would have to put ourselves to risks in dealing with such infectious disease and even more deadlier ones - HIV/AIDS. Having said this, I must also admit I have seen countless interns/residents who won't use the facilities when they are available. The reason - One of these days you are going to have to do something without gloves. So why waste a pair now? I totally condemn both the aspects of the story. Wait a minute. Who am I to comment? I am, for the benefit of the readers, just a would-be-resident in a Government hospital in India. I don't have any voice when it comes to such issues except for this blog. If I raise the issue in my hospital, chances are that most people (including patients) would consider me as a nerd. From professional aspects to sports - I don't know how many of you are interested in Euro 2004. The fact is that my favorite team is out of the tournament as of yesterday. They were outdone by the fantastic tactics of the Greek. I am not taking any credit of the Greeks but have to admit that using the same tactic over a period of 105 minutes was a tactical error from the Czechs. It's fine if you have a forward in Koller who is taller than anyone in the opposition. If you put aerial balls in from anywhere else on the field into the opponents half aiming Koller, chances are that he will win the ball for you. But if this masterplan doesn't work, why not try something else? That's what they didn't. And that's probably why they lost. They could have substituted the lack-lusture Poborsky in the second half to improve the 'service' to the box. And if you think I'm not geeky enough - I'm a resident doc in India who's into computers, running a website, has a four Gmail accounts, blogging, poetry - dig this! I'm going to try and learn computer programming for upgrading my website. It might be hard to find a more ambitious project anywhere else. But still, I'm going to try my hand at ASP/PHP etc. Wish me luck everyone!

Happy Doctor's Day!

First of all, I wish all of my colleagues and fellow doctors a very happy Doctor's day! But the Doctor's day hasn't started in an intellectually stimulating fashion for me - I read on the Malayala Manorama that the residents/workers in the Kerala House in Delhi were facing epidemic 'jaundice' which was attributed to excess Coliforms in the water. Now, as far as my theory goes, Coliforms don't cause epidemic hepatitis which is what the paper meant by epidemic 'jaundice'. The only thing that Coliforms are known to cause, in this context of course, is cholangitis, the signs and symptoms of which are quite different from this 'jaundice'. There must be a species of staff in the paper's editorial team called - Medical Professionals? Can't they run the story through them before it appears in print? Another thing that I'm dying to bitch about is the Government's idea of uplifting the historical landmarks in Kerala, particularly in Thiruvananthapuram, with ideas that are as teeny as it gets. For example, the City Corporation of Thiruvananthapuram spent a lump of money to renovate and 'decorate' the East Fort, the city's most prominent landmark. The final picture, which I'm unable to show you at the moment, is something like a kinky Vegas casino - the walls are lighted by lamps of the colors pink, green etc. Oh by the way, this is not Texas and we are certainly not in the 70's hippie era! Even though I didn't understand the whole process of "Legal Handover" of Saddam to the Iraqi administration thing, I could clearly make out the idea behind this cartoon on The Hindu which was about Bush's upcoming best seller autobiography! *winks*
Back to my life - My mother retired voluntarily from serving the Central Government for over 40 years yesterday. She was an employee of Department of Posts. There was an official sending off function at the office and a lot of her colleagues gave her a farewell accompanying her home. She, as I can understand very well, was very touchy about this. This was probably one of the moments in her humble career-one in which she had to sacrifice promotions for staying with her family. She used to be considered as a trust-worthy, reliable, efficient person at her office; almost the exact opposite to what she was in her family's eyes. Apart from this, I know how a work environment can liberate oneself from the limitations imposed by the family structure. I knew my mother enjoyed working immensely. But as she was tiring, she had to compromise on that to enjoy a quiet retired life. Anyway, the point that I'm trying to make is that I knew how important this was to her. And that is why I did my level best to get everything ready for the guests. I spent almost all day doing that hoping to make her feel really good about it all. And it worked! And I'm happy; maybe even proud! Apart from her colleagues, almost everyone from my father's side of the family came for the function. Some even got her gifts! You should have seen the thrilled look on her face when she opened up the package with the Mysore Silk Saree, an expensive one, which my sister and in-laws had sent! Everything was so bright and happy! One any other day, this kind of get-together could have been one of my nightmares-I would get stuck in these pointless arguments with my relatives about topics such as religion and marriage. But it wasn't in the end! It was actually fun! I enjoyed being the "nu" Me; somone who is mature enough, and matured enough in the eyes of others, to not be tampered with in his concepts about various issues. Would you believe that I actually enjoyed recording the new mallu hit "Lajjavathiye" with me on the guitar and my cousins on vocals?! This remarkable step in my musical career can be looked at as a deterioration in the quality of music that I play. Or maybe just expanding one's own horizons. I take the second.

Today, I came across an article on Medscape.com about Physicians and their blogs. Very interesting indeed! I had time to go throug a few of those. It's worth the read. I'm amazed to see the kind of topics being discussed in those. These are the kind that I would like to discuss as well.
-- Web Logs Offer Viewers a Rare Glimpse Into the World of Medicine : a Medscape.com article -- MedLogs.com : This should be the aggregated version of a lot of medical blogs. I'll let you know more later. -- Family Medicine Notes : Docnotes - Occasional Notes from a family physician - since 1999 -- A Chance to Cut is a Chance to Cure by Bard-Parker.
I'll review some more next time.

Welcome to South India's Leading News Site: "A female leopard, which was trapped by forest officials on Tuesday morning, looks out from her cage at the Sanjay Gandhi National Park on the outskirts of Mumbai. Several leopard attacks this year has struck terror in the city of nearly 13 million, killing ten people in June alone. Reuters"

Whew, another reason for my choice for studying in Mumbai! I hope I get to see leopards in action!

Guys, it's good to be back on the blog. It has been over a year since my last post on this blog and in an effort to break the shackles, I've guess I overdid a nifty Acronymn/Name meaning generator. http://www.go-quiz.com/acronym/acronym.php You can visualize the results that it generated using my names and nicknames. Oh by the way, I almost died laughing while posting those. Chip in with your 2 cents.