Category Archives: family

WHY NANDAN CANNOT FIND INDIA ON A MAP

I have not had any urge to write all these days, and I can’t say I am in the best of mindsets to do a good job. However, here is a small essay written, with my active help, by my son. I hope you tolerate me for this. You cannot find a drier piece than this, I am sure.

I live in the city of Kolkata, surrounded by dusty buildings, most of them made of bricks, and some of them of a mix of thatch, wood, mud and plastic. The latter type of building makes for the shanties that freely thrive in my neighborhood.
In one such shanty lives Nandan. I have been seeing him for the last two years. Nandan does not study in my school. He works in a garage next door, by the side of the street.
At those times when the ball flies out of the building walls and lands in the garage (whenever we play cricket in our compound), Nandan is found ready with it, handing it over to us reluctantly. I have sometimes heard him being rebuked by his master for wasting time looking for the ball beneath some damaged car or the other.
Nandan looks like a grease monkey. Really. He works on his back, lying on the rough muddy ground and hands over tools to the car mechanic who is his teacher and mentor. As the day goes by, the muddied lubricants from the spare parts of the cars find their way from his hands to his face and neck. The only thing the black paint cannot hide is his brilliant smile. But that is something I have seldom seen.
Nandan does not play with us, as he is busy at work. When we are at school, he is at the workshop, and when we are playing, he is right there. We got talking sometimes, but not much.
While me and my friends are getting plumper watching TV and playing on the computer, he is thin as a rail. He cannot even find his country on a map, I found! He told me one day that he wanted to learn English and maths, and asked about how my school looked. I don’t know whether he believed me when I told him how grand and old my school was.
At home, Nandan gets to eat with his brothers (while I have none), but his mother is too busy with household work to talk to him or put him to sleep. Or else she is too busy fighting with other ladies in the shanties over whose turn it was at the toilet or the water pump. I have seen this many times from my verandah, high up in my building.
I am sure he must be getting bitten all over at night by bugs, while I sleep in comfort a few storeys above him. I sometimes wonder whether I deserve being better off than him, but then, this is not the age when I need to handle tough questions!

MARY KISS MASS

Though I am a hard-headed atheist since the time the infant Rambodoc slipped mischievously from his Ma’s lap and hurt his little head, I have a soft spot for a little head. This soft spot includes celebrating religious holidays like Kiss Mass Day.

Today being accepted by broad consensus as such Day, I went out of my way to ‘enjaay‘ the holiday. To this end, I went into a multiplex armed with a fistful of tickets to a movie about cloning. The movie was called Ghajini. This was about a The Incredulous Hulk clone made into a movie that was cloned from a Tamil clone of an English/American movie.

Except that this desi Hulk does not seem to eat anything to justify his muscles. He just keeps getting whacked in the head, and this seems to stimulate as much Growth Hormone release as claimed by the various supplement companies who live in my Junk folder with the sole purpose of inducing me to buy their wares, to give an additional three inches to my manhood. To which temptation I have never succumbed even when the pickings were short in the lean seasons. If you can understand my tortured metaphors.

To get back to the movie, Aamir Khan’s muscles grow from his brains to his ears, after making a business class round-trip to his legs. When tears cloud his eyes, you can see 58 muscles twitching in tetanic fury. When he gets walloped from the back, you can see the haarmoans pumping up his delts and traps, and he swats mutant Ganjas like a gesticulating Amar Singh in Parliament while denying allegations of bribery. All in all, very impressive. I mean Amar Singh’s escaping those allegations, and more so his great contributions to the poor of the world. Like Bill Clinton.

One thing about this movie is that it seemed to attract all the gays in the city. The guy next to me (he was alone, and this is always a negative feature in a guy, according to my wife) was singing along with Aamir in the song sequences. There were some other (equally single) guys who stood up and clapped when Aamir came out of a BMW, as if they had been paid for that errand. So the general impression from the straight perspective was that “That guy is a gay. Imagine clapping for a guy! I can accept getting the clap from a girl, but this! Fagging gays!”

The morning show started around 10 in the morning, as promised (you know, there is a 10 PM show in the evening, too, but the movie guys took us in the morning, as they said they would). By the time the last punch had landed, Aamir Khan had put on around 300 lbs of lean muscle, and the sun outside had set. We had to make the most of the Great Holiday and left even as the last song was threatening to spill over on to dinner time, with the producers of the movie exhorting us not to leave, and to get every penny of the ticket price back with bonus decibel points. “Thanks so much, but we will be back for the sequel, whenever you find a suitable clone, that is”, we said, and took a much needed toilet break.

I then went down and bought groceries. I will soon drive a couple of hours till the next block where I will, with family pulling the leash, give a gift at a party, and rush back quickly in another two hours so that I can shut my eyes on another great, memorable day.

How was your Kiss Mass Day?

A CARE-ER CHANGE?

An anesthetist I know has decided to quit his job and move to another city.
He is doing so not because he is not happy with his current job, but because his daughter, who is a talented Carnatic classical singer, wants to train under some guru in Chennai.

In order to support his daughter’s career goals, our man is shifting base. The fact that he is an anesthetist, and a good one at that, allows him the freedom to shift cities more easily than, say, a surgeon in private practice. Having to build a career and reputation in a new place all over again would be nothing less than a curse.

On the other hand, a doctor is getting his son admitted to a local, small-time, private engineering college, though the boy got admission in other cities with better colleges. His reason: his wife and he wanted his son to live with them. He refused to understand that the parents’ decision was rather unfair to the son’s future prospects.

I have thought about the first example a bit seriously: how much would I be willing to forsake for my family? No, not for a life and death issue, but for something merely potential, like a better prospect for a child or a better job for a wife. I have realised that I could do it, provided the family members could accept the implications and repercussions of my move. In fact, I have long made a standing offer to my wife to take up a high-paying job in a First World country, so that I could become a house-husband (is there a politically correct name for this post?), dealing with the kitchen and garden, apart from taking up a project to write a magnum opus, the kind that publishers would throw their cheque-books at me for. I have also promised her free sex if she accepts this offer.

To cut a long story short, she has not even bothered to respond. She plans to keep me in bonded labor till such time as her interests are not fulfilled. Which probably means I will work till I drop.

Would you shift base for your spouse or kid? In the first example, the doctor who is shifting to Chennai is also into Carnatic music. What if your kid or spouse were to want to do something you did not believe in or share? Would you still disturb your career for that? Comments??

WORLDS APART!

My daily life is replete with ugly sights, foul smells, and sad sounds. Such is the life of practising doctors. I had accepted this long back as a part of surgical life, and trained myself to disconnect my non-professional life from the feedbacks of life with the sick and suffering.
A very minor taste of this:

My nephew, award-winning car designer Harsha Ravi, lives in a different world, as do many of you.
Here is what he is up to. Take a look.

Is it small wonder, then, that I strongly discourage youngsters from getting into medicine? With so many things to be passionate about and excel in, why choose medicine, with all the tensions, ugliness, etc.? What do you think?
One other thing, too: I consider youngsters like Harsha to be not merely lucky to have lives like this, but also smarter, in that today’s kids know what not to do!

Pics: patient pics mine; others from Harsha’s article.

AN IMITATION OF FLATTERY

Someone is taking this blog rather seriously, and copy-pasting stuff in websites.
There is this article on Biointelligence and Morphological Freedom that seems to be lifted right out of the pages of this blog.
Huh.

A FAMILY DISASTER

Today, I had to admit my wife to hospital.

She suddenly started laughing hysterically.

Nothing I could say or do could change her state.

I tried tickling her to distract her, tried to draw her attention by stuffing a big cucumber into my mouth, and dancing around in underwear.

She just would not stop.

Sad.

The timing was coincidental to my asking her, during an earnest discussion of our marriage:

“Do I have any downside, any negative, at all?”

Poor thing! No one knows why she is still laughing. The psychs have no answer.

Oh, the limits of medical science!

THE PHILOSOPHY OF HEART ATTACKS

A recent article (dated tomorrow!) in the Journal of the American College of Cardiology says that anxiety increases the risk of heart attack in men.

Anxiety may increase the risk of acute myocardial infarction (AMI) in men by up to 40%, even after controlling for risk factors such as age, education, marital status, fasting glucose levels, body mass index, high-density lipoprotein cholesterol levels, and systolic blood pressure in proportional hazards models, report University of Southern California researchers and quoted by Bloomberg News. An analysis of data on 735 men enrolled in the Normative Aging Study and followed for a mean of 12 years showed that the relationships between anxiety and AMI risk remained significant even after further adjustments for health behaviors (drinking, smoking, and caloric intake), hypertension medications, high cholesterol, diabetes during follow-up, and psychologic variables including depression, type A behavior, hostility, anger, and negative emotions.

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(pic credit: http://www.revolutionhealth.com)

Ha, I knew this all along! All this about reducing smoking, calories, and drink, and what do you have? Another dead duck. We never stop to think that we are not immortal. Unless you unwind, your heart is constantly going to be under the pressure that adrenaline (and its sibling hormones) creates. End result: an MI.

When do men actually unwind? The answer (though not from any reference I could quote) is after their first heart attack.

So, does living longer mean one should curb one’s ambition and prepare to live a life of limited achievements and stress? I think stress is harmful only if it is not welcome. If you feel stress of the kind that causes tension, anxiety and panic, it is bad for you. On the other hand, if you enjoy the challenges of life without losing out on the fun it offers, you would probably live longer and better.

I am, however, not aware of any properly conducted study that compares the longevity of people exposed to healthy versus unhealthy stress.

I have another theory, which will surely be proven in a Level One trial in the next decade in The Lancet: the worst, cold-blooded scoundrels on earth die the last, and long after the departure of those they have tormented all life. Those who cause anxiety probably live longer than those who take it. Conscience causes coronary constriction, if you can forgive this alliterative dose of alleged wisdom!
(Note that the above is merely my hypothesis.)

In case you are not an absolute monster, enjoying life’s challenges rather than merely following the herd and mindlessly aspiring for material goals, is likely to lengthen and enliven your life. It also follows that if you are a pessimistic, inward-looking man you would die earlier than one with a sunny, carefree disposition. When was the last time you smiled, dude?

A SUNNY STORY

When it bites, the bug
I feel a strong tug
To be me, careless and vain,
Throw words in a rhythmic chain
And focus on getting some grub.

Here is a short story in limerick:

“Always the money, honey!”
Said Mummy to Sunny.
“If you want to be good,
Become a rich dude,
Not poor and funny.”

Older as Sunny grew,
The better he knew
That money is the root of evil.
But it came through a will,
With currency, his morals he threw.

While he grew richer,
He saw a pretty picture:
A lass- love at first sight!
She, with great insight
Married this rich letcher.

On their first night
They had a fight:
She wanted one grand first,
He wanted to just enjoy his lust,
We’ll never know who was more tight!

A RESTAURANT PREVIEW

An engraved letter was lying at my desk at home all week. It finally forced me to open it.

Dear Doc Rambo,
We could not help noticing that since the time you attempted to become a famoush blogger, you became a famished one. As this is the season of good will and that kind of popular shit, we have the pleasure of feeding you if you can drag your sorry ass to our new restaurant at Silver Spring, Kolkata within the next two weeks.
Regards,
Manager,
Sigree

Well, a slight exaggeration, actually. It sort of said (if memory serves me right):

Dear Doc Rambo,
We recently analysed the last Census results to form a data base for our new restaurant in Silver Spring, Kolkata, and noted with pleasure that your name figures first among the select list of Indians whose tongue-tips can reach their elbows. Sir, we would be privileged to have you at our new restaurant within the next two weeks, as we are unable to think of more practical ways to check the culinary skills of our new chef,whom we are paying enough for him to consider bonking Paris Hilton.
Regards,
Manager,
Sigree

So, when informed that tonight’s dinner at home (dal, roti, sabzi, dahi) was refused even by the alley cat, I decided to venture out to Sigree.
Located at the mall in Silver Spring (a swanky new condo complex near the ITC Sheraton Hotel), Sigree, for some reason, looked like a brand new restaurant.

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We (wife, kid and blogdoc) were welcomed so profusely that the last named got nervous. Are we the only family they have managed to coax entry into their restaurant, I wondered.
The ambience was warm and unpretentious. There were certain murals and jug-like structures on the walls that I couldn’t describe or name. If I could, I would have been writing for the New York Times, rather than being stuck in Blogsville, writing anonymous posts for you stinkers wonderful people.

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The restaurant manager, Debdatta, came up to us and explained that they were going to Beta test their cuisine prior to the opening in mid-January ’08 and would appreciate our comments on the food.

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They started off with a few starters.
Among the vegetarian starters, we had:
Dilli Wali Tikki (a large blob of potato pastry with chickpeas, onions, masala and a bit of sauce).
Hare Masale ki Paneer (cottage cheese kababs in green herb gravy).
Chutney Wali Makai (a sheekh kabab made out of blended vegetables and pulses, mildly spiced).
Multani Chat (fried sliced baby potatoes in a piquant sweet red sauce spiced with ginger).
(Notice how professional I sound? Piquant indeed!)
Kurkure Bhendi (thinly julienned okra in light batter, fried and lightly spiced).

The non-vegetarian starters were:
Gosht Sheekh (mutton kabab).
Murg Chandni Tikka (ginger-garlic flavored white chicken kabab).
Murg Kandahari Tikka (spicy chicken tikka kabab).
Bhuna Methi Tikka (bhetki fish kabab with fenugreek).

All of these were superb, save that the Chicken kababs were not really the kind I like (chandni tikka: a bit too garlicky, and kandahari tikka suffocated by spices). In particular, the okra was mind-blowing.
After all these were demolished, mostly by the hungry laborer who had been operating since 7 in the morning, I told my wife, “Let us not sit around any more. Let us leave before they bid us goodbye, please come again!”
As if they had heard me, a troupe of waiters came in with the main courses.
A point of digression. The proper collective noun I should have used is ‘an indifference’ or ‘an absence’ of waiters. However, the waiters today were devoutly solicitous, almost as if I was their son-in-law-married-to-ugly-daughter come to visit. No absence, and no indifference.

Main course:

Amritsari Kulcha (tomb-shaped soft breads stuffed with pomegranate, mashed potatoes, onions and a touch of red chilli pepper).
Butter Nans/Baby Nans/Ajwaini Rotis.
Yellow Masala Dal (with a slightly burnt garlic flavor).
Gosht Chilman Biryani (mutton chunks in spiced Basmati rice, sealed in dough and cooked in a tandoor).
Sabz Dum Handi (fresh veggies in a mild green sauce).
Murg Shiroudi Masala (Chicken in red sauce spiked with black pepper).
Chaap-e-Baluchistan (Rogan Josh by another name).

In short, the chaap was the best I have ever had, and the Chicken Shiroudi packed quite a bit of flavor, too. The others were all very stimulating, with the Amritsari Kulcha getting my gourmet vote.

At dessert time, the Firni captured the flavor well, but was a bit too sweet. I was too sated to really enjoy the Shahi Tukda, which turned to something like Farex in my tired mouth. Good, actually, because I heard a female voice (probably belonging to my wife) saying, “I will never come to a restaurant with such shameless gluttons. Ever!”. I thought she was talking of others, but there were no others in the restaurant at that time. Odd, that.

By the time of the dessert, the others had long given up on food, and were desperately searching for a place they could lie horizontally over.
They wrote profuse eulogies in the comment sheets, while I rolled out on all fours, ready for the drive back home.

Being an astute surgeon, I realised the reason this insane assault on the body’s system with so much of food did not cause any feeling of sickness. I could see the parietal cells of my stomach lining frantically secrete acid to digest the initial starters, and then slow down, finally collapsing under the onslaught, limply secreting H2O instead of HCl.

If you are the numerology sort, here is a rating (out of 10).
Food: 9
Decor: 5
Service: 10
Hospitality: 10
Price: 10
(complimentary for us)

(Pedantic note for the greedy visitor from Googledom: Sigree is part of the Mainland China group of restaurants. This is a 168 seater restaurant, and has been preceded by others in Pune and Chennai. Bangalore and South City, Kolkata, are the next sites to open soon. Its chef is Sandeep Pandey, formerly of Gucchi of the Hyatt Regency, Kolkata).

(Pictures mine. Once the food came, somehow, we forgot to take pictures.)

DEATH BY IMPOTENCE!

ED AND THE MALE WORLD

Erectile Dysfunction (ED), originally from the Latin Impotentia coeundi, is one of the major diseases of mankind, and can be loosely defined as an inability to achieve an erection for successful penetration.

In normal populations, the incidence of major Erectile Dysfunction (ED) is 5 to 20%. Even in the young, ED occurs in around 13%, according to a study on boys between 18 and 25 years. This is remarkable, because ED is known to be seen in older, not younger men, as a rule.

One of the most respected and cited studies on the epidemiology of erectile dysfunction is the Massachusetts Male Aging Study. The study showed that 52% of 1,290 men aged 40 to 70 years had some degree of dysfunction, and almost 10% had total absence of erectile function.

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A new article in The International Journal of Impotence Research has some interesting things to say, based on a large study on the sexual habits of more than four thousand men, both gay and straight.

Most men in the prime of their sexual lives (18 to 44 years) use no drugs for sex, while some do it for recreational use, and fewer because they need to use them medically.

The recreational use of ED drugs is increasing, and seems to have a negative effect. The study says that, on surveying the participants’ perceptions and self assessments after taking ED drugs, their confidence and performance suffered unless they took drugs again.

As lack of confidence in one’s ability to gain and hold erections has been identified as an important psychogenic risk factor for ED, the findings have important implications. Recreational users of ED medications may be vulnerable to becoming psychologically dependent on pharmacologically induced erection.

Therefore, the young kids out for a trip on Viagra are rooting for trouble!

WHO CARES ABOUT ED, A BORING MALE DISEASE?

ED is now more than an andrologist’s way of making bread. It is now a sentinel for a variety of diseases. What are they?

* ED may be the first symptom of coronary heart disease in a young man. In fact, ED is now considered a strong indicator of heart disease, with strong correlation as to severity. In other words, the more severe the heart disease, the greater the liability to be having ED. Men who have less than expected degree of erection, or have it only to lose it midway (lazy erections) are likely to have a cardiovascular cause of ED.

* ED may present in an undetected diabetic.

* It is seen in long-standing smokers, alcoholics (whiskey dick or brewers’ droop), and those with lipid disorders, prostatic diseases, etc.

* Evidence has linked hypertension to ED.

* Drugs used in the treatment of various diseases can also cause ED.

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IMPOTENCE IN INDIA

India has been called the country of unconsummated marriages because of the phenomenon of ‘honeymoon impotence’, when ED manifests on the first attempt. Impotence in India is mainly psychogenic, unlike the rest of the world, where three-fourths of cases are said to be due to organic, not psychological causes. Of course, once a man becomes impotent, he suffers enormous loss of confidence and self-image, leading to further performance anxiety. So the psychological overlay (no pun intended, for once) is also visible here.

HOW DOES ONE TREAT ED?

If you are a man facing ED, the sensible thing is not to hide it, but come out with it to a physician. Screening for hypertension, diabetes and heart disease will follow. Smoking should stop, as should excessive boozing.
Then what?
Based on what is wrong with the patient, the treatment is commenced.
Usually, drugs like Cialis (tadalafil) are the first line of treatment. Among the ED drugs, a lot has changed since Pfizer came out with Viagra. Leftist limpos: please note that Viagra was not invented by a Government pharma company.
Cialis (Tadalafil) is now a preferred drug for ED patients. It works for 36 hours, can be taken irrespective of food, and one does not need to time the drug intake with sex, thereby making for a better experience. In contrast, Viagra (sildenafil) works for only four hours and needs to be taken half an hour or so before sex.
In some cases, the doctor may advise the patient to inject a substance like papaverine or a prostaglandin (Alprostadil) into the penis just before sex. Rigidity is best achieved with injections.
In psychological cases (performance anxiety, depression, schizophrenia, etc.), counselling and appropriate treatment is advised.
Specific cases where the penis loses rigidity due to blood leaking from the veins respond well to vacuum suction devices.

SURGERY FOR IMPOTENCE?

In a small percentage of cases, where there is no response to any of the above, the andrologist might consider implants. These are devices that are implanted inside the penis (and partly in the scrotum). One device (essentially a semi-rigid rod of silicone with metal wires), called the AMS prosthesis, may lead to a permanent semi-erect state. In India, it costs around 60,000 rupees (around 1150 USD). A local version has been made by andrologist Rupin Shah and costs only Rs. 10,000 ($250). The better prostheses (e.g., the three-part inflatable AMS prosthesis) enable erection only during sex (on demand). A pump (implanted in the scrotum) needs to be activated to push in fluid inside an implant in the penis. The implant fills with water, and the penis becomes hard. This costs around Rs.220,000 ($5050).

One problem with the penile implant is that any infection is disastrous, leads to removal of the device, and permanent impotence. Hard luck!

It should also be remembered that any treatment of ED, like drugs or injections, may cause a persistent, painful, permanent state of erection, called priapism. This condition is an emergency.
Unless treated within four hours, it leads to permanent impotence.

To sum up, a man’s inability to achieve a satisfactory erection is not a laughing matter. It may be a sign of serious underlying disease which can eventually kill him.

Note: pictures are mine!