Mr S is a fellow golfer and also my patient. He took to golf when he was past fifty and I have been observing his progress [or regress?] since then. Even when he began he was not very good, as it often happens when you take up a new sport at that age. Except for the walking that is involved in golf and swinging the club attempting to hit the golf ball squarely, he does no other exercise and as he has grown older his never very good golf swing has become shorter and stiffer. This is because he finds it difficult to turn his body fully and shift weight from one leg to the other. Though this is the lot of most of us ageing golfers and most of us have come to accept this as another aspect of ageing process and still continue to enjoy the game [more observant amongst my readers may have noticed that my handicap has gone up from 15 to 18].
This is not so with S. He cannot accept that his bad golf is because of his age and stiffness. He came to see me the other day and his opening remark was, ’Doc,’ I am giving up golf’. I kept quiet. On many a bad day I too have felt like doing so, but have gone back to play. The infernal game is like that. No other physical activity [with the possible exception of sex] is as addictive and frustrating as golf. ‘ I am not able to strike the ball, and when I do it, it is a slice [the ball taking of to the right in an ugly arc], I have become abusive and ill tempered, no caddy is prepared to carry my bag, my partners barely tolerate me and when I go home, I am so irritable that wife doesn’t even want to speak with me’ he stopped.
He sat quiet staring at me. I can understand the turmoil he was going through. Golf is one game where maximum consultations are done with sport Psychologists and in their absence my friend has found me to help him. I know that telling him that he has become old and it is natural that his game will deteriorate will only depress him more.
‘What you want me to do’ I asked him.
‘Give me something that will make me less irritable, I don’t want to lose my temper on the golf course’ he said. ‘But then, how will it improve your swing? Have you gone and seen the club’s pro?’ I asked him. ‘Yes I did. Took two lessons, He wanted to correct my twenty years swing, impossible at my age, it was a bloody waste of money’ he said.
Any way you have decided to give up golf, why then you need medication to quieten you’? I asked. I want to give it a last try, He said. I gave him a prescription for a minor anti anxiety drug to be taken half an hour before the start of the game. I also told him it might cause some drowsiness. He took the prescription and left.
Couple of weeks later I met with him on the golf course and asked him about his golf. He said, ’I am much better, I have stopped using my driver, 3 wood and long irons[ less forgiving of the 14 clubs a golfer is allowed to carry] and my slice is now much less though my handicap remains the same’. ‘How is your temper?’ I asked him. ‘I am paying my caddy twice the amount so that he can put up with me’ he replied. This meant he was bribing the caddy to accept his short temper [I will tell the caddy’s version in another story]. ‘So the medicine is working’ I asked. Yes, he said but not while playing golf, I take it at night with my evening drink, doc let me tell you I never had a better cocktail, I have never slept this well, you should recommend this to your other patients’ he said.
Sunday, March 28, 2010
Friday, March 26, 2010
Demand from the drunks
The Citizens of the city of Bangalore are now in the throes of selecting their ward representatives [carporators] who will administer the city for the next five years. This time over there are two hundred of them. Normally one would expect the contestants to be educated with a flair for social service with administrative ability and leadership qualities. Going by the newspaper reports and what I have seen and heard these candidates on TV, a large percentage of them appear to be slum lords, gangsters and extortionists, undercover dons who have come over ground only to contest the elections. Many of them have the additional qualification of being school drop outs. Their sole qualification in getting nomination from the major political parties is winnabllity.
Most are locally well known in their respective wards not for any acts of gallantry or for social work, but because of creating nuisance such as extorting, creating ruckus during festivals and taking out processions, boot legging and it should come as no surprise that many are rowdy sheeters registered with the local police stations. But they all have one additional qualification, that is money. This enables them to hire unemployed youth from the slums and shanty towns of the city where majority of voters live for doing election work. One TV channel showed these young men having a good time after the day’s electioneering, sitting in happy groups drinking and dancing. The electioneering involves visiting the voters with hands folded during day time and clandestine visits during the evenings to distribute goodies like clothing, kitchen utensils, cash and the prince of all gifts, alcohol.
Hooch is the term commonly used for illicit liquor sold without license. This city is in love with alcohol. Many years ago when prohibition was introduced [driven down the throats of people] all over the country, Bangalore was the only city that was spared. This city has many legacies left over by our erstwhile masters, the Britishers. One of them is the habit of drinking. Depending on affordability and class, there are three types of drinking men [and women]. The first are economically well off who drink the high end of spirits [scotch and other imported stuff], the second are the not so well off who drink what is called IMFL [Indian made foreign liquor] and the last are the weaker sections who drink the cheapest available that includes illicit alcohol. It is not uncommon to see many dying after consuming this illicit brew contaminated with methyl alcohol. But across the board we Bangaloreans love our drink and come election time we give free vent to this love of ours.
Alcohol users form the majority of voting public, and this time they have put forth their own demands to the prospective candidates. Stop making impossible promises like providing nonstop water, electricity, clearing the clogged drains and the like and work towards meeting the following demands.
Provide shelters near liquor shops where inebriated persons can spend the nights instead of on the footpaths and roadside as it is done now.
In case one was to be found sleeping off in the above unacceptable areas, see that they are not disturbed by the police and the good Samaritans who pass by. This applies to street dogs also.
When we are zigzagging our way back home late at night, passing vehicles must slow down and allow us to go our way. We should have the right of way and not these crazy drivers. Policemen should leave us alone and not drag us to the police station and disturb our sleep and pleasure.
Wives are a major problem. They don’t seem to understand the importance of alcohol in our lives. They scream and shout at us when all we want is to get our well earned sleep. Often we are made to sleep on the door steps of our own homes. This must stop.
Last but not the least; we are the major revenue earners for the government. Excise levy on liquor forms 40% of the state’s revenue. It is therefore the duty of all the future carporators to work to reduce the duty on liquor and all of us then can afford to drink quality liquor and need not risk our lives drinking illicit hooch.
Most are locally well known in their respective wards not for any acts of gallantry or for social work, but because of creating nuisance such as extorting, creating ruckus during festivals and taking out processions, boot legging and it should come as no surprise that many are rowdy sheeters registered with the local police stations. But they all have one additional qualification, that is money. This enables them to hire unemployed youth from the slums and shanty towns of the city where majority of voters live for doing election work. One TV channel showed these young men having a good time after the day’s electioneering, sitting in happy groups drinking and dancing. The electioneering involves visiting the voters with hands folded during day time and clandestine visits during the evenings to distribute goodies like clothing, kitchen utensils, cash and the prince of all gifts, alcohol.
Hooch is the term commonly used for illicit liquor sold without license. This city is in love with alcohol. Many years ago when prohibition was introduced [driven down the throats of people] all over the country, Bangalore was the only city that was spared. This city has many legacies left over by our erstwhile masters, the Britishers. One of them is the habit of drinking. Depending on affordability and class, there are three types of drinking men [and women]. The first are economically well off who drink the high end of spirits [scotch and other imported stuff], the second are the not so well off who drink what is called IMFL [Indian made foreign liquor] and the last are the weaker sections who drink the cheapest available that includes illicit alcohol. It is not uncommon to see many dying after consuming this illicit brew contaminated with methyl alcohol. But across the board we Bangaloreans love our drink and come election time we give free vent to this love of ours.
Alcohol users form the majority of voting public, and this time they have put forth their own demands to the prospective candidates. Stop making impossible promises like providing nonstop water, electricity, clearing the clogged drains and the like and work towards meeting the following demands.
Provide shelters near liquor shops where inebriated persons can spend the nights instead of on the footpaths and roadside as it is done now.
In case one was to be found sleeping off in the above unacceptable areas, see that they are not disturbed by the police and the good Samaritans who pass by. This applies to street dogs also.
When we are zigzagging our way back home late at night, passing vehicles must slow down and allow us to go our way. We should have the right of way and not these crazy drivers. Policemen should leave us alone and not drag us to the police station and disturb our sleep and pleasure.
Wives are a major problem. They don’t seem to understand the importance of alcohol in our lives. They scream and shout at us when all we want is to get our well earned sleep. Often we are made to sleep on the door steps of our own homes. This must stop.
Last but not the least; we are the major revenue earners for the government. Excise levy on liquor forms 40% of the state’s revenue. It is therefore the duty of all the future carporators to work to reduce the duty on liquor and all of us then can afford to drink quality liquor and need not risk our lives drinking illicit hooch.
Sunday, March 21, 2010
Maya's garlands
Indians are immune to the news, both visual and written, giving details of corruption in public life. If there is one single reason why we have progressed much less than what we could have, is because of this. I have written on several occasions on this and how we have come to accept and even appreciate the corrupt.
The latest is the felicitation ceremony of the corrupt politician queen, madam Mayavati. This scion and savior of Dalits [name given to the socially and economically backward section of Indians] is ruling the largest and the most populous state of the union called Utter Pradesh. On the occasion of the 25th anniversary of the birth of her party, she was profusely garlanded by her party men [sycophants].The garlands were made up of currency notes of 1000rupee denomination. The garlands were huge and were engulfing the diminutive Mayavati and they [garlands] had to be supported by her faithful. Was there any sense of shame or remorse on her face? No fears. There was a glow of great pleasure. Obviously there is no need to account for this money that must have come by some sort of coercion, when it is collected by politicians. There was an interesting TV discussion on this question of acceptance of money in this manner and one of the participants defended her saying that she has the guts to do it openly in contrast o others who do it under hand!
God save this country.
The latest is the felicitation ceremony of the corrupt politician queen, madam Mayavati. This scion and savior of Dalits [name given to the socially and economically backward section of Indians] is ruling the largest and the most populous state of the union called Utter Pradesh. On the occasion of the 25th anniversary of the birth of her party, she was profusely garlanded by her party men [sycophants].The garlands were made up of currency notes of 1000rupee denomination. The garlands were huge and were engulfing the diminutive Mayavati and they [garlands] had to be supported by her faithful. Was there any sense of shame or remorse on her face? No fears. There was a glow of great pleasure. Obviously there is no need to account for this money that must have come by some sort of coercion, when it is collected by politicians. There was an interesting TV discussion on this question of acceptance of money in this manner and one of the participants defended her saying that she has the guts to do it openly in contrast o others who do it under hand!
God save this country.
IPL 3
The slam bang cricket jamboree that goes by the name of 20/20 [twenty twenty cricket] is back to haunt the likes of me. For the next two months there will be no other news or sports show on our TV channels and I have no option but to watch it. Having said I prefer the longer version of the game, I am not averse to watching it. But the kind of entertainment this provides is aesthetically less satisfying compared to the game played in other formats. But that is not the younger generation thinks and feels. The stadia are full of young people watching [if you call making lewd noise as watching]. The viewer is bombarded with commercial clips not only at thee end of the over but even between balls!. Commercial interests have completely taken over this game and we are witnessing the death of real cricket.
Most of the viewing and paying public is young. This generation has grown up in a frenzy of change. They are used to loud sounds, lewd language, explicit sex, no leisure, traffic snarls, violence in real life and on the screens, corrupt private and public life and the IPL in its third successful season, reflects all this. Sad but true.
Most of the viewing and paying public is young. This generation has grown up in a frenzy of change. They are used to loud sounds, lewd language, explicit sex, no leisure, traffic snarls, violence in real life and on the screens, corrupt private and public life and the IPL in its third successful season, reflects all this. Sad but true.
Friday, March 5, 2010
Demise of Hockey
Field Hockey is a delightful game to watch and a dangerous game to play. It involves speed, stick work, body feint and stamina. There was a time we were the uncrowned champions of this game and won successive gold medals till the early fifties. Then on till early sixties we shared the glory with another great hockey playing nation Pakistan. We were called,’ wizards with the stick’. Such was our domination. I remember as a college student going to watch hockey matches to packed audiences. There was a lot of enthusiasm amongst the watching public and more number of youngsters would play this game. If I remember right our Leander Pais’s father Vace Pais was an ace player who played for the country. The decline began in the late sixties and never really has recovered as evidenced by the recent drubbings the team received from Australians and Spaniards [at the time of writing].
The question that comes to one’s mind how and why this has happened? My own guess is because of two reasons. One is that the other nations took up to this game in right earnest and prospered. The other is that we let the game take a back seat and allowed Cricket to take over. No youngster wants to be hockey star, they all want o become Tendulkars. So the base pool of players has dried up. It is often said that Europeans win because of their better physique and speed. This is no argument to defend our poor performance. A sardar youngster is as big built as any European and our tribal boys from Jharkhand are speedier than the Europeans.
The only way to avoid being the last ranked among the playing nations is to give Hockey the status and money. The talent will automatically follow because we are natural to this game.
I hope I will live long enough to see that day when India again becomes a top hockey playing nation.
The question that comes to one’s mind how and why this has happened? My own guess is because of two reasons. One is that the other nations took up to this game in right earnest and prospered. The other is that we let the game take a back seat and allowed Cricket to take over. No youngster wants to be hockey star, they all want o become Tendulkars. So the base pool of players has dried up. It is often said that Europeans win because of their better physique and speed. This is no argument to defend our poor performance. A sardar youngster is as big built as any European and our tribal boys from Jharkhand are speedier than the Europeans.
The only way to avoid being the last ranked among the playing nations is to give Hockey the status and money. The talent will automatically follow because we are natural to this game.
I hope I will live long enough to see that day when India again becomes a top hockey playing nation.
Wednesday, March 3, 2010
We paid for our lunch
At last this old fool is showing signs of growing senile; you may feel when you read this caption. Who else will pay you may think, I don’t blame you if you do so. But we doctors are special. We allow others to pay and that is why I thought it is worth writing about this lunch when doctors attending the meeting [actually the association of ours] paid for the lunch before the CME [continuing medical education] programme.
It was in 1980, more than thirty years ago, That I along with a few of my friends started an organization which later came to be known as family physicians association[FPA], entirely devoted to the CME needs of family physicians then called general practitioners [I still like that name]. Was there no such body to look after the learning needs? There was the local branch of the Indian Medical Association. But they never were able to understand that GP is funny kind of specimen who needs special education and this is spread across all specialties. He is not interested in the intricacies of how an MRI machine works but only wants to know how to differentiate a cyst from a solid tumor. If the learned speaker teacher spends an hour explaining how the MRI works, he can be rest assured to hear loud snores from the audience. Mine and other’s attempts at getting the august body of the IMA see reason failed and that made us after nearly five years of struggle, to go ahead and start a new organization with a small number of twenty doctors. This steadily grew and now it has on its roll six hundred!
Initially we met at the local medical association’s premises where we didn’t have to pay rent and managed the expenses of a cup of tea and biscuits from our own pockets. Soon the association asked us to pay rent. This meant our expenditure went up and also the expectations of our members who by now had begun feeling that a tea meeting left hem hungry and wanted to have something more substantial to eat. They came from different parts of the town and some went straight to their clinics from the CME and naturally a lunch was preferable to tea and biscuits. But who will pay for this?
By now, the original manageable, like minded twenty had grown and the members felt there is no harm in getting sponsorship. My advice then that it is better we pay for our lunches and for hiring the meeting place fell on deaf years. Sponsorship meant approaching Pharma companies and at that time FPA was not well known and did not have the clout which it has now. This meant us [office bearers] going with a begging bowl requesting sponsorship. What was difficult became increasingly easy and members got used to eating free lunch. Then why is this sudden desire to pay and learn?
Let me tell you a real life story which will make you appreciate why. I had a medical school friend who came up the very hard way. His initial years were very difficult and he had no money to pay for his daily needs and his education. He had to entirely depend upon the goodwill of his donors for this. Some paid his school fee, some his lodging and some for his food. The last named was according to him was most demeaning. He would go a house each day for his mid day meal. Some households received him with courtesy and tried to make him feel at home. Some would feed him only after the entire household was fed and some would give him previous days left overs. Very few thought he had a right to self respect. Beggars are no choosers and my friend was a kind of beggar. Receiver of help is always at a disadvantage and in most cases your self respect is at stake. Though my friend became very successful later in life he never would forget the indignity of this free meal.
Then am I right in comparing this with the four course lunch that Pharma companies give us in the sponsored CMEs? I see no difference. At least those who fed Satya [my friend’s name] did it without expecting anything in return. They were thus more altruistic. Whereas Pharma companies expect us doctors to help them to sell their products. Even if one does not do that they know when their sales person meets the doctor he will be received well. This is a perfect example of you scratch my back and I yours. As they are interested in product promotion it was often difficult o have the CME unrelated to product promotion. So the sponsored education remained lopsided. Nevertheless I like many others felt lopsided education is better than no education but the desire to free us from this dependence on Pharma companies was always at the back of our minds [though not all of us!].
Five years ago we took a decision to make the participants of our CME programme to pay a small sum of Rupees fifty [less than a dollar] as a registration fee. There was a mountain of protest. Many came to me and castigated me for having forced them to pay what was earlier free. Their argument was that the sponsor who pays for the programme and lunch does so because he benefits from this either directly or indirectly and who are you [I] to spoil this perfect I scratch your back and you scratch mine arrangement.
Logic almost always defeats reason. It never occurs to us that there is dignity in paying for our learning especially when we can afford to do so. But the logic that when there is someone else who is paying why go and upset the apple cart is still quite strong.
So a beginning has been made and a compromise has been arrived at. We will not go and ask for sponsorship. If someone comes along and sponsors on our terms [speaker and subject of our choice] don’t say no. If none comes forward then pay from your pocket. This is what we did.
We paid for our lunch!
It was in 1980, more than thirty years ago, That I along with a few of my friends started an organization which later came to be known as family physicians association[FPA], entirely devoted to the CME needs of family physicians then called general practitioners [I still like that name]. Was there no such body to look after the learning needs? There was the local branch of the Indian Medical Association. But they never were able to understand that GP is funny kind of specimen who needs special education and this is spread across all specialties. He is not interested in the intricacies of how an MRI machine works but only wants to know how to differentiate a cyst from a solid tumor. If the learned speaker teacher spends an hour explaining how the MRI works, he can be rest assured to hear loud snores from the audience. Mine and other’s attempts at getting the august body of the IMA see reason failed and that made us after nearly five years of struggle, to go ahead and start a new organization with a small number of twenty doctors. This steadily grew and now it has on its roll six hundred!
Initially we met at the local medical association’s premises where we didn’t have to pay rent and managed the expenses of a cup of tea and biscuits from our own pockets. Soon the association asked us to pay rent. This meant our expenditure went up and also the expectations of our members who by now had begun feeling that a tea meeting left hem hungry and wanted to have something more substantial to eat. They came from different parts of the town and some went straight to their clinics from the CME and naturally a lunch was preferable to tea and biscuits. But who will pay for this?
By now, the original manageable, like minded twenty had grown and the members felt there is no harm in getting sponsorship. My advice then that it is better we pay for our lunches and for hiring the meeting place fell on deaf years. Sponsorship meant approaching Pharma companies and at that time FPA was not well known and did not have the clout which it has now. This meant us [office bearers] going with a begging bowl requesting sponsorship. What was difficult became increasingly easy and members got used to eating free lunch. Then why is this sudden desire to pay and learn?
Let me tell you a real life story which will make you appreciate why. I had a medical school friend who came up the very hard way. His initial years were very difficult and he had no money to pay for his daily needs and his education. He had to entirely depend upon the goodwill of his donors for this. Some paid his school fee, some his lodging and some for his food. The last named was according to him was most demeaning. He would go a house each day for his mid day meal. Some households received him with courtesy and tried to make him feel at home. Some would feed him only after the entire household was fed and some would give him previous days left overs. Very few thought he had a right to self respect. Beggars are no choosers and my friend was a kind of beggar. Receiver of help is always at a disadvantage and in most cases your self respect is at stake. Though my friend became very successful later in life he never would forget the indignity of this free meal.
Then am I right in comparing this with the four course lunch that Pharma companies give us in the sponsored CMEs? I see no difference. At least those who fed Satya [my friend’s name] did it without expecting anything in return. They were thus more altruistic. Whereas Pharma companies expect us doctors to help them to sell their products. Even if one does not do that they know when their sales person meets the doctor he will be received well. This is a perfect example of you scratch my back and I yours. As they are interested in product promotion it was often difficult o have the CME unrelated to product promotion. So the sponsored education remained lopsided. Nevertheless I like many others felt lopsided education is better than no education but the desire to free us from this dependence on Pharma companies was always at the back of our minds [though not all of us!].
Five years ago we took a decision to make the participants of our CME programme to pay a small sum of Rupees fifty [less than a dollar] as a registration fee. There was a mountain of protest. Many came to me and castigated me for having forced them to pay what was earlier free. Their argument was that the sponsor who pays for the programme and lunch does so because he benefits from this either directly or indirectly and who are you [I] to spoil this perfect I scratch your back and you scratch mine arrangement.
Logic almost always defeats reason. It never occurs to us that there is dignity in paying for our learning especially when we can afford to do so. But the logic that when there is someone else who is paying why go and upset the apple cart is still quite strong.
So a beginning has been made and a compromise has been arrived at. We will not go and ask for sponsorship. If someone comes along and sponsors on our terms [speaker and subject of our choice] don’t say no. If none comes forward then pay from your pocket. This is what we did.
We paid for our lunch!
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