Tuesday, August 30, 2011

Attacks of sophistication

‘Doctor, I have sophistication in my chest,’ she said pointing to the middle of her ample chest.

I have realized in my rather long life of patient listening, not to interrupt. ‘They come and attacks, I cannot work, I feel my legs arms die, I shiver and shake and I no get sleep’ she stopped. I was about to ask her for some details of this weird set of complaints, when she said, ’han, I also have bumps here pointing to a bit lower part of her chest.

I found her to be recently married and she was being treated for polycystic ovarian syndrome. For the past twenty days she has been taking 500mgs of Metformin daily. Metformin is a drug given to bring the blood sugar down in type2 diabetics and also in women who have polycystic ovaries. Though dietary measures, exercise to reduce obesity are better and more successful methods of treatment, doctors are wont to prescribe this medicine instead of the laborious process of counseling to get the weight down which is the culprit.

All her complaints were due to the blood sugar lowering effects of metformin. Her suffocation [sophistication], dying of legs and arms, shivers, bumps [belches and a sinking feeling in the pit of the stomach] were all due to hypoglycemia [low blood sugar levels]

Fortunately she was not fasting like Anna, that would have been a disaster.

She became normal soon after she stopped metformin and her attacks of sophistication and bumps disappeared.

Anna's victory?

Amidst the din of euphoria following Anna Hazare breaking his 12 day old fast, if one looks closely one would realize that the civil society has not really won its battle. Its demand that only their version of the bill be passed was not agreed to. Their demand that the bill be passed without reference to the standing committee was also not acceded to. So also was their bill to include the PM. All that the government did was to agree to consider the Jan Lokpal bill along with the other versions and then bring in a comprehensive bill which will be placed before the committee and then before the parliament to make it into a law. The demand for a time frame too was not agreed to.

Then what did the movement and Anna Hazare’s fast achieve? It showed the government that the people of this country are indeed fed up with the poor governance and the indifference that they are being treated with by the beurocracy and politicians. That is what made the likes of Manish Tiwari and Kapil Sibal disappear from the scene in a hurry.

I was witness to the JP movement which Madame Indira Gandhi ruthlessly suppressed in the seventies. Popular sentiment was against her and she lost the elections. Then what happened? The stalwarts of the JP movement took the reins of power [Janata party rule]. Within two years they proved to be worse and Indira came to power again. Hopefully we will not have that again.

Having said this I don’t want this anti establishment [anti corruption, effective delivery of services, electoral reforms, decentralization of power] movement to lose its tempo and die down.

Aside: How is it that Anna with hardly any resources, managed to get so many followers? It is because of the congress spokes persons. Every time Manish Tiwari spoke 20,000 volunteers joined, when Kapil Sibal spoke, 50,000 did and when Ambika Soni spoke 100,000 joined. Saving grace was that Jayanthi Natarajan did not speak. Otherwise the whole country would have been on the streets!

Thursday, August 25, 2011

Anna's fast

Occasionally it gives me great pleasure to be proved wrong. It has happened in the past like when, the huge lump I felt in a patient’s abdomen was proved non malignant or when the patient with a strongly positive treadmill test had normal coronaries [arteries that supply blood to the heart]

When Anna Hazare began his fast, I felt it will not succeed because the masses of this country [aam admi] are so emasculated by the 60 years of stifling rule by the Kalas [to use Anna’s famous words, Gora gaya Kala aya]. It is the 10th day of this remarkable man’s fast and it appears as though he is succeeding in achieving his immediate goal of getting the parliament to debate his Jan Lok pal bill. When the bill becomes a law I am certain it will not be the same as his version.

The Kalas [meaning beurocrats and politicians at all levels] who are enjoying the power of corrupt rule and feel safe with the prevailing regulations not able to get after their ill gotten wealth, will move earth and heaven to prevent an effective deterrence to corruption. It is not just this, there are so many more. Delivery of health care, basic sanitation and water supply, conservation, building and maintenance of our roads and rails and host of others. It is just not enough if one is honest [a la Man mohan Singh]. One has to be efficient and decisive, qualities sadly lacking in the present day rulers.

There is a long and hard struggle ahead to change the basic character of the people of this nation.

[Gora is the Hindi term used for white and Kala is for black. What Anna means is when India became Independent whites left and blacks took over and the country has remained suppressed, now by blacks [Indians]]

Monday, August 22, 2011


‘Doctor, one new problem’, she said with a beaming smile as though she has won a trophy. ‘What new problem,’ I asked with concern that must have been visible on my face,

‘Don’t worry, it is just a little BP’, she said. She had found it out when she went her doctor in the neighborhood for having felt dizzy.

Esther Nirmala is now a 50 year old grandmother. She is 5’2” and weighs 90 Kgs. Unlike other obese women she is solid and carries this weight with unusual grace. I first came to know her when she was a schoolgirl 35 years ago. She belongs to a family which has a mixture of Hindus and Christians. Her parents were Hindu, her uncle and aunt Christian, her elder sister Christian, brothers Hindu and she married a Christian, Magnus Chetan. Nirmala herself is more Hindu and becomes a Christian when circumstances so demand. Like when her child should get admission or when she has to go a hospital. Most of the good schools and hospitals in the city are run by Christian organizations and she gets preferential treatment. But in day to day life she likes to be a Hindu. She usually wears bright red colours and on her forehead a circle of red kumkum [trade mark of a married woman]. This dual existence comes easy for her as it is a very mixed community she lives in. Once I had asked her about the church taking objections to her way ward behavior. She dismissed me with one word, they understand.

She could not finish her matriculation and soon enough found Chetan, another mix like her. After a few years Magnus alias Chetan moved away to gulf [where he still lives]. Nirmala lives in Bangalore and for years they have been meeting twice a year. This has resulted in two children.

35 years ago as it is now, the parents would get worried if the girl did not menstruate at a given age and it was a concern for the mother that at 16 Nirmala had not menstruated. Those days we did not have Ultrasound to diagnose but we could clinically recognize polycystic ovaries as the cause in fat girls. Nirmala was one such and I had cautioned that if this continues she may have problems. This bothered the mother a bit but not Nirmala. She went ahead and married her friend Chetan and even before the year was over became the proud mother of a baby daughter and in the course of next 5 years produced a son. Marriage causes problems for many but it corrected the errant ovaries of Nirmala.

She became a diabetic some 15 years ago. I don’t think her diabetes was ever under control. Her philosophy was very simple, go to the doctor when in trouble, Blood sugar readings mean very little to her. What she felt was more important. When I asked her what her blood sugar was. She said it was o k. knowing her I insisted, what is ok? 200 she said with a coy smile. [Meaning 200 mgs percent, way above normal but not threatening] I told her it is abnormal. She said a week ago it was 380! This is her usual defense, things could have been worse. Her whole attitude to life has been like this and I have given up trying to make her see reason. That she has lived 50 years without any major disaster is itself a surprise. But her wayward attitude worries me and whenever she comes to see me my heart beats a bit faster because I expect her to have some serious problem, given her background.

Now she is here with blood pressure. Raised BP and uncontrolled diabetes complement each other to destroy one health. I told her that and asked her to get some tests done. She had them already and showed the lab reports. They were not good. When I told her she should take additional drugs and diet more seriously, she conceded reluctantly. ’ alright, I will give up sweets’ she said as though she is making a big sacrifice for my sake.

Did it also mean she was happily eating sweets all along? You will never know with our Esther N.

Not once she showed any concern or worry and took my leave saying, you will see I will be alright in two weeks time’

This I felt was more to reassure me.

I wish I could have written all this in Tamil, the language between us, that would have been so much more fun.

Adithi Ashok

Some time ago I write about our ace tennis player, Rohan Bopanna [Thursday,sept9,2010]. Now it is time to write about another special talent, her name is Adithi Ashok and her sport is Golf.

Golf unlike many other games is a game played against the course and sometimes yourself. It is also a game in which it takes many years to become a mature and complete player. This is because mastering the game, according to me is extremely difficult and needs lots of time and practice. Added to this, golf course designers are building courses which are more testing then ever and these are also playing much longer than ever.

Given this background Adithi’s performance is astounding. She came on the national scene just a year ago when she won the national amateur championships for all age groups. Two days ago she competed against the top professionals of the country and almost won. She lost in a five hole sudden death playoff. The pro tournament was held in one of the toughest championship courses in the country, KGA Bangalore, and I was one of the privileged witnesses to this remarkable performance.

Why is it so remarkable, it is so, because Adithi is only 13 year old, thin built, waif of a girl.

My reckoning is, if she keeps on like this, she will play the world’s ladies PGA when she comes of age and turns a Pro. I hope when that happens in 5 years time, my faculties will be sharp enough to appreciate her feats.

Pregnant women and exercise

My friend Sunder sent me the following one and my fellow golfers will understand and agree with the man, but other readers, I am not so sure.

The room was full of pregnant women with their partners. The class was in full swing. The instructor was teaching the women how to breathe properly and was telling the men how to give the necessary assurance to their partners at this stage of the pregnancy.

She said "Ladies, remember that exercise is good for you. Walking is especially beneficial. It strengthens the pelvic muscles and will make delivery that much easier." Just take several stops and stay on a soft surface like grass or a path.

She looked at the men in the room, "and Gentlemen, remember - you're in this together - it wouldn't hurt you to go walking with her".

The room suddenly went very quiet as the men absorbed this information. Then a man at the back of the room slowly raised his hand.

"Yes?" answered the Instructor.

"I was just wondering if it would be all right if she carries a golf bag while we walk?"

This kind of sensitivity just can't be taught.

It kind of brings a tear to your eye

Thursday, August 18, 2011

TV Brainwash

Ordinarily if you are watching any TV programme you are spending [wasting] an equal amount of time watching commercials. These try and sell products which we may or may not need in day to day use. I sat through a three hour programme and counted commercials which advertised absolutely necessary products. Don’t be surprised, they formed only ten percent. Most were unnecessary and some positively harmful.

Let me list the harmful ones. The pride of place goes to food products. These range from soft drinks to chips and chocolates. All contain refined sugar and fat or sugar alone with additives. Packed with easily absorbable calories they are tailor made to get you to become obese and if going by available evidence predispose you to cancer and cardiovascular disease. [The China Study: Colin and Thomas Campbell] Packaged foods, ready to eat mixes, frozen preserved meats are no good for health when compared to the naturally available fresh food. These are rarely advertised. Have seen a cabbage or cauliflower or tomatoes being advertised except when on display in a supermarket? There the ad is for the chain of supermarket and not for the product.

Next in the list are the body lotions and sprays. Human skin produces sweat and this secretion has antibacterial properties. The smell is odor is unpleasant is a phenomenon that is culturally motivated. Of course you don’t want it to crust and irritate the skin, so periodically one has to have a wash. But removing the sweat and worse spraying the skin with deodorants and scented chemicals [with a flock of woman rushing after the sprayed man] is positively harmful. This may cause skin allergies and invite other organisms like staphylococcus to colonize and cause furuncles and abscesses especially under arm. There was a time when one shot of penicillin would make these disappear but now this common garden variety of germ has become a killer.

Whitening the skin creams take the pride of place in commercials. This is specially targeted at women. Why is it considered that a woman with pale skin is good looking beats me. Again it is culturally driven and the ads only help to keep this myth grow. It is nauseating to see this advertisement. So is hair growth and conditioning tonics. Mostly useless. But look at the number of men and women buying these products. As one senior marketing executive once told me that he can sell even a packet of saw dust with the right idea and image. This is true for most of these products. Saw dust is innocuous but I cannot say the same with these products listed above.

There is an obnoxious advertisement for skin itch in the groin area. This is usually due to a fungus common in the groin area. Though difficult to eradicate it is easy to treat with antifungals. But to advertise like this is positively in bad taste.

We are blessed with abundant health giving sun light and dark skin to counter the effects of excessive sun exposure. We are not satisfied with this nature’s protection. We are forced to use sun protection creams. Except when one has sun sensitivity or when there is danger of sun burn, one should not use sun screens routinely as it will stop production of much needed vitamin D. As it is we are seeing vitamin D deficiency syndromes in many office going men and women especially those who live in apartments.

When you have a perfectly working vehicle why do you need a new one? You need it because the TV ad tells you that your neighbor has one and your wife is goading you to buy one.

This list can go on and on.

My take home message to you is, if you have a gadget which deletes all the advertisements from the programme you are watching, please use it. Even better don’t watch TV at all. It will do your mind, body and pocket, a lot of good.

Saturday, August 13, 2011

Return of Anna

Anna Hazare is a rare human being. Such men and women got us our freedom from the British who knew that they have to leave sooner or later. British rule was for the benefit of Britain and not of India. The design and purpose of rule was to exploit the country’s resources. The institutions they built had one single purpose, which was to serve the mother country. This they did with active connivance of us Indians. Indians never in their history thought as one nation. There was no unifying force or a common cause which united us against the three hundred years of British rule. For majority of Indians it was just another ruler out to exploit them. That some good came out of the British rule is not to be denied. We got the railways, unified system of currency, Banking, an administrative machinery, survey of the country and records, a system of revenue and judicial administration, thanks to the British. All this was done in reality to benefit not Indians but the British. History is replete with examples of how methodical and ruthless this exploitation really was. But they were helped by our own people. The person who was financing the East India Company in its early years in Bengal was Marwari called Omi Chand [considered to be the richest person in the known world those days]. If one reads the well researched book, ‘Sea of poppies’ [author: Amitab Ghosh] one will come across innumerable examples to support this fact of Indians helping the British. Why did they do it so willingly? The answer is that they have done it since time immemorial. British were for them no different from others who invaded this country.

What this has got to do with Anna Hazare? What he is trying to do is what Gandhi did in the first half of last century. Make us think as one nation and object to exploitation. Corruption is one form of exploitation. Gandhi used communal harmony and nonviolent civil disobedience as unifying forces. Anna is using corruption. Is he going to succeed? Is it going to be a mass movement and change the politician and the beurocrat?

I very much wish this will happen. But my gut feeling is that it will not succeed. This is because corruption has come to be accepted by most that matter. These form the top ten percent of Indians. The rest are so emasculated that they are incapable of rising against the rulers just like it happened when the British were ruling us.
Still it is good thing that we have left in this country a few persons who have the gumption to fight, even if it is a losing cause.

Cricket Ignominy

As I write this Indian team is on its way to its third humiliating defeat in the four test series in England. Most of us cricket lovers who enjoy watching test cricket are dismayed with this kind of pathetic, dismal performance from a team which boasts of five world class batsmen and quality swing bowlers. Why did they fail?

Among other reasons, the main one is that there is no hunger to win. As I have written on earlier occasions, fat cats don’t fight. These players are a pampered lot with all the fame and money showered on them. There is no need to win when you are guaranteed a fabulous income. The Indian cricket board has used these players to make money is the common complaint, but then what about the players? Should they not object to this too much cricket? Why do they acquiesce to the unreasonable demands of the board? They do so because of greed.

These defeats should make the board and players realize that they cannot take us, the viewing public and patrons of cricket, for granted. The first step would be to stop the silly form of game called the twenty twenty cricket. This is destroying the true format of the game which is test cricket. Players who play twenty twenty cricket will not know how to play test cricket or if they do know then they will soon forget. This is what has happened to the test cricketers.

Injuries are a part of any sport. The more you play the more injuries you suffer. The greed makes them hide their injuries or declare them too late. This is why our bench strength is so thin.

I, though unhappy with the defeats, see a silver lining. This should make the board sit up and take notice of the deterioration of standards and the reasons why. I hope the paying and viewing public will boycott cricket matches and teach both the board and players a lesson.

Thursday, August 11, 2011

Eventful afternoon

It began with a game of badminton played with [against really] my regular partner Suresh James. Normally we play two games of singles and lately he has been winning. Getting beaten by a better and younger player is no shame if the games are well fought.But surprisingly this noon the story was different in that I played such a nice game that I ended up winning the two closely fought games lasting wellover 45 minutes.

Soaked to the skin with honest sweat and on a high [happens after a gruelling bout of excercise],I came home and casually switched on the sports channel,just in time to see Saina Nehwal playing against an Irish girl in the world Badminton championships.In two superlative games she comprehensively beat her opponent.This added to my high.

Went upstairs to the room to have a shower and change. Heard a rather strange fluty song. My bay window over looks a slender flowering tree with a crown of leaves and branches laden with flowers.This provides me with a daily dose of pleasure and today on it sat the singer, a Bulbul. I had written on an earlier occassion of my sighting and hearing the song of a Bulbul.But this one was different both in song and appearence. It had side red whiskers and a red vent with black brackets below the whiskers. This veriety of Bulbul is called the Red Whiskered Bulbul not ordinarily seen in urban areas.What a pleasnt surprise! My wife has been telling me that she has been seing a multicolored small bird hopping around and wanted to know it's name. Thinking that this was the one, I went down and called her to come up quietly and have a look. The bird was still there preening himself. Though fascinated, she said this was not the one she had seen.[I wonder if it is the common warbler that becomes coloured during breeding season, that she had seen?]. All of a sudden his mate [less colourful] appeared and both of them flew away.

Savouring this fantastic sight which added to my already high mood we went out and sat on the terrace to watch a display by a flock of pegeons which had landed on the terrace.She said,'there is so much we humans can learn from birds'. In one sentance she summarised the essence of bird watching.

This done, I did the set of muscle streches to ease the aches in the tired muscles and had the much awaited hot bath.

Topping it all, fixed a large single malt Scotch and listened to Bhimsen Joshi singing Rag Kedar for an hour.

Who is that fool who said life is not good?

Sonia and her cancer

Sonia Gandhi is the most powerful person in India today. For those of you who don’t know who she is, she is the president of the ruling congress party and thus effectively the ruler of the country. She is also the wife of the erstwhile Prime Minister, late Rajiv Gandhi. In a country where your family antecedenents matter often more than ability, whether it is by birth or marriage, it is no surprise to see the rise of Madam Gandhi in the congress hierarchy. As I said ability apart, her son Rahul Gandhi is being groomed to be our next PM after the term of the stooge PM Man mohan Singh comes to an end.

She was diagnosed with cervical [uterus] cancer some months ago at Lady Gangaram hospital in New Delhi. This hospital is considered as the best in our capital and world class care is provided here. Then why did Sonia and her retinue choose to go to Newyork for the surgery and subsequent therapy?

There by hangs an unsavory tale. We have still not gotten out of the bias in favor of anything foreign is superior to what is available here. Be it a simple cataract surgery or an ordinary removal of uterus, we rush to US or UK for attention when these are done in our hospitals by the hundreds every day. In fact advanced care in all super specialties is available in out hospitals both in public and private sector. Sonia’s choosing to be treated in the US not only reflects poor national character but also is an insult to our doctors especially those who treat cancers.

What surprises me is that not one institution, political party, doctors organizations have criticized her!

My letter to the newspapers was not even published.

Sunday, August 7, 2011

Cricket watch

As I write this, the number one test team, India has suffered two comprehensive defeats from the English in England. I watched the matches. There were several reasons for the dismal performance. As captain Dhoni put it, the team was jaded with too much cricket and injuries to several top players. This is true but not entirely. The reason why is that Indians do not know how to play the raising fast delivery that goes up above the left shoulder next to the left part of the head. It is difficult to leave the ball and sway the head away from being hit. The only way is to duck under or hook it. To duck under is ugly but can be done if the ball is seen early and the batsman is quick enough. This we did not do well and some like Yuvraj Singh got hit and became non players for the series.

Next option and an elegant one at that, is the hook shot. To see the shot played to perfection is a rare treat not available in international cricket these days. The last batsman who was an effective hooker was our own Mohinder Amarnath. I remember way back in the early seventies when the West Indians toured India, there was a batsman of Indian origin called Alwyn Kallicharan. In the Bangalore test played at the makeshift Chinnaswamy stadium, I was sitting way up in the built up stands behind the fine leg. I don’t remember who was the hapless Indian fast bowler was [they were not really fast]. What I remember was the hooked six over the fine leg and the way it was done. Kallicharan went down on his knee and the next I saw was the ball coming towards where I sat. The shot was also played by swiveling on the left foot when the ball came up shoulder high. Another West Indian who hooked the ball was Cammie Smith. Smith’s carrier was cut short in an automobile accident. The great Garry Sobers too was involved in this accident but survived to play for many more years.

One does see a semblance of this shot played occasionally and the one who did play this recently was again another West Indian, Chris Gayle.

Kallicharan kept visiting Bangalore in later years, not to play cricket but to see Sathya Sai Baba!