Onlookers

A year ago, during the presidential election hoopla, I started a post about the significant others of significant people, and discarded it. What had made me start the post at that time was Michelle Obama, the voice of sanity behind all the staging. I think by now, things have been said ad nauseum about the first couple of the United States and I will choose not to add to it, no pun intended. However, what does bring a somewhat related topic to mind is working at the ICU for five weeks.

The ICU is always drama. If real medicine resembles the unfortunate medical TV shows anywhere, it would be there. Lots of scrubs, harassed residents, cussing, codes, "Bring the crash cart!" calls, life saving and death. Most of the time, especially when one is a part of the drama, its hard to get perspective. However, at the end of twenty four hours of being on call, someone else takes over. Then, like I said a year ago in another post, one gets a chance to look back at the previous day. Last month, with the slight added luxury of being a resident and not a harrowed intern, I had the chance to evaluate a little more. What impression do I carry with me from nine thirty-hour calls? Its not how many people we shocked with electricity, not how many people we dialysed urgently or how many died, even. Its the people with the amazing family.

The weird aspect of the ICU is 'amazing' means so many different things depending on the situation. The patients are on so many machines that they don't look like actual people. The family is what makes them seem real. This brings to mind the husband of a woman with really bad H1N1 influenza, whose husband put pictures of her in the room, so we could see how much of a real person she was before she got ill. I shy away from being 'senti' as we call soppy sentimentalism in India, but sometimes, I have realized lately, it is almost justified.

The meaning of the word 'amazing', like I said, does differ with circumstances. It sometimes represents the grittiness of a daughter who decides her mother really would not want a tube down her mouth and a machine breathing for her. A son, who played classical music for hours on the violin for a dad who was unconscious, is one of the biggest heroes I have seen. The doctors and nurses who work there constantly and continue not to despair, appear great to me, the person who just passes through there for five weeks a year.

Sometimes, it is not even anything outlandish like the above instances. It is just the parents, husbands, wives, sons and daughters who come in day after day, and peer at their loved one through the glass doors, who see the person behind the tubes, who must be so scared when they see so many frightening things being done to that person. The strength of these people amazes me.

I do not think the work of a doctor in the ICU is the ultimate test of a good physician. It is one way of making a small difference. However, I do think the circumstances there are such, that they separate love from its imitation, and that, in spite of the bad timimg, is a beautiful sight.

Business class?

The following is something I jotted down during a layover in Chennai, when I was flying back to the US one year ago. I found it today and thought it was worth sharing.


"Another first. Thanks to a benevolent uncle, I am flying business class from Chennai to New York. I am actually still waiting in the business lounge, yet to board. Already, I feel like I have sprouted a halo. I checked in to smiles and deference. There is a tempting spread of food, but perhaps the most interesting spread is the variety of people in the lounge. Obsequious attendants who seem to have the "Soooper" Chennai attitude hidden behind the grooming. Rajnikanth lookalike (or wannabe lookalike) lounge occupant, complete with shades at 9 45 PM, pink shiny shirt with multicoloured stripes, and a blazer, sits champing "chickan sandwich". He is accompanied by a multiply ringed, pot-bellied gentleman. they seem to be making full use of the eats, and I will be astonished if there is any alcohol left in the place after they are done with it.

In spite of the name, there seem to be very few businessmen types. There is a distinguished gentleman opposite me with a vaio and a small tika on his forehead, which strangely adds to his looks of distinction. There is also a lady who seems to have the entire flora of Chennai on her head. Blackberries abound, so do golden wristwatches with wide straps. Quiet conversation in one corner, burps in another. All this vouchering must be leading to this odd mixture of sophisticated rich guys, other not-so-sophisticated rich guys with dink-chik ring tones, foreigners who have a touch of self-importance about them, and people who got plain lucky, like me.

When I came into the lounge, I was conscious of a need to appear more genteel than I really am. Looking around at this mishmash of types, I suddenly feel at home."

Written later, when I was seated in the plane-

"Cool! I've just been promoted to Goddess status. My seat has a back massager, it becomes a recliner, cradle or a bed. I get a free night-dress to wear during the flight. I wonder if they will also dance for me?"

Read that one?

Anyone with a true love for reading will know this. One good book leads to another. It happens by so many mechanisms. It may be several books by an author that you discovered was great. This is what is happening to me with Alexander McCall Smith. It may also be books that are referenced in other great books. The works of Charles Lamb mentioned 'The Guernsey literary and potato peel pie society' made me go and get all the Charles Lamb books. Although I am not proud of it, I read a lot of Shakespeare only because Agatha Christie quotes him so much.

Since I love bringing up questions, I have to wonder this aloud. What leads anyone to pick up a specific book? I was just looking at the list of books Mr. Obama is reading on his trip. I must say that it must be hard to have an entire nation critique what you read. Imagine resisting the temptation to read a crappy book because it wouldn't look good on the news! Apparently they even compare you with past presidents and judge you. The verdict seems to be that while BO is a more sophisticated reader than GWB (duh!), he doesn't match up to Bill Clinton. Apparently its also a problem he doesn't have a female writer on the list. While the entire nation's freedom lies with you, your own little choices are open to criticism, ridicule and dismissal. And people actually run for president?

But I digress. Coming back to wondering useless things, what leads anyone to pick up a book and read it? I used to read the back cover. It seems that the publication companies (who are asses) have done away with the back cover summary and have put it on the inside cover, which is extremely annoying. If you pick up a book and read the back cover as a reflex (which it is with me), you instead find what the Washington Post said about the book. Very little use, since the enterprising publisher, being very clever, has picked and chosen what words he will put there. Still, the criticisms sometimes do sway me and I read a book because the Newsweek says it has to be read. So I am letting a random critic make choices for the development of my mind? Disturbing thought. What if he was a serial killer on the side? What if all the critics were just posing?

The books I usually regret having succumbed to reading are the ones with the author showing up on TV and touting their book. They dress very nicely and speak on random TV talk shows about their so-called influences and I am sold on them. Only to find that they were talking through their hat. Malcolm Gladwell's 'Blink' is one such. Generalizations galore and blowing things out of proportion. Also crappy are the books which I read when the movie trailer looks good. 'Julie and Julia' to name one. She cooked an entire recipe book. So?

The ones that usually turn out well are the mildly apologetic looking books that stand on the library shelf, usually not in the 'new' rack. Which is where I found 'The Guernsey...society'. A book-lover friend is a great resource, I find. Another great way to find a corker is to look at the library book club list. That means the book has something to talk about, always a good sign. The classics are also where I usually have more luck, since to survive generations, a book usually has to be some good.

However, beyond these vague and unreliable tactics, I haven't found anything reliable to tell me how to choose books. Covers, authors with previous good books, reviews, talk shows, movies- everything can be deceptive. Which is perhaps why its such an absolute joy to find a stunner. Its like looking for a needle in a haystack, and actually finding it.

Viva

My name is most commonly misspelled as above. Its the name of a flop girl band in India. Has a cliched association with Las Vegas. And means "long live". Popped into my head due to chain of thoughts beginning with Michael Jackson. So he died, mysteriously, sadly, but most importantly, in the eye of the public. I was sufficiently moved to update my status on facebook in his memory. I saw that many others had waxed eloquent as well. If this guy had died at ninety, in a nursing home, forty years from now, would it have the same impact? No, mainly because people who would have a faint memory of his good music would be gaga themselves by then, but also because living to a ripe old age somehow undermines your achievement. We attribute genius to the van Goghs,the Ramanujans. The Alexanders, the Heath Ledgers move us to eloquence. The lines by Webster "Cover her face, mine eyes dazzle, she died young," pull on the heartstrings and remind one vaguely of Marilyn Monroe. The young are immortalized by death. But somehow the P.G Wodehouses and the Lewis Carrolls don't get the same romance allied with their names. Is this because we consider they got their due by living to a sufficient age? Surely, there is more credit in consistency than in dying early? When I read about these achievers who have led long lives, it seems to me that they have always been filled with a zest for living and a respect for life that I have not found in those we romanticize. I think the greatest character J.K. Rowling has yet created is Dumbledore, the old wild genius. There are probably a lot of Dumbledores we haven't spotted.

And in the background was playing..

Movies have enriched all our lives in many ways, I can safely declare. They have brought life and laughter to many a gloomy evening, they have sparked off many romances and they have created innumerable memories both not only by themselves, but by association. The many many times my family and I have spent watching the same movie and deriving more enjoyment every time cannot be replaced. However, if there was one invaluable gift which I had to pick among all the ways cinema has impacted people,it would be the background music.

The clash of drums is the most reliable way of knowing that something momentous is about to happen in an Indian movie. The lilting music on a shehnai has almost become associated with sadness and grieving. The typical rising tempo on a sitar or veena is one with optimism. All of us, if we search our minds can come up with the music we associate with rain, with romance, with loneliness, with flowers, with comic happenings, and pretty much every situation we are in. The "Taan-ta-daan!" and the "ta-dah!" we each utter when we show off something, is reinforcement of this fact.I had not realized it before,as I had taken it for granted, but any event, especially in a movie seems almost incomplete without a background score to drive it home.

The most talented music directors have perfected the art of making us almost unconscious of its presence, making us feel the situation through the music rather than listening to the music alone. I remember the excitement induced by the background score during the chase in the movie 'Cellular',but afterward, when I sought out that song by itself, it seemed commonplace enough. It is the marriage between the action on screen and the music that gives them both that added power. People who have watched the Tamil movie 'Mozhi' and remember the scene where they show the process of the music being added to the scene, will be able to relate to this.

What is it about the background that makes it so influential? I don't know but I suspect that it is the fact that each of us are born with an innate sense of music and we are happy to recognize the same faculty in the rest of the world. It is also a form of wordless communication. All of us are strangely made happy by that, it seems. We all even associate each product with the music in its ad. Who does not know the Airtel music and the Titan watches music in India? Similarly, everyone in the US seems to recall the Burger King music and many such.

Extending this to everyday life, it really makes a chore such as cleaning the kitchen seem pleasant when you are doing it with hindustani music in the background. The same applies to a dink-chik score during exercise or the latest bollywood number while folding clothes. Association of radio city with coffee, of Upendra numbers with autos makes all these things doubly enjoyable somehow. Simple pleasures and true ones.I am sure all our lives will bring varied problems and many tricky ones, but thanks to our friends in the cinematic world, we can at least face them with a song in our heads!

As I would like it

If I were to somehow have a say in high school education policies, it would be one of my first experiments to introduce a 'shadow month' in which each student would pick four professions and shadow them each for a week, just to know the nitty-gritties of actually living life doing that job. It would be a fascinating month, I think.

Even though I don't actually want to be doing a million different jobs, there are so many people I want to follow around, just for a day or maybe a week. Its my way of saying " Come, tell me how you live!" as Lewis Carroll so neatly put it.

So here are four kinds of people I would love to watch:

1. Music directors : I cannot think of a time when I have not wondered how these people do what they do. So, if a song has to be composed, who does their bit first? The music director or the lyricist? If a song has been written, how is it possible to put it into music without sounding forced? The same way, how can a tune just be fitted with lyrics? In addition to all this there is also the problem of actually conveying the message in a convincing, novel, manner. It has to be a fascinating study.

2. Archeologists: Everyday, these people get a peep into the lives of men and women who lived hundreds to thousands of years ago. The scope for imagination would be tremendous. In addition to physically reconstructing ancient pottery, they have the opportunity of reconstructing, in their minds, the lives of their contemporaries of another age. The conferences and debates between archeologists would be the most interesting thing to watch. Plus, carbon dating is cool!

3. Presidential body-guards: Being alert for twenty minutes in a row is a challenge. What skills do these people have to develop, that they stay that way for hours? How do they get trained in presence of mind? Also, what I really want to know is whether everyday is eventful and interesting for them or does it get trying to always be on the lookout and more often than not, have nothing happen? I also really really want to know the number of them that develop paranoid behavior!

4. Ball boys and girls at Wimbledon: They come and go like magic. They seem to have a system of continuously recycling and supplying players with tennis balls. They also always roll the balls straight. Sometimes, I have felt they read the player's mind somehow! It might be an exhausting business to follow these quicksilvery people, but I would love to try.

There are so many more questions on so many more professions that I hesitate to put them down, for fear of raising more queries than I can ever hope to answer. On second thoughts however, even if a few of them get answered, life will be more interesting. Also, sometimes, like in the middle of a rainy day, thinking of the questions is a lot of fun too!

So,one more of my pet castles in the air. Whether this one materializes or not is probably going to make no difference to my life, but it sure was fun to build it!

MICU

Its great to be able to live in the moment; its excellent to enjoy the journey and not focus on the result. If you can do it, that is. If not, hindsight is your answer. I divide my life into what-fun and only-when-I-look-back-will-this-be-fun activities. Ideally we would all have the former all the time, but remember what chemistry teacher said about ideal gases? "There is no-o such thing, children."

MICU- the Medical Intensive Care Unit, is one of the required rotations for an internal medicine resident, which is what I am these days. I am halfway through the one month rotation and every fourth day, I am on call for a continuous period of thirty hours. I come in one day, stay the night and leave the next day at noon. During this time, I admit people who are ill enough to be in the ICU. I also cover for the other three lucky ass residents who get to go home. So roughly the job about managing twenty five to thirty patients. More importantly, its about dealing with half that many nurses.

In my top ten list of the places to be at two AM, the ICU will not figure. No,really. 'In bed sleeping' will be the top eight. The other two will be 'watching movie' and 'gossiping with friend'. And why will this unique experience not make the list? A. Three beepers, all going off, alternately, all night. B.Twelve ICU nurses who have been there an average of ten years, letting you know what their opinion is of you, the poor eight month old resident. C. Ill and dying patients. All this every fourth day is enough to make life in that moment not so desirable. The resulting muscle ache also probably supplies about half the income of the pain killer industry.

That being said, I still find the strength to make it to the hospital and win the struggle with my cowardly self. This mystery can only be explained by the power of hindsight. Each on-call night drags by, but each morning there is this brilliant moment where one of my colleagues coming in to work asks me, "How was your call?" Then I look back and try to relive the night. Although I do remember the frustrations, the things I recall most vividly are things which like one of the nurses telling me, " Take a deep breath. It only seems like this will never end." Other gems like one of my ninety year old patients telling me she thinks I am doing a great job with her (She is ninety and sick enough to be in the ICU. There's your explanation for that!), and that one patient among several who get better overnight, make me believe that it wasn't such a bad time after all. This also gives me the shaky confidence to believe that I may even survive to the end of the month.

Yes, what-fun moments need to happen in life. The more, the better. However, one has to fill in the gaps too. What better way than thinking, "I am going to look back on this moment and feel like I have lived!"