Wednesday, November 27, 2013

It’s A Nutty Result

It’s A Nutty Result

There was an interesting article in last month’s New England Journal of Medicine titled - [Association of Nut Consumption with Total and Cause-Specific Mortality, N Engl J Med 2013] which talked about how eating nuts- walnuts, peanuts and hazelnuts for more than 5 times a week reduced death rates by 20%. This lowering of death rate is achieved by lowering the risk of heart disease and lowered cholesterol levels according to the study.  As the study says - nuts are nutrient dense foods rich in fiber, vitamins, minerals and anti-oxidants and all kinds of goodies. So are nuts the new miracle foods? Should we all rush out to buy nuts and start eating them?

Just hold on a bit and before we start stocking kilos of nuts at home, let’s take a closer look at the entire study again. With the current trend of sharing breaking news on social media most people just read the title and overall conclusions of any scientific study published (hyped) in the popular media - rarely do people take the time to read the entire article in full and try to understand the pitfalls in the study design or the subjects chosen. And that’s why when we take this entire study in totality we find a few queer aspects in it which might confuse these stupendous results.

First of all, the people who participated in this study (eating nuts regularly) were all nurses and doctors- so we can assume they would have taken care of their health in other ways too- like cutting out junk food and exercising regularly and eating lots of vitamins daily and so the reductions in heart problems and cholesterol might not be entirely due to the effects of the nuts, you get what I am saying? And also this study has specifically excluded those who smoke and those who are overweight which means that any results which talk about reducing heart attack risks is a bit biased towards those who are already fit and healthy and taking good care of themselves.

I mean, when you take a naturally healthy person and then say they have reduced risk of heart attacks because they ate nuts, put that way it’s not a very jaw dropping result is it? On the other hand show me a morbidly obese person who never exercises in his life but sits home watching TV and smokes 40 cigarettes a day and then tell me that eating nuts reduces his cholesterol and saves him from heart attacks and I promise to stop prescribing medicines henceforth and start writing 2walnuts/2almonds twice a day for 5 days as my prescription.

So in conclusion nuts are nutritious, beneficial and probably prevent heart attacks. But so does exercise and weight loss. And if you prefer not to go nutty do eat nuts but also try to live a stress/tension free life. Save your heart- ‘cos you only got one. Okies?

Tuesday, November 26, 2013

The Faithless

The Faithless

It’s a tough moment in life when someone you believed was your friend betrays you without a second thought. At some level, intellectually, you understand that what occurred is not unique to you, that it happens every day to everyone and there is nothing to be done except to move on and let it go but still the first shock of betrayal and the consequent thought of having been such a fool to be taken in like this - hook, line and sinker by a confidence trickster- "that" that is quite jarring at first notice. And then as you swallow the betrayal and think it over calmly you come to realize that the fault lies partially with you for failing to see that the other person was just using you as a ladder to move up in life while you believed that it was eternal friendship. In their mind you were just not the friend that they were in your mind - you were just a means to an end; an acquaintance who could prove useful someday and now that there was no more need you have been discarded without a backward glance. This bitter fact of being discarded after being judged useless hurts- hurts the ego if anything- but as better men than I have said before- the truth may hurt but its nevertheless necessary- for instead of going along in the false fog of belief in "eternal friendship/yeh dosti" the stark bright truth of betrayal is preferable any day- to let you know where you stand in relation to that friendship/person.

Right now at the very first moment of backstabbing it becomes easy to turn cynical and start doubting everyone- every friendship- as just one more betrayal waiting to happen when the conditions are right. But there, that’s exactly what one must guard against- ward against stone- to not let the betrayal of one person turn you into something you are not originally- a cold hearted person suspicious of everyone’s motives. In short to fight against the temptation to turn your heart into stone so that no one can betray you by taking you by surprise again. It’s easy, quite easy and so tempting to turn heart into stone and bar its gates to all your friends - but if once you start going down that path and become suspicious of every friend - you never know how it will end-  but i guess mostly in a lonely life filled with no fun, I suppose.

And so I will fight. I will swallow the betrayal. I will try to forget it and move on- it’s too early to forgive. And I will try my uttermost not to be suspicious of the motives of all my other friends. I will try to shun the easy path of cynicism and continue to trust everyone and never look back over the shoulder to see who is planning to betray me. And i will hope that people will prove themselves to be good friends and restore my faith in friendship. Finally I hope that if there is a providence somewhere let it judge the rights of what happened- if people use and discard friends for temporary benefits do they really deserve the success they get from that betrayal? Only god alone can decide and I leave it to him.

Wednesday, November 20, 2013

பிஈசா-2: வில்லா – ஒரு ஆராய்ச்சி

பிஈசா-2: வில்லா – ஒரு ஆராய்ச்சி

ஒரு சில படம் – நாம படம் பார்த்து வெளியே வந்ததும் மறுபடியும் டிக்கெட்ட வாங்கிக்கிட்டு திரும்ப உள்ள போயி இன்னோரு தரம் பார்க்கணும்ன்னு தோணும். சமிபத்தில் நான் பார்த்த பிஈசா-2:வில்லா அப்படியொரு படம். எதுக்கு உடனே டிச்கெட்ட வாங்கிக்கிட்டு மறுபடியும் பார்க்கணும்னா- இன்னொரு தடவ பார்த்தாலாவது ஏதாவது புரியுதான்னு பார்க்கதான். அப்பவும் ஒண்ணும் புரியலன்னா அது மணிரத்தினம் படம்னு கணக்குல எழுதி விட்டுடன்னும்- மறுபடியும் மறுபடியும் ஆராய்ச்சி பண்ண கூடாது. அப்படித்தான் இருந்திச்சு வில்லாவும்.

ஒரு சபிக்கப்பட்ட வீடு- அதுல ஒரு பிரெஞ்சுகாரன் மந்திரம் செஞ்சிருக்கான். அத வாங்குற நாசர் ஒரு ஓவியர்- அவர் வரையறது எல்லாம் அப்படியே நடக்குது – கடைசிலே அது அவர் பையன் உயிரையே பலி வாங்கிடுது. இதான் கதைன்னு நினைக்கிறேன்- இல்லன்னா திட்டாதீங்க- எனக்கு அவ்ளோ தான் புரிஞ்சிது. இதுல டைரக்டர் டச்சு நாம பாராட்டியே ஆகனும்- ஒரு ஓவியம் காட்ராங்க- அதுல சிவப்பும் நீலமும் நாலு லைன் தான் தெரியுது – ஆனா ஹீரோக்கு மட்டும் அது கரெக்டா புரியுது - அது ஒரு நடக்க போற கொலைய காட்டுதுன்னு – உடனே அவர் தான் தான் அந்த கொலைய செய்ய போறோம்னு தெரிஞ்சுக்கிட்டு அதுக்கு முன்னாடியே தற்கொலை பண்ணிக்கிறாரு. சத்தியமா ஆடீயன்சு யாரும் இந்த ட்விஸ்ட்ட எதிர் பார்த்திருக்க மாட்டாங்க- அதான் திகில் படம், இல்லையா?

இது எனக்கு எது ஞாபகபடுத்துன்னா – காலேஜில்ல படிக்கறப்போ எக்ஸாம்ல மனுஷன் படம் வறைவோம் – அதுக்கு ரெண்டு கை ரெண்டு காலு ஒரு தல மட்டும் தான் இருக்கும் – ஆனா அத வெச்சிட்டு எங்க வாத்தியார் எனக்கு மார்க்கு போடுவாரு (எனக்கும் ஆச்சரியம் தான், என்ன செய்ய) – அந்த மாதிரி ஆளுங்களுக்கு தான் இந்த மாதிரி திகில் படம் புரியும் போல. 

இது புரிஞ்சா பத்து மார்க்

நாங்கெல்லாம் அந்த அளவுக்கு வொர்த் இல்லை- நாங்க கேட்கறது எல்லார்க்கும் புரியற மாதிரியான ஒரு சாதா தமிழ் படம்ங்க –உங்க அதிமேதாவிதனத்தை எல்லாம் காட்டி எங்களை குழப்புனீங்க – அவ்வளோதான் எங்கள மாதிரியான “சாதா” சினிமா ரசிகர்கள் “விட்றா இத தீபாவளி/பொங்கலுக்கு டிவியில் பார்த்துபோம்”ன்னு வீட்ல இருந்துடுவோம். ஓகே’வா?

Sunday, November 17, 2013

Last Minute Wisdom ????

Last Minute Wisdom ??? Or Blues ????

Disclaimer: This post is a work of fiction and any resemblance to any person or incident in real life is strictly imaginary and no way involving any professional trust issues.

This morning I was left completely free of any work, quite unexpectedly if i may add. And no it was not of my own volition for I would much rather have been busy doing some surgery but my only patient for the day canceled her surgery and walked away without looking back. And that is the story I am going to share with you now. There i was all bright and early in the morning, with a strong filter coffee inside me and entering the operation theater for my morning surgery when I heard a mild commotion near the operation table at the far end of the room - near the anesthetic apparatus. I walked over to see what the heck was going on and that too right on my surgical time and was surprised, well shocked would be a better word - to see my patient still on her feet when by rights she should have been flat on the table conked out by the anesthesia and ready to be cut open.

As i neared the group surrounding the girl(the patient) and arguing with her- the girl shook off the nurse who had a restraining hold on her arm and saying "I don’t want the operation" she walked out of the theater leaving us all flabbergasted with her insouciance. There was nothing we could have done to stop her- she had every right to decide on the surgery- right up to the last minute and she had obviously exercised her right to walk out at the very last minute possible. My mind working overtime on the why, I hurried back after her to catch her before she left and ask her if she could at least tell me her reason for canceling at the last minute.

And as I came out through the swing doors of the theater I could see my patient arguing vehemently with her mother who was waiting outside the operation theatre and just as I neared them her mother turned towards me and said "doc, give her anesthesia and just do it, don’t listen to her, she is just afraid". I shook my head sadly at her and said "now listen Mrs. So-and-so, she is a major and she has every right to decide what’s good for her. I never treat people who are unwilling for treatment" and as soon as I said that the girl pulled her mother along by the arm and they left without a backward glance- ruining my day effectively.

A few minutes later as the entire surgical staff got back together in the empty operation theatre to discuss what had just happened there was an immediate attempt to lay the blame on me as the admitting surgeon for not getting the patients wholehearted willingness before the surgery. I immediately defended myself by taking out the case notes to show that the patient had met me thrice over the past ten days and had done all the necessary investigations promptly which showed she was willing to undergo the surgery till she had come in and I wanted to know from the operating staff nurses and the anesthetist what made her change her mind just before anesthesia.

As a matter of fact no one really could say why for sure but we all could make a guess- some patients, in fact most patients rarely realize the seriousness of what they have signed up for until the moment they are lying on that operation table staring into the overhead light and waiting for the anesthetist to start injecting. Its then that they have a profound realization that this is IT- I am undergoing a surgery involving my body parts and a lot of blood. If it’s a case of where the patient has been suffering from pain or disease for a long time then they actually welcome the surgery as the last step towards a permanent cure for their disease. But most cosmetic surgeries are not for pain relief- but just for vanity's sake. Hence second thoughts when they are on the verge of changing something they might not have liked but had been born with and accepted till now.

And later on as I sat in the canteen sipping an insipid cup of tea I went over the various visits of that girl (before today) for consultation and I could have kicked myself as I realized that the patterns fit. Right on the first visit she had said “my mother feels that I have so-and-so problem” when she described why she had come. And then later on during the second visit when I had complimented her on her punctuality she said the credit should go to her mom who had dragged her there on time. In hindsight I see now what I should have realized before - that the patient was not interested much but it was the mother who had pushed the girl to get it done to improve her chances in the marriage market and so the patient had gone along with her mother’s wishes up to a certain point and then had suddenly rebelled -causing a shock to the poor unfortunate doctors.

The trouble with doing cosmetic surgeries is most patients don’t realize themselves why they want the surgery. They are usually confused and act on the advice or more probably the taunts of their near and dear- usually a mother or a boyfriend or a husband. Many's the time when a young and good looking girl walks in to our cosmetic clinic and says straight off "My husband feels my nose is too large and wants me to reduce it". Whenever I hear this dialogue I am immediately tempted to advice her to go back to her husband and ask him how come he didn’t notice the large nose before the wedding and which body part of hers had captivated his attention so much that he was willing to marry her just to get his hands on it disregarding the obviously large nose staring right in front of his face. But of course I can’t tell the women patients that kind of truth can I? Or else I would be accused of breaking up families, god forbid. In fact, most nose surgeries are unnecessary in my opinion for every individual has a different shape and all of them have their own beauty- we don’t need to make it all the same boring type.

And this is the reason why for any cosmetic surgery we docs spend a long time counseling the patients against the  surgeries or at least make them wait and come back again and again until they are absolutely sure they want to undergo the treatment and not do it on a sudden whim. Especially when it is for young girls who  are about to enter into the marriage market and want to get things corrected beforehand- we always do counseling to make them understand that their self esteem is not affected by body issues and they are doing it for the right reasons. And as I personally keep saying every chance I get- for below 45 years of age- just diet and exercise will achieve all the results that surgery can give. It’s only in the late 40's and early 50's you need face lifts and wrinkle removal surgeries. A balanced diet and adequate exercise does wonders for your face and keeps you young forever.

And this is the respectable part of the profession I am talking about while in fact there is another less disreputable part of the profession we don’t usually talk about which involves unnecessary surgeries (from the surgeons point of view) but where the patients are willing as hell to get them done- things like breast enhancements, buttocks lifts and vaginal tightening and hymen reconstructions etc. Doctors are supposed to be non-judgmental when it comes to patients but that can’t stop us from thinking inside our own minds can it? Like itching to ask a patient "ok you get your breasts made big for one boyfriend who likes 'em big and then he dumps you and your next one fancies bigger butts and you sign up for it too..How far will you go? How many alterations will you make to all your body parts till you finally catch "that dream boy" for whom you have been holding out? Why don’t you marry an ordinary guy who will accept you as you are and not demand you get any of your body parts enhanced according to his fantasies?" That’s simple logic isn’t it? Instead of getting so many surgeries done just to impress the unworthy?

Call me old fashioned but some of the very worst/worthless surgeries in my opinion are the sexual satisfaction surgeries like vaginal tightening and new hymens for old surgeries.  The gossip in the change rooms of surgeons is about the several society ladies and businesswomen in their 40's who have had their vagina's tightened and hymens reconstructed post divorces – something which is becoming commonplace and routine over the past few years. But the worrying trend is of younger and younger ladies (even in their 20's) getting it done multiple times after every break-up just to act like a virgin for their new boyfriends and that sounds sickening to me. And in one extreme case I heard of recently -getting a new hymen every year (for the past three continuous years) after taking a nostalgic annual vacation in Goa with the ex boyfriend - who of course pays for it.  Even if it comes cheap at 30,000 bucks a pop for your cherry how many times will you get it popped? Is it that important to act a virgin/sexual innocent even if you are not and won’t it be much simpler to just find someone who accepts you as you are- even if he learns you have been around the block a few times? Hmmm, somehow I just can’t understand the logic behind some of these decisions people make. I don’t care much about the inner beauty/outer beauty concepts but the one thing I do believe is to learn to accept people the way they are.

Anyhow I guess that is enough ranting for one day and this post is getting too long and boring for you. Conclusion- lesson learned and never more a surgery scheduled unless the patient agrees multiple times in front of multiple witnesses...ok?