Tuesday, March 31, 2009

two new arrivals

There are two new arrivals in our garden. The jasmine creeper gave out the first flower of the season. (One month after the flowers were noticed in the market. Better late than never. I am glad that our creeper remembers that it can bear flowers too and not only leaves). A single flower, which made it’s presence felt through mild fragrance much before I went near the plant. ಒಳ ಹೊರಗೆ ಹಿತ ಮಿತವಾದ ಘಮ-ಘಮ as Sri Nissar Ahmad puts it. No chance of forgetting my ex assistant Shevanti as long as the plant is around. She had planted it.

The second new arrivals are the baby bulbuls. We had noticed the parents flying in and out of some bushy plants in our ‘garden,’ with thread, twigs and feathers in their beaks. I think by the time we noticed this activity, the nest building was almost complete. Soon afterwards, we located a cup sized nest amongst the dense foliage of the plant. We left the nest and the birds to themselves and kept away from the place for nearly a month. Then one morning I could not hold my curiosity any more. I went closer and peeped in. Even with out my glasses I could see one bird in the nest and could even make out a red patch and the crest on the head. I broke the news to my family exitedly. “What a surprise! The Bulbul eggs have hatched and the hatchling has already grown. It almost fills the nest. It may fly away shortly!”. My wife told me not to be stupid. “It is the mother incubating the eggs” She said. It was difficult for me to believe that the shy bird which never even ventured near our balcony if one of us were inside the kitchen, stayed put in the nest even though I was peering at it from a distance of one foot! Of course, it must have recognized me as one of the competitors for it’s legitimate share of bananas hanging in our kitchen, and it was ready to forego rivalry and share the happy news of anticipated new arrivals. Hence it sat unperturbed, comfortable in it’s nest, nonchalantly looking me in the eye. I wondered at the change that motherhood brought.

Today morning I took another peep with my glasses on, to find two babies sticking their neck out of the nest and opening the beaks wide in anticipation of a juicy worm in their mother’s beaks. They were disappointed to find this despicable human with not even a beak, let alone the worm. The first look at this sample of the human race must have been enough to create contempt towards the race for life. When I looked in again after half an hour, they crouched low in their nest and turned their heads away. Any way, I hope that these bulbuls have better luck than the baby tailor birds which suddenly disappeared mysteriously, last year. The bulbul parents have taken pains to select a place which hides the nest well. But they keep twittering and fluttering around the nest all the time and give themselves away. And this activity increases whenever they notice a predator around.
I can already see the crow which is observing everything from the distant roof top with it’s cocked head and the cat that is prowling on the compound wall. For both of them these babies are only another link in the food chain. I wish the babies best of luck.

Monday, March 23, 2009


IPL is shifted out of India. If you are one amongst the fortunate few who might say “what is IPL”? please consider yourself blessed. I know a little more about it and don’t like what I know about it. There are many things that I don’t like in this world and no body cares. No body need care. It is only my feelings. I do not understand why I feel happy about IPL being in trouble. I have nothing to do with it and it never troubled me in any way. I go through the scores of other cricket matches in the news papers. I completely ignore IPL, except to read the selling price of the players. Then why am I against it? I really don’t know. It may only be plain sadistic pleasure.
I tried to think for a few minutes why I have strong feelings against it. It is possibly because, here, the hype and glamour overtake essence and talent by leaps and bounds. For the same reason I have a negative feeling about the reality music shows, dance shows, quiz shows, fashion shows and all others. I think in all these activities glamour, hype and cash rule. I hate giving first place to these. Is it sour grapes? God knows.

Whatever it is, the truth is that, I felt very happy the very first time our home minister played a wrong note about conducting IPL this season. Since then, I followed it as avidly as I would, my child’s CET performance. I do not remember if I added an additional flower during my daily pooja but the gods have granted my sadistic request.

I met one of my friends during my morning walk. I did not know his views on cricket. I could not just exhibit my happiness carelessly. I cautiously said “did you hear about IPL”?. He asked me what happened to it. I told him that it is shifted out of India and he thanked me for giving him the good news. Then onwards the morning walk was a pleasure. Even after we enjoyed stoning the dead IPL during our morning walk, some traces remained in mind and I posted them here. Still, if any one is mourning losing IPL, I don’t mind changing my views temporarily – for the sake of the mourner- and joining for a minute’s silence.

patient's words or doctor's words?

At least half of the middle aged patients whose teeth I treat, suffer from (apart from my treatment) blood pressure, diabetes, heart conditions and such other general disorders. Since the conditions and the drugs used for relief, have some bearing on my treatment, I make it a point to quiz everyone in detail regarding their general health. In most of the cases what I hear is vague, exaggerated or underplayed. I have patients who have mild acidity, worrying their head off about the cleaning or a minor filling that they have to undergo, and people with 250+ sugar levels and 180/115 blood pressure assuring me that they have only minor problems and goading me to go ahead with complicated extractions.
This patient said that he had some cardiac trouble, an year back and that he is fine presently. He recited the list of drugs which were prescribed, saying , “ I take ********0.5 mgs for giddiness, *********25 mgs for blood pressure, *********5 mgs to prevent clotting of blood, *********10 mgs for acidity, ********* as a tonic etc etc.
As I usually do with such cases, I told him that I do not rely up on what the patients say and asked him to bring the prescription written by the physician. He brought it the same evening. I looked at it and have decided to depend up on what the patients say, in future. You see the prescription here.

Tuesday, March 17, 2009

not found at given address

My brother was here to attend a meeting at the Goa University. He is a scientist and though a bit absent minded so as to qualify for his post, very methodical and always punctual. As soon as he arrived from Pune and reached my house, he called the co-ordinator who was to arrange conveyance to the university. The co-ordinator said that he would send a taxi and wanted to know the location of my house. My brother began saying “I am with my brother. His name is Dr. Raghunandan and the house is behind Honda Activa showroom near……”
He was cut in the middle, “Oh, Honda, I know, I know Honda showroom, the taxi will reach there in ten minutes.”
The co-ordinator called the taxi driver and began saying “This gentleman whom you are supposed to pick up, is Dr.********. He is staying with his brother Dr. Raghunandan at ..…”
The taxi driver cut him off “Oh, Dr. Raghunandan, I know, I know. I will be there in five minutes”.

The place where I presently reside is my fifth in Ponda. (No, I did not shift residences to create confusion amongst the general public. It was done for valid reasons) The taxi driver knew the third, and went to Silva nagar. House is very much there but no Raghunandan. He called the co ordinator “Sir, they say that Dr. Raghunandan is not staying in this house at Silva Nagar , Where is he?”
Co-ordinator : “You fool, you did not hear me completely. His house is behind Honda show room. Hero Honda showroom understand?”
The taxi driver reached behind Hero Honda show room and found a pond of dirty water containing four pigs and two buffaloes enjoying the cool waters, blissfully unaware of the hunt for the elusive Raghunandan.
Taxi driver to co ordinator : “Sir I am behind Hero Honda show room but no Raghunandan here either”
Co ordinator : “These scientists are very absent minded. They don’t even remember proper address, you wait. I will find out”
Co-ordinator to my brother: “Sir, the driver says there is no Raghunandan behind Hero- Honda….”
My brother: (already late for his meeting but still keeping his calm as only he can do) “The trouble with you people is that you have no patience to hear what is being said, completely. All my students are also like that. I said Honda Activa showroom. It is near Jaycee Nagar. Not Hero Honda. I have been waiting for half an hour and I am already late……” cut off again.

An indignant taxi driver brought the taxi to my door, accusing me of troubling everyone by not being present where I was expected to be, and shifting residences with out informing all the taxi drivers in Ponda.

My wife always has a grouse against me saying that I am never present where I am required. If she wants me for some minor help in the kitchen, I am washing the car. When I am required to drop her to the market, I am attending a patient. When a patient is knocking on the clinic door, I am in front of the computer typing some nonsense, so on and so forth. She heard half of what the taxi driver said and whole heartedly concurred with him, saying “Say that again. He is always like that. Never found where he is expected to be.”

Sunday, March 15, 2009

a phone call

The telephone rings and I pick it up.
“I want an appointment today.”
“May I know who is speaking?”
“One patient.” (don’t be an idiot. Who else will want an appointment?)
“May I know your name?”
“You know me doctor. I have come to you before.”
“Tell me your name please.”
“Mrs. Kamat.” (with reluctance)
( I have at least two dozen kamats in my records)
“Which Kamat?”
“Don’t know me? You removed my tooth doctor.” (With annoyance)
“Please tell me your full name.”
“******** Kamat. Can I come today?”
“What is the trouble?”(I try to guess what I am in for)
“The tooth you removed, it is paining.”
“You mean the place where the tooth was?”
“Yes. In that place.” (can’t you understand that much?)
“When did I remove it?”
“Two-Three years back.”
“Three years back?”
“Yes doctor. Same. It is paining. “
“It can not be. Any way, you please come over. I will see.”
“When shall I come?”
“Any time between five and eight in the evening.”
“Shall I come at six?”
“Please do.”
“No. I can’t come at six. I have to take my son for tuitions.”
“Come at seven.”
“Seven’o clock my husband comes home.”
“I said any time between five and eight is OK for me.”
“Shall I come at seven thirty?”
“Will your clinic be empty?”
“I hope not. I do not want my clinic to be empty.”
“I will have to wait no, doctor? When there will be no patients?”
“I pray to god that ALWAYS there will be patients.”
“Ok then. I will come. Please see me first doctor”

This is one of the sample conversations that I go through everyday. If I am free, it is amusing and entertaining and some times I even try to prolong it. But if a call takes this turn when I am in the middle of some treatment and my assistant is holding the receiver to my ear, it could be very irritating. Whatever it is, I wonder at the clash of interests between me and my patients. Almost all of them hope that my clinic is empty whenever they come, and I hope that it is always full. I belong to the ‘noble’ profession of giving relief from pain, but I have to prey that people suffer, so that I can step in to provide relief, earn my living, and in the bargain get the ‘noble’ tag!

Wednesday, March 11, 2009

A 'swamiji' in my clinic

It is believed that if you do not offer water to one who is thirsty or prevent him/her from drinking water, you would be born as a lizard in your next life. Similarly, if you disturb one’s sleep, you may expect to be re born as a bed bug. I do not know the punishment for preventing some one from eating, but I am sure to take that form in my next life. I have prevented a lot of people from eating, though for a short duration. But there are many more unfortunate ones who have been forced to forego their meals for weeks together. Yesterday, one of my patients who had a wisdom tooth removed months back, was complaining that his tongue is still numb and he is unable to eat anything. I believe he has lost ten kilos ( he did look slim). I do not know whether to sympathize with this gentleman for the loss of feeling and taste in his tongue, or rejoice over the new found technique for making people loose weight, and cash up on it. “Pay for relief from tooth ache. Weight loss free !!” Not a bad slogan.
In any case, if you find something familiar about the cockroach, crow, rat or dog (my wish list for the next life) that you meet in your next lives, you know why it looks familiar.
While I commit the crime of preventing some one from eating, almost on a daily basis, I even achieved the feat of removing one tooth and making hundreds starve, once!

I met the swamiji for the first time when he came with a request for getting a golden tooth fixed in his mouth. He was in his thirties, well built, with lush black hair flowing on to his shoulders. He wore a shiny ochre coloured dhoti and was covered in a similar top cloth. He sported a coin sized red religious mark on his forehead. There were two thick gold ear rings in his ear lobes and a slightly thinner pair pierced on top of the ear. There were rings on almost all his fingers, each one with a different coloured stone. He wore gold bracelets and arm bands. ‘Rudraakshas’ strung in gold adorned his neck. There were anklets on his legs and rings on the toes. With his feet clad in clattering wooden sandals, he made a spectacular entry into my clinic more than ten years back and has remained my patient ever since.

He is the religious head of one of the lesser known Hindu religious sects. I believe, during a casual periodic examination of his Horoscope - akin to an annual medical check up- the stars and planets which influence his fate, decided that the swamiji should wear another golden article on the right side of his body. Since all other parts of the body were already occupied by a gold ornament, it was suggested that a golden tooth be fixed. (I do not know what effect it had on the swamiji. But the decision brought good luck to me, at a time when the practice was slow.) Out of professional ethics, I did try to dissuade the swamiji from grinding out a perfectly normal tooth to accommodate a cap, but he persisted. The planets were definitely in my favour. I made a golden cap for his right ‘eye tooth’. He was very happy with the effect. I remembered to suggest to the professor of prosthodontics, in the dental college, to add one more item to the list of ‘Indications for placement of a Jacket crown.’

I did not see him for quite sometime after that. Then, one day I found a dozen of his disciples at my door. There was a united appeal for an immediate appointment as the swamiji wanted a tooth removed. I refused point blank, to remove the tooth if it was advised by the stars. But that was not the case. There was some special occasion, with elaborate rituals, going on at the ashram. A decayed tooth chose this very moment to make it’s presence felt and all of a sudden swamiji had a severe tooth ache. He was unable to concentrate on the celestial guests who had come over to get themselves worshipped. This time the tooth determined extraction and the planets had no role to play.
Minutes later, a cavalcade of few cars and half a dozen two wheelers blocked the narrow road in front of my clinic and the swamiji was led in. I finished the extraction fast and he was able to get back with in half an hour and attend to his guests. His disciples were delighted. Everything was fine.

I had my lunch and was half way through my afternoon nap when the bell rang. It was the group of disciples again. The swamiji was able to carry on with the rituals and had completed them to the satisfaction of all concerned. The gods had accepted the offerings, blessed the congregation and left. It was time for everyone to take care of their stomachs. And a difficulty arose now. The swamiji’s jaws were still numb and he was unable to move them and eat. And since the swamiji had not eaten, the hundreds of followers who had assembled, anticipating the feast, were also starving. I had removed one tooth and had made hundreds starve! I was expected to go to the ashram, give some antidote to my local anesthesia and see that the swamiji is able to eat. Now, we are one way experts. We can make the jaws numb. Bring them back to normal? Sorry. No way. But there were hundreds of empty stomachs looking up to me. And, I did not intend going lower than the cockroach in my next life. I went to the ashram carrying an ampoule of vitamins and a syringe. I was half expecting to be lynched by the followers for immobilizing the swamiji’s jaws. But they were very respectful. As the swamiji’s doctor, apparently my status was quite high. The huge crowd which was anxiously surrounding their guruji parted. I made a big show of a thorough examination, pretended as if I found out the cause of trouble and injected the vitamins. Then I massaged the jaws, pulled out the lips and tongue and asked the swamiji to move his jaws. There was nothing wrong with them any way and to everybody’s surprise and relief he could! He smiled and slowly took in a spoonful of kheer. I looked about me hoping to find large scale appreciation and gratitude. But all the disciples were rushing out into the dining hall. The miracle dentist was forgotten. “ Upaadhyaayashcha vaidyashcha kaaryaante aprayojakah” says the sanskrit verse. “The teacher and the doctor are useless after the work is done”. This was some years back.

The swamiji was here this morning again and I recollected all these. This time he came for the treatment of his front teeth. The price he had to pay for being elevated to a higher rank. I believe his guru has promoted him to the rank of ‘yogiraj’ from mere ‘yogi’. With the elevation in the rank there is a change of insignia. Just like our majors and generals. Now his ears are adorned with ‘karna kundals’ – two very thick, may be half an inch thick- ear rings, not of gold but looking like some wooden material. They hang from the only place free of rings in his ears, the middle hollow part. Who ever worked them into his ears must have used a pick axe. I did not ask whether it was done under anaesthesia. There must have been some painful ritual associated with it because he said that soon after they were placed, he felt giddy and fell down on his face, breaking his two front teeth. It is not easy going nearer to the gods, alive. I have started the RCT and will have to place a crown also. I have no idea what decision the stars take about the material to be used for the crowns, but this time they are being used for the purpose for which they are meant.

Monday, March 9, 2009

kannada blog

I have started a kannada blog – kaaDu haraTe, which can be visited at www.maatu-kate.blogspot.com. Typing in kannada takes longer and I find that it is impossible to get certain words in the blog. Either that or I have not yet found the trick of getting what I want. Whatever it is, I will start with short posts – anything that I find interesting - verses, paragraphs, jokes that I have liked. Since it is kaaDu haraTe, anything goes. I have posted a joke from beechi today. I tried typing ‘three’ ie ‘mUru’ as it is in the original script but I could only get either ‘maaru’ or ‘mOru’. So, I made it ‘naaku’- four. I think that I will have to allow myself such concessions. Hoping that I will be able to continue and improve the postings.

Wednesday, March 4, 2009

searching for the soul mate

When ever I look up a bird in Salim Ali’s “The Book of indian birds,” I wonder at the apt description and the sincere effort put in, to be in a position to describe it so. The description for Magpie Robin is,
“One of the more familiar birds in towns and villages. Shy, silent and unobtrusive during non breeding season. Conspicuos during breeding season when male sings lustily from favourite tree top or post, chiefly early mornings and late afternoons. Songs punctuated by upward jerks of white- fringed tail. Also, very good mimic of other bird’s calls.”

This Magpie robin, as is evident from the picture, attracted my attention because of the incessant and insistent calling. It was 4.30 in the afternoon. It sounded like a dozen birds over there. The power line happens to be one of the favourite perches of this robin and the bulbul, and this robin perched there nearly for an hour calling for it’s mate. Do not know the result yet. Meanwhile, the bulbuls which have already paired themselves and are at peace, allowed the use of the powerline for a good cause and waited patiently on the nearby branch.

Monday, March 2, 2009

root re boring?

I might have explained the process of tooth decay and it’s treatment at different stages, thousands of times. I feel like the priest reciting the stories following the Satyanarayana pooja. People hear it out of courtesy, not really bothering to listen attentively. I, like the priest, do my duty. Many a times I feel that I should record my talk and switch it on, to save myself the bother. I was at it once again. The man in front of me was a vehicle mechanic. He had noticed the big, black hole in his grinder long back. It did not bother him much. It only forced him to use a pin to dig out the food particles lodged in, and he carried a pin in his shirt collar for convenience. Better, easier and much cheaper than going to a dentist. Sometimes, even after the dentist finishes meddling with the tooth, the food continues to find it’s way into inaccessible areas. Having been forced to seek a dentist, now, he used his pin to point out the cavity to me so that I do not get into some other tooth. Last night, he said, that when he dug the food stuff out of his tooth, there was a shooting pain. It had persisted and prevented him from sleeping. He was unable to brush his teeth in the morning but had tried to drink a cup of hot tea, which had made matters worse. Half a dozen painkillers which he had swallowed and few drops of petrol which he had put into his tooth did not help. He was about to try more exotic remedies when one of his friends –a sensible one- had advised seeing a dentist. The same friend recommended this clinic, saying, that there are few or no patients and there is no need to wait.

There was no need for me to do a detailed investigation. The fellow had to have his tooth extracted, or undergo the root canal treatment, RCT for short. Simply put, RCT means cleaning out the cavity and drilling deeper to reach the roots and search out the narrow hole (we call it root canal) which runs through them. Having found them we need to widen them so that we can go inside- with instruments I mean- and clear all the infected tissues that are present in the canal which are the cause of pain. Then we need to disinfect the canal and pack the whole length of about an inch of the root canal with filling material. Only then, the large cavity which has been the highway for infection, is sealed completely. Usually I am able to put this information across and I try my best to make people understand what procedure they are undergoing. With our mechanic friend I was trying it with out much success. He believed that it was the large hole that was the cause of pain, and if it is packed or “filled” it will cease to trouble him. He had stuffed it with cotton and felt that the pain was little less. Going one more step ahead, if the hole is thoroughly plugged, it should all together stop bothering him.

I wrote a picture of the tooth and explained (very slowly again) that the tooth as we see in the mouth is only one third of it. The remaining two thirds are inside the gums, as more or less conical projections and we call them roots. At the centre of the roots is the narrow canal which contains blood and nerves. The cavity which we see on the tooth is the opening for the infection to reach these roots canals. The nerves in the canals cause pain and it is this part of the tooth that needs to be treated etc etc.

He heard me patiently once again but evidently did not understand what I had said. He felt that the RCT business is very complicated. Surely there has to be some easy way. He had heard his friends say that their teeth were just filled in a jiffy with some cement and they were fine. He asked me whether it would help if we pack the cavity with lead or silver which were stronger instead of cement? Or even cover the whole tooth with a cap? He obviously had more information on dentistry than I had expected but I was not in a frame of mind to appreciate his knowledge and I was about to start tearing my hair.

However, I thought of giving one final try. I went into an area familiar to him. I told him to think of the tooth as a car. An old car. The body was dented and rusted. The engine was much worse but not visible. I asked him whether the car is going to be fine and run, if the body is repaired and repainted? He laughed at me and said that there is no point in doing anything to the body unless the engine is repaired first. I told him to think of the visible part of the tooth as the body of the car and the roots with its contents as the engine. I told him that the engine of the tooth is bad and unless you attend to it, whatever you do to the body won’t help.

In spite of his pain he smiled. He said that he understood what I was trying to convey and asked me how much does this root re boring cost?( As I believe, “engine re boring” is a way to make a defunct engine run a little longer.) Even though he said “root re boring” for RCT, making use of a term with which he was familiar, I knew that I had got the message across, effectively.