.....and the meaning of life.

What are we here for,ultimately? Earning shitloads of money?To further the family name? To finally prove to somebody that we are more than what they thought we were? What is the primary aim of our existence here on earth?

There have been volumes printed on this subject..and I do not purport to be an authority on this subject. But here I would like to present my viewpoint. Feel free to roll your eyes and doze off as you please.

I feel the ultimate purpose is to feel free inside. Not in a way that destroys our bodies and our souls like how most drugs do, but in the kind of manner that makes us liberated when we know that we have come to terms with who we are and have accepted it, instead of forever fighting with these issues with no end to the battle in sight.

I do not mean this in a way that we accept all the negative energies we have within us and say "Well,this is who I am,and that's that," but to change,with genuine intent,what we see within us as not productive to the bigger picture as to how we see ourselves,and not how others see us.

This is easier said than done, and the number of people who achieve it in their lifetimes is miniscule. In fact, it is the hardest thing that we will have to face in our journey here.

If you know how to do it,do let me know.

The choice for freedom,regardless of circumstance is there everywhere. Those who are interested in this subject can read "Man's search for meaning" by Viktor Frankl,a Jewish Psychiatrist who was imprisoned by the Nazis during World War 2. How he came to terms with his situation-he had lost his wife, and his brother and other immediate members of his family-and used it to his advantage-is masterfully depicted. He says that,ultimately, not matter whatever the shit it is that is going on around you, there is the core of you that can choose how you respond to it.

I can only hope that we do not need such dramatic and stressful life events to make us aware of it. We can realise it right now,as I type this and as you read it,that it is ultimately within us. We can always make excuses for not being able to do it, but in the end it will catch up with us.

Heavy Duty!!

Hi,

It has been 2 months since the last entry and the reason for said delay is the fact that I have started my residency in NIMHANS,Bangalore, and it's a Baptism by Fire kind of situation. From spending the past 2 years in virtual hibernation in front of a book to 12 hour days in a tertiary referral centre was a bit jarring. Although welcoming work,it didn't take immediately....the hectic hours, the endless number of patients in the OPD, to weekly duties and so on.

One thing I have realised is that the mental aspect of suffering is way way overlooked. It is all too easy to concentrate on the physical,organic aspects of health,but in truth the daily issues we wrestle with occur in our minds. I am,of course, not referring to the overtly psychotic schizpohrenia kind of picture, but we do encounter mental strain more often than we do the physical kind.

The number of psychotic cases,defined by the ICD(International Classification of Diseases) as that having delusional or hallucinatory behaviour with disturbances in Psychomotor Activity,is truly astounding. The Neuroses and the Anxiety cases are a minority,something which I did not anticipate,thinking that they far outweigh the Psychotic/Schizophrenia spectrum. But in truth it is the other way around.

The agony a patient with mental illness goes through can only be imagined. My professor told me that the film "A Beautiful Mind" starring Russell Crowe is a kind of marker to understand what a patient goes through..in the movie,the protagonist does not know what is real and what isn't! Imagine being in a situation like that,where you believe things to be true but it is in fact the other way around.

Ok,ok enough of the hi funda gyaan.

I do not know why people have praised Iron Man so much. I did not find anything so spetacular with it to begin with, although it is better than The Fantastic Four series, but not better than the X Men,well at least not yet.It will depend on the further sequels to decide. But Robert Downey nailed the part of Tony Stark,who later on becomes Iron Man. Nobody could be better suited for the role,man.

Only a little more than a month left for The Dark Knight!! It is gonna rock. Seriously can not wait.

I haven't had much time to discuss the circumstances that lead to my getting an MD,when the 5 of you who have read my previous entries will recall that I was chosen for the Diploma in Psychiatry but not the MD. That,I hope will be covered in the next one.

Take Care.

2 contrasting letters.

Letter 1:

Hi!!
Today is one of the happiest days of my life!! The Supreme Court has okayed the OBC reservation! Which means that people like me can get into IIM,the place of my dreams and what my family would love for me to get into,at only half the struggle that those poor unreserved candidates have to slog night and day for!

Although I am not so poor-we have an independent house and 2 cars-and have had a good education-and I am not so dumb either,ah but who cares!! Now my getting into IIM is so much easier. Although the Supreme Court has said that the "creamy layer-" by that I guess they mean me,are to be excluded,we can bribe a clerk in the Government Office to get us a certificate saying that we are underprevileged,and life will be a cakewalk after that! Even if that fails,and the clerk tends to be a bit stubborn,we'll pay him cash and give him a bottle of the finest Scotch and the latest mobile phone as gifts. Hell,a little bit of money for a lifetime of comfort. It isn't such a bad bargain right?

I feel sorry for my friends who belong to the unreserved category,but I'm sure this is payback for the centuries we've suffered as a people. Many of my friends are not as well off as I am,and they're also writing the CAT exams-without reservation,mind you-I don't know what their chances are. I guess I stand a better chance than them,although many of them are more hard working than me. But in the end.it's all about me,and I'm happy for this.

Sometimes I wonder whether I'll go through my whole life being branded now that this quota will be implemented. But so what? My family and future generations will be in comfort,and it's a fair trade for a few uncomfortable moments now and then.

I am so pleased with the Government that my vote will surely go to them-and the elections are coming up soon!! I really thank them for finally giving us a voice with which we can speak-the voice of a quality education in a premier institute that is otherwise nearly impossible to get into if I would written it without the quota in my pocket. Thanks so much!!

Letter 2:

I can't believe that they're going through with it. I thought that truth and fairness would always prevail,but now I realise how naive I truly was! I come from a middle class family,and I got into Engineering College on my own merit and a free seat,at that. And until now I was working really hard to get into IIM,but now that this quota has been implemented,I honestly don't know what my chances are. Because I know for a fact that I am hard working,but now an OBC candidate who works half as hard as me will be selected! And he will be picked up by all the multi nationals! I also know that I am not as brilliant as most of the people who get through the cut throat competition. But then an OBC candidate will get the same mark as me-which means he would not have been selected otherwise-and get into IIM-A! Is this fairness? Is this Justice?

How can I look at my good friend-who is now one of the previleged lot-and not be envious of him? Won't it affect our friendship? Won't it create a rift between people like me and people like him? How can I control my anger when he gets into any esteemed institute of his choice and I don't,when we've both worked exactly the same?

I guess the only option for me is to go abroad now,if I don't get into IIM. What other option do I have? I don't want my children to suffer the same way I have. They deserve a better life than this,for sure.

I thought the days of casteism had come to an end. Now with this quota,it's come back with a bang,bigger than ever.Thanks for listening. You may know of me but do pray for me and people like me,it's the only thing that will work for "us," as opposed to "them."

Why Psychiatry?

Those of you who have read my blog previously must be knowing that I'm going to be doing a 2 year residency in Psychiatry. And it has been something that I've been adamant on doing for a long time. People have often asked me why it was that I was so keen on doing a residency in only this field.

I don't know the answer to that one yet. Not fully anyways. I believe that people have as many mental problems as organic ones. I believe that it is important to improve the quality of people's lives,and not only the duration of it. I believe that mental health is a science that is still in it's infancy,where there is a lot of as yet untapped potential to flourish.

When compared to about 50 years back when Schizophrenics were tied to their beds and made to stay there until they were deemed cured. Sometimes a cure was never possible. Now,it is possible to be cured of the condition on an OPD Basis,without even Hospitalization. Even if a cure is possible 33% of the time,remarkable progress has still been made. Same with Depression,and with Bi-Polar Mood Disorder. But there is still a stigma attached to this field,especially in rural areas,even to this day,when epileptics are thought to be possessed by a spirit when in the midst of a seizure.

The problem of addiction is something that will also need attention. Especially with the times as they are now. According to Dr.Ali Khwaja,noted Psychologist and Career Counsellor,Bangalore has the highest number of Cocaine addicts in the whole country! This is in addition to Alcohol and other substance abuse issues.

This is one area of medical practice that is a bit of an orphan as far as the medical fraternity is concerned. I guess that old adage which has been used for a long time and given in Erich Segal's medical romance 'Doctors' says it all:
A Physician knows everything and does nothing,
A Surgeon knows nothing and does everything,
A Psychiatrist knows nothing and does nothing.

So,there are challenges in this field. The most important of them is to remove all the misconceptions that are related to Psychiatry,and to make the services more accesible to the public. Not in terms of actual availability of Psychiatrists,but to reduce the inhibitions they might have to meet one.

It's an uphill task. No doubting that one. Let's hope change occurs; rapidly and effectively.

Sorry for the long hiatus,Ladies and Gems,but for the past month or so I've been used to doing absolutely nothing and loving it. The sheer effort to try to type thought into screen was too much to bear for this person who can have a degree,if it existed,for slacking off. At least in one area of my life I can get a gold medal!!
In the meantime I've been trying to read a little of the huge backlog of books that I had amassed while being immersed in Academia(Pretending to be immersed in academia,really). One of my favorite authors whose books I had been wanting to read is John Irving. His works are basically black comedy,but there are times when he can be poignant. In addition to being laugh out loud funny,but for the most part his works balance the two. And he does it really well,man.

"Until I find you" is his latest novel,and one of his darker ones.It tells the story of an emotionally numb actor who turns out that way due to the relationships he has with his hippie mother and a host of women who are older than him,but who play a pivotal role in shaping his future character. It also deals with the topic of child abuse,as seen through the eyes of an eleven year old, and the whole issue of how people conceal secrets from you and reveal what they want you to believe and hide away the truth conveniently for their own twisted purposes. The flaw in this novel,as in many others of his,is a tendency to overdescribe. Especially locations and situations. But his characterizations are superbly executed.

"The Water Method Man" is perhaps his funniest novel,about a shallow,self serving young man who sort of drifts through life...and about his embarrasing urinary condition!! How he realises the errors of his ways and tries to rectify them is what his novel is about. It's non linear sequence was something I liked. But after perhaps "The World according to Garp," this is his funniest novel yet.

One thing that I realized after reading "Until I find you" is of the paramount importance of human relationships,especially the ones betwen parents and children. But how something as seemingly trivial as a simple interaction between two people can lead to our lives being a living nightmare,or a wonderful experience,is something I am fascinated by. How they are the subject of virtually every song ever sung in mainstream media,and how therapists come on talk shows to counsel couples at war(or on the brink of divorce) and milk their tragedy to their maximum advantage,and how countless books have been written on the subject.

And yet,this is something that cannot be truly solved in one fell swoop. It needs time,it needs effort,it needs patience, and more than anything it needs people admitting they're wrong,even when they have a great deal invested in appearing to be right,or claiming to be. And the ability to meet the other person midway,even when it's something you really don't want to do.

This theme has been highlighted in "Magnolia," the Paul Thomas Anderson film that shows how the lives of many people intersect on one particular day,and how the only thing people are looking for is love,acceptance,and forgiveness. And those things not being given to them causing them to hate themselves and their lives. It's beautifully acted and well written,but there is one sequence that makes it become a Hindi movie. But the movie still carries itself pretty well.

"Taare Zameen Par" is one of the top 5 Hindi movies of all time. It's fantastic,man. Darsheel Safary is so convincing as a Dyslexic that for a while I really thought he was Mentally Challenged. It is such a beautiful movie that I couldn't stop crying from beginning to end. The way in which children who are "different" are treated in school is fantastic. It is the brutal truth. Although every school tries to tolerate-not encourage,mind you-children with special needs,they fall short and the teachers end up being totally frustrated and hurl out all their frustrations on that poor child. How will a child know? How will a child know that the teacher had a bad day at home and hence is shouting at him more than what is necessary? And imagine the kind of trauma that the child will have to face. It's scary to think about it.

The traffic in Bangalore is becoming worse. The continuum is expanding at an alarming rate. What was intolerable a few years back is now considered "manageable". More trees are being felled,to make way for more traffic. The city of Bangalore has had more traffic and more malls,and more employment opportunities in recent years. But all the malls have exactly the same shops! A Levi's showroom,a KFC,an expensive bookstore,and a Westside showroom etc etc. The point is the malls are expensive,and many of them are similar. I don't know if there is even a point I'm driving home here. It's just that semi-duplicity is rampant these days.

The character of a city is not determined by the number of expensive places there are for shopping,and not by the number of fast food places that are there. It is determined by..........

The number of pubs it has! HAHAHAHAHAHAHAHAHAH!!!

Ok,sorry. Bangalore rocks!!!!

No,really.

The basic allure of Bangalore might have been in the greenery of the city,in it's climate,in the hospitality of it's people. Not in the malls and in the showrooms and the rest of that jazz.But it is true that this was where pub culture originated. Ok,maybe I'm a bit biased.......Kidding!

Now it's time for a confession: Recently I made a ruthless estimation of my good and bad points. There was one particular trait I could not classify. It was this: An amazing ability to state the obvious.

Now can you,the reader,after having read my blogs,ever say I have stated the obvious? Naaawww......

And among the numerous bad points I listed out,sarcasm was in the top ten. Me??!! Sarcastic?? Those who know me well will be shocked!

OK,just a little bit of humor to lighten the mood a little.

"No Country for Old Men" did not deserve the Best Picture Oscar. I feel it should have been "There will be Blood." What I didn't like about "No Country.." was the fact that there is a lot that is left to the imagination of the viewer,maybe this was what helped it win Best Picture. But I want to watch a movie to be entertained,maybe to be moved,and for me to give me something ponder over. If the moral of the story is that life basically goes on,regardless of what happens,or that nothing will change anyway,then there's no point in my going for a movie is there? I can see that in real life well enough!!

Daniel Day Lewis was brilliant,as usual in "There will..." I think we can only see searing performances from him. Same with Denzel Washington. He can only be excellent. Like in "Philadelphia," where I felt his performance ruled the movie. Although Tom Hanks won the Oscar,I feel Denzel should have at least been nominated. Because it's not only a movie about a lawyer who has AIDS,it's also a movie about a homophobic lawyer who defends a gay man. Same with Edward Norton. It'll be really cool to see him as Bruce Banner,and as the one who transforms to the Incredible Hulk. Heath Ledger,before he passed away was also one who was the role he played.He wasn't an actor who played the part .He was the part. In Indian actors,Aamir Khan is the best of the lot. All these guys give so much of their energy to the role they play that it's a pleasure to see them on screen.

Ok guys,I'm typed out for now. I'll be writing soon. Stay tuned!

Mukund.

Found this saying on John Mayer's Blog and liked it a lot.

Now that I have the time to do the things I always wanted to do,I find myself drawn to doing absolutely nothing at all! I am Planning a trip to Mangalore/Manipal and perhaps Mysore,as I need to go to ask for a refund at Manipal University(where I joined a DNB programme before the NIMHANS result came out) and because Mysore is the place where I spent 6 of the best years of my life and haven't visited in a year and a half.

What I like about Mysore is that the side effects of globalization and opportunity haven't yet kicked in there,hence the traffic is manageable, land is not as overpriced as in Bangalore,and you won't find shops squeezing into each other in any street possible in the hope of attracting customers.Instead you will find wide roads and some greenery and one of the most beautiful lakes you'll ever come across in South India.It's called Kukurehalli Kere(Lake). Apologies if I haven't got the spelling right,but my heart is in the right place:-)

In terms of eateries, The Jewel Rock is one of the finest restaurants I have ever been to.Period. The food is good,drinks are reasonable,and the ambiance is good. In fact,it is unique in that everything about that place is NOT EXCELLENT,yet many people of Mysore are bowled over by that place and keep frequenting it. I was one of them,back when I was there.

The palace was,is,and will be the first thing that pops to everybodys mind when the word "Mysore" is spoken but I visited the place only once,and that was because my family was with me when they were waiting to admit me in College,and I haven't gone there since.

You tend to feel comfortable in a place like that, and although I couldn't stand the place during my first 3 years there,towards the end of my course I absolutely loved it,and I sorely miss it to this day.

Apart from that I have been seeing movies that are not new. In fact I just saw Munna Bhai MBBS for the first time about a week back. Yes,I know I know "How the hell have you not seen it?" and all that but I loved it!! It was hilarious and although replete with songs and melodrama ( 2 things I find hard to tolerate in a movie), it raises a lot of issues that are relevant in the practice of Medicine,things like treating the person and not the illness,taking the time to ask the sweeper of your hospital his name,and getting close to your patients,even if that means risking getting hurt if the person doesn't respond favourably,or in the worst case,dies. Because Medicine these days is becoming like any other industry,with Corporations ruling the roost,and money talking all the way through. In fact,money talks to such an extent that some of the Doctors who man the Primary Health Care Centres(PHC'S) take money from patients even though they aren't supposed to

What they are doing is not imminently unjustifiable because the kind of pay they get is really really bad, and they have families to feed and they need more than what they get as their salaries.

But on the other hand,the patients who come there are so poor, and for them to spare even 20 rupees which they give to the Doc ,for services rendered,hurts like hell. And if they have a condition that is beyond the scope of the PHC to treat,then God help them.Because even with the Yashaswini Scheme for Farmers being fully operational,the discounted bill is itself exorbitant for them. Had they been charged the full rates the number of suicides of farmers would have risen drastically.

Which is why health care needs to be more affordable.Because diseases like Cancer,Heart Disease and Diabetes do not have a class preference and affect the rich and the poor equally. The poor are left to wither and the rich tolerate the hand that fate has dealt them,with insurance playing a major supporting role. But even with the best of hospitals,the bottom line is profit. Because if a hospital shuts down,then they will not be in a position to help even if they really want to.

The Hospital that is closest to attaining middle ground is Narayana Hrudayalaya,where you find the best of consultants and where the rates are as subsidised as is practically possible. The "charge the rich and serve poor " philosophy works there,if not perfectly then as close to ideal as possible

Anyways that's it for now..more later. Take care and try to be charitable.

Hello!!!

I'm back!! After a self imposed exile of 2 months where I was trying for a residency amidst the toughest competition I have ever faced..believe me I faced the same set of exams last year but it was nothing compared to the intensity this year. Survival of the Fittest would be the principle applicable here...people have realised that only the toughest get in..and so it is in 2008.

The good news is that I have been shortlisted for a Diploma in Psychiatry in NIMHANS...and I am not going to say anything until counselling is over and I submit my documents and sign in as a student there.

These exams have made me very superstitious. I refuse to believe anything until it is 100% sure,and I sign on paper with the instituion I am supposed to be a part of.

The other thing of import that has happened during these 2 months is the death of Heath Ledger. A great actor who will be immortalized as Ennis Del Mar in "Brokeback Mountain" and as The Joker in The Dark Knight come July 18th this year.

And Benazir Bhutto was assassinated. As with most things political these days, the elements are Terrorists,A Dictator losing grip on the country he has been ruling over for the past 10 years, and more Terrorists.

We were at the receiving end of some horrible umpiring by Steve Bucknor in Australia, someone whom I thought of as being one of the more sensible umpires of recent times. But the shitty decisions he gave made me want to haul his ass and pack it off for good to The Windies or Honduras or wherever he is from. And I think that is the treatment that should be meted out to him.

I also had the pleasure of going to The Christian Medical College in Vellore to attend an interview for a Diploma in Psychiatry residency there. While the interview result was one that I had not expected(I was not in the main list,but am 3rd in the waiting), I saw exactly how much of an impact that Hospital has for the town and for the whole of India in general. I stayed for a day in a small lodge in a street opposite the town campus of the hospital, and the street was crowded as hell with lodges,shops,restaurants and messes of all nationalities(from Punjabi ones to Bengali) and the streets were filled with people from all over the country-presumably relatives of patients who were admitted in the Hospital, and the hospital itself is top notch.

What I did not expect was to have a Professor of Psychiatry personally give me a samosa while I was waiting for my interview call!(I was too nervous to eat and politely refused...hope that didn't piss him off..maybe it did. Is that why I wasn't in the main list??!! Kidding) That gesture spoke volumes for me...the rest of the staff in the whole hospital are rumored to have the same attitude when it comes to patient care. And I would love to work there. For the simple reason that I want to see what it is that makes these distinguished,top-notch Doctors work in a place like that for a pay that is so low when any other corporate hospital would welcome them with open arms with salaries that are at least 5 times what they are getting there. I can give them the highest compliment I can offer.

These 2 months have taken quite a beating on my psyche..I have been enormously stressed and I have wasted a lot of time in worrying,time which could have been better spent in studying, but hindsight is always 20:20 and so it is that I can now look back and say that I could have done more.

Let the counselling at NIMHANS get over then I can be all jubiliant and euphoric. But until then its strictly fingers crossed.

If i seem a but disoriented,it's because its 3.45 in the morning! My old habit of studying till late at night hasn't left me..yet!!

More later.