Dear Family Date : 30/12/2012

I am speaking from my new home not very far from you. I am fine and in great comfort particularly after my pain has gone. The week before I left all of you I was in great pain and was not able to tell any of you. Though I know father did feel something was unwell about me he would often forget about it because he had many things to remember all day. But no regrets, I am fine now.

Here I spend my time the way I used to when I was with you. Barking and running around. Do you remmember be running for my own tail when I was a child. I often do the same now as well. Its fun to do so. I feel very energetic and healthy. There is somebody like father who plays with me with the red ball , throwing it on the road to pick and bring back. I don't want to give the ball back and he would take it out of my mouth or behave as if he ignores it and after sometime suddenly turn around to pick and through again. I love it all the same again. Father pats me , hugs me and even sleeps with me on the floor. He rubs my chest and I feel like swaying with comfort and then he loves me with a rub on my head.

Toko brother is someone I miss here. There is no one who loves so simply. He has small hands and feet to play with me, carefully putting them in my mouth and believing in me that I shall not hurt him. He loved me on returning from school, cared to give me a piece of the food he ate and always kept the chocolates away from me. He called me brother and best friend. I hope I will find a guy of the sort here soon. Hope toko find a friend soon at home as well.

Hey I am sure Mom is sad and feeling gloomy. She loved me I know. Let her know I live in peace here in my new home though away but not very far. I will always be close to her. She taught me dicipline and love all at once and kept the best food. She gave me medicine when I was sick. The injection she gave me on the last day was very comforting. It decreased  pain I could not tell you all. I missed the food she cooked for me [and I saw you eat it all.. bark]. Did I ever tell you that when you were in Japan I slept close to her window because I was scared more than her and she always thought the other way. I loved to see all of you together at home and mother cooking and we relishing the food. Do you remember the way I used to finish the Aloo Paratha at one go. Well those were good day. Tell mom I loved her as much.

I shall miss our sister and my gracious care takers who silently always loved me without a complaint. Kalatai is an angel all in one . She loved me with all she could – the timely food , clean place to lie in and unforgetful concern when I would go for a walk alone. I troubled her more than any by soiling the courtyard. There were times when I could not hold on and other times it was a habit but I know it was always a pain for her. I wish I could say to her how much I love her.

Grand parents must be missing me as well. Do you remmember the time you managed to run the car over me. The only comfort was Babas lap with his comforting silence. I loved the presence of Ma and Baba because you were always so much happier in their presence. I do have many elderly people here but you know they always take time to get friendly. Shinde Kaka will miss me and I shall miss him as well. But he will be happy to know that here in my knew house no body ties me up and there is enough pedigree to last forever. I go on very long walks on my own and come back home safely.

Though I live close to you even now and am very happy and in good health, I do miss all that happened in the last 6 years , the shouting, the chasing, the happiness the anger, the periods of loneliness and being with all of you. Tell mom that I never scared the butterfly , the squirrel or the birdie. I used to be excited to know how there lives were. Now that I will have a choice to become something on earth, I hope to become one of them and if I am close by I will keep watch over my brother grow. I wish you all happiness and sweet memories of me. And I shall carry the same with me as I meet the elements of world.

Love

Ginger.

spine 2012

13/09/2012


Spine conference 2012, chennai



The live workshop was held today at the Madras Medical college. It was a experience after 7 years. I meet colleagues whom I didnt remmember and yet they were glade to meet me. I was also happy to se the surgeries done by our colleague surgeon. Dr suresh Babu , Dr Parthiban were procedures done to make understanding easy. But dr Satish and dr Vivek Patkar appeared to make things difficult. I found that a lot of colleagues had never done the anterior cervical approach to the CV jtn and were amused by the procedure. I only wish Dr Patkar would have organised his instruments before starting the procedure. Criticisms appart , the experience was only suggestive of revival od confidence. Maybe one day I shall be able to do it my self at Ratnagiri. Hope to see more work tomorrow.

If at all we had protocols – how should it be?

At the end of the conference – Neuro-trauma 2012, I realised that we are having a diverse practice patterns throughout the country. To the best of my knowledge, every neurosurgeon [with the exception of a few] were adjusting and reinventing methods to deliver the very basic of care to the patients who come to them. Whether it be in the high end ICU of AIIMS and NIMHANS or be it in the remote centres like Ratnagiri the purpose is the same – if possible save the patient. Out of my own experience the facility of the internet, I have chosen a format which is practicable in my environment both economically and morally. Since neurosurgery is tech-intensive, one has to choose what is viable.  If we keep the same objective in mind, development of protocols should not be a problem. I therefore suggest 2 levels of protocol formation – Protocol 1 and Protocol 2. Protocol 1 should be the best as per the international standards where as the protocol 2 should be a scientifically logical and basic and economically rational option to be followed by all neurosurgeons through-out the country. In this respect we should take examples from the protocols developed by the Indian Association of Paediatrics [IAP].

Neuro-trauma

Aug 2012

After attending the conference at cochin [ which was nodoubt well organised] the most obvious thing was the complete chaos in the existing neuro-truma system in the country. There was a clear distinction between the institutional segment and the community based neuro-truma management segment. Then there was that obviuos difference between the teaching institutes where the trauma patients are left to the trainees and the corporate sector where the patients are carefully managed by the consultants. Some of the institutional presentation were disappointing when compared to the results delivered by qualified neurosurgeons operating from extremely low resource areas. Cost of treatment appeared to much lower on the peripheral units. Research presentations were poorly selected and hopefully in the future such presentations will not be allowed. Every body talked of a neuro-truma registry but none had any ideas about how to go about it. I am sure most of us will convienently forgeet the issue as soon as we reach home.

think oblique: IMA ratnagiri : shouldnt we reflect on our selves

Aug 2012

After attending the conference at cochin [ which was nodoubt well organised] the most obvious thing was the complete chaos in the existing neuro-truma system in the country. There was a clear distinction between the institutional segment and the community based neuro-truma management segment. Then there was that obviuos difference between the teaching institutes where the trauma patients are left to the trainees and the corporate sector where the patients are carefully managed by the consultants. Some of the institutional presentation were disappointing when compared to the results delivered by qualified neurosurgeons operating from extremely low resource areas. Cost of treatment appeared to much lower on the peripheral units. Research presentations were poorly selected and hopefully in the future such presentations will not be allowed. Every body talked of a neuro-truma registry but none had any ideas about how to go about it. I am sure most of us will convienently forgeet the issue as soon as we reach home.

IMA ratnagiri : shouldnt we reflect on our selves

I was amazed by the insensitivity of the colleagues during yesterdays IMA meeting which was held after one our colleages was questioned about the billing pattern and he was unable to respond ,or rather responded in a very immature manner toa smart and shrewed local politician. the question remains , wether the local politician was at fault at all. Actually he has  the right to ask - though the methods may differ - which by the way is poorly defined by our existing law.
the colleague in question is one of the worst in the medical feild with regard to concern for patient and the facilities he has made available. His NICU is noting next to a shit hole [actually europian toilets are better]. He wons multiple properties and a transport business. I wonder why he sticks to the profession of medicine if he is not able to do justice to it. Unfortunately ,I was a part of the assembly of doctors who did not speak out.
I chose to do my part as best asI could. I wonder wether we will be able tosustain it because almost the entire remaining assembly had complete sympathy for the apathetic attitude dispalayed by the doctor in concern.

Ratnagiri : related to event of 5/07/2012