An update

It has been a long time since I entered a post here. Just to update everyone, here is a simple synopsis of things that have happened in my life:
1. I rushed home to make peace with my dying mother in the third week of August.
2. I completed my first month in the new home
3. I went back to Mumbai on my planned fortnight-long holiday from the 17th of September to the 20th. In between, my mum passed away to meet her Maker.
4. Upon returning, within a week, I took my study break to visit the United States of America on my first ever visit. The purpose was to participate in the World Congress of Gastroenterology - where I was to mount, display and answer questions on my scientific poster at the Orange County Convention Center, West Concourse, in Florida, USA. I stayed in a budget hotel for 5 nights and used some of the free days to roam around and visit some of the major city-wide attractions, including Universal Studios and Seaworld.
5. Life has gone back to a relaxation mode and I have resumed my work in the hospital.

And that's pretty much it, insofar as a synopsis goes.  

Writing after a long time

It is true that I have been very busy the entire last month. Just last week, I had to rush home to India to help my family look after my mum who took suddenly and critically ill and was admitted to the ICU. She came down with sepsis secondary to infection in a bed-sore. With treatment, during the three or four days that I was there, she managed to pull out of the critical stage and has gradually improved over the last 10-12 days that have elapsed since. 

In other news, I am trying to get a visa to visit the U.S. to present a paper (a poster, actually) in Orlando, Florida, in mid-October. This would be at the World Congress of Gastroenterology. Towards this end, I went for an interview at the US Embassy in London. The interview went off well, I think, and I should be granted a visa to go there. 

Now, I am shifting to new rented premises outside the hospital. It's bye-bye to the rooms I resided in for the last over 20 months. It will be a bitter-sweet parting, as these 1 1/2 years have taught me a lot ... and not just about my work, but also about living alone in a developed country, where one can have anything one wants by ordering it online or buying it in a store. I have hoarded so much stuff that when the van-renter came to pick up my things to transport it to my new premises, he simply gawked and said he had never seen as much luggage with a bro! Well, my luggage was phenomenal in volume - stretching to over 300 kg by his estimate. It consisted of several cardboard boxes and literally dozens upon dozens of plastic bags. As I write this, I have shifted all my luggage to the new premises, but a lot is still to be unpacked and put away in its proper place. 

In the afternoon, I visited the Furniture shop of the British Heart Foundation and bought several used pieces of furniture that will be delivered to my new place tomorrow. These include a dining table, two chairs, a glass display case, a computer table, and several other smaller items. Once they are all set-up, I should be ready to live in my new place.

So, where is it? It is a mere 5 minutes' walk away from the hospital in what is known as Victoria Mansions. Hopefully, I will complete my move within the next 36 hours. HERE is a map showing my new place. It is only 300 meters away from my current location (and the hospital) as the crow flies, but translates to about half a km if you follow the roads.

In quite other news, I went to the Blackpool Livewire 2017 event at the Promenade yesterday. The event organisers had offered free passes to the concert as well as to the after-dinner party for the first two days of the event, viz. on Friday and Saturday. I had requested passes for two people only for the Saturday, and the passes were waiting for me in my inbox when I returned from India. They had upgraded my pass to a VIP pass. This pass enabled me to access the VIP area on the promenade. This was an elevated shamiana facing the large stage where singers and performers came, traipsing in a line, to entertain the crowds. 

Is anything else happening? Yes. I did a few registrar locums now. One was at Whiston last month and the second was just a few nights ago at Oldham. Both of them were in Paediatrics and I guess they went reasonably well. 

At my own trust, I am now a person that is increasingly entrusted with tasks done by middle-grade doctors, and I guess my progression is just about at par with my expectations. I should be looking at better prospects once my current tenure expires in February 2018. Whether it will mean a proper middle-grade job in Blackpool, or whether I will have to look elsewhere, I do not know. We will have to wait and see. 

And that brings me to the end of the post. Do let me know your reactions to this post and comment on what you think. Thank you.

Medical Education and Practice - India vs England

One of my Facebook friends has asked me to pen a post on comparing the teaching system in the U.K. with that from India. Frankly, there is no comparison. Firstly, the kind of illnesses we see in India and the ones that we see in the U.K. are quite different. Secondly, our healthcare systems are completely different. In India, we work with limited budgets, whether in government/municipal hospitals or in private clinics/hospitals. 

In the U.K., too, there are some budgetary constraints, but the supplies are all top-class, and there is no shortage of essential as well as non-essential stuff, except for the items which are in the very expensive range. 

Thirdly, and this is the most important difference: the system is driven by evidence - the kind of evidence that comes from research and trials - and is completely based on protocols that are specific to each institution but framed from national and international data that is published by national-level agencies. Such evidence is periodically reviewed so as to be abreast of the current knowledge. This kind of evidence is completely lacking in India. Individual doctors may, from time to time, update their knowledge base and use this to help their own patients. Devising of hospital-wide uniformity of treatment never does occur, so that every doctor treats the same condition differently, based on their own learning, experience, and hearsay from their peers.

Coming to teaching: We have excellent teaching in India as well, but it is fragmented. Doctors learn from their seniors when they are students, but as soon as they start a private practice, they give secondary importance to continuing education. The Medical Council of India and state-level bodies like the Maharashtra Medical Council etc. have recently moved to enforce that every registered practitioner should have a certain number of points to be able to stay registered on the professional register. However, the points can easily be collected by sending the money to the organisers of teaching programs and then receiving the participation certificate in absentia. Many a times, doctors will attend a conference or learning seminar just to get the points, but not use the learning to improve their practice. Occasionally, doctors will, for reasons of expediency, join programs that are not even from their own speciality, just to gather the required points.  

In the U.K., learning is referred to as teaching! Thus, when a student says that they are going for teaching, they are actually going for learning. While I haven't done my formal medical training here and cannot, therefore, comment on how their teachers are, I can definitely say that medical students here are far more experienced than Indian medical students are, in practical, hands-on experience. This is because, from their third year onwards, when they attend the wards (just as we did or do in India), they begin to clerk patients in a proforma, taking the patient's history, examine them, etc. and they will, in their fourth and fifth years, be expected to give a differential diagnosis, and formulate a plan of management for that patient. This allows them to think like practicing doctors years before they actually will practice clinical medicine. 

What really makes the difference in their training, however, is the fact that they have to collect, and later produce, evidence of their learning. This has to be uploaded by them electronically, and I have often had students presenting a medical case to me and then coming back a few minutes later to take my digital signature on their mobile phones to collect the evidence that they did, in fact, present a case to me. They will also sometimes send us a link to give a feedback on how their performance went. This is a requirement for them and not an option. This enables them to advance professionally in a more structured, evidence-led method than the kind of haphazard learning that we have in India.

I hope this answers the question for my friend, and helps others too, to understand how the system works in the U.K.   

Flashback to day 1 of my vacation: an interesting quartet

Blog entry: 27^th April 2017: Flight to India 

I must admit that I haven’t found the time to connect with you, dear readers, from the time I flew to my homeland from Manchester on the 27^th of April. The flight was interesting, as were my flight companions. On the first leg of my Air France flight, I flew in a smaller airplane run by AF’s partner Flybe. It would take us over England and then over the Channel to Paris’ Charles De Gaulle airport in just over an hour. I sat in a window seat. This flight had 2x2 seats, so I had just co-passenger. He was a giant of a man, around 40+ with a simple English name that I can’t remember now. He and I got to talking, mostly about a GPS app that he was constantly studying on his iPhone. It seemed to be like any Maps display, only, much more detailed and multi-coloured. It reminded me of my school day maps with physical contours of the land, etc.

He told me that this was an open app that one could get on both Apple and Android devices, but its accuracy was underpinned by the defense sector. It cost a huge amount of money as it was highly detailed. If I am not wrong, it costs nearly GBP 500-600 to buy the maps on this app! I was stunned. I wondered why he needed this app. He told me he was a trekker who climbed hills alone, and he needed to know exactly where he was if he ever got lost!

As we touched down at the Charles de Gaulle airport, we parted ways. My luggage would arrive in Mumbai directly. I was walking towards the right gate for my connecting flight. I met, quite by chance, a young woman who looked Asian/Indian. We began chatting. She was Jerlin. Born and brought up in Mumbai, Jerlin is a Keralan-descent trained nurse who had reached Paris from Ireland where she had begun work in the past year. We stuck together while awaiting our flight. She told me this was her first holiday to India after her joining the Nursing force in Ireland, and that she was going there to attend a family wedding. Jerlin was a bubbly young woman who kept laughing. She was a very good listener too. Her luggage was loaded with gifts and chocolates for her entire family.

Our flight to Mumbai departed on time, and it would take us over 7 hours to fly this distance. My seat companion was a Gujarati IT person called Mehul. We shook hands and spoke to each other. As the plane cut the distance, we chatted away. He has settled in Toronto, Canada. He told me he travels to India nearly once, sometimes, twice in a year. Happily married and with kids (I can’t remember how many), he was an extremely nice person.

Once the seat-belt sign went off, we both got up to stretch our legs. We met a young Bengali woman of Indian origin named Benazir who, like us, had got up to stretch.

The two of us and she struck a conversation near the steward’s service area (which is also where we had our seats – viz. Mehul and me). Our friendship, casual though it was, grew slowly, and we were chatting away for an hour or more while other passengers came and went past us. We then met Benazir, a Bengali woman who was based in Berlin, where she was pursuing a doctorate in English literature at the Free University of Berlin. She had a remarkable story to share, and both Mehul and I were engrossed in her telling it. Presently, who should come around to visit the loo (which was right ahead of our seats) but Jerlin. She and the three of us were now a quartet, and we continued to chat for another hour or so. It was a great thing. The stewards, one of them a smart Frenchman who was jovial and very helpful, gave us space to continue to stand in a tight group and continue to hold the conversation.

Eventually, we parted and returned to our seats when the stewards announced a snack service. Outside, the skies had turned dark as we were flying due east from Paris. We would arrive at half past eleven in the night at the Chhatrapati Shivaji International Airport. From here, Jerlin and I would go to our respective homes, Mehul would fly onward to his home in Gujarat, and Benazir, to her home in Hyderabad. We promised to stay in touch.

Our baggage safely retrieved, I then hired a cool cab and reached home at a little after half-past one in the morning. It was now the 28^th of the month. I would sleep after a bath and tea. The next day, after my 3-4 hour nap, I would begin my Indian vacation.

Update and more

Dear Readers,

I have been amiss in not posting anything on this blog since the past nearly one and a half months. I will offer no excuses for this, but I do wish to say this: I have missed you all as much as you have missed my posts - perhaps it is a greater loss for me. 

So, after the passing of the one-year milestone, my life in the hospital and in Blackpool went into a routine. Nothing exciting was happening and I was plodding on from day to day. I did locum duties about 6 days in all, and they were mostly in Bolton and at Bassetlaw. Of course, they helped me save more money and earned me a bit more of practical experience.

Back home in India, my family began gearing for my expected visit to Mumbai in the first week of January. This time, the primary reason for my Mumbai visit would be to attend the 40th reunion of my GS Medical College batch of '77. We would be going to Kashid and our stay would be at Prakruti Resorts. This is a large resort spread over a big area of 100 acres. There are indoor and outdoor activities here, including carrom, tennis, a swimming pool, a discotheque, and more. The rooms were decent, and in line with their 4-star rating. Nearly 60 out of our batch of 160 attended the get-together. We - i.e, my family and I travelled together. Inas and Hannah were initially apprehensive about what they would occupy their time with as they would be the only offspring to travel to this holiday. In the event. they were quite happy with the entire package. There was much they could do as a pair, and also, they played with the rest of the class when we had beach handball as a game. The food at the resort was really good, and they varied the menu at every meal so that I had a taste of many different kinds of foods and hence, enjoyed myself.

The reunion itself was remarkable. It was a memorable experience because we had all had different life jouirneys  but were now on a common platform with no differences of sex, social backgrounds, religious beliefs, financial standing or any other yardstick,

In addition, I had a good time with my family. I ate out with my daughters on a few occasions and with the whole family (i.e. including wife Nishrin) on a few more. It was all quite enjoyable. The outing with both daughters was in a mall, where I had food with them in Bombay Blue in a mall known as Phoenix Market City near Vikhroli. This was a lovely lunch with mostly a mix of Italian and Mexican food. 

With Hannah, I had a meal or two in more casual outlets when we went shopping together. With the family, I went to World Streat Foods at Nariman Point  unique experience.  This is a recently opened restaurant that brings world street foods to you in the ambience of a comfortable, indoor place. We really enjoyed this one. We had food from Sri Lanka, East Africa, the Americas and also stuff from other parts of the world. 

As I have posted on social media, I was able to help out some people with their life-problems. One of them was a mom with a child with a borderline delay of milestones. Another was an ex-patient of mine searching for advice on the choice of post-graduation in his chosen field. 

Finally, this short visit, I rejuvenated myself to return to the UK for some more serious work.

India Visit, Day 1: World Vision Partnership Meet

I was aware that there was an opportunity for me to meet two of my four sponsored children at the Mumbai Partnership meeting arranged by the NGO that has enabled me to organise charity for underprivileged children: World Vision India (see their website). My arrival at the Mumbai airport was at around 1 p.m. My objective was to reach the venue of the meeting before half past two. I knew that would be almost impossible, since I had to first travel to my home in south Mumbai, and then, to the meeting venue which was again in north Mumbai, at a suburb known to many as the Queen of Suburbs of India, or, simply said, Bandra. I hastily completed my immigration formalities.By half past one, I was out of it and into the cab hire area. I chose a cool cab and was on my way home within a few seconds. I requested the cabbie to wait for me to go up and dump my luggage and then, when I came back down, to take me to the Bandra suburb to the venue of the meet. 

When I arrived at the auditorium, someone from WVI immediately engaged me in the registration process, while another one called out to the two Mumbai-based children who had come to the venue with the hope of meeting me. We then met up with each other - me and the two children, and it was a magical moment that I won't ever forget.

Here are some photos of that memorable occasion. 

After meeting with both my friends, I went into the auditorium to attend part of the Partnership meet which was about showcasing the work of the organisation as well as presentations by many of the sponsored children who have now grown out of their childhood and are settling down in higher education and so on. It was all very inspiring, but I left soon as I was dog tired from my air travel. However, I did capture a few moments from the events on the stage. The first is a group song, while the second is a screen grab of the head of the WVI addressing the gathering.

Returned home to finish unpacking my stuff and then went out to have a nice fish dinner in the restaurant down my lane. I slept early as I planned to take an early morning bus to Tungarli to join the rest of my extended family and my own in a move that would take everyone by surprise. 

What the surprise was

Nearly a fortnight later, I am ready to continue writing my blog as I was too busy to sit down and write. As many of you are already following me on the social media, you all may have guessed that the surprise I spoke about on my previous entry was my completely unannounced but well-planned visit to my home-town for 10 days starting 26th February 2016.

Hannah, my daughter, and I had discussed the possibility of my visiting Mumbai a few months ago; in fact, she was the one who had broached it. I had said it would not be possible as it would be too quick to ask for a holiday after my joining the new job in November 2015. She had got reconciled to this, but I began to think, why not. When I came to know that my entire family would be on a trip to a family get-together on the last weekend in February, I spoke to the doctor who arranges off-days and vacations in our department. I told him I needed some days off which could be deducted from my annual quota of vacations. He agreed with the dates I proposed. Once he sanctioned this, I booked my flight tickets and proceeded with the plan to visit India. 

A major incident occurred in early February which could have toppled the apple-cart. My brother-in-law suddenly passed away. My own family's participation in the larger get-together was dicey, as my wife Nishrin was suddenly bereaved. Over the next few weeks, the loss dulled somewhat, and many of my cousins, including those who had planned the get-together convinced Nishrin to, in fact, join in the do. As the day of the do neared, so did the day for me to fly. I finally took the host couple (actually, the ones who did all the arrangements for the do)  into confidence. I told them that I needed the address of the bungalow they had hired for the do, as I was planning to reach there as a surprise. The couple, Salim and Samira, were pleasantly shocked when I shared the news with them, as they had, sort of, accepted the fact that I wasn't going to be among the family at the meeting. They promised to keep the secret. 

A few days before the actual event of the get-together, my family announced in our extended family group (on Whatsapp) that their participation was on. I knew now that my trip and its objective of a secret arrival was going to be a success. I flew to India on the evening of the 26th, arriving via Abu Dhabi on a Etihad jump flight on the afternoon of the 27th. I had broken the news to my neighbour, who usually have a set of spare keys to my house. They had coordinated my arrival with me so beautifully! And had kept the secret as well. Had I not confided in them, I would have had no way to enter my own home on my arrival! 

All the chips fell in place, then, and I arrived to a locked house at about half past two on the Saturday, My immediate task was to dump my luggage and proceed immediately to a social event organised by World Vision India, a non-governmental Christian organisation that I am a part of as I have adopted some poor kids through their agency. They were having a big Mumbai Partners' Meet at a public auditorium in Bandra. I was supposed to meet my Mumbai-based adoptees here between 2 and 3 p.m. Although I was running late, I did manage to reach a few minutes after three, when the kids I had adopted were about to leave, having waited for me for over an hour with their mothers. I met them then, and had photos taken of our meeting ... but that's another story. 

I will end this entry here, and continue my visit experiences over the next several entries. Do read on. 

Thanks for visiting my blog ... do put in your thoughts into the comments section.