Tag Archives: attitude

Kitna Deti Hai in Real Life !!!

If you happen to watch Maruti car advertisements in the last decade they would usually have the “Kitna Deti hai” (How much average does this give)  advertisement campaign.

Kitna Deti Hai

     Kitna Deti Hai

Like most Indians I too am concerned about the average my car gives before buying. But this Saturday visit to Fiat Wheels Showroom at Mohali for servicing of my car was an eye opener to how much people take this “car average” issue seriously. Talking to sales team about customer choices these days, the guys shared am amazing incident on this theme.

A customer had ordered a new car for around 7 lacs(10000$) and at the time of delivery the dealer filled the car with around 5 liters of diesel. As the car company claims the average around 20 km per liter the customer who hailed from Ambala(Around 90 km from Chandigarh)calculated he could reach Ambala with the said amount of Diesel. The dealer specifically asked him to get the car filled with diesel and then proceed to his hometown. After around one hour of delivery, the salesman received the call from the customer that car had stopped midway and diesel was empty and he did not have anyone for help. So he asked him for help and the dealer responded and the salesman reached the spot after about an hour with diesel.

The incident is a glowing example of how good we are at mathematics and how little misery on the customer’s part can spoil his fun. Just imagine having spent 7 lacs (10,000$) on the car and then avoided 2500 Rupees (30$) for a full tank.

The scenario can be projected to the life of many people where we spend stupendous amount on buying the thing but when it comes to maintenance/annual service we aren’t very keen unless the item is giving us a problem.

Kitna Deti hai

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Filed under advertisement, attitude, life, Opinion

The Paradoxical Commandments

by Kent M. Keith

People are illogical, unreasonable, and self-centered.
Love them anyway.

If you do good, people will accuse you of selfish ulterior motives.
Do good anyway.

If you are successful, you will win false friends and true enemies.
Succeed anyway.

The good you do today will be forgotten tomorrow.
Do good anyway.

Honesty and frankness make you vulnerable.
Be honest and frank anyway.

The biggest men and women with the biggest ideas can be shot down by the smallest men and women with the smallest minds.
Think big anyway.

People favor underdogs but follow only top dogs.
Fight for a few underdogs anyway.

What you spend years building may be destroyed overnight.
Build anyway.

People really need help but may attack you if you do help them.
Help people anyway.

Give the world the best you have and you’ll get kicked in the teeth.
Give the world the best you have anyway.

 

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Filed under Death, honest, Inspiration, life, love, Opinion, paradox, people, poem, poetry, secret, success

Anesthesia Vs. Anaesthesia: Does It Really Matter?

Ashish Khanna, 1998 batch

Connections-May 2013 (Volume 10, Issue 2) 

The Oxford dictionary definition of Anaesthesia is “insensitivity to pain, especially as artificially induced by the administration of gases or the injection of drugs before surgical operations”. The Merriam-Webster dictionary defines Anesthesia as “loss of sensation and usually of consciousness without loss of vital functions artificially produced by the administration of one or more agents that block the passage of pain impulses along nerve pathways to the brain” Synonymous: yes?

Anyone would agree that the difference between Anaesthesia (British English) versus Anesthesia  (American English) is above and beyond the addition of a single alphabet of the English language. I started my journey as an anesthesia resident in a country where Anaesthesia was the correctly spelt version of the branch of medicine that dealt with this specialty. Today, three years after re-training the art and re-learning Anaesthesia to be spelt as Anesthesia in the United States, it is time to look back and ponder on the finer points.
The decision to leave your own country after finishing a residency always comes with a pinch of salt. As you look to expand your clinical and academic training beyond the horizon, you are faced with the uncertainty of the unexpected. The challenge is a system of medicine distinctly different from your home country and a culture to healthcare that demands considerable understanding. A question that I am very often faced with when I make my frequent trips back home is “What is different about Anesthesia practice in the United States?” It might come as a surprise to a lot of people if I say “nothing at all” in reply. Well, what is different is not Anesthesia or Anaesthesia, only the fine print!! The other very frequent question that is thrown at me is the almost rhetorical “Is it better there?” Let me step back today and say let’s keep all this better – worse talk aside. It never was and it will never be fair to compare two vastly different systems of medicine. As I direct this piece of writing to those friends of mine who are faced with doubts and internal struggles before they leave the comfort of their own homes I would like to emphasize one singular fact: forget about quality of medicine or quality of life and remember the biggest challenge is the ability to train to re-train or put
in more simple words another residency program after a prior residency in your home country. Starting a residency program in Anesthesia under the Accreditation Council for Graduate Medical Education (ACGME) at the Cleveland Clinic Foundation, I realized early on that the essence of getting the most out of this education is to wipe my slate clean and restart again. Tell the world that you are trained in your specialty in your own country and you are capable of doing your thing does provide you with the much-needed independence of clinical work at times, but can be your worst
enemy if you want to acquire new knowledge. It is important to understand that there will be days where the attending will hold your hand when you are doing a procedure that you have done so many times before or might tell you that “this is the way it is done here”. Days, when you need to keep you’re your ego at home. Days when you will feel your neurons are struggling to cope with erasing old skills and acquiring new skills for the same procedures again. But, hey did you want to  do things the way you were doing them in your own country? That said, what is the reason you
made this trip across 4000+ miles half way across the planet? The answer to these questions will help you understand that unless you let your guard down in a foreign land and show that you are an open book you will never learn anything new and in essence never grow as a clinician. Medicine is repetitive science; it is very easy to be lulled into a false sense of satisfaction practicing the same
things over and over again, the same very way every day. The only way to appropriately imbibe your area of expertise and to mature as a clinician is to step out and see what else can be done differently and is being done differently. My message here is not to train in the United States after training in India, but to train at different places and in that process acquire a new set of skills all the time.
Going further, another area of distress for the physician from India as he or she steps onto alien soil is the cultural aspect of medicine. The interaction between peer groups as resident doctors and patient physicians as healthcare providers is different to say the least. As you move away from the “yes sir/ma’am” policy to “yes Dr. XYZ” even when that Dr. XYZ might be your department chair, you will quickly realize that you have to prove your worth as a resident by the sheer quality of your work and not the weight of your courtesy and multiple salutations directed to your staff. Decision making for the betterment of your patient is another area where the young resident here is thrown into the deep end every single day. An ICU attending will ask you for your plan, and so will your anesthesia attending in the operating room. And yes, your plan will be plan that will be executed as long as you can justify it. And that holds true for every provider from the lowest level of an intern to upwards.
Protecting patient privacy and respecting that the patient is the true owner of his or her healthcare information is another moot point here. Not to discuss patients with names or anything that could identify them, not to talk about them in the hospital corridors or the escalators is a habit that is difficult to get rid of. The tendency to try to force your decision as a clinician on the patient or the patient’s family is also something that we live by all the time in India. The patient is the master of his/her own destiny here and whether it be morbid obesity, chronic smoking in a vasculopath or narcotic abuse in a chronic pain patient, your job will be to ask them whether they feel they can change theirlifestyleand not to enforce that change on them. Difficult times will also revolve around “End-of-Life” decisions in the ICU and DNR (Do Not Resuscitate) statuses. The ability of families here to think very practically for their dying loved ones and to let go of them when there is point of futility, is commonplace. Another challenge that is
beyond the understanding of anesthesia and different from back home, and is something that you
have to deal with on a regular basis.
How can I forget to include in my set of challenges also, the change from using pharmaceuticals as brand names versus names of salts back home. Or the different abbreviations that come inherent with another healthcare system. Yes, I gave my senior resident a quizzical look when he said “Did you tube your patient” ( a.k.a intubation) or “Can you do the A-line first?” ( a.k.a arterial line) or “ Is he off the vent ?” (weaning from the ventilator) or “When is your ICU patient going to the sniff?” (a.k.a skilled nursing facility). There are numerous more such which define the distinct cultural differences in healthcare here in the United States.
As I look back today, I know that things have evolved for me as a clinician but also more importantly as a human being. I look at medicine differently; I look and understand a patient’s emotions differently. That to me is the pivotal change. For all those fellow friends who are getting ready to step out on this often-treaded path of training in another country after training as a specialist in India, I hope this writing will give a better idea of what to expect. All said and done, the
difference is not in quality of healthcare or the quality of life that you can expect to live, but in what you can assimilate from the new system of medicine.

In the end, it is not Anesthesia versus Anaesthesia, and it really does not matter!

Dr.Khanna

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Filed under Anesthesia, attitude, GMCH, health, humor, life, Residency, USMLE

Your Safety Our Concern !!!!

Animals police

Traffic Controllers ??

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Filed under attitude, Bizzare, dog, effort, funny, humor, life, news, pets, safety, WORK

GMCH: A Look Back Into Time

Divyanshoo Kohli, 2003 batch

Connections:September 2012 (Eds: Divyanshoo’s essay was originally published in the 2012 issue of the GMCH magazine Glimpse)

As the Independence Day of India rolled by, I read an interesting series of article on the state of the country that looked back at the past 65 years of the country. It was an instructive reading, at times critical, at times sentimental and occasionally comical. It is in a similar vein that I pen down these thought regarding the state of GMCH over the past 22 years.We began way back in September 1991 in a rented building that was still under construction. Much like the students who reach the class 10 minutes too late and asks around softly for ‘an extra pen’ and prays for the good humor of the attending, we too were on a borrowed existence teetering on the precipice of failing. The stools that the students sat on were marked for Government College for Men-11, the building was for mentally challenged children (poetic!), the specimens were from PGIMER! The hostel of GMCH students was in the engineering college in sector 12. Even the director was on a loan from PGI and the patients were seen at the poly clinic in sector 22! The faculty had been hurriedly assembled from any place feasible. Like a newly born, we were dependent for everything on everyone.
Like the famed Indian approach to things we began with nothing, survived with sheer luck and blossomed through sheer perseveration despite the powers that were. Getting a letter of recognition for the medical college had all the ingredients of steep uphill battle that remind me of the ‘83 victory of Kapil Dev or VVS Laxman’s terrific score against Australia. Some of the old timers recall going on hunger strikes and shuttling between Chandigarh and New Delhi in a desperate attempt fighting an obdurate and insensitive bureaucracy that was beholden to the letter but blind to the spirit of the law. We owe it to the members of the initial batch who fought for their own and our good.
As the decade rolled by, things began to gather pace (or thereabouts!). After a series of false starts, the building of the hospital was inaugurated. The Prayaas building, our rented home in sector 38, got completed. The current students would not be able to appreciate the open hallways and the dreadful anatomy halls complete with a feeling of freedom that characterized that place. We ended up moving from sector 38 to sector 32 a few years back. Earlier, the first and second year students often commuted from 38 to 32 for college functions. Some of those innocuous trips have actually ended up in wedlock! The hostels for boys and girls were constructed; the emergency started functioning as did the ICUs. I was still around when the C-block was inaugurated and we would often lose our way in that labyrinth. Soon, the D-block came into being as well.
Through these years the college, the hospital, its faculty and students grew in numbers, strength and stature. We held convocations, organized national and international conferences one of which was graced by the former president Dr. APJ Abdul Kalam.
The strength of our college and hospital has been to a huge extent the faculty that has guided us from strength to strength as we scaled from peak to peak. A lot of the original faculty members stayed with GMCH – Drs. Atul Sachdev, Jagdish Chander, Ram Singh, SMS Lehl, AK Attri, Harsh Mohan, Kanchan Kapoor, Rajeev Sharma, Suman Kochhar among others. However, some incredibly talented people left early as well: Drs. Krishan Vij, KK Gombar, AS Bawa, Robby George among others. While the reasons they left were myriad, their loss was monumental and absence felt acutely. Any hospital is the sum of the talent of its physicians and talent retention is incumbent on the administration.
The brand ambassadors of the college are always going to be its students. In this context, the college is well-endowed. Consistently, the students entering the MBBS course have been the top-rankers and
crème-da-le-crème of the tri-state area. We have also consistently shone brightly in the national PG entrance exams of PGIMER, CBSE and AIIMS. I vividly remember the time 2 years ago when my mother had to undergo a hysterectomy at PGI. To my intense surprise and undisguised relief, every single resident in that particular Gynecology unit was from GMCH (including 2 from my batch itself)! If demographics are anything to go by, the residency class of OBGYN there is dominated by the girls of GMCH. Interestingly, some of the students have gone in a full circle and have joined the hospital as faculty – a truly joyous feeling of accomplishment!
The success story of the students in the US is self-perpetuating. We have excelled in the USMLEs and are starting to create a name. As an example, during my interviews in the USA that were spread all along the east and Midwest, I had to pay for accommodation only once! Everywhere else, there was someone from GMCH who opened the doors for me and let me stay overnight. I have no relatives in the US but still feel that help is only a phone call away. For a lot of my friends, the experience has been the same.
A matter of pride for all of us has been the newspaper stories of our students excelling in the civil services exams. Our students have gone into services as diverse as the Indian army medical corps, the IAS and even the corporate world. There have been some blemishes on this count as well. The recent spate of suicides among the younger lot has been a matter of intense shame and introspection. All our glory and accomplishments fade away when one of our own goes down so tragically.
All in all the students and faculty have worked hard to reach where we are. It is easy to bask in the glory of the bygone days and let the nostalgia sweep us under its dizzying influence. It would however be futile to pat ourselves on the back and enter into a state of inertia. Much like our nation, we have worked a lot to awaken, break the shackles and cobwebs, and gather pace as we race ahead. The time though, is to fly.

Divyanshoo KohliKohli Divyanshoo

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Filed under chandigarh, college, GMCH, India, life, precious moments

Small Milestone

It was an immense pleasure to see this blog achieve over 25000 hits this month.And incidently this happens to be the 50 th post and makes it more special.

Over the past few years there have been visitors from all around the world and have nearly 100 comments made on the posts.It gives an immense pleasure to thank all the comments,criticism,  appreciation that have come along the way and have helped me improved the blog and kept alive the passion of writing in me.

And lastly thanks to my parents,wife, sister ,teachers and friends who have have encouraged me in continuing the work………

winner

Without inspiration the best powers of the mind remain dormant. There is a fuel in us which needs to be ignited with sparks.

Johann Gottfried Von Herder

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Filed under attitude, life, mind, precious moments, Thanks

A Flower’s Desire-Pushp Ki Abhilasha

A great poem on desire of  a flower

Reminds me of school days.Wonderfully written and used to be my favorite poem during school days …………….

 

चाह नहीं मै सुरबाला के गहनों में गुंथा जाऊं


चाह नहीं प्रेमी माला मे बिंध , प्यारी को ललचओं

roses
चाह नहीं सम्राटों के शव पर , हे हरी डाला जाऊं


चाह नहीं देवों के सर पर चधों , भाग्य पर इतराऊँ


मुझे तोड़ लेना बनमाली ,उस पथ पर तुम देना फेंक


मात्र  भूमि पैर शीश चढ़ने ,जिस पथ जाएँ वीर अनेक

                           माखनलाल चतुर्वेदी (Makhanlal chaturvedy)

English Tranlation

The Yearning of a Flower Desireth not to be on the young lass’ Tresses…living twice all over,

 Desireth not to be in a garland Binding, enticing young lovers, 

Desireth not to rest on the mortals Of Emperors – aren’t we equally God’s own?

 
Desireth not to be on the heads of Gods To take pride in mere fortune,

Pick me out, O Gardener! 

Strew me on the path that the Brave tread To sacrifice for Motherland!

 Let me, in obeisance, bow my head!

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January 12, 2013 · 5:36 pm