Living in a Fish Bowl!

“When a man is denied the right to live the life he believes in, he has no choice but to become an outlaw.”
― Nelson Mandela, Long Walk to Freedom: Autobiography of Nelson Mandela

We often believe that the information that reaches us is always the right information. why wouldn't we? We are not living in China where information is censored by the government nor is there any dearth of information with the world wide web which has largely been free of any restrictions till now! I recently understood the perils of listening only to one side of the story for too long. Over time that one side of the story is perceived as truth.

Last month I was working in a hospital which has international fellows coming in from different countries to train in specific disciplines and then go back to their countries to use that training. I had the good fortune to meet one such fellow from Palestine who was working in the same department I was. We shared a common love for the sub-specialty we were working in and over discussions of ophthalmology we also discussed a whole lot of international politics too. The information junkie that I am I was only too happy to know about stories I would probably never ever hear about.

The stories the international media feeds us or even the Indian media feeds us is that Palestinians are a group of people governed by terrorists and that Israelis are always the victims of Palestinian intolerance. We’ve been fed these pro- Israeli stories so many times that we believe it as fact. But the true picture is not so straightforward.

I do not want to go into the whole history of Israel- Palestinian conflict which is extensive and most of which is available on the internet. I want to talk about stereotypes and misconceptions created by international media. It’s interesting to note that Israel is a country that was formed only in 1948 on Palestinian land and now ironically it is the state of Palestine that is not recognized by the UN. The British who  ruled over the Palestine area could not handle local tensions between Arabs and Jews so after the world war II out of a sense of compensation for the Holocaust granted the formation of the state of Israel.This in turn resulted in the large immigration of Jews into the Palestine area hence making it a Jewish majority. The Israelis have been fighting the Arab countries ever since and the conflict with Palestinians have continued to this day while Israelis have peace treaties with Egypt and Jordan.

As an impressionable teenager I read with tears in my eyes the story that Anne Frank was narrating so calmly in her autobiography. The Holocaust was a truly horrific episode in Jewish history. The 1972 massacre of the Olympic athletes was tragic as well (Steven Spielberg made the movie ‘Munich’ from this episode, who incidentally was the director of the Holocaust movie ‘Schindler’s List’). I had concluded after reading so extensively about Jews, about the tortures and concentration camps during the Nazi regime that Jews were the most oppressed race in the world and that anyone who are against Jews are inhuman by default. But i failed to realize until I met this Palestinian doctor, how instances of injustice to the Jews have been documented over the years in print, broadcasting and movies but the Palestinian stories are somehow elusive to all of us. I’m not belittling the Holocaust nor am I endorsing the terrorist attacks on Jews. I want to shed some light on the other side of this Israel-Palestine conflict.

You would be surprised to know (I was too) that Palestinian territories are landlocked territories surrounded by Israel and people from these areas are not allowed to go towards the sea by Israeli authorities (though it is only 40km from their border) and all the Palestinian borders are controlled by Israel including its borders with Egypt and Jordan. There are no airports in Palestine and anybody wanting to leave the country will have to go through Israeli airports for which you would need loads of paperwork and permission. There are two Palestinian territories, the Gaza strip and the West bank but these are separated by Israel and hence have two different governments with no common governing mandate and ruled by different political outfits. A Palestinian from one territory is not allowed easy access to the other territory hence both these territories are mutually exclusive and independent of each other.

Despite being highly educated there are limited employment opportunities in Palestine hence many Palestinians choose to live and work in Israel. Israel is a developed country while Palestine is barely there due to restriction of Palestinian border trade by Israel. Palestinians who chose to live in Israel are forbidden to marry, have a family or even ever visit Palestine again. Even this Palestinian doctor i met works in Israel in a Christian hospital. He lives near the border with his family and makes the daily to and fro journey from Palestine to Israel just to earn his livelihood. His wife too does the same to work in some telecom company in Israel. All these journeys and checks to have the right to have a family!!!

But the most touching story I heard from him was this. His elder sister married and emigrated to Australia with her In-laws in 1987.Since 1987 she has never been able to visit Palestine again. So she decided to visit her country of origin with her two kids last year. After landing at the Israeli airport she was stopped at the border check point. She and her kids were Australian citizens with Aussie passports. The Israeli authorities told her that her sons had the right to pass the border but since she had been a Palestinian before 1987 she would have to produce a Palestinian ID to do the same. His sister and her kids had to return home without visiting anyone from their family. My Palestinian friend has not seen his own sister for the last 25 yrs!!! These stories are not exceptions but these are commonplace instances in that region.

This is like a goldfish living in a fishbowl…. despite seeing everything the goldfish can never go out of the bowl nor can it hope any other goldfish to give it company. Its life is governed by the rules of whoever feeds the goldfish and not by what the goldfish wants. If you make them live like goldfish is it any surprise that they retaliate in a violent way? Humans were not meant to be in a fish bowl nor are they goldfishes.

When he spoke about the whole situation there was no anger in his voice, only sadness.Sadness over all the Jewish friends he has lost over the years, over the misconceptions that dominate all over the world about Palestinians, about all the family members he can never see and how their freedom to live life the way they want it is not there but no one knows or cares about it outside their country.
His words at the end were very profound, “No Palestinian ever killed a Jew in the Holocaust yet today it is we Palestinians who are paying the price for it.”

P.S. just check out this one article i found on the net which can be said mildly anti-Israel…. its by Arindam Choudhury of whom i’m not a huge fan but in this case he seems to have got his research right!

http://www.thesundayindian.com/en/story/when-weapons-are-to-be-tested-the-gazas-become-the-casualty/44225/

The Surgeon Conundrum

“From inability to let well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom, science before art and cleverness before common sense; from treating patients as cases; and from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us.”

Sir Robert Hutchison, 20th century physician, British Medical Journal, 1953

I often hear descriptions of famous surgeons as “great”, “amazing””, “brilliant”,etc. and wonder how those adjectives get decided. The corollary used in describing a surgeon is somewhat akin to a performing artist or an athlete. The problem with such an approach is unlike an athlete who can be assessed by statistics or artists who is assessed by cultural expertise of common people, a surgeon does not lend himself to such assessment. A surgeon does not have a publicly available success rate statistic nor do common people have any expert knowledge of surgical procedures to know if a surgeon is great or not.
Is surgery so hard? Yes and No.
YES because one needs to put in years and years of study to even have the opportunity to hold a scalpel and from then on has to practice relentlessly for many more years to actually master the surgeries in his/her specialty. For that relentless pursuit the surgeons usually have to sacrifice the prime years of their lives to this task, having no time of their own, decreased social and personal life and often living under debt or their parents’ financial benevolence for a little less than half their lives. 
NO because its not magic. Most surgical procedures have certain established techniques which if practiced over many years become second nature to the surgeon. So if you know the rules you are set. Of course it goes without saying that you would need a certain level of aptitude and intelligence to learn the complex machinations of the human body,decent memorization ability and a whole load of patience but essentially surgeons are human beings like the rest of us. Only that we surgeons are the lucky ones among humanity who get to wield the scalpel to help humanity as a reward for all those years of hard work.
Skill can vary of course like in any profession, they can be excellent, good, average, poor and miserable. Skill, we surgeons are often told is what separates the great from the rest and yet there are many average skilled surgeons doing incredible service to mankind which many highly skilled surgeons could not.
So does mere skill of a surgeon decide his greatness? Here its a big no. From what I see from the inside of a surgeon’s world, having started my surgical career 3 yrs back, the greatness of a surgeon has to be measured beyond just skill. Like my Professor in college used to say, “ Any fool can operate,even that cobbler on the street or that OT technician, maybe even skilfully but what should separate you from those fools is that you should be able to judge what surgery the patient needs or if he needs surgery at all?” (he had more colourful words to say, this is the watered down version of it, LOL). I recently heard an amazing perspective from a very famous surgeon (he’s a brilliant surgeon by the way) : “ The reason older experienced surgeons do lesser types of  surgical procedures than younger newer surgeons is not because they are any less fearless or capable than the younger ones its because they are tempered with the wisdom of what works and how well. The ability to cut down on trying too many things and to bring more efficiency and longevity to surgery is what experience brings”  These are two different perspectives with a converging opinion on the importance of clinical judgement of a surgeon being paramount!
Doing too much or doing too little? Where do surgeons draw the line?
For that the “art of judgement” is the crucial quality of a surgeon. I sometimes feel we as surgeons are often guilty of “surgical over-aggressiveness” . There are times when doctors operate when in hindsight just waiting would have done the trick. Sometimes when a medical treatment would be far more beneficial than a surgical one. Other instances when after surgery the patient is worse off than before. It’s not to say these doctors have any vested interests to operate. They mostly always want to help the patient and often in their zeal probably do too much. Sometimes its more harder for the doctor than the patient to accept that nothing more can be done. But again in trying to solve the “doing too much” problem, surgeons should not fall into the “doing too less” trap which so often happens in many hospitals these days where patients aren't demanding or in the know. There are several instances when doctors just chooses to delay instead of taking that acceptable risk to operate since they don't want to be responsible for somebody’s poor surgical outcome. Some don't even refer to a specialist who is capable of doing the surgery with lesser risk. In the end such a patient’s surgery is not done at the correct time resulting in handicap or he/she succumbs to the disease. This attitude is worse than the “doing too much” phenomenon. As an example i distinctly remember one little girl of 5yrs who came with multiple metastatic cancer to my hospital when the original small eye tumour which was detected a year earlier was not operated by the doctor assuming it to be benign. A clear case of doing too less and the experience is so heartbreaking for everybody concerned.
There are no definite answers to most surgical decisions because medicine is a field where results cannot be predicted with pinpoint accuracy like a mathematical model. But surgeons have to take these calls everyday and no one else can do it for them.The surgeon’s judgement sometimes lies between life and death of a patient so its not as simple as people believe it is. I am happy to say with full confidence though that for the most part more good than bad gets done in the full balance of things. The ability to do as much as possible to help the patient yet never letting one go overboard is a balance every surgeon should aspire to attain and this balanced judgement is what makes a surgeon truly GREAT.

What women want…

Before you mistake this for another sexist diatribe against the female sex by a testosterone charged male, let me clarify its no such thing. To the contrary I want talk about how society is oblivious to what women want. News channels these days are filled with “human interest stories” of sex crimes, rapes, assault, domestic violence, etc. on women and children all over India. It is as if there is a sudden epidemic of perversion and sexual frustration by men India-wide. I see a lot of people on these TV channels and outside say this is due to western influence –their clothes, relationship concepts and habits. It is as if sexual crimes never existed in India before. Well what the TV channels are gladly ignoring in their project to create this “breaking news” phenomenon is that these crimes are not new events in Independent India. The perverts,the sadists, the paedophiles were always there but we as a society never acknowledged them. We protected them among lies, cover-ups and  false family honour. Every time we see some new report on a ghastly crime, we as a part of society give an appalled shocked expression, shrug it off and move on believing such things are rare events in civilized society. The real fact of the matter is the problem lies in the mindsets of society as a whole. The sad part is the crimes are not as surprising as the comments by leading political figures and officials in law enforcing agencies. These politicians and the police are supposed to be representatives of our country’s people and if they think thus by projection the country also thinks like that.What do they say?

“The woman who got raped was wearing a mini skirt, was an alcoholic and a prostitute. She tempted that rapist to rape her. She had it coming”
“ The man’s affection for the child has been misconstrued as child sexual abuse. There are no paedophiles in India. It is a western phenomenon”
“ Women should know how to dress decently in order not to get raped”
“ Women should not work in offices after dark so that they will not tempt rapists at night”
“ The western influences are ruining the culture of our country. Women should not dress in western clothes, should not drink, not use mobile phones and internet, not have male friends,……(list goes on)”

If these statements shock you then you really haven’t been reading the news lately. There are many more such banal statements being given on a daily basis.I don’t know who was asking for their explanations but nevertheless they did provide their distorted logic for public consumption. What is unfortunate is that these statements are coming from not just religious fundamentalists,policemen and politicians but from some members of the National Commission for Women. If people appointed to safeguard interests of women (who are women themselves) think like this then really women in our country have no hope. I think the actual rape has happened in the brains of these commenting people.

The ploy to put the blame of rape squarely on how women behave is an old one. They will tell you men don’t have any control over their sexual craving and its only natural that they will rape someone who will sexually arouse them. They believe that the onus is on women to avoid rape. It’s like saying that any man can become a rapist if present in the given circumstances which commonsense should tell us is not the case. Chivalry and gentlemen have not died in this world and not all men are rapists if it even needed to be said. The rapist will rape anyone without regard to looks,clothes,behaviour, age and sometimes even gender. Instead of acknowledging this problem these people will try to put morality and culture into the equation. Aside from the fact that I don’t think two hoots about the culture of our country (much less ruining it), there is no credence to the belief that it is somehow ok to rape a sex worker or a lady who drinks or a woman who wears revealing clothes. It is behind this belief that rapists, sadists and paedophiles in our country find shelter in. If society acknowledges that the crime is committed in the minds of rapists rather than due to situational happenings, only then something can be done to curb these crimes.

Women in our country should be free to wear the clothes of their choice, work in professions they want to, go to any place at any time,to eat and drink whatever is legally allowed to all citizens AND STILL NOT GET RAPED. That should be the societal standard and not primitive ideas of these dinosaurs called politicians and policemen who are probably living in a cave.

The idea that women are respected in our country is a myth. Except in certain pockets where women find a pride of place, in most places in India everyday we see women being insulted, abused and exploited. The IT boom and corporate culture has improved the stock of women in our country. We find that more girls are getting educated and making a living for themselves than the previous generations did. But societal prejudices still remain and the behind those signs of progress among women hides an ugly truth. A truth nobody is willing to acknowledge : “Society still considers women as inferior to men.” These men and women( the voices of society) who give statement after statement believe that its always the woman’s fault (even some in the NCW think so).Unless this mindset is not corrected no law will control these savages committing crimes.

The media which is supposed to be the progressive voice of our country is as regressive as can be. Recently we saw footages from a Guwahati based news channel showing images of about 20 men molesting and stripping a 17yr old girl. This episode teaches us two things. ONE: People who would seem normal are the people capable of such serious crimes. There are no signs to separate these savages from society as a whole. TWO: There are no ethics and sensitivity left in the media. While seeing the video we are also listening to the cameraman actually encouraging the molesters to go further in their ghastly crime despite futile pleas by the girl to leave her alone. The reporter of that news channel even has the gall to interview the molested victim and ask her personal details immediately after the incident. Then they broadcast it live all over India and say they actually helped identify the culprits while actually they were just creating a TRP raising story. They did not even try to help the poor girl. This is how depraved our media is. Its not just one news channel, every news channel in India broadcast it without any shame. The identity of that girl was flashed like a sign of victory thus destroying the last shreds of humanity. The govt. did one better (rather worse), they sent some elite high brow delhi socialite women who claimed to be from the NCW who conducted press conferences along with the victim. Even a molestation is treated as platform for politicians. What law will these politicians bring in when they themselves behave worse than those molesters.

This is not to say some good work is not going on. The child abuse bill and domestic violence act are some examples of good legislation. But unless the powers that be change their prejudicial stand point no law can be enforced to actually decrease such crimes.

feel free to read what western media thinks about the rapes in India:
http://www.slate.com/blogs/xx_factor/2012/10/26/rape_in_india_a_sexual_assault_spree_in_haryana_brings_out_the_crazy_in.html

Lessons learnt in Kolkata

Three years spent in Kolkata has been an experience which changed the way I looked at life. Here are few of the lessons i learnt in Kolkata.
Lesson #1: There is no clear distinction between good and bad people.
People who are good hearted are not good in every aspect and they will still do the wrong things sometimes so that it suits their situation. While they say there is something good in everyone, I found out this to be untrue. There are genuinely bad people in this world and they have no guilt nor remorse in what they do. People who do good are not necessarily rewarded and people doing bad things get away scot free despite everybody knowing it. In Kolkata i met some of the best human beings as well as some of the worst products of humanity. I met people who genuinely cared about others and others who would use people to further their own agendas. This was one of the first lessons I learnt while I was here.
Lesson #2: Integrity is the only currency in the world...without it all the money, fame and achievements count for nothing!
Integrity is the first virtue people lose when they want to get ahead at any cost. The cost? putting other people down, lobbying, flattering their superiors, scheming to achieve an advantage over their peers, losing friendships and trust in order to get ahead. I’ve seen them all during my 3 years in Kolkata.  Some of these people might even go on to tell you there is no other way to be successful in today’s world yet there are people with impeccable integrity living dignified lives even today.  We should do our job the best way it can be done and everybody else play their part. Often times others don’t play their parts but that should never lower our ideals and integrity. Our purpose in life should never be affected by the bad things other people do! If you keep your integrity(and whatever you stand for) despite all temptations and rewards to lose it, you have something to be proud of about your life! Everybody keeps a safe distance from people with integrity and will think twice before they mess with them. Not only that all your achievements have incredible value as its all yours and not dependent of somebody else’s generosity. I would like to quote Ayn Rand who is an authority on these matters.

Honesty is the recognition of the fact that the unreal is unreal and can have no value, that neither love nor fame nor cash is a value if obtained by fraud—that an attempt to gain a value by deceiving the mind of others is an act of raising your victims to a position higher than reality - 

Ayn Rand

Lesson #3: The best punishment to people you don't like is to ignore them.... you can live in peace and it drives them nuts!!!
Heh! Heh! This is a practical lesson I learnt while I was in Kolkata. With time I came to know that it is impossible to  change somebody’s view/opinion/behaviour/attitude if the concerned person does not respect you. No matter how many logical arguments you may produce to prove that what they are doing is wrong they will never move from their position. So when it comes to these people I preferred to give them the “silent treatment” which worked wonders. It drove those very people so crazy that they straightened up to doing things how i wanted them to. If they didn’t mend their ways i at least had the peace of mind since didn’t have to talk to them.
Lesson #4: Genuine interest is key to most things.If you haven't got wonder in your life you have very little else.
During my residentship i saw many residents- senior and junior who took up Ophthalmology even though they were not interested in it and took it since they did not get the subject of their choice. They were in various degrees, uninterested, critical of the subject and mostly non-working due to it.I am a moderator in an online career guidance forum for doctors and I met several people who joined ophthalmology and were regretting their choice. I took up Ophthalmology since I was interested in the subject and once I started my residency I was totally hooked. There was no looking back. For me Ophthalmology was the best subject in the world. I was initially pained that all the above people did not see it that way but slowly understood why. Ophthalmology is a tough subject to like if you are not interested. It involves learning a new set of skills quite different from what medical students are exposed to during their undergrad period. So its a paradigm shift in their learning process. Also in most medical colleges (fortunately not mine) in India they give very little surgical hands on experience to residents of Ophthalmology. This may contribute to them being frustrated but mostly it is because of lack of interest. We all have to make compromises in life at some time or the other, but I feel even when we compromise we should choose a path which we will go through till the end. Again interest is the most important thing.
Lesson #5: There are no born surgeons. The surgeon who does not work hard to improve is the bad one.
When I first started my residency my biggest fear was whether I'll be able to do surgery competently.I did not want to play with human eyes to humour myself. But surprising even myself I did turn out to be good enough. I had a good reputation among my colleagues and my teachers regarding my surgical skills. But surgery never came naturally to me or probably I was a slow learner. I did struggle to fit in initially and due to peer pressure I did go through some periods of depression. But I picked myself up and worked hard to improve myself. Reading about surgery I found out was the best way to improve your technique and minimize your complications. Watching live surgeries and videos by experienced surgeons was the second best way.  My boss was the biggest inspiration behind me. Every time I had a set back he was the one who motivated me. He said to me “If i could learn eye surgery at the age of 37 yrs, you being so young have a lot going for you”. I did improve and did quite well eventually. So every time I wanted to learn a new surgery I read extensively about it, assisted in many surgeries and watched many videos. This was the philosophy I tried to inculcate in all my juniors with varying success. A lot of people want a short cut in everything. But surgery is such a field that there are no short cuts. You have to do the long haul or not do it at all. So whenever I saw any of my juniors not willing to work hard even for their own selves it always disturbed me. But those who were willing to listen did very well. I feel a slow but careful surgeon is better than a fast, over-confident and talented surgeon. The ideal surgeon is the one who is open to constructive criticism and advice from seniors and teachers while remaining confident about oneself. He should leave his ego when operating and be sensitive that he’s operating on a human body. He should always work hard to improve his skills in every way possible yet be prudent enough to understand that complications happen in the best of hands and our goal is to minimize our complications and not to eliminate them. This was my career defining lesson.

Lesson #6: A doctor's life is tough but it's an uniquely gratifying experience! Doing good is easy if you want to do it.
My friends in other disciplines would have me think that Ophthalmology is not a satisfying branch since in most cases we are not battling to save patient’s lives. But I beg to differ because sight is as precious as life itself and saving vision of patients is as satisfying as saving lives. In fact since we see very few deaths in our practice we have happier lives. When I was doing my residency I was exposed to the abject poverty of patients in West Bengal which is much more grave than in Karnataka. It was tough for me to handle initially but gradually I learnt how to give efficient care to the appropriate patients. I learnt to listen to patients problems (not necessarily health related) to help them make the right decisions for their situations. I tried to reduce their hospital spending by effective means. I sometimes went to great lengths to convince my superiors to take timely decisions. It was a great management lesson for which I did not need to go to a B-school to learn. In the end I found that if you truly care for your patients, have empathy towards their varied problems and have respect towards them you will find a way to help them in the best possible way.
Lesson #7: Never compromise with personal relationships…friends and family.
Always stand up for people close to you despite all odds. In their time of need you should be their biggest asset. You may sometimes stand to lose your footing supporting them but in my experience it’s been worth it. When you are in trouble you’ll see how they will come for you.  I am blessed to have the most amazing friends wherever I have lived and my family has been my pillar of strength all my life. Friends and family are the most important people for you in success and in failures.
Lesson #8: Positive attitude cures a lot of bad luck!
This is my lifelong aspiration. To see the positive side of things. To believe that there are no wrong turns in life, only new roads to find. Anything that happens to us which may initially seem like bad luck may be an opportunity to do something different. There will be plenty of people who will say some things are impossible. They will discourage you from pursuing your dreams. They are all liars and are people who lack  vision. Belief in what you do is paramount, so if you believe in something never give up half way. Go the whole distance and  you'll see you were right!

Careers, Decisions and Priorities!!!

I am like a wide eyed boy in a huge toy store who wants to find out what every toy can do before his parents take him home.  I'm passionately curious about the world around me since when i can remember and that trait has never deserted me even now.I tend to be fascinated with more things than i can probably give my full attention to. I remember as a child dismantling electronic equipment to understand how it works despite being punished for it later or reading extensively about some interesting story the day before some exam which would not be asked in any exam. I don't know whether this has been actually a good thing or detrimental  in my life but I guess I cant be anything else but me. Mine has been a life of curiosity and facination! I have this uncanny ability to find a sense of wonder in the things i'm doing which i think is a gift. All the elders in my life(parents,relatives,teachers) are very effusive that I make a career for myself but I dont really know if i have planned for a career as such.Some years ago I read an article by Shekar Kapur, the world renowned Director of Hindi and English language films.He said " I had removed the word career from my dictionary when i was 22yrs old as i find that word restricting" Well though i took more time than Shekar Kapur did to realize this I have come to the same conclusion too, more so in the last 3 yrs when I was doing my residency. I think i can be more than a single body of work. I can have multiple roles and do it just as well. Yes I would like to work as an ophthalmologist like i'm trained to but what i will eventually become will not depend on furthering a career or on monetary consideration but on what I believe i should be doing and how I think I can touch people's lives.

Now that i'm nearing the end of my residency I'm contemplating my next move from here on. During my residency I was first introduced to a sub-specialty in Ophthalmology called Orbit and Oculoplasty which initially did not much appeal to me until one day in the OT i saw a face being reconstructed after removal of a large mass of malignant tumour of the eyelid. It immediately caught my fancy. But i guess the turning point of my residency was when i assisted my boss in a procedure called Lateral orbitotomy where you have remove a tumour from the back of the eye after sawing through bone. I found that procedure so fascinating that I thought to myself,  thats what i want to do! That was when i first thought of pursuing Orbit and oculoplasty as my sub-specialty and over the years it has become my favorite sub-specialty. The interest is so apparent i don't think anybody in my institute has any doubt as to which specialty I shall pursue. When told of my plans, my parents though supporting weren't very enthusiastic. So were many of my professors and relatives. They told me "why do you want to do something where you wont have enough cases and there's no money in it?" or that "why would you want to do anything other than cataract surgeries when there are so many to be done and also so much money in cataracts? " Well I dont know how but i was able to ignore all these people and i applied for a fellowship in orbit and oculoplasty in LVPEI, Hyderabad which is the best place in India for that sub-specialty. As i write this i'm waiting for the selection results which may or may not go in my favour.

I recently attended a conference where 2 of the leading figures of Orbit, oculoplasty and ocular oncology, Prof. JRR Collin and Dr. Carol Shields were conducting a workshop in their subject of expertise. They are the very people whose text books we read and i was completely bowled over by their enormous knowledge and genius in their subject. The clarity and simplicity with which they spoke has been so inspiring. I've been touched by Dr. Shields' passion for her subject. Their talk probably removed the last shreds of doubt from my mind about orbit and oculoplasty.

I guess money has never driven me as much as passion has all my life. I have achieved whatever i passionately wanted to do and fortunately it has never really been for financial gain. So i guess my next step should be to do what I would love doing. That said i find even cataract surgeries and corneal  surgeries fascinating too and maybe would not mind pursuing that either if for some reasons I may not get to do oculoplasty...John Irving, one of my favorite writers once said "I could have been a lot of things and even good at it but if I had been anything other than a writer my life wouldn't have been quite as satisfying" I guess Irving echoes my feelings towards orbit and oculoplasty. My life wouldn't be as satisfying if i couldn't pursue it. But unfortunately there are not many fellowships in India for this upcoming sub-specialty( in fact only 1 vacancy each in 3 big eye institutes in south india). So it has been a huge risk on my part by not applying for anything else. Right now I remember a sentence my professor of pediatrics in medical college used to say "Always give your best because if suppose you do not succeed, find peace in the fact that you couldn't have done anything more than your best".... So i'm keeping my fingers crossed. :-)

The 3 miracles!

It has been quite sometime since I've posted something on this blog...I was busy the last 6 months or so

preparing for my MS Ophthalmology exams. I'm happy to say I have passed my exams with flying

colours. This degree has meant a lot to me. I think I have finally found something I'm truly passionate

about.My experience over the last 3 years of residency in Regional Institute of Ophthalmology,

Kolkata in has been some of the best years of my professional life.I've learnt so many things and also

realised how much potiential I have to change people's lives. Today I want to share three stories during

my residency in which I was instrumental in somebody's happiness and which brings immense

satisfaction to me. There are many many more but I dont want to bore you with it all. These 3 stories

are what i call miracles not only for those patients but also how it changed my outlook towards my

profession.

Miracle 1 : When i was ending the 1st yr of my residency, I had just started doing cataract

surgeries independently and confidently. One day in the OPD a woman about 60 yrs of age entered who had mature cataracts in both eyes. In fact she was so blind that she had to be supported by 2 people into

the OPD room. For all practical purposes she was totally handicapped. I examined her and did the work

up and got her admitted. My boss gave me the opportunity to operate on her.i operated on both eyes

just a week apart from each other. The day after i operated on the second eye i entered the wards

early in the morning and observed the most beautiful sight in the world. That same patient who needed 2

people to support her everywhere was running around the wards excitedly laughing and talking to all the

other patients. The patient and their relatives somehow knew i was the one who operated on her. They

were so thankful to me that I was touched. That was the the most satisfying moment of my

professional life until then.

Miracle 2 : It was sometime during the second year of my residency. A 22yr old woman came to

our OPD. She had a condition called Congenital Blepharoptosis of one eye, where one of the eyelids

cannot be lifted like the other hence creating an asymetry in her facial features. Its not a life-

threatening or a significant visual handicap but it made an unsightly appearance due to which she was not

getting married. Lot of hospitals had refused to operate on her saying its a cosmetic problem and was

finally referred to my institute since its a govt institute and the patient was poor. I personally took up

the case and worked it up and my boss as he has always done entrusted me with the operation. I

operated on her and the operation was a huge success and it improved her appearance manifold. She

was discharged and I had almost forgotten about it. Then one day about 5 months later when i was

seeing patients in the OPD, that woman with her father had searched the whole hospital looking for me

and finally found me in the OPD. They had come to invite me to her wedding which was fixed after the

operation. This was such a humbling experience. That day I realised that no problem of

the patient is small and that we have so much power to change their lives if we show empathy to

their woes.

Miracle 3 : I was in my final year of residency and was working in a retina unit. A depressed

young woman walked into our OPD. She had a painful blind eye which needed to be removed. She had an

unsightly eye since childhood due to an accident and was very depressed with how it looked. I wanted to

remove the eye and have an artificial prosthesis fitted so that it looked like a normal eye. My present

boss was not that enthusiastic since in government hospitals due to the high case loads, they often

remove a painful eye and leave it like that without thinking of the social stigma it may cause. And being a

retina surgeon he was not sure whether it would turn out well. But I persisted and finally convinced him

to admit that patient. I operated on that eye and fitted an implant and prosthesis. It was a success. in 2

months time she had a prosthetic eye and nobody looking at her would have realised she did not have an

eye. Even my boss who was skeptical initially was very impressed. I was travelling in the metro after work one evening and that woman and her husband approached me there. I almost didnt recognize them. Both of them were looking so happy and they were so grateful.

I wish i could have captured their joy in my camera but couldnt. This was the best gift I could get for

all the effort I took to get her operated "properly" : HER SMILE.