“So what is that you are reading in that Madam?”he asked leaning over
my seat. Bus journeys bring me a new kind of trepidation every time despite being
a regular commuter of the Bangalore Metropolitan Transport Corporation
services, well for reasons known. I must confess that this time I was disturbed
in the middle of reading a very intense book on life’s simple pleasures written
by Ruskin Bond, well who else.
I looked up, and what I saw was wonderful. It sort of made my day.
The curiosity in his eyes, very childlike much against the
obtuseness of the regular bus conductors I have come across. I do not blame
them, but such is their peripatetic life.
“It’s a book” I replied with all the politeness I could and the
inspiration I had gathered from Bond’s writings.
“It doesn’t look like one!” he giggled.
“Arey Saaar! It’s a big phone, I have seen this with many
rich people these days, so how much does it cost Madam?” inquired an equally curious lady sitting behind me, munching
on a handful of peanuts.
There is no right place or people or time for such engaging
conversations here in India. If you give yourself a chance they are bound to
happen, after all they aren’t of any harm, all these infectious chit chatter.
“It’s an Ebook reader, instead of carrying many books we can
read in just one” I replied.
Their inquisitiveness was bound to increase, what followed
were a twenty more questions. The journey turned out to be very interesting for
me, the whole experience of making such naive people understand what Kindle and
such gadgets are all about, thankfully they did not think of me as some great
show off like people usually do.
“So how many books do you have in this?” he asked.
“Around five hundred…”
I replied and continued reading, and when I did that he was
brimming with amazement or amusement of some kind, either of the two or both
maybe, I am not very sure.
“MADAM ! So you have the whole world in your hands!”
He opined so with a smile and went about his duty of issuing
tickets and checking the passes of fellow passengers. The lady was back to her
peanuts.
And I was back to my Kindle His admittance was very subtle
and nice indeed. I have read a hundred books last year for kicking a start. Reading is
something I am willingly working on now. Be it the choice of books or the
reading speed, there is always something beyond our horizons and I am realizing
this over time, with every word, with every line and every book. The world is
indeed in our hands while we are reading and by one of those happy coincidences
I happened to come across these words from Bond himself:
"Can you tell me what is that you find in this picture?"
I asked a dear friend of mine today who unfortunately but willingly did not get into medicine years ago.
"At two places there are smaller particles than the rest, little above the centre..." he replied.
"Not bad! Gonococcus inside pus cells, that's from urethral discharge" I said in excitement.
"Ugh! Careful!" he said.
"They are heat fixed and dead!Don't worry" I said and reassured him.
"See I would have made a good doctor" he opined with pride.
Of course he would have, life is all about the choices we make isn't it. There are moments when I screen these slides for minutes together and miss some fields which would have led me to some important diagnosis. And then there are moments such as this when I know what I find under the microscope is going to change someone's life. There is no satisfaction greater than that, therefore I go from one field to the other, to another and finally end up with a stiff neck!
It is an interesting world out there, in and around the cells.How our body interacts with the pathogens is a beautiful science. What you see in the picture are intracellular organisms, imagine our body mounting an immune response and trying to engulf these little bugs, things inside are more dynamic than we know.
"There are some atypical cells probably" said the pathologist.
The doctor was worried, it was his wife's PAP* smear report after all. After a brief discussion they both decided to go for a Human Papilloma Virus detection just to ensure that the picture does not turn out to be bad. He walked to another section and spoke with the Microbiologist regarding the case, the investigation would be outsourced from there to another laboratory which carries out molecular diagnostics.
A couple of minutes later.
"What sample is required for HPV-PCR** pa?" he called the microbiology laboratory and asked.
"EDTA-sample Sir" a technician replied.
The doctor billed for a HPV-PCR test from the billing section and sent the sample from the sample collection centre as told.
The EDTA vacutainer reached the laboratory through the house-keeping. Another technician received it and took a printout of the worksheet and kept everything ready for the test to be outsourced.
Now one may wonder what this is all about and what happened after that.Let me tell you what the final report was:
Hepatitis B Virus- Not Detected
Human Papilloma Virus
Eh? B or P, what is in a letter? Definitely a great raise in Blood Pressure! I did fall of the chair when I heard this. Everything is pretty much kicked to Pluto if there is a miss or a change, especially in a health care setting when this happens it is not at all pardonable. I am sharing this because it is a necessary learning, unfortunately I wasn't around when this happened. I heard various versions from the technicians regarding this matter, what I understood was the kind of miscommunication that happen over telephonic conversations. The doctor called asking for HPV, the technician heard it as HBV and advised him to send a EDTA vacutainer, but in reality it is either a cervical swab or cytology fluid that needs to be sent. Well even after that with the mismatch in the bill, nobody really bothered to cross check. The outsourced test was for HBV-PCR since it was an EDTA vacutainer. The realization dawned only when the doctor called asking for the HPV-PCR report after two days. HPV is a virus associated with cervical cancer and HBV is a virus associated with hepatitis and liver cancer, two different clinical presentations and diagnoses. The matter is getting sorted out, and we hope not to have such disastrous events again.
What bothers me is the mechanical nature of work that happens in most of the hospitals. This happened with a hospital staff, a doctor, I cannot imagine the scenario if it was a patient. It does happen nevertheless. Nobody talks about it, the matter is hushed up or sorted out by us doctors or dealt by the patient relations section. I am talking about it because this kind of maleficence is something we all need to be aware of, as doctors and as patients. We need to always ensure that abbreviations or short forms are not used for drugs or tests during diagnosis and treatment. After all it is a matter of someone's life or death. There is a thin line, a very thin one. Thankfully this incident was something that could be handled, if it was something else I couldn't have forgiven myself for being a part of such a work team! It sends a shiver down my spine, every time I think of it. "Do No Harm" is sometimes easier said than done.
*PAP Smear- The Pap smear is a screening test for cervical
cancer. Cells scraped from the opening of the cervix are examined under
a microscope. The cervix is the lower part of the uterus (womb) that
opens at the top of the vagina.
**PCR- The polymerase chain reaction (PCR) is a
technology in molecular biology used to amplify a single copy or a few
copies of a piece of DNA across several orders of magnitude, generating
thousands to millions of copies of a particular DNA sequence.
Eliya, this house has a couple of entrances
apart from the main door that one can see here. Once upon a time there was this
man in his eighties loitering around the kattewhich is built
all around the house,a little elevation or a bench to sit is called so in Kannada. The summer heat of coastal towns of Karnataka ensure that
one stays out of the house, sweating yourself out in the sun is better than
getting fried like jackfruit chips in a pan of coconut oil inside the four
walls. Fit and fine, dhoti clad with a walking stick but very much unlike
Gandhi, this man, my Eliya Ajja was
a man of swear words. He would walk from one door to the other looking for
something outside or eagerly waiting for someone to come. If we were at one
door wanting to go out we would find him there, thinking of not to trouble him
we would move to the other, lo and behold he would be standing there too tapping
his walking stick on his shadow on the floor.
“Ajja!hopale daribidi”[Leave some place for us to go]we would tell.
“Acha bagilinda hogu”[Go through the other door]he would reply.
Go to the other and he would be there
again.
“Ajja!!!” we would scream our lungs out.
“Entha upadra ningaladu makale!“[What
trouble you give me kids!] he would shout back with a 'nayi inde mone' [son of a d** in Malayalam] and continue to
stand there.
Eliya Ajja strolling in the front yard
As far as I know Ajja was not much
into reading and writing, knowledge during his days was beyond all that. So
when I thought of letters and books of mysteries of life my ancestors have left
me only one person came to my mind. And it had to be him, my Ajja, a man
of shadows. There is this interesting story I have heard during night time from
his dear wife, my Ajji with whom he has had the best of arguments and also his
life. She would always add this nice prologue.
‘Aaaringu heleda!’[Do not tell anyone!]
The story would then begin.
Dakshina Kannada is a land of ‘Adike
Thota’ [areca nut farms]. Monsoon skies and greenery, mango trees and
sunshine, peacock calls and tender coconut water, cashew fruits and small
rivulets, ah! This experience deserves another post. Well Ajja being a farmer
took the best care to ensure he had a decent crop every year. There were a
couple of servants in the thota working
for him; ‘Aalu’ as they are called,
of course the caste system is now abolished. This incident was to do with one
of them. Areca nut markets were in rich business during that time, and where
there is money there is bound to be some theft.
On one dark night Ajja was out for
his rounds guarding his thota with
his ‘bedi’[rifle].
Apparently he heard
some movement, thinking it was a ‘kudka’[wild fox]
who was a frequent visitor to his thota at night he pulled the trigger and fired
a shot in the air. Far away, he heard a noise, like the deep ripping growl of a
thunder. He walked some distance, after only a few lapsed heartbeats he
understood someone was hurt and wailing. It was one of his ‘Aalu’ Rama, he was
shot dead. Ajja thought he was probably there to steal some areca nuts like he
had done previously, unfortunately it was his bad day and he paid a heavy
price. Not knowing what to do Ajja pulled him into a cave, he hid his body
behind the bushes and returned back home. The next day, Rama was not to be
found anywhere and news spread. "Rama has run away to the ‘Ghattas’" so people were told and thought, it usually happened with Aalus during those times, they would run away in search of work to the
Western Ghats and beyond.
The story would end here, and life
continued.
What Ajji narrated is something hard
to believe. I wonder how much of this is true. Ajja was a hero definitely but how
can anyone escape a murder even if it is accidental? Or is it possible for a
man as frail as an old areca nut tree himself to do this? Look at him, look at the picture. Can it be
him? Did Rama really die? Or did he run away? This kind of furtiveness is
interesting, it does not let me move on. It has been years now since I heard
this story, as a child I did not think much of it. But when I visit my uncles
at Eliya now, I think of whatever Ajji told me. In the lull of the noon when
Ajja’s clock is ticking or when the rest of the house full of his children and
their children are gorging on telavu[dosa made of rice batter] with kai[coconut] chutney or
when the raindrops fall from the edge of the roof at night I become aware of the voices coming from
somewhere up. It feels like Ajja wants to tell me something.
I wish he wrote down something
somewhere about what exactly happened, about Rama, about his escape and most
importantly how did he feel about the entire incident. I wish there was a
letter or a diary. Such thoughts compel me to search the atta[attic] or the old cupboards and trunks hoping that there is
something. I do this every time even now whenever I visit Ajji mane. On the flipside I am sure Ajji is up
there somewhere watching me and laughing ;-) After all what is life all about? You
and your loved ones, little mysteries about each other, some truths and lies, some
stories and experiences, some memories and moments, some learning and sharing,
some love and hate, some satisfaction and guilt, sometimes just being there for
each other and living your life to the fullest. I wish this was all in a letter
or a book. Their funda of how they went about doing it so graciously along with
raising nine children! That would definitely not be any cock and bull story. I would be the happiest if these beautiful mysteries are revealed and that would be my higher calling to follow and live by.
Love and miss you both, two of my most favorite people in this world.
The best love story is not about
Romeo and Juliet who died together,
but of Grandpa and Grandma
who grew old
together :-)
PS: I am participating in this creative activity organised by makers of The Path of Zarathustra in association withBlogAdda.
There is something specially striking about this
signboard. Isn’t it more inviting than it is supposed to be? This is on the
door of my 11 year old nephew’s room. I was compelled to enter after seeing this.
Fortunately I survived the voltage, the weapons, the guns and the explosives
;-) It completely overwhelmed me, this level of imagination. Perhaps because it
reminded me of what I put up on my room door when I was a kid. Thoughts were
simple back then, a Winnie-The-Pooh or a crayoned flower would do.
Kids these
days have exposure to a lot of things unlike the medieval times I belong to, and this little
fellow seemed nothing short of a genius to me when I had this inspiring
conversation with him this afternoon. It deserved a write up on this blog.
“Do you really have them inside your room?” I asked him
and chuckled.
“Haha Raksha Chikki, you don’t know that much also?” he questioned me in return and jumped on his bed doing his typical
antics.
I looked at him with amusement.
“You think I am Yakub or what, I have to become like
Abdul Kalam to make some super strong ones!” he said adjusting his spectacles and grinding his
bunny teeth.
I am a proud aunt today. Sometimes we don't need treaties and conventions to make this world a better place. If we make sense, a sense which helps us know what is right and what is wrong it will eventually make peace.A kid sees something what we adults don't.
