I can't comprehend this new phase of life of mine, where I keep listing and keep forgetting things I want to do, only to realise when it's too late. Life is so chaotic, even though I don't have that much to manage- just myself and my fellowship. A fellowship, or what should I call it- it feels like much more. It's just a constant whir of events for which I'm taken on board. 

Sometimes I don't understand whether I'm going on an upward or downward path. 

Initially I'd joined medicine to change the face of healthcare in India, or at least that's what I told myself i shouldn't be afraid to dream about. Money would be no matter, money would come anyway. My goals had to be much bigger than that. 

But from there, as the years have passed, it's gone from "the face of healthcare in India" to maybe just one hospital, that follows my idea of ethics, doing good to the community that it services. And then, I just had the dream to become a consultant, run my own practice. From there, now, I just wish I could make enough money every month to buy the shoes and bag I want without asking my parents. But even that seems like a faraway dream. 

On the other hand, 4-5 years ago, when for the first time, I'd read about vNOTES, I remember thinking that THIS was my dream- this was how I'd advance Gynecology, becoming a vNOTES practitioner and reviving the gold standard of Gynecology while also giving patients the best possible state-of-the-art care they could find. But I had imagined myself old and experienced by the time I ever touched a vNOTES instrument; instead I've been participating in vNOTES weekly or even more often, right now. I imagined that Urogynecology would be a perfect branch for me to specialise in after a few years, but I've already started pursuing it! All the things I hoped for, and imagined that they might instead slip away as unrealised dreams-- are tangible right now. In a way that I'd never imagined it, in a way that makes me wonder if I'm even doing what I wanted, but it's visible from where I stand; just palpable but slips like sand if I try to grab on. 

Maybe that's just what a fellowship is. 

More than anything in my medical career, I've learnt patience and pain tolerance, in ways I can't explain or justify my self-victimisation when in fact, I'm living the dream of many. 

My mind is constant noise in this new life, and seldom useful- I'm always having to correct the mistakes of my impatience. 

And that, is my next mission. To slow down, to think carefully, to be thorough, to make sure, and to be right before I do something.

Here's to nothing! 

Snapped

Death is not always tragic. Sometimes it's the best possible scenario, when you know a patient has no chances of getting better. If someone in agony is never going to reach their previous normalcy, then there's no point in continuing. 

How many kinds of agony are there?

Physical, which we can see. But what about mental agony? 

I guess, in this country, or in the world, we're never going to treat those two things the same. Is it even true, that depression also sometimes exists in a way that simply cannot be treated? 

Losing a young patient to suicide is not expected in the department of Urogynaecology. Now that, is truly tragic. 

What is this to us? An unsolved puzzle? The loss of a great case report? A lost opportunity to maybe even advance the field? No, it was completely different. 

This was the first patient I'd ever let enter this deep into my life; I had thought of her so many times outside the hospital, over so many months, and prayed for a solution to the mysterious situation that had taken away her life as she knew it. 

The text message that conveyed the ending, was shattering. It would be simply self-serving and pathetic to speak much of the doctors' feelings in this situation - this loss is not ours, though we feel it. There is an empty space in the place where I used to hope for her, so willfully. I can't even imagine what her loved ones are going through. 

This is beyond tragic - An unfinished story of a new mother, a tender mind that had no hope left, or chose not to keep waiting around, a silent, losing battle that probably couldn't be seen or acknowledged by anyone else. A small baby who looks so much like her, probably totally unaware of her loss. 

I feel restless not knowing what I can do to help, not knowing how to make things better from here. The best I can do, is probably say a prayer that the situation bleeds the least possible pain from here onwards, at least. How can anything make it better? 

A person's chapter is never truly finished, not if they live on in the minds of the people that were influenced by them. And I was one of those people, influenced by her soft nature paired with immense strength. No matter what anyone says, I'll still believe that she was strong, and she fought hard, and tried her best, because I know she did. 

Onward and Upward, Always Forward

I once read a story about all the things that come close and whisk away, without ever leaving a whiff of their presence.

Some wondrous, others horrendous; these things that never happen would drive you crazy to know they exist, and that they came right up to your doorstep. Sometimes it's unnerving to think about the events that do occur- it's always just a minute step away from something drastically different. 

Just a single swerve that could have avoided an accident, or just a single habit that could have avoided a deadly disease. Just a mark lower that could lose you the rank, which got you a seat, that led to a job on which your life currently runs. 

And when you break it down further,

You really think about the last decision

And the things that led upto it, that made you do something a certain way; nothing more than a mood swing or a force of habit, sometimes just a whim. Unexplainable, just for the heck of it-- You might have done something out of the norm, that saved you from, or sacrificed you to horrific misery. 

If the weight of these decisions really start weighing in on us, I'm sure we'd spend a large part of life being painfully undecided and confused-- which would be another influencial decision on it's own! 

And probably this is why, you can never ask what if things had been different, because humans aren't creatures with authority big enough to ask, "what if"-- we live here, in the present, in the way it exists now. And every moment that we have something to be grateful for, we better be grateful and humbled for it. And when we are sinking in hot soup, all we can do, is to request, request to all the forces that may or may not exist, more powerful than us, to please lead these chance decisions of ours to a better place than we are on that day. 

The events of the past month have been unforeseen, crazy, and chaotic. But I think I've done a good job at not succumbing to my emotions, at being a rock, and doing what matters- even if I did some of them wrong. Beyond the critical care/operation theatre stands the family, and their place is right there. When the family tries too hard to control medicine, things go wrong. 

I don't know what led a single cell to mutate in a different way, and I don't know why it had to happen- I honestly don't want an answer to that question, because no answer can make me feel better about it. Onward and upward, always forward- this has to be the motto. 

Being Persistent

The past two years have been really humbling; it's been a roller coaster ride. (Mostly downward jolts with a few slow upward turns.) From being the boss where I was, to realising how little I knew about seniority and knowledge itself as an innocent post-graduate, once I got out of that course-- it's been a journey. 

I honestly wish I could share this with the seniors who treated me like I was nothing-- whom I know now, that they were almost equally just nothing. I'd like to think I kept it in mind while dealing with my own juniors. I hope I did that well. 

And most importantly, I'd like to pass on the thought to my juniors- remember that you're nothing, so it doesn't slap you in the face -- to me, it felt like a harsh cold wind on a snowy night whose existence I only found out about when I stepped outside my warm, heated home. You can feel like the queen of your home all you want, but it gives you no edge when you have to step out and survive in the wild. 

I used to think little of people who didn't dare to dream big. Of all the ways life limits us, they impose the very first limitation on themselves - their very own thoughts. 

Around 5 months back, I received a searing realisation, that put my right in my place. 

The need to dance like a monkey on social media for popularity (not just metaphorical).

Marketing, managing, entrepreneuring -- The requirement of skills I never had, and don't know if I can develop now; the lack of which is WHY I was a nerd who studied Medicine, in the first place! 

Nepotism, even in the field of medicine. 

Inevitably, other professionals managing to achieve the dreams I always wanted to, in a much faster way. 

Social media, constantly telling me that my life is NOT "#goals", and I was a fool to ever choose this path for myself.

The threat of corporate targets, to ruin my purpose in it's entirety. 

Need for permission to even touch a patient, or exercise the knowledge I have. 

Realisation that big dreams are for big people; even if they never dreamt of them. They are not for people with no traction or means. 

Being screamed at, feeling likened to a street dog. 

From there, the opportunities seemed meagre and the outlook, grim.  

Honestly when I quit my job, I just wanted a way out of medicine. Being a housewife seemed so attractive (as long as I didn't have to do any house work). 

But just recently, things have changed and I have started to dream again - differently, this time. Slowly. A new job, inspiring people, and some amazing conversations, have made me realise that people can make it, even if they stick to their ethics for an entire lifetime. 

GPDE: Good people DO exist, on the contrary to the words of cynic I knew from school. His ridicule of my goals had motivated me to defy him, by sticking to my path of good. 

But the goals have really changed, from confidence to inquisitiveness, independence to skill-acquisition, seniority to excellence. Impatience to persistence. From the goal of revolutionizing things to just taking it one patient at a time, being the best provider I can for each of them.

Revolutionizing needn't be cancelled; it can be put on hold simply till I find the means. But it's not forgotten. Slowly, up the ladder, one rung at a time. I've been appreciating myself at each step, thanking God, the universe, parents, mentors, my husband, friends and/or whoever else supports me to continue on this path. ❤️

Happiness

I used to think that happiness would come from achieving your dreams; I realised that it could come from learning to settle with and appreciate whatever you managed to accomplish. 

I used to think that happiness would come from winning things; I realised that it comes from enjoying whatever you do, and that's the kind of person that finds victory even in loss. 

I used to think that happiness would come from attaining a certain body weight or figure; I realised that it could come by changing my goals to health instead of beauty. 

I used to think that happiness would come from living at home with the people and comforts I'm used to; I realised that it could come from learning to enjoy my new life, and cooking to music. 

I used to think that happiness would come from a degree of luxury and aesthetics in my surroundings; I realised that it can come from the pleasant breeze from the window of any damp, dark room I'm sitting in, if I can bring my mind to truly experience it. 

I used to think that happiness would come from being with a person who was exactly the way I imagined- someone who could read my mind and entertain my every whim; I realised it can come from appreciating my partner, learning to love his personality just the way it is, and from feeling his love when he doesn't delay giving me the things for which I actually ask. 

I used to think that happiness came from making big things happen; I realised that it's more of a state of mind than a result of external entities. 

It sounds like a clichè, but it is so for a reason. 

Still 30

Getting older; What a vague phenomenon

Does it stand for anything?

Is 30 really a milestone?

A milestone that provokes change?

Or just something that comes and goes

I guess it depends on what you make it

Me? Well, I want to become kinder--

Kind to people around me

With empathy and compassion

A sweet tone- but real, not fake,

Which takes the sincere effort

Of putting myself in the other's shoes.

I want to be the kind of person

That's a substitute for medicine

Whose voice, like honey

And presence, like healing herbs

Can cure.

I want to be kind to my body

Stop overeating as a means

To kill boredom and sadness

Stop drinking and eating the things

That it gets injured by processing.

I want to learn the right way

To take care of these things

And not do whatever was taught to me

And easy because

It's already a formed habit.

I want to give it love, peace

And moderation

Which will help it to help me

For as long as the years are to come.

I want to be kind to my mind;

I want to stop doing the things

That make me hate myself

From guilt and regret

Like speaking (and throwing) things

Out of temper and impatience.

To stop blaming stress

For the lack of creativity

That used to make me love myself;

To realise that

It's actually an addiction--

To a non-living object

That provides endless entertainment

So I never get to (or have to) face

My very own thoughts.

I want to cook with love

Sing with grace

Suture with skill

And be mentally present

For all of these.

I want to be kind

To the passion of my past;

To gather the knowledge

That makes me relevant to the world

And rekindle lost dreams,

And turn them into ambitions,

Plans, and new endeavors. 

30

So I'm 30! I guess I should be upset that I'm not longer in my twenties; on the contrary, I'm really happy to be where I think I belonged all along. 

I'm excited to step away from the peripheries of the limelight and voluntarily sink into the shadows. It's great to be done with the age where I'm supposed to be the centre of attraction, but never was anyway, always creating a sense of failure or of not being good enough. I'm excited to reach the age where what matters is what I do and say and not (as much) how I look. 

I'm excited to be adult enough to not be bogged down by everyone else's expectations, to be mature enough to understand that I can't do everything. Out of those, I will choose my own expectations from myself and strive to achieve them and be satisfied. 

And I'm excited to finally choose myself, to choose comfort and happiness in the way that I want them. I'm excited to be done with high school and college gossips, to be done with the ifs and buts of a relationship and just fix my marriage in stone. I'm excited to try and be a good wife, which is different from trying to be a good girlfriend in the way that it's not for anyone else's eyes except our own. 

I'm excited to be at an age where I'm no longer lost or confused about my identity. I know myself, my strengths and weaknesses, and I don't have to hide them because I'm not ashamed of them anymore. Of course I'm still malleable but I know what comes easy to me and what not. 

I'm excited to work on making myself stronger and more capable, in ways that make my life better and more worth living. To more exercise and antioxidants. I hope it goes well. 

Schemes

Hard not to feel dejected at the sad state of affairs of doctors and medicine in general. Alas, even medicine is held at the mercy of business, marketing, advertising and smart publicity. All the morals and ethics I might have adopted along this 10 year journey seem waste. What was the point of learning to put a patient's needs ahead of my own sleep, nourishment and even bladder needs? It's clear that doctors who practise that way will have empty waiting rooms unless they learn to sell themselves. From 10 years, life was tough but I never hated learning. Now I hate everything that I'm learning; it's making me despise myself as well. What was all this hard work for? What's the use of any hard work I may put in the future? It will never be enough when I don't want to have to acquire the so-called "tricks of the trade". It feels cheap and degrading. 

It was better working in a public hospital and contributing where they really needed it, blaming the government from time to time for paucity of resources, but giving it the best I could. 

I wanted to go back after learning everything I needed to, to give the best of justice to whoever seeks my care, but it seems impossible. In such a highly competitive world, who wants to help or even allow me to learn? 

A few weeks ago, I felt I was at a crossroads with an impossible decision. Now I feel I'm at a dead end. Unable to learn the skills I require to serve the way I want, unable to push forward and become better, unable to fight dirty and get ahead... adult life with no kind of guidance or direction whatsoever. I feel so lost. I really want to leave this profession. 

My needs expand to fill the void

Everytime a new hurdle is taken away 

Never-ending requirements

Never feeling fulfilled 

Happiness is but an illusion; 

Even when it exists, a delusion

Who's to blame? Me? Her? Him? 

What's the point - take them away 

And I'll still be left with this vast sea

Of expectations, demands and sadness

From never having them fulfilled 

This personality itself is work

It's an enormous hurdle I'm unable to cross 

I don't see anything else at fault 

Except me and my own damn self. 

Hatred, loathing I feel in plenty 

From inside me, reflected, diffracted,

To all directions, like a scattered beam 

Towards everyone, everything else

I spread the misery that I live with. 

The nights I spent 

Wishing I were someone else

And the days that went by 

Wishing I never existed at all. 

Depression, disease or a lack of mindfulness

Countless explanations; all excuses

Nothing I say or do can acquit me 

It's me, I'm the culprit 

Take me behind bars, whip me 

Put me on the chair

Pull out the flail, and then a rope...

Nothing is punishment enough

Just end it, end it, end it- I plead, make it stop 

What did I do to deserve this;

To be a criminal with no control 

Over her actions, words and sins 

The life and moods of a Gynaecologist

The life and moods of a gynaecologist are so unpredictable. I can feel super proud for something that went right, though I knew it was my luck that nothing bad happened. And I can beat myself up for days for an unfavorable outcome despite giving it my all. It's hard to be the one holding the reigns to the human body; it cannot be fully tamed. 

What even determines success or failure in a case? The exact same protocol used for two different humans hardly end in similar results. How should anyone predict what would work for whom?

And patients and families expect answers with such pinpoint accuracy. Will the mother be okay? Will the baby be okay? What time will she deliver? How many hours left? How long will the operation take? How many days will it take my infection to reduce? And such details.

We have so many patients in prolonged NBM that whose surgery we keep postponing. But also, we have patients whom we never asked to stay NBM and whose surgeries are so unpredictable that they end up having a risk of aspiration. We counsel a patient for normal delivery and end up rushing them to section ourselves. We counsel them about the risk of oligohydramnios or twins and how many risks those pose to the baby, only to ultimately lose the mother to an AF embolism. We counsel multiparae about PPH and how many blood packets they'll have to keep ready in order to prevent/postpone death, but their uterus ends up retracting perfectly like nobody's business. We counsel patients about the risks and problems of anaemia and instead, they end up having severe, life threatening reactions from the iron we transfuse.

We have guidelines about how a mother's height and a baby's weight during a delivery, but regularly end up doing emergency Caesareans even for tall mothers and small babies.

We think of and prepare for 999 different possible outcomes for a particular mother, yet sometimes, we're surprised by the 1000th one.

For decades we've been reading endlessly about how to 'doctor' correctly, and still can't answer any of your questions with absolute certainty. Let me be honest, this field instills deep rooted fear in me, that I'm sure I have in common with most doctors who have enough experience to share this apprehension.

After all the years of book reading, and information collection, all I can really say is what's most likely to happen or not, and there's no way I can predict whether any single patient falls into the norm, the predictable subset, or falls way outside of it and behaves differently due to some chance events. The body reacts to situations and medicines however it feels, and there's only so much we can do to alter it. All the information we have is really just a careful observation of many, many patterns-- that gives us an illusion of control. 

And with this illusion of control, we manage to do a better job than any lay person would in our place, which is all that gives us the authority to impart advice and sometimes call the shots. 

But hearing that a patient thinks of me as a God? This is another thing I fear deeply; none of us are God and we don't aspire to be. We don't even want to hear that; that's too big an expectation placed on our perfectly human sized heads. Please don't crush us with it. We're just another flawed entity of God's creation, trying our best to fix the physical flaws/prevent possible flaws in others. 

Normal delivery or a Caesarean?

The decision between a normal delivery and caesarean is much more complex than for what it's given credit. 

A normal delivery is the natural way to go. It ends in a healthier mom and baby when everything goes right. And usually everything does go right. 

But when it goes wrong, boy does it go wrong. When we see complicated normal deliveries, it feels much worse than a simple caesarean section. When things have been pushed too far to deliver normally, things get way, way worse than they should. 

I won't speak about the different ways things can go bad, but it at such times, it always feels like the situation would be much better if a Caesarean was simply done.

Some moms end up with two cuts- an episiotomy given as a result of persistent efforts towards a normal delivery-- and a lower transverse abdominal scar given as a result of the ultimate inevitable fate, a Caesarean section.

So why not opt for a Caesarean to begin with? 

Because Caesareans cause a multitude of ill effects and you're sure to have at least a couple of them. Your odds are better trying for something more natural and having surgery as only an option to fall back upon- IF NECESSARY. 

There's no advantage in directly opting for a surgery as it seems "easier", because will definitely have ever-lasting effects on your body. Most of the worst disadvantages of a Caesarean creep up on you only after a few days, weeks, months or years. 

So how do you choose between the two? This is a very complicated decision that will (and should) keep changing based on factors like the other medical illnesses you have, how old you are, how tall you are, how spacious your pelvis feels, how big your baby is, how your body responds to medications given for inducing labour, how the baby's heart beat responds to labour itself -- and so many more. The best thing I can tell you to do is find a ObGyn that you trust and follow their advice. Pregnancy itself is a very dynamic and high risk condition. Labour can bring so, so many surprises or go wrong in so many ways. And everything that does, usually goes wrong in just a few seconds or minutes.

But be assured-- nothing usually goes wrong, so don't worry. Most of these things that can go wrong will be recognised at a very early stage and managed by your ObGyn pretty quick.

 

Keep an open mind. Be flexible with your decision and don't get disappointed no matter what happens. A healthy baby and healthy mother are more important than the means you take to get them. And once you have that, be grateful for how lucky you are.

My body

I watched a video about China's insane beauty standards and how it's causing an uprise in eating disorders all over the country. It was an amalgamation of different people's experiences. What was great was the video also included one positive experience of a healthy-looking girl who just lost enough weight through diet and exercise that she's happy with her body now. 

I love the middle ground here. Where everything is accepted, and above all, what's accepted is the right to one's own comfort. 

I wouldn't say I've had serious problems on this front, but yes, the shape and size of my body has made me thoroughly uncomfortable on several occasions. Getting called out for it is always very traumatic for me. 

But you know what? That's because I'm not in possession of the body with which I'm comfortable. And the fault lies within me. If I was an even slightly overweight gym instructor or zumba teacher who didn't have any comorbs, I don't think I would even think twice about a self-absorbed uncle that asked me to "Walk. No, run, run a lot". I'd know I'm doing my best and I'm healthy, if not living upto insane beauty standards. 

Luckily I'm not at the impressionable age nor do I care enough that I would develop an eating disorder; but I do eat my feelings. And it's time to stop using "all body types should be accepted" as an excuse to give into my gluttony. 

Fit, healthy, comfortable and happy- that's the goal. 

Stop To Smell The Roses

It's odd to be the one writing this, because generally I would have been the one needing to hear it. But the past 2 months have found me happier than ever and maybe this is the reason why. 

I'm stopping to smell the roses-- such a cliché, right? 

Most of my circle, we're all high powered, driven people. We wanted to do something that matters. Being a doctor was the obvious choice, so we studied hard to become one, and we studied hard to specialise. And once we gave it a good 10 years, we were hit in the face by a dead end. The cold, dry realisation that being a doctor isn't worth the God-complex you imagined you'd have. It's just a job, like any other employee at our age, but with a lot more working hours and much worse pay. The struggle never ends; we aren't helping struggling patients anymore, in fact, we're the ones struggling to find any patients. There's actually enough of us, we aren't precious to our country anymore, we worked hard to reach here, but the next guy to take our seat would have done just the same that what we do now. 

The dream to live a life beyond normal seems bleak now. This doesn't seem to be the way to create a change anymore, it's a world full of doctor-haters and patients completely sceptical to your advice. The same people who would listen and simply believe an RMP, a relative, or a baseless article on the internet won't believe you as easily. 

Ten or more years of medical education seem pointless, the decision seems misguided once we realise everything isn't what they seem to be. The 'dark underbelly' of medicine is just ugly. 

Damn. 

Beyond this existential crisis, I believe there lies a different way to look at this unexpected turn our lives have taken. 

How many of us actually enjoy being with our patient? Do we see our knowledge and expertise come in handy at the right time to them, and appreciate ourselves for it? This appreciation isn't something we can expect from anybody else. 

In today's cut-throat competition between us all, it's a given that we're all competent-- if we want to be. Our demeanour, tone, and manner of speaking is everything. The profession of a clinician has it's roots in empathy, and I genuinely believe that's the only thing that can set us apart. The way you handle a bad situation, the percentage of yourself and your feelings that you allow to get involved in your work-- these things matter. 

Do you stop to smell the roses? 

Do you play with the babies you deliver? Do you take a moment to assimilate the difference between before and after a patient comes to you? 

Also--

Do you ask about your patients' story? Do you know their life beyond their medical history? Do you know their problem, and not just their presenting complaint? Do you let them confide in you? Do you go to work to do a more sincere job than the next person in your place would have done? Do you spend time to cross check if everything is done? Do you slow down, to learn it the right way? Do you study for the day that this Information will enrich someone else's life? Do you take the extra step to do good for someone else? Is your work, beyond work? 

I guess we've reached a point of change in society, where we have no choice but to do our job for us. To go to bed at night knowing that we did something that makes us happy and nobody else. To know that we had a chance to stop to smell the roses, and they smelled absolutely wonderful. 

To you, from the Arctic

I'm writing from 250 kilometres north of the Arctic circle -- Santa's own home. 

A few years back, I looked at a picture of Kakslauttenen arctic resort and their glass igloos and hoped that sometime in life, I would be able to stay there. To lie on a hotel bed while Aurora borealis did it's thing outside my ceiling was a dream. And having Saurav on the bed next to me was a part of that dream. It was him who first told me what the Northern Lights are, and how he wants to see them with me. I don't know which part of the past month is more surreal-- we got married, and it was a beautiful couple of ceremonies. I stayed with him and his parents for over a week and got to know my new, wonderful family. And then we came to Finland for our honeymoon. This is definitely a changeover from the past 20 years when Hyderabad was the only thing that was real to me. 

Ivalo is so picturesque that it feels like I'm watching a beautiful movie on a screen, until I step outside the indoors into the biting cold of -14 degrees Celsius.  

I'm looking around right now and realising JUST HOW LUCKY I AM, from inside and out of the very same igloo that was once just a dream. 

Really, anything is possible. 

A Happy Change

My life changed again today, with a profound epiphany. 

It changed once a few years back when I realised that everything I do gets evaluated by others; that when I dance, people characterise it as good or bad, and when I sing, people think of it as off-tune or a worse version of the original song. Why do I have to constantly strive to keep my shortcomings private, never to ever be exposed? 

Why can't I just drive, without being told that I'm a "typical woman driver"? And why can't I enjoy warm sunlight on a cool day without being told that it'll make me even darker? Why can't I go out without being conscious of my faulty figure, my small eyes and my bald spots? Why can't I just smile as much as I want, without being told that it's "too much"? I'm happy, dang it. 

Why do I have to keep up with the trend, instead of wearing what makes me comfortable? Why can't I just be left to my own personal style?

Why can't I just love me for being me? 

Why do I have to give up my lifelong dream, just because I'm afraid of being judged for a conservative lifestyle? Why do I have to be scared of not being able to post glamorously on Instagram? Happiness means different things to different people; why can't I be left without judgement for my idea of it? 

Just today I realised, once again, with previously missing pointedness-- that most people don't care. I'm free to do as I like! 

Every person is so busy with their own life and their own insecurities that they don't have time to create new ones for me. In fact if anyone does that, it's only a reflection of how overwhelmed they are by their own insecurities -- and judgement by such characters doesn't bother me at all, not in the least. 

If I'm really turning into a comic piece, so be it! I love making people laugh. I'm getting myself one step closer to the gift of acceptance. Removing the weight of everyone else's (possible) judgements has made me feel so much lighter. 

Better Than the Strain Within

I forgot what it used to feel like 

To lie in peace 

To enjoy each task

To sing while I drive 

And dance in the shower 

To watch a program 

Or make something pretty 

Without any reason. 

Endless activity around me

Each activity causes a diversion 

A diversion of thought 

Each thought carries weight 

Together, it adds up

To the weight of the world on my shoulders 

From the shoulders I'm bogged down 

Hanging now only by a thread 

With unspeakable tension in it 

Oh, when will the thread break 

That seems like a better scenario 

That tolerating the strain within 

Kakatiya Medical College, Warangal.

My institute is in the news for all the wrong reasons. It makes me feel as though public doesn't understand the medical profession. It's probably since we're a closed community. I have explained at least a dozen times to my family that a "night duty" lasts for 36 hours, from a  morning to the next evening. Yet they still assume that it means a night shift, probably a maximum of lasting 12 hours. 

Is it so hard to fathom? Over 3 years into it, I can't believe that it's unimaginable for many. 

Being a doctor isn't just a profession like any other; it's a way of life. You can't eat as often as you'd like, you often have to hold in your "nature calls" until you have a suitable time to attend to them. This isn't confined to any single person. We as a group don't live our life as impulsively as the general population, because a practising doctor knows what's at stake if he doesn't do his job properly; when the situation demands it, we voluntarily give up our lunch in favour of a critical patient and don't consider it a big deal because that's how we would want our loved ones, or even ourselves to be treated if needed. 

We understand that our right to basic necessities aren't before another person's right to live and be healthy. We don't bestow health upon those who don't have it as if we are Gods. We do whatever best we can as humans, knowing the weight of our actions is much heavier to the patient than to us. 

We don't get maternity or marriage "leaves", we replace our duties with others who are willing to compensate for our work and take our patients under their wing, and we do the same even when we're sick. Even if I had an accident and was seriously injured on the way to my duty, as long as I was conscious I would try my best to convey to my hospital that someone would have to cover my shift for me. Whatever reason I don't turn up for, my absence means a lack of hands resulting in suboptimal patient care and possibly loss of life. And that has priority in my mind. 

This culture is understood amongst those already habituated to the profession, but newbies take some time to grasp the significance of what they're doing and how much of their lifestyle the job demands.

We don't leave early without a replacement. We've all done many-a-duty abusing painkillers, and delaying our check-ups to our doctors in the ways we tell patients not to. And I personally hold no one responsible for this except myself, who chose this profession over everything else. 

All of us have been scolded by our seniors and at the same time they've taught us what we need to learn to earn a living for the rest of our lives. Being scolded by a well wishing senior is far better than having a lawsuit against me one day for lack of proper training. Even worse, it's better than losing or harming the lives that were meant to be treated better by a person with my degree. 

We get trained for the hardships to come during the first year, and a good senior trains his/her juniors to be sincere and efficient during their first year of post-graduation. 

This first year on the job is when we work the hardest, learn the most and push our limits to make better doctors out of ourselves. This year makes us feel tortured, pained and stressed. It's the year we idly contemplate suicide as the easiest way out of this spiral we're now stuck in forever.

It always feels like we're singled out in this. But when we interact with others, we often find that we are in the same boat together with our peers. And when we hold out, we get to be a part of what I regard as the best profession in the world. 

It's worth it, for the feeling we get when we resuscitate our first patient, deliver our first healthy baby, conduct our first painless surgery; the achievement differs according to the specialisation. For the first heartfelt "thank you" for which you're responsible. I'm deeply saddened to know that a young soul didn't make it far enough to feel those amazing things. 

Maybe there are inherent flaws in our system. Maybe there is a lot to learn from foreign countries where training from MBBS to residency takes much longer than the 10 years it takes here. Maybe there is much more to be done for more even distribution of stress management over the years, standardisation of treatment protocols, and legalisation of a proper pecking order within the profession.  

We mustn't normalise illegal hierarchy, or ragging, or harassment. Then also, we shouldn't normalise the high expectations we have from our doctors to be Gods and give us everything we want when we demand it. We shouldn't normalise how severely understaffed we are and how junior doctors do many things they aren't meant to do. We shouldn't normalise young doctors working themselves to the point of hospitalisation. When a terminal patient is brought in and subsequently dies, we shouldn't normalise the relatives beating the doctor to death. Where's the news coverage on all these? Very rarely do we feel justice in our lives. So we train hard, to make our bodies work in overdrive so that we don't go wrong, even where normal humans would usually go wrong. 

The weight of this training can't be called as "ragging". And the blame definitely cannot be borne by a single person. 

Today I'm writing about something that's been deeply affecting me over the past few months; something I struggle with on a daily basis, I have to keep reminding myself that the path I'm on is the exact one on which I want to be. 

As an adult who lived in the US as a kid, I always had dreams that didn't involve going back out of the country. My life's experiences taught me otherwise, that true solace is inside, that aesthetics and glamour doesn't provide true happiness, and life is nothing if you don't seek true happiness. 

From the point of my mental maturity, I surrounded myself with the same kind of people, who believed in genuine closeness over pretention, and I believed that they were my constants.

One by one, and then another; each of these people have only left me behind, leaving this so-called path of true happiness, to choose luxury, affluence and beauty over their old life, the one we'd shared together. 

I try to tell myself that I haven't strewn, and that there's nothing sad about a NRI girl returning to a thriftily designed school, a strict and grimy junior college that gets you where you need to go, a undergrad school with all of the matter and none of the frivolity, ultimately to land in a tier-2 "city", for her post-graduation, a place that's changed her nature enough that no person from her past circumstance seems relatable anymore. 

I try to tell myself that a good night's sleep is more important than an attention-catching Instagram page. 

I try to tell myself that the touchy-feely events of each day, each human interaction that I worked this hard for, and each patient that I benefit are worth all the trouble and sacrifice. 

I try to tell myself that vernacular fluency and enjoying folk songs are never a bad thing, that these things are only bringing me closer to my ultimate goal. 

But how long can I hold out? 

The shiny offices, beautiful canyons, short clothes, toned bodies, wine glasses and skyscrapers are starting to look good now. 

Suffering

Suffering is the perfect word to describe your life, thathagaru. It was what you had through most of it. Come what may, the God you believed in so unwitheringly saw to it that you kept suffering. You're the one who taught us discipline, showed us that one can uphold their principles above all else, and stick to their rules despite the worst of unfavourable circumstances and constantly failing health. Even after retirement, you had discipline that none of us could match even as students. You never hesitated to take on the role of a strict grandpa to ensure that we all did what we were supposed to do. Nevertheless, sitting next to you and listening to your stories galore made some of my favourite childhood memories. Every story always had a moral, the very reason you narrated it to us. Your hard and fast rules are etched deep into my mind and form some of the mantras by which I live. Your legendary irrational temper was always non-existent when it came to your granddaughters. The wet kisses on my forehead in your last days are memories I'll treasure forever. You always wore your heart on your sleeve. Quick to cry, easily enraged, fast to apologise and love again; you and grandma are the pioneers of open-minded, forward thinking in our family, and whoever you were played a part in shaping us into who we are today. You never gave up on your duties despite the worst of health; your enormous sacrifices and never-ending commitment to education-- yours, your sons' and all your granddaughters' -- is probably the sole reason all of us chased our dreams and are where we are today. For that, there's no amount of gratitude that'll ever be enough. 

I'm glad to finally see you at peace. I don't want to mourn your death; I want to celebrate your life by living the way you taught us to. Sorry for the disappointment, thathagaru, and since you believed there is one, better luck for the next time.

Life -- is it fair?

Not to complain that mine isn't blessed, but is it fair to have life imposed on us from before we are born? Is it fair that this choice of seventy or eighty years (if I'm optimistic) is made for us? With modern medicine, it's much longer than that. 

The planet does not benefit from our procreation. Continuing the lineage of this overly evolved species isn't a favour to anyone else. And don't even get me started on attempts at continuation of one's own family name (dynasty?!) or efforts to increase numbers of a particular religion/group. Boy, am I glad that I don't carry the weight of that. 

Where's the question of the importance of something so frivolous, when I'm questioning the importance of mankind's existence in the first place? Am I the only one who sees the futility of these efforts? Yes, each activity is an effort-- having to deal with heart break, rejection, sickness, handicap, loss, giving exams, securing a university education, and even banal things like climbing a flight of stairs, sometimes, just getting out of bed; each of these things is painful at the least. Sometimes it feels like the pain might just kill me-- oh, but only if it were so easy.

Why would I want to recreate this for someone I'm supposed to love and nurture? 

The best way to nurture that entity is to make sure I never bring it to this endless pain which we call life and constantly assert that it's something for which to be grateful. 

Birth is a choice, the choice of the one giving birth. And I reserve the right to choose. I only wish that I could convince others of the same.