Archive for June, 2012

Several feet under, a few tired feet up at mid-day

26 June 2012

As the world zooms around them, seemingly unaware and unmindful of their sweat and toil, workers of the Namma Metro project catch a breath at their worksite at the Kempe Gowda bus station in Bangalore on Tuesday.

Photograph: Karnataka Photo News

Also view: The complete Namma Metro photo portfolio

Will an Ilayaraja song open London Olympics?

26 June 2012

Naanthaan ungappanda (Tamil for I am your father), a song composed by Ilayaraja for the 1981 Kamal Haasan film Ram Laxman, and sung by S.P. Balasubramanyam, is reported to be part of the playlist for the opening ceremony of the 2012 London Olympics, being directed by Slumdog Millionaire director Danny Boyle.

Boyle has recreated a London countryside for the opening ceremony and Ilayaraja’s number is said to be based on a folk number. Boyle had gone with A.R. Rahman for the Oscar-sweeeping film Slumdog, whose signature track Jai Ho was sung by the Mysorean, Vijay Prakash.

Read the full article: Ilayaraja opening for London 2012
Also read: And oh! we forgot the actress from the Punjab

This one—and four hundred and ninety nine more

25 June 2012

Five-hundred doesn’t seem like much of a number in an age when the chors talk in crores. But when it is 500 fullgrown trees that will have to make way, this time for the metro project near the Bangalore railway station, you wonder. And wonder.

Photograph: Karnataka Photo News

Also read: How to kill a City in 53 easy steps

Where only a low angle can convey its girth

“A city whose soul has been clinically removed”

CHURUMURI POLL: Who killed Bangalore?

German visionary behind our vanishing beauties

The case against Aamir Khan’s view of doctors—II

22 June 2012

K. JAVEED NAYEEM writes: After Aamir Khan stirred up a hornet’s nest with his show about the misdeeds of doctors, I seem to have done the same with my article, which some people have seen as a defensive act from a member of the medical fraternity.

I have received many letters from viewers of the show and my readers too who have vented out their gall at the heart-rending sorrow of the victims and my audacity in protecting the image of the doctors supposedly responsible for it.

Apart from the two cases I discussed last week, many have challenged me to disprove him on the other counts where he has revealed many more misdeeds of doctors. I certainly will do so in full measure before I pull the curtain down on this matter, which I do not intend to do in a hurry.

I stepped in just because I felt that in showing what certainly seemed to be the main issue of that episode, Aamir Khan certainly picked on two very wrong cases to prove his point about all that has gone wrong with the practice of medicine in our country.

***

Yes, medical practice is no longer as sacrosanct as it once was and there is a lot that needs to be set right if it has to serve the needs of suffering humanity.

While someone attempts this, I would like to remind society here that a lot needs to be set right if medical practice has to serve the needs of practising doctors too.

If only Aamir Khan had done a little bit of research to locate some real cases of medical malpractice or negligence and ferreted out the real incriminating evidence behind them, before presenting them before his audience, he would have done some real service to society.

Moreover, instead of just presenting one version of what happened it would have been most appropriate and fair to all concerned if he had simultaneously or immediately after, given a chance for the doctors or the hospital managements to present their defence.

This would have made it more interesting and lent the utmost credibility not only to his show but also to his image and intentions. Of what use is any re-buttal if it has to be done through some other source or on some other platform? Even now, it is not too late for him to arrange this in one of the forthcoming episodes and I hope he does it.

***

Coming to his accusation that most doctors prescribe only expensive, branded drugs even when much cheaper generic alternatives are easily available, I would like to set the facts right here. It is true that for every branded drug there are at least a hundred cheaper versions readily available in Indian market.

This is thanks to our government’s policy of allowing anyone with a little money to ‘buy’ a drug manufacturing licence and start making a killing. Beyond this shred of paper that ensures complete legal immunity no other infrastructure whatsoever is necessary to set up a drug manufacturing plant in a tin-roofed shed, located in a seedy bylane and ply this lucrative trade.

Most such drugs do not have any drug inside. So, what goes into these tablets, capsules or tonics? They contain either plain chalk powder, sawdust or sweetened and coloured water.

If this seems like an exaggeration, why do we regularly have incidents in our country of spurious and sub-standard drugs and even vaccines killing the people who happen to receive them?

Why do the drugs dispensed by our government hospitals fail to bring down the high fever that bends the bodies of the poor patients who go there, while the same drug prescribed by the very same government doctor but dispensed by the private chemist across the road quickly puts them back on their feet?

One of my former professors at the Mysore Medical College who valued his integrity and honesty more than the instant material wealth it would have brought him, refused a promotion and returned from an administrative posting when he was pestered by spurious drug manufacturers to accept huge bribes and clear their pending applications.

He chose to remain in his almost non-paying teaching job, preferring to sleep on a pillow of a clear conscience rather than on a bed of currency notes. Today, without exception whatsoever, every one in the city respects him as the best example and embodiment of the rare qualities that one seeks in a doctor.

And, for this uprightness, he also happens to be one of my guiding beacons and I turn to him for the right counsel whenever I am faced with a professional problem or a moral dilemma.

***

The companies that manufacture branded versions of drugs have a reputation and a track record to protect and they will therefore get periodic quality checks done by authorised agencies to uphold the set standards.

In this respect, many reputed Indian companies and multinational manufacturing giants who have invested much money into research and development naturally keep the prices of their products a little high. This is understandably inevitable and we have to accept the fact that quality can come only at a cost.

It has now become a fashion to simply blame multinationals for all our problems.

Yes, multinationals may be exploiting us with their expensive products and in doing so they may even qualify to be called anti-nationals but at least they give us safe and effective drugs. If your doctor insists on your buying a particular brand of medicine, it is often because he or she has established faith in it.

On the other hand, if you end up buying a generic drug whose manufacturer is unknown and whose quality can therefore never be ensured, with what confidence can he or she treat you?

People may accuse doctors of yielding to the enticement and pressure of pharma companies but that is not the whole truth. If only generic drugs are permitted to be sold in the country as some people wish, the profit margins to the sellers, instead of the quality of the drug, will decide what the patients get.

I would prefer to give up practising medicine altogether if I have to do so without any control over what my patients get as medicine.

That is why all my prescriptions carry a line in small print at the bottom that says: “Responsibility for this prescription ceases if drugs are substituted, redispensed or sold without a valid bill.”

***

Aamir Khan while talking on the show and also before a Parliamentary Standing Committee yesterday about the need to promote generic drugs to keep treatment costs low should have taken a little trouble to ascertain the sources of drugs dispensed at most of the government hospitals across the country today.

As far as I know, we should be surprised if any of these drugs happen to be from any of the top 20 trust-worthy drug-manufacturing companies, which are operating in India. This is thanks to corrupt officials and politicians who rule the roost.

It is an open secret that heavy bribes have to be paid at every stage, to get oneself on the list of drug suppliers to the government healthcare sector and also to get tenders passed from time to time.

Therefore, it is no surprise that as each bureaucratic milestone is painfully crossed, the quantity of the real drug in the formulation naturally keeps decreasing until only the chalk powder, the sawdust and the sugar-water that I talked about, manage to reach the final destination!

***

Common sense should tell us that good drugs that really work, can only come from good companies that can get the prices that do justice to their quality control and good manufacturing practices.

In our country, all the good intentions of a doctor who insists on any particular brand of the prescribed drug can be derailed by many agencies.

With the already prevalent suspicion in most patients’ minds, just a whisper that the doctor is on the payroll or patronage of a drug company, from one dishonest chemist who wants to sell a brand that pays him more, is enough to convert doubt into conviction.

Patients must understand the fact that the best advertisement for any doctor’s capability is the efficacy of his or her treatment and in this respect, no doctor will endanger his reputation by prescribing a drug of doubtful quality simply to get a cut from any pharma company, as alleged on Aamir Khan’s show.

The great Khan further talked of needless lab tests that doctors order just to get commissions from labs who in turn recover these expenses by issuing reports without actually doing the tests.

While I do agree that most labs these days pay cuts to beat competition and stay in business, I do not think any decent medical lab would issue reports without performing the tests. If this practice exists, it is only at the slimy bottom of medical practice where the most unethical practitioners of the art operate and it is no index of the integrity and honesty of doctors in general.

But when something as ugly as selective female foeticide does exist in our country, and since some medical doctors have been found guilty of it, we cannot completely deny the existence of these ‘unperformed tests’.

***

Since doctors too have now been brought under the purview of the consumer protection act, litigation has become easy and cost-free for any disgruntled patient. Patients can now file cases against doctors at the drop of a hat over the most frivolous issues and doctors who used to spend their leisure hours unwinding in tennis courts, are now forced to spend much time and money in standing and defending themselves in law courts.

Very often, they have to be at the receiving end of adverse and financially burdensome judgements, as they cannot prove the correctness of their actions on the strength of paper records and reports.

Because courts go only by material evidence while deciding cases, doctors now to indemnify themselves against litigation are forced to order a plethora of lab tests and also go in for higher and higher malpractice insurance. Naturally, unknown to them, it is the patients themselves who end up paying the cost of these tests and the premiums for these insurance policies.

The commissions paid by labs are just a side effect of this sad development and they are actually not the main cause for the unnecessary tests, which now have to be accepted as quite justified, considering the present scenario. The labs have to resort to this unethical practice because they have to stay in business and recover their investments after paying the steep interest on their bank loans.

Today, it is no surprise that more than 75 per cent of the wide array of lab tests that doctors order, is what the consumer protection act has forced on them. The moment this act came into the scene, the sanctity of the relationship between the patient and the doctor that existed over the years died forever.

With just one stroke of the law-making pen, the sacred Vaidya of the age-old Indian shloka: ‘Vaidyo Narayana Hari‘ was unceremoniously tossed out of the hospital window.

Now, like how it happens in a Shakespearean tragedy, the scene has changed completely and the patient is only an aggressive consumer and the doctor only a very defensive service provider.

You may argue here that not all patients are aggressive and vindictive. But how are we to decide who the good ones and bad ones are, beforehand?

***

In this cat-and-mouse game, Dr Jekyll can become Mr Hyde and vise versa, without warning.

We doctors regularly see not just really aggrieved and wronged patients turning to the courts but also those who did not like the outcome of their treatment. There are records of people having gone to court with false charges simply because hospital bills were not waived off or reduced as requested by them.

I know of many patients who attribute all that befalls them later to the ‘wrong’ treatment that they once received at some hospital.

Similarly, I routinely encounter women who blame the tubectomy operation they underwent decades ago for all the aches, pains, coughs, colds and cancers that they now suffer from.

I have once seen the inside of a consumer court as an expert witness and I did not find it a very comforting or friendly place. While watching the proceedings, I noticed charges being traded left and right by litigants, like paper missiles, without any regard to the wisdom enshrined in any textbook, either medical or legal.

Now I do not intend to revisit the place, especially as a defendant.

What I am going to say here may shock you but even I am guilty of ordering some ‘unnecessary’ lab tests sometimes in my practice. However, these lab tests are only unnecessary from the point of view that if I am fully honest, I really do not need their help to make a diagnosis, which is where all lab tests are meant to help us.

I order these often expensive tests only to keep myself and my practice safe from any medical malpractice litigation. Very often, even where I find the diagnosis staring at me in my face, I never proceed to announce it or treat the condition before I get the verdict straight from the horse’s mouth.

And, here my helpful horse is the friendly neighbourhood diagnostic lab, which is naturally a pretty expensive horse to boot because of all the expensive equipment it bears on its back.

In the event of the need to treat some poor patients, which I do quite often in my practice, I ask the patients’ relatives to simply sign an undertaking that they cannot afford the cost of the recommended tests and are therefore willing to go by my clinical diagnosis.

I then quickly keep this precious document in my bank locker, which I have hired just for this purpose!

For me these uninvestigated cases are the most comforting ones to treat, as they, while making me feel like a real doctor from the good old times, do not impose a strain on my conscience.

Coming to the really pathetic portrayal on Aamir Khan’s show of the plight of women from Andhra Pradesh who seem to have been subjected en masse to needless hysterectomies or removal of the uterus, I am almost certain that this must have been some kind of an insurance racket involving unscrupulous middlemen and it needs to be investigated fully. All those found guilty, including the doctors if any, should receive the most deterrent punishment.

These days whenever patients get themselves some kind of medical insurance, agencies which would have sold them the policy, often prevail upon them to make the best use of the cover before its term expires. They do this to make the insured persons feel that investing on the policy was a worthwhile expenditure because it helped them to get treated for some ailment, real or imaginary.

While most of us would be happy not to have needed our medical insurance cover, many people especially from the lower strata of society, feel cheated if they have to get it renewed year after year without putting its benefits to any use.

I regularly come across many patients who are desperately impatient to put their medical insurance to some use and it is often a difficult task to dissuade them from doing so.

Very recently, a lady came to my clinic with a medical insurance policy for Rs. 1,000, which she had received as a compliment for buying a crate of dish-washing soap. Under its cover, she wanted me to certify that she was under my treatment for which she was willing to share 50 per cent of the amount with me.

When I did not oblige she went away complaining that I was so unhelpful in getting her what was legitimately her due under the policy. She would perhaps have even felt that I stood my ground only because the miserable incentive was not large enough to make me abandon my principles!

***

Aamir Khan should understand and accept the fact that the medical fraternity he is lampooning on his show is guided and governed by many complex issues that deal with life’s most complex and elusive problems.

Practising medicine is more of an art than a science, where two identical problems often do not respond identically despite identical lines of treatment. When it comes to medicine, he is after all only a layman and medicine certainly is not his cup of tea like how it is mine! I wish his attention now shifts to something he understands better.

For instance, the black money that keeps the projector wheels turning or the close liaison between the film industry and the underworld. But that takes the kind of courage that this kind of Khan perhaps does not have in him.

(K. Javeed Nayeem is a practising physician who writes a weekly column in Star of Mysore, where this piece appeared over two weeks)

Also read: An open letter to Aamir Khan from a Kannadiga

CHURUMURI POLL: Aamir Khan vs doctors?

The half-truths of Aamir Khan, the truth fountain

What’s wrong if Aamir Khan exposes ‘butchers’?

Is P.C. Sorcar building the Sky Wheel in Mysore?

18 June 2012

 

VIKRAM MUTHANNA writes: I read in the news that Mysore will be the third city in the world, yes in the world, to get a ‘Sky Wheel,’ a super-sized giant wheel. There are supposedly only two other cities in the world that have this—Singapore has the ‘Singapore Flyer’ and London has the ‘London Eye.’ However, there is one also at Niagara Falls.

Well, soon we too will have a very creatively named ‘Mysore Eye.’

The very thought of how high it would be made me giddy, and it wasn’t just that, but how inconceivable an idea it was.

Then I continued to read the news report. It said that it would be completed under Rs 30 crore.

Oh! I started feeling a little shaky and wobbly now, then even more good news—it will be completed in four months. That’s it. I collapsed with laughter.

We have just gotten over the high of getting a bullet train and now this Mysore Eye literally will take us high.

Who is kidding whom here?

The Mysore Eye supposedly will have air-conditioned cabins that will fit four people and as the wheel rotates slowly the foursome can enjoy the panoramic view of the city’s places of tourist interest, upto a radius of 20 kms.

One official said, “We will be able to see Ranganathittu bird sanctuary, Srirangapatna, KRS, Chamundi Hill, Mysore Palace, Chamarajendra Zoological Gardens and Karanji Lake.”

Great, wonderful but wait a minute, can’t we get an aerial view of all these from Chamundi Hill itself?

Can they build a giant wheel taller than the Chamundi Hill?

It is baffling as to why a small city like Mysore, which has a beautiful hill within the City limits, needs to have a giant wheel to view the city? London has the London Eye as it has many grander heritage buildings and modern architectural wonders that can be viewed and enjoyed better from a high point.

And since in London and Singapore — unlike in New York which has high rise buildings like the Empire State building which the public can access to view the city skyline — there is no such high rise building that the public can access and also the fact that there is no high ground within these cities from where one can view the city, the London Eye and Singapore Flyer serve this purpose.

But Mysore has a hill at its heart which is bigger, better and safer than a super-sized giant wheel built in a hurry. If anyone wants to have an aerial view, they simply have to drive up Chamundi Hill and it’s free, unlike the Rs 500-600 they will be charged for sitting in the Mysore Eye.

Also, tourists who come to Mysore visit Chamundi Hill anyway. So why will they pay extra money to see the same aerial view?

Now about the cost. First off, the London Eye was a private venture; it is owned by Merlin Entertainments group and they pay a substantial rent to the government, which goes to the London city coffers. But our Mysore Eye is a government venture, paid for by the taxpayers’ money and to be built by Innovative Studio Pvt. Ltd.

To build London Eye it cost Rs 640 crore, the Singapore Flyer cost Rs 720 crore. Now we want to know how is it that our officials are going to build something on the same lines, something world class, with just Rs 30 crore.

Then there is the time issue. The London Eye took two years to build, the Singapore Flyer a good three years; but our men are going to finish it in four months. Wow! Our officials are going to build what took two efficient nations around three years and over Rs 700 crores in just four months and with just Rs. 30 crore.

It makes us wonder if magician P.C. Sorcar is the contractor.

Either that or we are getting a Mysore Eye that is nothing like the London Eye they say it will be like.

So, like the other two, will our fancy giant wheel also run into cost over-runs and remain incomplete — like the aquarium, like the ring road, like the broadgauge, like the Raja Marga amongst other delayed projects? When it comes to project management, we have heard of the concept: under-promise and over-deliver.

But it seems when our officials get into project management, their concept is: over-promise and never-deliver.

Then the safety issue. When you hurry, you have reasons to worry. We have to ask how safe will a sophisticated feat of engineering with high technology inputs be when it’s built in a short time and with a tight budget?

In a country like Singapore itself, the super-sized giant wheel has been stopped a few times. Notably once for over six hours when the wheel stopped moving and 173 people were trapped. Some of them had to be rescued using slings and ropes. Are we ready with the rescue plan?

It is said that this project has been in planning for three years. Really? It took them three years to come up with a giant wheel but they need only four months to build it? And in three years the best name they could come up with was ‘Mysore Eye’ after ‘London Eye’?

This seems like a project conceived in a hurry so it could be made part of the Global Investors’ Meet-2012.

Also if it is so viable, why didn’t Innovative Studios present the project to the government to build it themselves with their own money, pay the Karnataka Exhibition Authority (KEA) rent and make money on ticket sales like London Eye? This questions Mysore Eye’s financial viability.

Instead of investing in a non-viable giant wheel, may be it would be better if the government creates a spacious viewing area upon Chamundi Hill with reasonably priced tickets, which also houses coin binoculars and clean toilets. It will cost much less, will be much safer and the visual range, we are sure, will be longer than a giant wheel.

Oh, Lord! How much more misguided ‘good news’ can we Mysoreans handle? Let the Karnataka Exhibition Authority first increase the number of toilets and keep them clean at the Exhibition Grounds. Let them increase the security and protect the women from eve-teasers in the Exhibition. Let them organise and make transparent the tendering process first and then they can talk about ‘Mysore Eye.’

Until then, which we are sure will be a long time to come, the KEA can be rest assured that there is nothing better than our god-given Mysore Eye — the Chamundi Hill.

Photograph: Kingfisher flight IT2404 landing in Mysore, with the Chamundi Hills in the backdrop, on its inaugural journey in October 2010 (Karnataka Photo News)

Also read: Who wants a 4-lane road to Chamundi hills?

Who the hell wants a bullet train to Bangalore?

 

‘Paes-Bhupathi war resembles a ‘C’ grade film’

18 June 2012

E.R. RAMACHANDRAN writes: Mahesh Bhupathi has openly refused to play ball with Leander Paes in the forthcoming Olympics. Mahesh and his chosen partner Rohan Bopanna have written to all India tennis association (AITA) that they would like to be paired together for the event.

Anil Khanna, AITA general secretary, has not taken kindly to this salvo, and has asked Bhupathi to play doubles with Leander Paes, or else he will be sacked.

The Paes-Bhupathi duo, once famous as ‘Indian Express’ has been reduced to a ‘C’ grade Bollywood movie with vendetta written all over. The seemingly ‘he loves me he loves me-not’ syndrome between them has all but driven the charm out of the famous doubles combination of the game.

It’s surprising they reunited thrice, each time having quarreled for reasons not spelt out.

AITA has not been able to broker a lasting peace between the two nor the past greats like Ramesh Krishnan or Vijay Amrithraj. Their love-hate circus, which they practice amidst,’ love all’ when they start a match is at once amusing, baffling and a trifle sad.

To be sure, most top tennis players concentrate only on singles, except for a rare John McEnroe, and doubles is generally left for lesser-known players. None of the Indian players have been able to break into the top 100 ranking except for a brief while by Somdev. It is in doubles and mixed doubles India has been able to make a mark.

This vendetta will be played again when selectors sit down to select India’s mixed doubles combination. Mahesh and Sania Mirza Malik having just won French Open would obviously like to play but whether AITA will allow this remains to be seen.

Isn’t it better AITA send a young combination of Bopanna and Yuki Bhambri (in place of injured Somdev) to represent India instead of the warring, sparring veterans and send out a lesson too?

Medals are important but not when the players display immense hatred in public. What good will it serve  future of Tennis in India and what lesson it will have on budding youngsters even if they win a medal?

Also read: Revealed: How the Paes-Bhupathi split began

CHURUMURI POLL: Who will be next President?

14 June 2012

After weeks and months of speculation, there is finally some official activity in the race for the next President of India.

The Trinamool Congress leader Mamata Banerjee says the UPA chairperson Sonia Gandhi has revealed two preferences: finance minister Pranab Mukherjee as the first choice and vice president Hamid Ansari as the second. In turn, Mamata and Mulayam Singh Yadav of the Samajwadi Party have indicated their choices: prime minister Manmohan Singh, former Lok Sabha speaker Somnath Chatterjee, and former President A.P. J. Abdul Kalam.

The announcements turn the political applecart upside down.

Mulayam and Mamata have effectively snubbed Sonia, Manmohan and Pranab, thrown cold water over the overweaning ambitions of Pranab Mukherjee, cast a big question mark over Manmohan Singh continuance as PM and the longevity of UPA-II as an alliance and advanced the prospect of an early election.

So, which of the five names in the air could make it, should make it, to Rashtrapati Bhavan?

Or, all things considered, is this just kite-flying and could we see a totally dark horse (or mare) ride up Raisina Hill? And who could that be: Lok Sabha speaker Meira Kumar, Congresswomen Mohsina Kidwai or Margaret Alva? Or how about Sam Pitroda?

‘What’s wrong if Aamir Khan exposes ‘butchers’?’

13 June 2012

E.R. RAMACHANDRAN writes: Ajji returned from Allahabad, suntanned after a brief visit.

Rama Rama. It’s unbearably hot. Agni nakshtra should be reworded as Agni Raaakshsa. Mysore is heavenly with dark clouds and signs of rain already.”

She was happy to be back and touching base with her friends.

As she watched Aamir Khan‘s Satyamev Jayate episode on disabled people, she wiped a tear.

“This is really needed. We are blind to all these kinds of things even when we were surrounded by it day in day out.”

“What is it, Ajji?”

“Female infanticide. Because of dowry and so many other beliefs, people are getting rid of female foetuses. It is such a shame that it is being practiced even today with some unscrupulous doctors abetting the crime. Idu paapa alveno?

Howdajji. Nowadys who bothers about paapa and punya?”

Alvo! We take pride in reciting Lalitha sahasranaama. We take pride in Dasara celebrations worshipping Goddess Chamundi. We also celebrate Durga puja. But nobody in the world kills foestuses as we do the moment we know the baby is going to be a female. It is widely prevalent in the North.”

Nobody could question Ajji’s views on North having just come from there.

Howdajji. We are masters of hypocrisy.”

Alvo. We have so many Gods and godmen. Why is nobody is raising their voice against this? Why don’t swamis teach their baktha vrundas that it is against religion, scriptures etc? What kind of discourses do they do?” she demanded.

“Swamijis are busy in their own fiefs, Ajji. They are busy celebrating their birthdays, fighting pitched battles with the media, and the like.”

“Our Software Seethamma was saying that a couple of weeks ago in Satyamev Jayate, Aamir showed the malpractices of doctors—their unabashed habit of writing out a battery of tests and examinations so that can get a cut and doing operations even when it is not necessary.”

“True Ajji, it created a lot of controversy. The medical council wants Aamir Khan to apologise!”

“Seethamma told me last night that film actor Sridevi’s mother was operated on the wrong side of her brain by a New York doctor.  They are called as ‘medical butlers’ there it seems!”

Ha ha ha, Ajji.”

Ashte alla kano. Our ex-governor T.N. Chaturvedi’s son died on the operation table in Bombay Hospital while being operated for back pain—not a life threatening case at all—by a famous doctor and his team. A young boy who had come home for holidays from America walked in to the hospital for a comparatively simple operation and came out dead. If this is the fate of famous people, God only should save ordinary people like us!”

Howadajji. Aamir Khan is precisely taking up cases where it is proved doctors are corrupt. A few years ago, Ketan Desai, president of medical council of India and his associate Jitendra Pal Singh were arrested  for taking Rs 2 crore for giving recognition to a medical college in Punjab.”

Ayyo manehaalra! What kind of doctors will we get from such colleges? We will get medical butchers as surgeons! I hope they are in jail now.”

“Yes, Ajji.”

“Crooks in every profession say contractors who adulterate cement etc must be exposed. But  if some doctors who are supposed to be in the ‘noble profession’ and have taken oath that they will serve mankind indulge in selling body parts,  make money unscrupulously playing on our emotions Aamir Khan is rightly exposing such charlatans. Satyamev Jayate means ade alva. Only truth should triumph in the end.”

Neenu helodu khandita nija, ajji.”

Also read: An open letter to Aamir Khan from a Kannadiga

CHURUMURI POLL: Aamir Khan vs doctors?

The half-truths of Aamir Khan, the truth fountain

Designed for humans, inspired by nature?*

11 June 2012

It certainly does not look like the iPhone or Vertu, so which mobile phone brand does N.R. Narayana Murthy (net worth $1.7 billion) secretly swear by? Could it be Samsung Galaxy S III?

After receiving the Pride of Karnataka award from Round Table India in Bangalore on Friday, the Infosys chief mentor delicately punches the screen alongside the actress Ramya known in these parts as Divya Spandana.

* Search engine optimisation techniques shamelessly at work

Photograph: Karnataka Photo News

Missing: Kannadiga pride at global investors meet

11 June 2012

N.V. Krishnakumar compares the just-concluded global investors’ meet(GIM)  in Karnataka with the Gujarati version of the same event, in Deccan Herald :

“During Vibrant Gujarat, the entire gamut of the state—from their culture, cuisine and language to their entrepreneurial spirit, quality of life and Gujarati pride—is marketed to investors and visitors. Without preference for any sector or district in the state, the strength of Gujarat as an engine for growth is promoted and noticeable to all investors and participants much to their own admiration.

“At the Global Investors’ Meet, a lack of vision is palpable. Government and its advisors have failed miserably to promote the overall strength of Karnataka. Along with mining rich districts, most of the attention revolves in and around Bangalore. Missing is the Kannadiga pride at the event.  There is no mention of the beauty of the state, its salubrious climate and its outstanding educational institutions. The stunning architecture, iconic food, great wildlife, the myriad places of historical prominence and cities that are in close proximity to ports and sea coast finds no mention.”

Read the full article: GIM vs Vibrant Gujarat

Photograph: Chairs being arranged during the global investors meet in Bangalore on Friday (Karnataka Photo News)

Also read: Whose global investors’ meet is it anyway?

Prosecuted, fined, rejected and a Rs 36,000 cr deal

Us and them: Brick and mortar vs click and cursor

One law for man, another for our Godmen?

10 June 2012

B.S.NAGARAJ writes from Bangalore: Watching the sensational developments in Swami Nithyananda‘s “ashram” over the last couple of days and his “escape” to an undisclosed location, you wouldn’t be wrong in concluding that there is a republic within the republic of India.

And that republic is less than an hour away from Bangalore in a town called Bidadi.

Here the laws of India don’t apply. Just like the Vatican. You and me have to seek an appointment to get inside. Government officials have to wait at the gates before they are escorted in through the various layers of security by Nithyananda’s minions.

Yesterday when a scuffle broke out between Nithyananda’s thugs who call themselves brahmacharis and brahmacharins and a few Kannada activists who went there for a press conference posing as journalists, the police were forced to register a case.

Nithyananda was named accused no.1.

The police go there reluctantly looking for him. A couple of hours later, the DC and SP emerge from inside to say they don’t know where NIthyananda is but add they have advised his associates that it is better for him to return to the ashram only “after the storm dies down.”

So, did they facilitate his escape?

More than 60 hours later, there is still no word on Nithyananda’s whereabouts. But a minister, as well as the DC and SP, are said to have called on him at a resort nearby where he has taken refuge, even while they continuing to say with a straight face that that they are not aware where the self-proclaimed God-incarnate is.

Meanwhile, one news channel carries on with its relentless coverage of the horror that is Nithyananda. Claiming to be victims of his sexual exploitation, people recount the gory details of the abuse to which they were subjected to by Nithyananda and his gang on Suvarna television.

Parents of victimised young men and women weep.

There is a welter of support and sympathy for the victims from viewers, many phoning in from the US, Singapore, Poland, Dubai, etc. Angry protesters burn his effigies across the state, demanding that he be externed to Tamil Nadu, his home state.

The government is unmoved. Chief Minister Sadananda Gowda is busy signing MoUs with investors in Bangalore. Home Minister R.Ashok and Law Minister Suresh Kumar make some feeble noises about taking action.

Little else.

On the other hand, the government moves in quickly to quell any potential violence during a planned protest march in Bidadi on Sunday by taking custody of many activists this evening.

Curiously, most newspapers and television channels are pretending as if what’s happening in Bidadi isn’t news-worthy. Reportage of Nithyananda-related events, if at all, is cursory. Opposition political parties are no better either in their response.

Other religious heads, save a few, don’t appear to be bothered. One mutt head has the gall to say that Nithyananda, whose devotees list include actors Malavika Avinash and Juhi Chawla, is the target of a conspiracy.

Ditto for pro-Hindutva outfits.

Not a murmur from our rent-a-quote intellectuals either. No Ananthamurthy, no Bhyrappa, no Girish Karnad, no Devanooru, no Rajkumar fans’ association.

The leading lights of the IT industry who have an opinion about everything in the IT capital may think it is none of their business, though many of the sex swami’s victims are sterling techies.

A few weeks back, the Sadananda Gowda government took control of the 15th century Sosale Vyasaraja Mutt in Mysore on the charge that the pontiff was misusing mutt property for personal benefit.

No tears need be shed for Sosale but if the government is sitting ostrich-like over far serious charges against Nithyananda, there is surely room for suspecting its motives.

Victims have told the channel that the swami used to brainwash them into believing that he was God, and that having sex with him would enlighten them. Apart from sexual battery and physical violence, they have charged the “Paramahamsa” of keeping them in the ashram against their wishes, making them part with their money, and much else.

Also read: Just vonne one question I want to ask Ranjitha

The half-truths of Aamir Khan, the truth fountain

8 June 2012

K. JAVEED NAYEEM writes: Satyameva Jayate, which literally means “Truth Stands Invincible” or “Let Truth Prevail”, is a mantra from the ancient Mundaka Upanishad believed to have been written by our sages in 250 BC.

The slogan was popularised and brought into use by Pandit Madan Mohan Malaviya in 1918 when he was serving the second of his four terms as president of the Indian National Congress, and it was later adopted as the national motto of India after Independence.

Today it is inscribed at the base of our national emblem, the Ashoka pillar, and is also found on every one of our coins and currency notes, handled by the rich and the poor alike but without anyone ever noticing either its presence or significance whatsoever.

While it was meant to keep our conscience in a state of constant wakefulness to uphold the greatness of our rediscovered nationhood, we Indians with our dishonest ways and dark deeds have sadly kept its guiding light out of our murky lives.

***

Today, ‘Satyamev Jayate’ also happens to be the title of a very popular TV show being aired on every Sunday morning to tell us Indians all the wrong that is happening in our country which we need to set right.

Very recently, in the fourth episode of this widely watched television show, its host Aamir Khan, the popular film hero, chose to speak about health-care services in India and the threat of ‘rampant’ medical negligence. He called on real life ‘victims’ to share their trauma.

One such victim of alleged medical malpractice was retired Army officer Major Pankaj Rai who lost his wife Seema to what he called a badly botched up kidney transplantation operation.

Without naming anyone or any hospital during the course of the show, he said that his wife died as a result of gross medical negligence at a very reputed hospital in the country when she was subjected to a combined kidney and pancreas transplant that was done without the consent of the patient herself or any of the family members.

What Aamir Khan perhaps did not tell his viewers was the fact that on his show he was all along showing them only half-truths about what had actually happened.

And, mind you, half the truth is very often a great lie.

***

All details of the Seema Rai case are now available on the internet at the click of the mouse button. You can easily find out that the transplant surgeon who was accused of being inadequately trained and ill qualified to carry out the operation was actually someone who was trained in the United States with good experience in multi-organ transplantation.

The physician and nephrologist who treated the patient and managed her on dialysis for more than two years before she underwent transplant surgery too had 16 years of clinical experience in the US before he chose to return to India to serve fellow Indians.

He has been practising in India since 2003 without any charge having been levelled against his competence either in the US or in India.

Now, whenever a doctor who has been able to survive and practice in the US, which is one of the most paying but also certainly one of the toughest environments to practice medicine, chooses to return to a country like India, we cannot easily garland him with the accusation of either being selfish or inefficient.

This doctor in question, therefore, does not need me to write a page of unqualified and unpaid defence for him, to uphold his reputation or image, especially when I do not even know him personally.

***

Major Rai alleged on the show that the doctors who did not even have a licence to do the job, whisked his wife off to surgery in the middle of the night without his or her consent and transplanted the kidney of a cadaver donor, along with a pancreas, that was not only an unnecessary medical procedure but also one that risked his wife’s life as well.

What our famous host or his aggrieved guest did not tell us during the show—where they were applauded and cheered by their captive audience—was the fact that this case of alleged medical negligence has been heard by more discerning experts.

The State medical council in its ruling has clearly said there was absolutely no medical negligence involved and there was no motive of personal monetary gain on the part of the doctors. The incident has also been debated over by many professional bodies both in India, and abroad too, including a law University and all of them have ruled that there was no element of medical negligence involved in it whatsoever.

Despite these rulings, the family has chosen to pursue the matter with a claim for a steep monetary compensation and the matter is sub-judice still.

No monetary compensation can do any, let alone full justice, for a human life lost and for the ensuing pain but while the matter is still undecided they should not have aired their angst with misrepresented facts on a TV show meant for the masses hungry for sensational scoops.

It appears the patient who was on dialysis had registered for cadaver kidney transplantation with a government body called the zonal coordination committee for transplantation (ZCCT). Now, cadaver transplantation means the transplantation of organs harvested from brain-dead persons, which is resorted to when living relatives with matching tissues are not available to donate their organs.

In such a situation whenever a suitable organ becomes available, as it usually happens after a fatal road accident, the patients on the waiting list are informed and asked to report immediately if they are interested in getting the transplant done. There is very little time for this procedure to be undertaken as the organs from a brain-dead donor have a very limited lifespan before they are transplanted.

In the case of a kidney, it is best transplanted within six hours after death and usually not more than twenty-four hours to ensure best function after transplantation.

Moreover, the decision-making has to be fast here as other waiting prospective recipients have to be informed if the first one refuses. And, even after a prospective recipient is identified some more hours are needed to establish tissue compatibility.

Therefore, the summons from the hospital for a cadaver transplant patient to quickly get admitted sometimes comes only as an urgent midnight call and there is nothing surprising about it.

***

On May 1, 2010, when the ZCCT, the agency that allocates cadaver kidney organs, informed that a potential cadaver had been identified and Seema Rai was one of the potential recipients, she voluntarily got admitted to the hospital for the procedure.

The patient was evaluated by the nephrologist and the transplant surgeon who discussed the cadaver transplantation procedure with her family after which she, who was a teacher at an international school, along with her husband, gave the informed consent for surgery.

They did this after discussing the relative risks and benefits of surgery with the transplant team and also, over the telephone, with one of their relatives who was perhaps a doctor in the United States.

According to their nephrologist, the transplanted kidney was functioning very well but three days after the operation the patient developed a severe bleeding disorder called disseminated intravascular coagulation or DIC. This rare complication, which is known to occur after any major surgery or even the delivery of a baby, causes massive bleeding which is difficult to control even after transfusing many units of blood as well as blood products like plasma and platelets.

It can happen in the best of hospitals and a very famous film actress, Smita Patil who could have sought and afforded the best treatment anywhere in the world, helplessly succumbed to it after childbirth. Despite the best efforts, this patient too failed to respond and expired and her death cannot be said to bet a consequence of any act of negligence of either the transplant team or the hospital.

***

In another case, a patient was shown who claimed that a surgeon had amputated one of his toes needlessly. The ‘needlessness’ of this operation was revealed by another doctor only after it had already been performed. I fail to understand how the second doctor could give such an opinion when he or she had never seen what the problem was like before surgery.

In a situation like diabetic gangrene of one of the toes, a difference of opinion can be expressed only before the surgical procedure and not afterwards. No expert, however efficient and experienced can comment on the need for surgery or the lack of it after the condition has been treated.

No mention was made in the show of whether the patient was a diabetic and how well controlled his blood sugar was before the procedure.

From what I could see on the show, the foot looked like a classical case of diabetic gangrene that had been treated with the perfectly approved and appropriate treatment of surgical amputation. In fact, because healing can often be very slow here, it looked like the perfect answer to any diabetologist’s prayer about what the outcome of correct and prompt treatment should be!

***

Whenever truth is told, it should include the whole truth including the inconvenient bits. This show is not just unabashed ‘truth-telling’ but it aims to hammer the truth in after breaking it into convenient bits.

The whole exercise seems structured to appropriate for its lead star the role of being the truth-fountain. My worry is that he presents both a populist and ‘one-sided truth’ on an enormously complex social issue with a dangerous authority that only his kind of stardom can muster.

In his show, Aamir Khan has certainly taken a huge leap from simply raising the awareness of his audience to being a medical expert, interlocutor and activist all rolled into one.

Here he is not just making a fictitious film where he can manipulate facts to create a sensational effect on his viewers. Here he is sensationalising a real life situation in a reality show watched by very well-educated and even a technically qualified audience too in addition to the lay public that laps up as truth all that comes from the lips of their hero.

The show goes beyond a lay talk show, which at least pretends to allow different shades of opinion to argue, debate, agree or disagree with a situation. It only shows a blind judge without any qualification, showing his audience the subtle shades of differ-ence that lend charm to the sunset that his stardom dreads.

Await more comforting truths next week!

(K. Javeed Nayeem is a practising physician who writes a weekly column for Star of Mysore, where this piece originally appeared)

Also read: An open letter to Aamir Khan from a Kannadiga

CHURUMURI POLL: Aamir Khan vs doctors?

CHURUMURI POLL: Medical insurance: a big ripoff?

Once upon a time, when my doctor was an angel

Do Mysore’s doctors, hospitals have any ethics?

A leopard doesn’t change its photogenic spots

6 June 2012

The photograph of a leopard attacking a forest department staffer during a rescue operation in Mysore, captured by Karnataka Photo News photojournalist Narayan Yadav, which won the gold medal at a national photo award contest in Jodhpur recently.

Photograph: Narayan Yadav/ Karnataka Photo News

Five reasons why Manmohan Singh is ‘guilty’

6 June 2012

After tearing down every one of Manmohan Singh‘s ministers, “Team Anna” has trained its guns on the prime minister himself, calling him “shikhandi“, accusing him of turning a blind eye while his colleagues were making merry, and charging him of presiding over the coal scam.

In a piece in The Hindu, Singh’s former media advisor Harish Khare offers a backhanded defence of his ex-boss:

“Manmohan Singh is not corrupt, but he is definitely guilty. He can be easily charged — along with his political partner, Sonia Gandhi — of pursing a politics of decency and of elevating reconciliation to a matter of state policy to the extent of avoiding confrontation; a luxury, statecraft does not permit a prime minister.

“Manmohan Singh is guilty of making the grievously erroneous assessment that Mob Anna was just a bunch of well-meaning civil society busybodies; he is guilty of not seeing through their incurable political agenda.

“Manmohan Singh is guilty of not being ruthless enough to crack open the Nira Radia tape case, a rogue operation carried by unscrupulous corporate elements.

“Manmohan Singh is guilty of not marshalling the intellectual and policy arguments to tell the nation that Vinod Rai‘s maximalist interpretation of the Comptroller and Auditor General of India (CAG)’s mandate has dangerously undermined the constitutional structure of equilibrium.

“Above all, Manmohan Singh is guilty of pursuing the noble quest for reconciliation at the expense of another maxim of statecraft: those who spurn the public authority’s hand of reconciliation must be made to learn the cost of confrontation. He is guilty of not learning the lesson from the mid-1970s and early 1990s when mobs were allowed to overwhelm the democratic institutions and their liberal ethos.”

Read the full article: Guilty on many counts, not corrupt

CHURUMURI POLL: Aamir Khan vs Doctors?

4 June 2012

The Bollywood actor Aamir Khan is the master of the publicity stunt. Just before 3 Idiots was released, he got into a tiff with the author Chetan Bhagat on whose book the movie was based. Even as Peepli Live! was making news, he got into a row with the movie’s masterminds: Anusha Rizvi and her husband Mahmood Farooqui.

So, the news about the Indian medical association (IMA) taking objection to Khan’s Satyamev Jayate episode last week, in which he turned the spotlight on medical misdemeanours, should be taken with a pinch of salt. Still, the question must be asked: has Aamir Khan exposed India’s worst-kept secret or only scratched its surface?

In the said episode, Aamir Khan showed the Sunday morning TV audience how doctors take a cut from pathological laboratories and specialists to refer patients, how patients are misled to make them undergo unnecessary and expensive treatment; and how doctors are paid by pharma companies to prescribe specific medicine brands. Victims spoke openly and bravely of how their illnesses were exaggerated for the personal gain of doctors, etc.

Now IMA wants an apology from Khan for having “defamed” the medical fraternity and for having given only one side of the story. There is talk of legal action although IMA’s honchos admit there are “black sheep” in the profession. So, is Aamir Khan right in exposing medical frauds, or is the IMA barking up the wrong tree?

And what is your worst story of medical malfeasance?

External reading: Shaming the Hippocratic oath

Also read: An open letter to Aamir Khan from a Kannadiga

CHURUMURI POLL: Medical insurance: a big ripoff?

Once upon a time, when my doctor was an angel

Do Mysore’s doctors, hospitals have any ethics?


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