Skills with the Scalpel and Beyond.

January began with the excitement of nearing the end of our internship. After the debacle that was the NEET PG exam, I began with my stint in the Department of Anaesthesiology.

While most of the time, I was involved in having a look at the Pre Anaesthetic Evaluation of the patient, shifting the patient to the OT and monitoring the vitals, there was also the opportunity to intubate the patients either in the OT or in the ICU and also in giving spinal block to patients being posted for LSCS. Less often, there were also epidural anaesthesias given and Central Lines inserted. The 15 days in the Department involved elective OT, Emergency OT (which was followed by a day off) and ICU duty.

Another thing about the Anaesthesiologists in the Department was how they were always so full of questions! I particularly had an interesting time discussing with Dr C as well as Dr H who were open to all kind of answers and also provided interesting points to ponder upon.


Following this stint in Anaesthesia, it was time to get my hands dirty in surgery! And literally so; With diabetic foot debridements aplenty and the casualty bustling with head injuries, there was never a dull moment in this Department.

Although I was initially very apprehensive about my non existent surgical skills, I was extremely fortunate to be in what I would consider the best unit in surgery. Headed by Dr K who had a huge patient pull (never a day passed without patients turning up saying they were related to him and thus demanded VIP care) and with Dr N and Dr V  who were good spirited and encouraging to the interns, it made for a moderately busy unit with good surgical exposure for an intern. Particular credit must be given to Dr V who almost ALWAYS made it a point to involve the interns in any decision making and gave ample opportunity to do the procedure (skin to skin). At a time when our incisions are still unsteady and prone to fishmouthing, Sir had the confidence to give us a chance to learn. We initially had Dr K as our JR who was well informed and guided us in the casualty for critical cases and later we had Dr P who was also a friendly guide in the wards and the casualty.

As a surgeon, While Hernioplasty, Lap. Cholecystectomy, mastectomy, BK/AK amputation, Trendelenburg Procedure (for patients with Varicose Veins) and cyst excisions remain the elective bread and butter, the emergencies like acute appendicitis/rupture, hollow viscus perforations are the emergency cases which would require early preparation of the patient and an operation at the earliest. Of course, there are a host of local procedures which also come under the jurisdiction of surgeons such as local cyst excisions, incision and drainage of abscesses, suprapubic catheterization, foreign body removals, excision of ingrown toe nails and many many more! Basically a general surgeon has a lot on his plate!

One of the important things I learnt in surgery is that the operation per se is only one part of the treatment provided by the surgeon. The pre operative care as well as post operative care are as important as the procedure itself and goes a long way in deciding the prognosis of the patient.

There were patients who had fairly uneventful surgeries but developed complications post operatively owing to their preoperative comorbidities such as COPD or uncontrolled Diabetes.

A particular patient I will remember is the HBsAg positive Mr. GN who came to the casualty with pain abdomen at night. When his USG happened only the next day afternoon, it revealed a case of intussusception which was operated upon the following day after ensuring he had received some nebulisation in view of his chronic smoking history. While the patient recovered quickly post operatively, he returned soon enough with abdominal wound dehiscence and swab cultures showed sensitivity only to colistin.

Mrs. S was another long term occupant in the Female S/D ward who only had her old and wrinkled husband caring for her relentlessly. Day in and day out he followed us until we made arrangements for free blood transfusion for her, until we had posted her for a below knee amputation that eventually gave her some relief.

Being a part of her OT was another memorable experience altogether with the Gigli saw!

There were a few interesting cases such as a pancreatic cancer in advanced stages. She presented with obstructive jaundice so a Triple Bypass surgery was done with a palliative perspective. There was the patient with open skull fracture who came to our casualty one evening. The contents of the cranium were clearly visible and were palpable. The patient was surprisingly stable so a quick wash and some stay sutures later, we had him rushed to NIMHANS but I had my doubts on his prognosis. Imagine my happiness when I returned after a few days leave and saw the same patient referred back from NIMHANS after an anterior cranial fossa repair and moving around normally!

Thus, after 2months of learning in the Department of Surgery, after even giving a seminar on post operative management of a surgical patient, with some wonderful memories with my co intern Sanjana, with the new junior interns, it was time to bid adieu to the last leg of my internship at Sri Chamarajendra Hospital, Hassan.

Amidst the tots, toddlers and teens!

Fresh out of the insulated NICU, I began my stint in the Paediatric department with alternate day OPD and ward duties. This meant that I had about half a day and a night off on the ward days and alternate day night duties.

On my first OPD day I reported on time and when I was on my rounds (prior to the actual rounds with the consultants), the recently admitted patient Kishan, a 11 month old boy on ventilator had no cardia and his family attenders began mourning. We quickly did the emergency resuscitation but to no avail. We called the duty doctor who verified the same and informed the family. It was only later that I realized that it was a case of Retroviral infection also present in other family members that was the main factor leading to all other complications.

There was Umme Kulsum, a case NS1 positive Dengue fever of Unit 1 that I monitored because I saw how she progressed from throwing up over a glass of water to half an idli to a full meal. On my subsequent night duty, she had platelet counts around 40,000 , abdominal pain and hypoproteinemia leading to some edema. Over the next few days, her counts dropped further necessitating transfusion after which she made a gradual recovery. It was indeed a happy moment when this little girl gave a broad smile, a shy thank you and made her way out of the wards. The next such happy moment was when Saniya Banu (who was in the PICU for a while) and her elder sister Hiba Tehreen were also discharged upon recovery and they left after a thank you from their mother.

Dengue cases are on the rise this season and they usually present with the primary complaint of fever, sometimes associated with myalgia and vomiting. The management is not specific but mainly consisting of fluid therapy (Ringer Lactate), regular BP monitoring, daily platelet and haematocrit verification. It's when the platelet counts drop further that the crisis deepens with abdominal pain and bleeding as the next set of manifestations. But so far, the dozen or more cases admitted have all made a successful recovery.

The next case that's worth mentioning is a case of hydrocephalus and subgaleal hematoma that was brought to us for a short stay after which we referred it to NIMHANS for a VP Shunt and further neurocare. There was the standard running around for a free ambulance under NRHM (National Rural Health Mission), some reassurance to the parents that NIMHANS would provide quality medical and surgical intervention at affordable prices and Krushi baby was sent packing.

Along with Krushi came B/o Mani who was brought one afternoon after she had 4-5 episodes of convulsions the previous evening. While the mother was extremely emotional and burst into tears at the slightest question/ explanation, the father was rather demanding and expected 24*7 presence of the consultants. This otherwise adorable cherubic little one also had fever and we got a CT and EEG (Electroencephalography) done which again pointed towards a neurologist for further reference (Query: Viral Encephalitis) but then she aspirated on her feed (probably the mother's enthusiasm after a week of keeping the baby on NPO (Nil Per Oral)) and had some respiratory distress, much to the anguish of the parents. At this point, I was some kind of interface between the NICU sisters who were viewed with hostility and the parents who simply wanted to hear that everything was going to be fine; something we cannot guarantee once a child is brought to the NICU. Luckily enough, she made a satisfactory progress, was shifted to the PICU and then was sent home after she regained her active joyful state. Here's hoping she makes a remarkable progress with no recurrence.

After this came two cases of mesenteric lymphadenitis presenting with pain in the right iliac fossa and some vomiting. The management involved initial NPO, fluid therapy, antibiotics and fat free diet. There was also a case of what appeared to be paraphimosis which I promptly referred to the surgery department. Samarth was born out of a precious pregnancy and was brought for complaints of breathlessness and cough. He recovered in time but M Sir asked for an Echocardiogram which revealed TAPVC (a type of congenital heart disease) and the cardiologist contacted me citing that he needed further intervention because he was likely to go into right heart failure in the near future. He was referred to a higher centre while his family remained apprnehensive and distraught upon hearing this news. Perhaps he is now at Jayadeva receiving the right treatment. Then there was Deekshitha with multiple enlarged infraclavicular lymph nodes which slowly regressed with antibiotic therapy and Rizwanoor, a four month old with bright kajal lined eyes who had been fed 'Nandini Milk' by her foster parents who spoke nothing but Hindi and Assamese and here I was trying to communicate with them with my not so fluent Hindi. Well, it did lead to some heated moments but nevertheless, she too made a satisfactory recovery.

Probably a case I will always remember is that of Prarthana, a 4 year old from the interiors of Arsikere who was referred here for focal seizures. She presented in status and had been given a diazepam earlier. I was in the ward when she was brought in so I asked for her to be started on Eptoin stat and left to contact Sir. The seizures continued so he started her on Lorazepam and then Gardinal followed by Eptoin again. She remained disoriented after which she began feeds, small conversation and was on her feet after a few days. We got the necessary blood investigations and CT scan and somehow her progress wasn't satisfactory since she was still not completely oriented and had some motor incoordination but since they were insisting on a discharge, M Sir did a Lumbar Puncture and we sent the CSF samples to the Micro, Patho and Biochem department and the reports were not obvious but suggestive of albuminocytologic dissociation. I did tell the mother (her father had met with an accident and was admittedly elsewhere) the need for further monitoring and that she was not completely okay yet and this was only a Discharge on Request. Probably because the little girl addressed me as 'Akka' or because she actually responded to me or that the mother was expressed her gratitude that 'Jayashree Doctor' helped them, I wanted to see Prarthana back to her playful state. I sincerely hope she too makes a complete recovery. It's only upon seeing cases like her and others that I've realized the extent of poverty in the patients here. While most of the services are at very nominal rates, it is still a dent to many families. God forbid, when we tell them that the child needs further treatment at a higher centre in Bangalore, I have literally seen the fear in their eyes as they imagine the exorbitant cost of treatment in Bangalore. It requires much reasurrance and restoration of faith before they muster the courage for the next step.

Several cases not in my unit but noteworthy of a mention are a snake bite (cobra) that was promptly treated with ASV (Anti Snake Venom) and he made a complete recovery from near nil saturation and cyanosed state back to his naughty brat state, a case of Acute Flaccid Paralysis (GB Syndrome?) that presented with classic ascending paralysis, late involvement of respiratory muscles and bladder dysfunction. Their vague history and travel history from Mangalore initially created a Nipah scare that was duly dismissed and he was then referred to a higher treatment for specific treatment (IVIg) and cases of cerebral palsy that also have seizure disorder.

When I'm not prescribing drugs after (struggling and) calculating the pediatric dosage, I've given stomach wash, learning cannulation in little ones which can be especially tricky when the concerned patient is a fidgety yelling kicking toddler who will glare at you and screech at the top of his voice for hurting him. So I'm currently practising on the older variants and will hopefully work downwards. There are nights when the duty is fairly uneventful with just a few admissions giving you atleast 4 hours of undisturbed sleep  and then there are nights when every complicated case ranging from poisoning to respiratory distress to febrile seizures lands up at regular intervals making sleep an inevitable myth. 

Now, I'm in Unit 2 and I have some really good professors who are friendly and are very clear in their instructions. They also respond to all queries leaving no room for ambiguity. There is A ma'am who is approachable and always responds in case of emergency. She has an advantage with the language and hence communicates better with patients from different communities. B Sir is probably the earliest to appear in case of crisis, also responds even when he is not in charge, calm and composed in all emergencies, never takes risks when it comes to a critical case and ALWAYS makes it a point to explain the prognosis to the patient attender. M Sir is probably one of the sought after paediatricians in Hassan with people coming from far specifically to see him. His speed of consultation is actually terrifying. His ability to detect something abnormal in a short period of inspection and auscultation is truly something inspiring.

So with a week more of Paediatrics to go, I have nothing but interesting experiences to share, memories of parents gratitude, anger and frustration are things you will have to become accustomed to. When you've seen many cases with the same illness, you will know it's an uneventful prognosis but to the parent, it is the first and hopefully the last time their child is afflicted with this illness so they will need all the reassurance that in due course of time, their child will get better.

pre Monday Morose Musings of a Medico

Maybe I should make a To-Do List of all the things I want to blog about before I commence because I actually have many musings to put down.

Anyhoo, Last week I made what will probably be the last Bangalore visit for the year. The journey to Bangalore was actually good. I travelled by the morning train after quite a long time and there’s nothing like a some rainfall, pleasant music and a good weekend to look forward to. It was Di’s Birthday so we had the usual cake cutting and balloons kind of party.

On our return journey, we happened to strike a conversation with two college girls travelling to Shimoga as a part of the ball badminton team from Maharashtra participating in the nationals.

I definitely had a good experience trying to converse with them in my defunct Hindi (“Aap Kahaan se Ho? Nagpur ke saamne? Wahaan ke Orange acche hai na?” and other cringeworthy moments.) Furthermore, they were from Chandrapur , Sevagram and other areas in the interior of Maharashtra and were travelling together for the first time. With great pride, the recounted how one of their seniors selected from a previous such Nationals tournament later went on to join the Olympic team. With their education being funded by a scholarship, they get good support from their family. Most of the compartment uncles asked for their story in turns and gave appreciative nods while the aunty beside me underplayed the whole scenario. (“Swalpa nu English baralla alva? Nagpur Orange enu chanagiralla, Chikmangalore oranges eh chanagiradu.” and other face palm worthy moments).
While Shimoga was inundated with heavy rains the same evening, here’s hoping those girls go far ahead and shine. :)

This week has been hectic to say the least. Getting back to college, we had to finish with the OBG end posting which was taken by Arathi ma’am who had a LOT of questions.

After the Surgery internals were announced (which clashed on point with the South Zone Quiz), we had some running around and letter writing to do which were all duly rejected until further intervention from the Psych Dept ensured that we would take the internals with another term a few days later.

After this came the BNET quiz for which I didn’t really prepare but tried to read up on some Anatomy and our present portions. While I barely scratched the surface of Anat, I must mention how I felt quite happy that day because reading from BDC brought back some memories of Vasudha ma'am explaining the structure with the brain in hand. I really wish I could go back to her just to listen to her teach!

When I got all excited and made stick figure man notes! :')

And so we set off to Dharwad from the hostel around 5AM, boarded the direct bus, alighted at Hubli and finally made it to the sprawling SDM campus. While initially there were no other contestants in sight, they made their appearance by the aforementioned time and the quiz began with an initial MCQ based prelims.So the prelims had about 50 questions in 50 minutes and we did quite well! The finals had about 5 rounds including a rapid fire. While we didn't make it in the finals, BP and Disha came second and will represent our college at the finals in Bangalore. :)

After some snacks at their canteen, we set off towards Hubli to board the bus back to Shimo. We had a make shift meal of Jolada Roti and Random curry and Rice at a nondescript hotel as dinner and headed back to the hostel by 1am.

I had typed a LENGTHY paragraph on my phone which I didn't save and thus I have more reasons to be a grouchy git.

There's always something new to see, some new experience every time I travel.

The little one who began crying when the bus started because his grandpa hadn't got back yet.
The woman who patiently picked out the lice from her husband's head even as he bowed down to her.
The old woman who couldn't stop arguing with the conductor at the top of her shrill voice until another passenger explicitly asked her to shut up.
The young boy looking out of the bus at the young girl standing outside in the evening drizzle; sharing a wordless moment, perhaps until their next reunion.
The lost puppy on the road, the mentally ill man grinning away to glory, the hen on the bus making eerie sounds and the woman crying in the ER..

I could go on but you get my drift; every person, every moment is a story in itself if you bother to look.

So why am I a grouchy git? After yesterday, I felt I am lacking on SO many Basic levels. I mean, there are things you should know and those that are good to know (i.e will be useful later). There is no point trying to work on the second category when you have some loopholes in the first itself. I feel I did not reason out enough but that stemmed from not being aware/sure of so many things to make the necessary connection. Anyhoo, got enough and more on my plate for now!

So by this virtue, I cannot attribute my happiness to any physical entity, person or event. Which would mean I would have to feel intrinsically happy. Does this mean the happiness one gets from any of the above is not to be encouraged because we would be dependant on it? Or is the fear that the deprivation of them would cause us to feel sad?

I don't think I can blog much in the coming weeks (this is the lame lie I come up with every 15 days -_-) but I think it wouldn't be a bad idea to blog instead of spreading my neurotic tension to everyone around me.

On another note, I should probably update my status on all media and issue a public notice that I am not responsible for my lousy acyclical moods; the fault is in Rguhs. -_-

I haven't heard too many new songs lately but I think the old ones more than compensate for it. Am I the only one who feels that moments can be recreated with music? And that the happiness you feel with these pleasant recollections, is probably enough? As in, an old some heard in childhood brings back some cherished memories, the ones from school actually make me laugh because we are all so naive.. :) (Did you know That is her favourite song? It's such a bad song XD)

Further more, I am often torn between having the everything that happens is for the best kind of mindset to the 'No, of course not, why try to see good in bad' kind of comeback. The best resort would be to ignore both and just do what has to be done. (I Didn't say I do that all the time; don't assume.)

Confusedly yours,
J

The Insomniac's Idiosyncrasies.

What if these thoughts are not my carefully coordinated ruminations but merely the result of random arrangements in my brain that resulted in these specific words, even as I type this?

When you overdose on caffeine and are charged with a hundred different thoughts, it is prudent to blog and scare the few readers away with your useless rambles.

So first things first, we had our Ortho Internals and I made up a lot of rubbish including the meaning of Orthopaedics (yes, we had a second paper for our practicals with many more opportunities for me to mess up). Atleast a TB Hip/ Spine would have made my day but CTEV was a small reprieve. And that reminds me, Ilizarov (from the limb lengthening technique) said something like this:

'Any biological organism when subjected to constant stress under living conditions, is expected to grow.'

I quote this not out of a bout of inspiration that if we induce ourselves with the right amount of stress, it would catapult us into greater heights (you could do that too, Fyi) but out of sheer annoyance and frustration with the supposed Imposition awarded to us by the OBG department for our unplanned 'mass bunk'. Clearly, subjecting us to irrational punishments has only got us at the end our patience and at our wit's end. -_-

But when I'm not mindlessly copying lines from Shaw's, we've been taking a lot more cases this term asking every Savitramma, Ratnamma, Basamma or Vasanthamma their history. When we're not taking gynaec cases, I'm discreetly judging women by their belly bump to pounce on any pregnancy in the 3rd trimester to take their case and possibly proceed with the examination. Apart from this, its a Cat and Mouse game of trying not to draw the attention of Dr S for sitting, breathing and basically daring to live. -_-

Apart from these facts and and the ominous fact that my going home remains dependant on the End Posting, college is progressing as usual. So it was Abhi's bday last week and we had a some real fun :) I don't think I've laughed until my stomach hurt in recent times!

I think the best time of my day is in fact the night when I'm uncluttered of all unnecessary niceties and have my freedom, even if, only for a few hours. Yes, of course, all these chains and shackles are in my own head.

Take a moment.

• Before you yell at that boy for nearly running into you, take a moment to realize he's pushing a trolley of food for your own mess.
• Before you assume the worst, give people the benefit of doubt or a chance to explain their actions.
• Before you curse profanities upon someone for inconveniencing you, understand that they're only doing their job.
• Before you give someone a piece of your mind, take a deep breath and just let it go! Whatever it is that's bothering you, it isn't worth your peace of mind. 

Reading some new and interesting things these days; from the development of language in an infant (Skinner Vs Chomsky), science of emotion (when you see a tiger, do you run because of the fear or do you feel fear because you run..?) and even the physiology of hunger and satiety (my obesity prone elevated leptins should have diminished taste sensations but as Abhi rightly said, my taste buds seem to be on the higher end of the spectrum) and the neurochemistry of addiction (mice which were taught to work for a stimulation that would result in a reward (Dopamine treaaattt!) would do so even at the cost of their starvation and thirst just to receive that 'kick'.

On yet another note, I would hate to agree with my annoyingly accurate father as to how social media is a double edged sword and must be used wisely and I never seem to accrue this simple wisdom that even my sister seems to have been bestowed with. -_-

Ohhhh and before I forget, Ma's part of this White Whale Challenge that's being organized by the folks at Science Utsav.
Basically, they've got the parent community involved in activities and tasks that they've got to submit in a day. While Day 1 had Ma going to the near and dear relatives for a 'free hug thing', Day 2 was about thanking the people in the community who help us like the milkmaid, postman, driver, lift attender and so on.

I'm actually quite surprised and interested by this initiative and also extremely happy that Ma is game enough to take on something as spontaenous as this! :)

Although I feel confused and annoyed 2826282927 times a day for all the mind numbing, thick skulled drama around me and the rubbish that is thurst upon my disinterested ears, I also feel at peace for atleast some semblance of sanity that prevails despite the murky waters. It also gives me hope of better times ahead.

*Everything has changed: Ed Sheeran* :)

Ciao!

Psychiatry Case Presentation Abstract

Diagnostician’s Dilemma: Convulsing from OCD to CPS!

Presenter: Ms. Jayashree S Rao, 4th year MBBS
Treating Team: Dr. K S Shubrata, Associate Professor, Dr. Narendra, Assistant Professor, Dr. Nagaraj A V, Consultant Neurologist

Mr M, a 30 year old single male, working as an employee in a government office, from an MSES, urban background, presented to us in January 2017 with an illness of 3 years duration. His illness was of insidious onset and episodic course, characterized by brief episodes of obsessive rumination lasting for less than 5 minutes, multiple times a day and decreased concentration in work because of these thoughts. He was also suffering from adjustment disorder, depressive type because of these unremitting episodes. He has taken multiple consultations with psychiatrists with failed trials of Sertraline 150mg and Fluoxetine 60mg. He has also taken five sessions of Cognitive Behaviour Therapy (Exposure Response and Prevention) but to no avail. Mental status examination revealed depressed affect and obsessive rumination of which the exact theme was not clear. Further clarification in history revealed that these episodes were actually a part of Complex Partial Seizures. Neurologist opinion was sought and the EEG revealed inferior frontal and temporal epileptiform discharges. He was started on carbamazepine with which the episodes showed complete remission.

This case stresses the importance of detailed history taking without biased mind and getting the right investigation as and when required.

This Or That.

They say I think in binaries. 0 or 1. Black or White. Good or Bad. Necessary or Unnecessary.  I see no in between, no intermediate entity. I have always had clear cut definitions. I don’t like blurriness; be it in my vision or in my perspectives. This is how I’ve always been. Do I want to change that? I don’t think so. That perhaps explains the uneasiness that gnaws within me.

There is so much I want to do. Am I really working in that direction? Or am I just working and waiting for everything to miraculously materialize? Ugh, I don’t know where this is stemming from but I’m feeling a lot of discontentment about myself. Is it probably inversely proportional to how ‘happy’ I momentarily feel?

I pride myself for my ability to not be influenced by the choices of those around me. It is one trait I hold close to myself hence, I’m pondering if I am consciously responsible for my actions or have I been influenced by those around me, willingly or unwillingly. 

Gokarna, March 2017 with Abhi and BP.

I don’t have the answers to any of these. I know I think too much, trust me, I don’t like it either that my brain keeps churning out such inane rubbish in the midst of an Aortic Aneurysm and I tuck away these thoughts in a tiny cubicle in my brain, assuring it that I will open the Pandora’s Box once I get the time to blog about it. :)

I want to talk a lot more but I don’t know if this is the medium to unload all my burdens, but it makes sense to reflect to oneself instead of somebody else because you will eventually hear an opinion, an advice, a suggestion or better still, a similarity in thought. All of which is unnecessary when all you need is a mirror. A plain mirror to lay the bare truth in front of your eyes; with all its ugliness, its scars, bruises and perfect imperfections. And that cannot come from anyone but me. (To cut a long story short, I find it as important, or probably more important to understand myself, consolidate my thoughts and be a whole person by myself than anything else. 

Or is this defensive attitude stemming from my fear of being influenced by new ideas and thoughts? 

What is nice may not be necessary and what is necessary may not be nice. 

In the end, nothing matters except what you believe in, what you stand for and what you do.

Subtleties are always better. I could write a million lines on everything I can imagine, which a far more powerful tool than reality is. I want my imagination back. I find much more beauty in metaphors, in an indefinite entity than in the raw face of reality. 
Maybe. 

And that reminds me;

http://scienceblogs.com/mixingmemory/2006/07/17/the-cognitive-science-of-art-r/

Read under ‘Perceptual Problem Solving’. I remember reading those very lines in VS Ramachandran’s Emerging Mind.

On an unrelated note, the marriage seems to have bitten the GRS family cousins as 2* more have fallen for the trap and wedding bells shall be ringing throughout this year. 

Jogging everyday hasn’t helped in physically (Let’s be honest :P ) but it certainly elevates my mood and automatically trashes all the clutter that I tend to attract with a magnet. -_-

Can’t wait to meet my super-achieving Minnulli over this month end (hopefully). :)

Bye Bye Old Faithful :)

(Trust me I’m not a raving lunatic who fondly addresses a virtual entity and distances actual people who listen to her. I just like me more.) 

Simultanagnosia

So I was reading up on a few new things and I came across this word:

Simultanagnosia

Technically it means “missing the forest for the trees”. Person fails to comprehend an object as a whole and can only perceive only parts of it. A person might look at a table lamp but fail to recognize it for what it is. He or she sees the base of the lamp and assumes it to be something else, like a box or an ashtray. Isn’t that what happens to us sometimes? We get so caught up in little things that we fail to move on to see the bigger picture. What I mean is, don’t let bogged down by petty things, there’s a lot more waiting for you if you change the way you see things. Don’t narrow your vision to just the bare minimum, think of what lies ahead and stay motivated. Sometimes, Life requires us to focus on the finer details but sometimes you need to have a bird’s eye view of the big picture.

Childhood is synonymous with playing outdoors and cuts, bruises and scars and perhaps the trophies of a childhood well spent. I’ve got scars on my knees that’ll last a lifetime thanks to rolling down a road while being chased by dogs and during cycle rides. I remember the one over the knee took awfully long to heal and formed a thick brown scab that I prematurely peeled off until the process had to be repeated. Why am I describing an ugly scar that occurred more than a decade ago? My point is, wounds need time to heal and it’s not something you can rush through. Imagine if I had put a plaster over and continued cycling like the wound didn’t exist? Sure, it wouldn’t look messy initially but eventually the wound would just get worse and take longer to heal. Sometimes it’s important to acknowledge a wound and take steps to treat it. Ignorance IS NOT always bliss in such cases!

People will walk in and out of your life according to their will and wish unless you stand guard and latch the doors. Beware of intruders and don’t be surprised if insiders chose to decamp without notice. Yet, remember that there is always a silver lining. Just when you’re at your wit’s end, Life will surprise you with something that will brighten you up in spite of the thunderstorm. Remember to be thankful for those moments of happiness in the middle of uncertainty, for those people who share their umbrella in the rain and for most of all, remember to believe. Just believe, in yourself, your dreams and your principles.

Literary Ventures:

Eleventh Commandment: Jeffrey Archer
Vision in White: Nora Roberts
The Secret Countess: Eva Ibbotson
Anna Karenina: Tolstoy
Animal Farm: George Orwell
Hitchhiker's Guide: Douglas Adams
Contact: Carl Sagan

Musicophilia:

Sanam Re: Arijit Singh
Pyaasi: Swarathma
Aayat: Arijit Singh
Same Old Love: Selena Gomez

SFCBR: (Early blog readers, you may be familiar with this term)

On a positive note, it is indeed great *giggle* to get back in touch with old, long lost friend and realise that some people don’t change. It’s actually mind blowing to think that though it’s been 13 long years, good people remain inherently the same as they were. Indeed, a pleasant surprise :D It’s also refreshing to see so much positivity and faith in your abilities :’) I also reconnected with Punyakoti after a long time.

Auf Wiedershen (Germanic influence lol)

Playing With Fire.

How foolish could I be to think that I can dissociate from an intrinsic component of myself and assume that I will be fine? Yes, you can amputate the limb but there's no running away from the Phantom pain. There are some things that have become so ingrained in my persona that any attempt to bring about changes will only lead to chaos.

Exams are approaching and I'm supposed to be in hyper-study mode but that doesn't always happen. There are days when I study and I'm happy with what I've read and there are days when I attempt to study but nothing seems to diffuse through the scalp.

These days I've been reading about pathogenic protozoa like Entamoeba, Trypanosoma, Leishmania, Malaria and so on. Malaria for example has a life cycle in the female anopheles mosquito as well in the human host. The bite of the mosquito transfers the sporozoite to the human and this ends up in the liver where the pre-erythrocytic cycle occurs. The meront is formed which later bursts to release merozoites that penetrate the RBC and develop through 3 stages. The trophozoite that is formed matures and upon the bite of the mosquito, it is transferred to the gut of the mosquito in its blood meal. Here the sexual reproduction (sporogony) occurs and there is a zygote formed from the male and female trophozoite that enters into the salivary gland of the mosquito and is transferred to the human host in its next bite. There are 4 major forms of Plasmodium species, P.Vivax, P. Falciparum, P.Ovale and P. Malariae with Falciparum being associated with the highest mortality (Blackwater Fever) and generally presents with fever, chills and sweats that recur periodically. 

So apart from these there are several other protozoans like Toxoplasma that reaches a dead end in the human host. The definitive host being cats and other felines, the infective sporulated oocyst is transferred to humans through any contamination in food and water and it later develops from bradyzoites to tachyzoites  that later form tissue cysts. These are particularly notorious in the immunocompromised and cause life threatening complications when it is congenital like the 3CS: Chorioretinitis, Cerebral calcifications and Convulsions. 

Apart from these there are also creepy crawlies to deal with, their pathogenicity and clinical features being distinct. Some of them worms I've been reading include Diphyllobothrium latum (Fish Tapeworm- it has 3 hosts. It affects humans and then is transmitted to (as coracidium and then procercoid larva) cyclops from where it reaches fish (pleurocercoid) which is consumed by man and the cycle continues..), Echinococcus Granulosus (Dog Tapeworm- where man is only an accidental host and it results in formation of hydatid cysts in the liver and other sites), Taenia solium, Taenia saginata (beef and pork tapeworm that cause complications like neurocysticercosis through its cytsic forms: cysticercus bovis and cysticercus cellulosae) and so on. There's so much more to do in so little time and what's more important is also revising what I've read instead of just going on and on! -_-

Before this, it was Virology and that was quite interesting. Viruses are usually RNA or DNA or in the rare cases of retro viruses (HIV) it's a DNA:RNA virus that forms the genetic material. Viruses can causes almost all sorts of infections:
CNS: KJD, GSS, Rhabdo, Polio
Respiratory: Adenovirus, Rhinovirus, SARS, Orthomyxovirus,
Diarrhoea: Reovirus? Norwalk, Astrovirus..
Haemorrhagic: Arena virus, Ebola, KFD
and so on...

Coming to Pharmacology, there is SIMPLY WAY TOO MUCH! It's not a problem to read up on the new chapters but what is definitely a problem is revising all the drugs we've been reading in the course of one whole year! Just take the names, they sound so familiar, similar and yet so confusing! Take Amiloride, Amiodarone and Amantadine.

• Amiloride is a diuretic that acts at the Collecting Ducts and inhibits the renal epithelial Na+ channels and thus causes diuresis. (I think)

• Amiodarone is a broad spectrum anti-arrhythmic. I think it belongs to class II antiarrythmics and can be used for a wide range of arrhythmias. 

• Amantadine on the other hand is a multipurpose drug: It was introduced as an antiviral drug for treatment of influenza (mechanism is probably something to do with the Neuraminidase and Hemagglutinin antigens on the virus) but was serendipitously found to have anti-parkinsonian effects. It complements the action of Levo-Dopa and can probably used in the early stages. (I think)

• Now Amantadine rhymes with Cimetidine and Ranitidine but don't be confused because those are H2 Proton pump blockers which you would prescribe for Peptic Ulcers and gastritis because they reduce the gastric acid secretions. 

• Similarly, there is Metronidazole, Tinidazole, Satranidazole, Secnidazole that are used in the treatment of amoebic dysentery (E.histolytica) because they have this nitro group that goes inside the Amoeba, gets activated and attracts all the electrons so that the Pyruvate-Ferrodoxin Oxido-Reductase Pathway (PFOR) is inhibited so this ultimately has -cidal action on the pathogen. These are effective in anaerobic conditions if there were to be oxygen they themselves would compete with the nitro group for the electrons.. But don't confuse this with Ketoconazole, Fluconazole, Itraconazole or Voriconazole because these are antifungals that act by inhibiting the cell wall synthesis (I think!)

 I could go on and on and I might actually do more of this sometime :)

Pathology is progressing at snail's pace. I recently read about pathological conditions of the kidney and this itself spanned several days because of its convoluted nature (pun intended). In many cases, the diseases are a classic example of "Subversion from within" as Robbins describes the pathogenicity in HIV-AIDS. For no good reason, antibodies are formed against the basement membrane of the glomeruli and with similar auto-antibodies in the lung, you have your Good-Pasture Syndrome. And then there are immune complexes formed which are deposited giving rise to conditions like HSP and Lupus Nephritis..
Basically there are two clinical presentations:

• Nephrotic : Proteinuria, Lipiduria and Edema
• Nephritic  : Proteinuria, Haematuria and Hypertension

Apart from the glomerular, interstitial and tubular dysfunctions there are neoplasms (Renal Cell Ca), cysts (ADPKD ARPKD), hydronephrosis and so on.. 

Recently a strange thought struck my otherwise dormant frontal lobe. The water we drink is said to be "purified" thanks to the aquaguard water purifiers in the hostel as well as in the college. But nobody really looks into the maintenance of these purifiers or the steel containers that store the water. The water we consume no doubt has some bacteria. So what we could do is do a Coliform Count and also culture the bacteria in several media hoping to see which bacteria turns up. So there are two schools of thought with which we could proceed:

• The water we're drinking is fairly harmless so if the reports show presence of any bacteria it would mean our body has developed some level of resistance of these bacteria over time. This could be compared to water supply in a fairly cleaner source and see if there is any pathogenicity of these bacteria in a different region.
• The second approach would be to see if the water we're drinking has actually caused any disease in the hostelites and identify the causative bacteria. Has the bacteria evolved to evade the purification and become resistant? Again, one could compare with another water source and observe the trends.

As Uppi Sir said, it is a viable project (that I could attempt after 2nd year even if that means it can't be an ICMR project because the deadline for ICMR would be January when I'd be in the middle of practical exams) and I could work on it with the available resources provided and "define the problem" and then work on it. Whenever we begin any such project, it is very important to ferment the ideas into something definitive. What is the purpose of the project, what do you aim to find on microscopic analysis, how would you choose to analyse the data, how are you going to compare this with other water sources and what's the bottom line? One needs to have definitive answers before embarking on something new like this. 

Moving on to matters of the heart and conveniently ignoring Forensic Medicine which I need to read more of, I seem to be in a perpetual state of confusion and disappointment. 

I either have an inherent genetic defect in maintaining relationships- mutated MHR gene (Maintain Healthy Relationship) that probably explains why sometimes somethings never work out with some people. Or maybe I don't put enough into it or don't make amends or I expect too much from people or I just end up with the wrong people! 

Looking back always brings regret, which is why I try my best to steer my hyperkinetic thoughts in the right direction, but then there are times when you wish you had done things differently. I have this "Äll or None" personality. I either give my 100% and give my best to make things work or I don't try at all. I need to find the comfortable middle ground where you stay at a comfortable distance and maintain a better equation with people. 

There are times when I crave for silence. Silence from the chaos of my thoughts that are constantly in motion like electrons colliding against each other in Brownian motion. I crave for some solidarity of my thoughts, some respite from the constant tug of war that distracts me from anything I do. It stems from disappointment: a feeling of repulsion and disgust to who I've become against the stark contrast of who I wish I would be. Adapting to people and circumstances constantly has suppressed the true nature of me. There are moments like these, in these fleeting moments, in the scribbled notes of a story incomplete or an amateur attempt at poetry that I find myself. It is in this silence that I can sense creativity bubbling within me, hoping to find an outlet.

As someone rightly said (or as I understood it), sometimes you need to talk to people. The world feels less of a burden and much more bearable. In my case, it is my blog that I turn to, sad as it seems that it is a mere virtual entity. An imaginary non-existent figament that purportedly contains my thoughts without any reaction but giving me the satisfaction of having unburdened myself. Words, thoughts and ideas are the fuel of my existence. They define who I am and they help me evolve and discover more.Yet, trying to do away with even this mode of release is just slow asphyxia. Like the Carbon Dioxide that we need to exhale out of our system (before it can stimulate the Respiratory Centre in the brain, preferentially bind to the Hb and wreak havoc), my has invariably become a lifeline. A creative process that has become a part of who I am. In the past, the blog was a mere glimpse of who I am. Over time, it has evolved into something more concrete. It's either that, or I've officially gone NUTS. :D It would only be self-destructive to stifle my voice against the waves of conformity. 

I cannot run away from the consequence of my actions, I can only make peace with myself. I cannot rebel against what I chose, I can only accept the reality. In the end, we are not defined by those around us because they are never constant. So there is no point pondering infinitely about how we are perceived by people who do not eventually matter.

What I Do In The Library

• Mature is when you are polite with the people you don’t really get along with because it seems the right thing to do but it’s mistaken as fake.
• Natural is when someone behaves in a certain way that is perceived to be fake by those around him/her. Example: some people have a fake laugh.
• Opportunistic Faking is taking advantage of a situation for your benefit by saying things you do not mean. *Sycophants*
• Synergistic Faking: Two people playing along for a mutual benefit

On a lighter note, I have discovered that I have a rare but seriously awkward condition known as Paroxysmal Laughter Syndrome (PLS). The genetic causes have not yet been established but they occur due to a sporadic mutation in the SNL gene. (Sane and Normal Laughter) Going back to the basics, I read in Vilayanur Ramachandran's neuroscience books that laughter is the body's way of recognizing a false alarm. A mother approaches her 8 month old child with arms outstretched and a serious expression. The baby is surprised and worried that it has done something wrong. As the mother approaches closer, her expression softens and she suddenly takes to tickling the child. The child bursts into peals of laughter at this and creases of fear vanish. Why is it that the child laughed? What is the neurological basis behind this sound produced by the larnyx when we notice a funny incident? The idea is that in the course of evolution over centuries, laughter has evolved as a mechanism of letting the body know that "It's all okay, no harm done". The brain had expected some danger but the turn of events proved contrary and hence we burst into high pitched giggles or happy squeals or sometimes into a loud cackle that causes bystanders some discomfort. So my problem is that I tend to burst out laughing in the most inappropriate circumstances and seem to have no control over it. It might be at a friend's birthday treat, or when I notice two individuals walking or in the middle of class/postings or worse still, while discussing a serious matter with the Principal. A thorough in depth analysis of the reason behind this has brought me to the conclusion that I have a tendency to over-think. When the people around me heard the same sentences, they didn't find anything remotely amusing. But my confounded brain makes some connections that they couldn't imagine (nobody could believe that I would think in that angle) and hence I had a tough time stifling my laughter while the others looked at me in surprise. The other incident could also be attributed to the same cause. The brain processes a simple harmless data into something much more fancy and embellished that appears humorous and hence the intractable giggling in inappropriate situations. What remains now is now I somehow learn the art of keeping a straight face and avoid embarrassment. 

In case you want to know more:

• http://brainworldmagazine.com/neuroscience-of-comedy/ 
• http://www.nature.com/news/1998/981217/full/news981217-2.html

Another thing I discovered recently is the redundancy of Antidepressants. Depression is something many people will claim to have experienced but the few who have been clinically diagnosed with it would know that it is a quagmire of hopelessness that would drag you into its realm and before you know it you are incapable of getting out of the whirlpool of endless thoughts circulating within. From what I know, there are two theories (among others) that are proposed for the pathogenesis of depression.

• BDNF (Brain Derived Neurotropic Factor) is an important component that has an overall role in controlling emotions and thoughts. Any decrease in BDNF could trigger depression.
• Monoamine depletion. Seratonin, Dopamine and Noradrenaline are some of the neurotransmitters whose variation could also contribute to depression. Current antidepression therapy is aimed at mainaining the levels of these neurotransmitters at the optimum levels. Drugs include:
• MAO-B inhibitors: Moclobemide
• Amitryptilline, Nortryptilline, Imipramine, Desipramine, Doxepin, Dothiepin
• Fluoxetine and other SNRIs.
• I can't remember the newer Anti Depressants.
• NUTELLA. This single substance could alter the treatment of MDD radically if it were administered to all those suffering from disappointment, loss, desperation and hopelessness. As most people who have consumed this sinful delight would know by now, Nutella is fairly addictive and this ensures it has a regular fan base. A casual google search of the science of nutella addiction threw up some results that caution against it's use.( http://www.healthy-holistic-living.com/what-you-need-to-know-about-nutella.html?t=SOE )

My point? Eat Nutella, Live Happily Ever After! :D 

Songs are my refuge when the world shuts its doors or when I choose to shut my doors against the world. Playlist:

• American Oxygen (Rihanna)
• Bas Ek Pal (KK)
• Beetein Lamhein (KK)
• Naseeba (Sunidhi)
• Mine (Phoebe Ryan)
• Khwaishein (Arijit)

Toodles! :D

Of What Is Dead And Buried.

Apologies. (in case you were waiting)

• February, the month of sports, cultural events and college day has passed. It's back to the routine of classes, postings and practicals for a while now. Except that the class trip is coming up over this weekend. :D

Saana Kundu and Mee. :)

• Restarted jogging (or rather, brisk walking) for the simple reason that it helps me remain active and for the rest of the day, not to mention that I need to remain fit.

• Bibliophile Updates:
• Chasing Tomorrow by Tilly Bagshawe (thanks to Anu! :D )
• Best Kept Secret by Jeffrey Archer (thanks to Likki! :D )
• Be Careful What You Wish For by Jeffrey Archer

• We're currently in our ENT postings. By the end of these postings we would have seen several endoscopies and Indirect Laryngoscopies (fingers crossed for chance to see a Tympanoplasty in the OT. After 3 days of maám, Ballal Sir taught us today! (rather he extracted answers out of us and tested our Anatomy by going into the specifics. The thing is, we tend to mumble the answers (right or wrong) to ourselves and the teachers either lose interest in us or demand to know what is it that we're whispering to ourselves. Although it was a HIGHLY embarrassing session where we realized how much we've forgotten, it was interactive and fun as well. :)

• We finished our OBG Postings which was majorly a theoretical session where we learnt about Pre Ecclampsia, Gestational DM, Ante-Partum and Post partum Hemorrhage, Labor, Cesarean Section and several other topics. What rankled us is the fact that the next batch is getting to watch procedures in the OT while we never did. :(

• Professors respond based on the kind of interaction they receive from the students. An interactive session encourages the teacher and they share more information because they know the students are receptive. This is a probable explanation why each batch is treated differently in the postings.

• Communal violence in Shimoga town prompted the authorities to declare holidays and impose curfew and Section 144 in the surroundings. Normalcy has returned and the Section will be lifted post Holi.

• Pathology has started to worry me because I realize that my brain does not want to accept, process or retain anything related to Leukemia. Being insulted by Mr.Y has become a regular affair and you develop some tolerance to it but the worrying fact is that there is actually truth in what he says. Sarcasm from Mr.V is nothing new but the fact that he is actually being honest is rather depressing. What kind of clinicians will we become? What kind of diagnosis will we do? What sort of Examination will we do on our patients? What kind of studying is this if it doesn't help you treat your patient?

• I don't know if it's a good thing that I keep reverting to the past and tend to look at it as a guiding light to what lies ahead. In some ways, I miss the excitement of first year, the rush to go take our place in the dissection hall (lest some other hyper excited idiot starts off dissecting by getting their hands on the dissection box), the little preparation we did before dissection (because RK wouldn't spare us if we failed to answer or atleast made a decent attempt) and our involvement in the whole process. Have things changed? Has the excitement dwindled? Or does it depend on whether the lecturer is engaging enough?
• Patching up has its advantages. You feel lighter and a load seems to have lifted off your chest. You no longer carry the burden of misunderstandings that continues to grow rapidly with time like a malignant tumor. Sometimes, you've got to leave your ego behind you and make the first move. Everything else will sort itself out. :)

• Too many things have been going on lately. Too much confusion and way too much nonsense. And that brings me to the point I'd like to stress upon in this post: Me-time. The idea of personal time seems to have completely vanished. The idea of having time for oneself has become extinct and everything is either a joint effort or a collaboration and I'm beginning to realize how much I've become dependent on this collaboration. Now, I've always been comfortable with the idea of being "solo", more than that, I've actually enjoyed the clarity of thought and peace that it gives, even if the rest of the world interprets it as anti-social.
• Certain decisions ought to be taken in the near future. Neither is the perfect solution but one must decide which is more viable and which is the closest solution to what I need.
• Of late, I've been gripped by a persistent dilemma. About the future. Have I really chosen the right thing? Is this career suited for me? Will I be able to do justice to it? I seem to have elapsed into a vortex of passivity and rarely do I emerge and interact productively. Added to this is the misery of having forgotten Anat, Physio and Biochem which the professors take joy in pointing out with great scorn and sarcasm. This makes me question myself, are my methods wrong? Is my approach wrong? Do I need to revise more often? Or am I not cut out for this? This is the profession I have chosen for myself. Will I be successful with the same rate of effort? My weakness is that I evade, avoid and detest explaining any concept. I'm slowly beginning to realize how important it is to be able to describe a process, a condition or a mechanism with simplicity. This quality is one of the foremost prerequisites of a medico, not just the ability to fill endless pages of information. Painful as it seems, the distinction that I worked for means nothing. Every other day, I question myself as to how I've passed first year of MBBS. Have I cheated myself more than anybody else by passing?
• Very often, one is tempted to join the herd. When even those closest to you, it doesn't seem so bad after all. But then, it's at these moments that you should stick to your principles and do what is right.

• I am strongly tempted to Delete (Not Just Deactivate or Uninstall) WhatsApp, Facebook, Instagram, Snapchat and Hike (yes, even silly Hike) but such temptations have become a regular thing. Rarely do I "succumb" to them.

• Plans to meet MaPaDi have once again been postponed. It might be another month before we meet. Bheemi has exams coming up, I have ENT, She'll have her results and then hopefully I can meet them all. Nidhz is busy with boards (for an entire month. Phew!) so it will be a while before I meet them as well. It's been I while since I spoke to Ajji-Bajji, I should probably call her today.

• Check out the Prognosis App on Google Play Store. An interesting app where you've got to diagnose a case based on the given input, investigate with relevance and treat accordingly. You score based on your performance and you get a detailed explanation regarding the diagnosis and course of treatment and why the other options are less appropriate in the case concerned. 

• OH AND BY THE WAY, I've completely forgotten to mention about my May Plans!! This may be a little hard to believe (you might even be tempted to Roll On The Floor and Laugh but it's true). I intend to travel by myself to Mumbai and meet Bhopieeeeeeeeeeeeeeeeeeee for a few days. (I can do cool stuff in life too)
• I'm currently writing another story. Let's hope I persevere and finish it. :D
• Musicophilia:
• It's Empty (The Click Five) [Song courtesy: Annlee! :D]
• Yun Hi Chala (Swadesh)
• Jeena Jeena (Atif <3)

• Quote Factory:
• "Anyone can be a good winner. The sign of a great man is how you handle defeat." -Jeffrey Archer (Best Kept Secret)
• "Sneham Mathram Puchikaruthu (Malayalam) - Never Belittle Love."-Preethi Shenoy (Life Is What You Make It)
• “You’re so bossy.” “Why is a woman always described as bossy, when if a man did the same thing he’d be thought of as decisive, commanding and displaying qualities of leadership?” -Jeffrey Archer (Be Careful What You Wish For)

                                        

Seeya Later Folks! (Sedative Hypnotics awaits! BTW Did you know that Sedatives technically are not for insomnia but for producing a calming effect and decreasing irritability? Hypnotics are the ones used in those cases to induce sleep. Sounds confusing? Read this.

Awwwww.

Incendium

This is device that can really make a difference to healthcare facilities in remote regions, especially when sophisticated diagnostic devices aren't accessible.
http://timesofindia.indiatimes.com/home/science/Indian-team-in-global-competition-to-build-powerful-home-medical-device/articleshow/40487838.cms

Like the blurb says, memories can initiate different emotions in people. And there are always those memories we would like to forget/ get rid off to avoid the emotions they are associated with. This mice based experiment shows promise to PTSD and depression patients to reverse the emotions associated with certain memories by identifying the region (dentate gyrus) and tagging the neurons associated with the storage of that memory.
http://newsoffice.mit.edu/2014/brain-circuit-links-emotion-memory-0827


Interestingly, Harvard University is also working on similar lines to 'erase bad memories' but this involves inducing Xenon gas which can block NMDA receptors [The N-methyl-D-aspartate receptor, a glutamate receptor, is the predominant molecular device for controlling synaptic plasticity and memory function.]
http://news.harvard.edu/gazette/story/2014/08/erasing-traumatic-memories/

Now, really! It's all part of evolution. We're constantly evolving. From the Stone Age man, to the advent of fire and invention of wheel, the birth of printing by Gutenberg to the age of smart phones, supercomputers and Google glasses, it's all part of an ongoing process.

http://www.economist.com/news/books-and-arts/21614088-neuroscientist-warns-will-internet-eat-your-brain

I agree, this didn't get the publicity that it deserves given the complexity of it. A paraplegic volunteer literally 'kick'started this year's World Cup in Brazil thanks to a robotic suit. Bet you didn't know that!
http://www.bbc.com/news/science-environment-27812218

And finally, I'd like to wrap up with this very promising article about the advent of Neuroscience Era.
http://online.wsj.com/articles/michio-kaku-the-golden-age-of-neuroscience-has-arrived-1408577023

Dreaming Is A Free Art.

First of all,

• Private India: James Patterson and Ashwin Sanghi [A thriller about a serial killer]
• A Painted House: John Grisham [Surprisingly enough, it doesn't have anything to do with law suits, courts or advocates. Just a simple story set in a rural Arkansas written from the POV of a 7 year old boy.]
• The Mother I Never Knew: Sudha Murty (two novellas, set in Karnataka, simple uncomplicated tales)
• Kim: Rudyard Kipling (currently reading..)

I discovered:

• Quora (Hilarious, informative and interesting.)
• Minube (I'm making distant travel plans without moving an inch.)
• Coursera (I've signed up for a few online courses. On the Topics I Like. For FREE. from Top Universities.I'm excited! :P) I mean seriously, there's so much you can do online. I mean worthwhile stuff. :P And here I am scrolling through endless newsfeed on Facebook. -_-

This is how my weekly schedule generally is: (No really. This is for the coming week)

• Monday: Doc Appointment, Swimming
• Tue: Driving exam practice, Swimming JustBooks
• Wed: DRIVING EXAM (ALL THOSE READING THIS, STOP FOR A MOMENT AND PRAY THAT I PASS. THANK YOU. NOW PROCEED.)
• Thursday: Habba, it seems.
• Friday: Another Habba, it seems.
• Saturday: Swimming, Justbooks, Meet friend.
• Sunday: Swimming, Family Time
• Monday: Swimming it seems, Sanjana's ghar (Finally!!)
• Tuesday: Sanjana's ghar
• Wednesday: Vasanthnagar (Finally!!)

And so on. -_- In the past week, I went back to PESIT and met Maidha and Manasa. Yes it was good to be back, see all the familiar faces and meet up with old pals. But sadly, I felt out of place. I mean, the campus, the people and the whole atmosphere was so awesome, I felt I didn't belong there. I wish I knew why. Maybe its for the simple reason that I don't really have any 'gang of friends' there. Just a few people I'd like to keep in touch with. I didn't really do much; I chatted with Manasa and marveled her hot haircut (which I can never dare to get, despite living in a hostel, 250kms away from home.) and then hunted for Maidha. I hogged her cheese sandwich and walked her to class while grumbling about how fashionable her campus was. And then I took the bus back home. It's just 10 minutes away anyway.

By now, you might have discovered that:

• I'm an incurable fan of Bullet Points.
• I love announcing the books I've read, currently reading or intend to read.
• My blogging frequency has definitely increased, but the quality of blogging has definitely dipped. Oh Well, Age does that to you. 

My latest talents include:

• Driving a car. (while the driving instructor has another set of clutch and brakes with him, but hey I'll soon start off in the i10 :))
• Riding a gaadi. (Yes! Finally! I ride to swimming class everyday. Okay, the funny part is that Appa's office is on the same route so he comes behind me. -_- BUTBUTBUT, I ride without anybody following me as well. It's fun. :) Will I get to zoom through the streets of Shimoga? Maybe, Maybe not.
• Swimming several laps of the breadth of the swimming pool. Nothing can get more exhausting. But it's a lot more enjoyable than sweating it out on the treadmill for burning the same amount of calories.
• Jumping into 8 feet depth. (Hey, maybe that's called diving! *Yayy!*)
• Wolfing down 3/4th of a Small Peppy Paneer Pizza in MINUTES. (It's got to be a record, I swear. I was practically famished so I devoured it.)
• Changing my WhatsApp DP alarmingly often. *giggles* I can't help it, I find all these amazing quotes and witty oneliners and sarcastic stuff that I simply can't resist from making it my DP.
• Accepting that some people will continue to be a part of my life. What I can change is how much I'm going to care about it. This realization has actually made me a lot happier, less of a worrier. It's in my hands to decide how much importance I give to any task or any person, so it's about time I take advantage of that. :)

Fear is looming large as the days pass, results may come in the near future. What has to happen will happen. Uncertainty is hard to bear and but maybe that's solace sometimes. Because atleast, that gives you the benefit of doubt. Unsure of what lies ahead, what to expect and where I'm heading. Sometimes I wonder, where do I really belong?  It's neither here, in Bangalore, in the comfort of my home, nor there, in Shimoga, in the hostel, but with myself. That's the only constant. People move in and out of our lives, few persist, fewer will be there for us, but we are the only constant, our only hope for a better tomorrow. Nobody else, nothing else will really be there for you until the end. It's just you, at the end of the day. In the end, only you will truly appreciate your efforts and achievements, only you will sit back and regret on the lost opportunities, and only you are responsible for the kind of life you lead. 

“That is part of the beauty of all literature. You discover that your longings are universal longings, that you're not lonely and isolated from anyone. You belong.” 
― F. Scott Fitzgerald

“Home is a notion that only nations of the homeless fully appreciate and only the uprooted comprehend.” 
― Wallace Stegner, Angle of Repose

Cheers! :)