Children of Gurez

 Far away in the midst of the snow clad mountains,

Exists a piece of land descended from the heavens
Nestled in the valleys in tiny hamlets,
Amidst flowing streams and rivulets

A meadow of green in the warm summers
Myriad hues during the monsoon showers
A carpet of snow beside the melted glacier,
Each day was a new chapter for nature.

Little ones who grew up in these lands,
With no gadgets but snow and flowers in their hands,
Away from the chaos of distant sands,
With only basic needs and no lavish demands.

A shepherding life for the summers,
A dormant life for the cold harsh winters,
Little ones living in a far away land
Where life has a different story planned.

In the midst of man-made borders and beliefs,
That only give rise to dispute and grief,
Children with their pure innocent soul,
Perhaps bear the heaviest toll.

The Walk Home.

My father said we were to pack up soon,

A long walk; because I wasn't born with a silver spoon.

I asked if I could bring my bat and ball,

But he said I would get one when they would reopen the mall.

I waved goodbye to my friends at the site,

The construction workers with whom I spent every night.

The mother carried the heaviest load among us,

After all, didn't she carry bricks without a fuss?

My father said we were to walk home to the village,

Yet my blistered feet did not give much mileage.

He said we would work in the fields and harvest,

But I was hungry and in need of rest.

My mother says a virus is here to stay,

To remain indoors is the only way,

But my father asks, what about our monthly pay,

And so I'm walking; to a place far away.

Anecdotes from the Medicine Wards... (1)

With much trepidation about the big majors I set foot in Medicine and my first consolation was that I was shunted to Psychiatry for the first 15 days. So I had 9 to 4 psychiatry duty followed by Medicine duty in the casualty on OPD days. A big relief was that I was placed in Medicine D Unit which had professors who were friendly and ready to share their knowledge. I was indeed lucky to have skipped the units with a cranky or an unsympathetic professor.

Though my time in the casualty was restricted to the post OPD hours, there was plenty of work since the cases simply never stopped coming! From accelerated hypertension cases (a cool 240/110mmHg), uncontrolled T2DM, chest pain, acute GE, CVA, fever with chills to alcoholic liver disease, alcohol withdrawal and the ever so common poisoning and snake bite cases, there were an abundance of cases that were constantly rolled into the casualty often giving us not even a moment's respite because there would also be calls from the wards/ICU/ICCU/Emergency regarding any patient who would need immediate attention.

In short, even though we were 4 interns in the unit, the workload managed to keep us on our toes at all times.

Dr. Hoysala, Dr. Muthuraj Sir, Dr. Halesh Sir, Dr. Impana and Dr. Sanjana C (missing in action : Dr. Venkatesh Sir)

An interesting case would be of Aravamma who came with classical chest pain, referred from a smaller government hospital (Belur?) after the ECG there showed what appeared to be Ventricular Tachycardia and her BP was around 180/100mmHg. Her previous history suggested IHD and she had undergone angioplasty earlier. Presently she needed immediate treatment in an ICU facility and since we had one bed vacant at that time, we explained the risks, the prognosis and admitted the patient. 

We started her on Amiodarone (an antiarrhythmic) at 150mg (1amp) in 100mL of NS over 10mins but she still remained tachycardic (180bpm) so we had to give her a DC Shock and the change in her heart rate was evident immediately. It was a scene reminiscent of a sitcom when I held the paddles (thanks to the guidance of Halesh Sir who gave me the opportunity) and the familiar 'charge' and 'clear' was announced. Although she remained critical after the initial recovery and she had to be referred to Jayadeva Institute, it was a memorable moment that made a lot of difference.

Then there was Gowramma who was admitted for chest pain and pain abdomen under Medicine but collapsed after her pain abdomen which required a CT scan went unattended. In retrospect it appeared to be an intestinal perforation which should have never been admitted under Medicine but under Surgery where she might have had some chance.

In contrast there was another patient who had chest pain and pain abdomen. While we had an ECG and Troponin I to rule out IHD, it was the CT Abdomen which suggested metastatic growth in the liver hence she had to referred to a higher centre even though she appeared to  be stable.

There  was Rangegowda who was a known case of IHD and had a poor prognosis and when he had a second arrest, by the time the ECG taken reached us and by the time it was seen by the duty doctor, he had suffered another arrest and couldn't make it.

Then there was Jayalakshmi who came with bleeding gums and her inital platelet count was around 500/uL. She received about 6 pints of whole blood transfusion for her anaemia and thrombocytopenia but her last platelet count was around 28,000/uL.

After a peripheral smear, the next logical step was a bone marrow biopsy to investigate the cause of thrombocytopenia. After some running around, I coordinated with the Pathology professor who taught me how to do a bone marrow biopsy with a Jamshedi Needle at the sternum. We had a look under the microscope and it appeared to be a case of ITP so we put her on oral steroids (Wysolone) and discharged her after nearly 10 days of admission.

There were a lot of patients who came in with genuine complaints and were admitted only to have no investigation done and were only visited occasionally by their attenders who viewed them more as a burden and hence didn't bother to get the necessary blood transfusion done or even get them the medicines prescribed. Another patient who had severe pitting edema of upper and lower limbs needed a 2D Echo because her ECG suggested a previous MI but it took an angry phone call from my side explaining the seriousness of the old lady's situation to get the absconding attenders who were away due to festivities.

It was disappointing to see how little some attenders cared and at the same time there were exceptions like the 13 year old boy who got his grandmother Arjunamma admitted for fever and anaemia and ensured that she got 2 pints of blood transfusion and a USG Abdomen done and had been the main cause of her good progress and successful recovery.

There was Thayamma who came with weakness of Right Upper and Lower Limb and the CT Reports confirmed the stroke but it was the CBC which caught my eye with an elevated WBC count (149*10e3/uL) and a Peripheral Smear confirmed the probable diagnosis of Chronic Myeloid Leukemia. Unfortunately, even after we explained the need for a bone marrow biopsy and the availability of the appropriate treatment at Kidwai Institute, the attenders and the patient were inclined to go home so there wasn't much we could do.

Probably one of the most heart-rending cases are those of 'Unknown' patients/destitutes who have literally been picked up from the streets after some passerby would have informed the ambulance hotline. Since they had no attenders, it was left to the hospital staff to get the investigations done, ensure her nutrition, hygiene and well being. The sad reality is, when one is not accountable, the entire team begins to take less effort because they know they are not answerable to anyone. 

The (unknown) old woman who was brought in an inebriated state only mentioned vaguely that she had been assaulted by her son while slipping in and out of her delirium and so gangrenous foot required a doppler according to the surgeons who didn't offer any other treatment, the fractured forearm couldn't be put into a slab because of the swelling according to the orthopaedics, her sugars were elevated but there was no Insulin supply in the ward, her Urea and Creatinine were elevated but with all other comorbidities, she certainly wasn't a candidate for dialysis and thus ended the story of a woman neglected by her own kith and kin and subsequently by society as well....

(To be continued)
https://moodymusings95.blogspot.com/2018/11/the-lessons-and-learning-in-medicine-2.html?m=1

 (some names may have been changed)

Lead Kindly Light.

From mounting debts that pushed them off the edge

Through affairs that drove an irreparable wedge,

To the grieving for whom relief was a far fetch,

They chose the untrodden path of no return.

While somewhere a wife grieved for her beloved

Elsewhere a lover regretted hasty words unapproved.

And yet another father repented over love unshowered,

For they had lost a loved one to a preventable illness.

Tender care and concern was what they needed

To nudge the fallen spirits that could be reignited

A warm kindling fire of support was all they pleaded,

To awaken the sanguine Phoenix from their ashes.

To save one from the clutches of despair,

Is akin to saving a drowning man at sea.

By giving wings to a wounded man's dream,

Be that social pillar that shall heal and repair.

Suicide is not the answer.

Written in view of Suicide Prevention Awareness.

Keep your eyes and ears open!

Here we are at the end of August with 2 months of Medicine looming large. The past month has been spent in the Ophthalmology department and presently in the Department of ENT.

Ophthalmology department worked very systematically and since there were PGs here, there were specific tasks allocated to the interns. We did a LOT of IOP measuring, VT measuring, Lacrimal syringing, conjunctival washes and seeing the OPD cases upto one extent following which the PGs would take over. We even had a seminar assigned to us on a specific topic and thankfully that went without a hiccup. 

The Department is extremely productive; there are OTs almost thrice a week with one of them being a 'Camp OT' where more than a dozen patients would come for the cataract surgery. Apart from the regular cataract surgeries, Pterygium excisions, dacryocystectomy and Trabeculectomy procedures, there was the speciality clinic where they did laser procedures for Posterior Capsule Opacities (PCO: a common post op complication), Testing of Visual Field by the Automated Perimeter, B Scan (when the fundus was not well visualized on Direct Ophthalmoscope) and Fundus Fluorescein Angiography in cases of Diabetic Retinopathy and CRVO and so on.

While some days were interesting with something new presenting in the OPD like a Corneal Ulcer or Nystagmus or perhaps a foreign body, other days were spent in the mundane reality of testing the IOP of patients who simply refused to follow my instructions in spite of the simplest of explanation in the most controlled calm voice possible. Ophthalm duty did not actually involve frequent casualty calls and even when they did, there would be a first year PG to help you with it. The PGs were friendly and the kind you could approach for all the questions that pop into your head.

Following 13 days in Ophthalm (I took two days off and headed home for the weekend. Ah, bliss.), It was time for ENT. The ENT OPD was definitely busy and there were regular admissions for the surgical procedures like Tonsillectomy, Septoplasty under FESS, hemithyroidectomy, Excision of swellings, Tympanoplasty with Mastoidectomy and sometimes even emergency tracheostomies.

 The OT is twice a week so more often than not, due to the heavy load of cases, a patient ended up having his surgery after it had been postponed ATLEAST once. After a 'shakeup' of things regarding the casualty duties, it appeared that we would not have to do duties but of course that was not meant to be so the duties are back on and we keep the PGs in the loop.

While ENT does bring you in close contact with infections, it also brought out the effect of people's habits. Oral submucosal fibrosis was a common presentation after years of tobacco chewing as was a carcinoma of pyriform fossa or a tonsillar malignancy in chronic smokers. One patient came to us with a very obvious swelling in the neck that ulcerated in few days, change in voice, inability to swallow and in stridor requiring a tracheostomy within a few days. While some of the early stage cancers are given RT/CT, the others are given more of palliative care since they would not be eligible for radical neck dissection and RT due to the  widespread growth of the tumour.

Another patient I followed up was Eshwaraiyya who came to us with uncontrolled epistaxis. He had earlier undergone ligation of the sphenopalatine artery at St. John's as well but the problem had reared its ugly head again. He had a history of cerebrovascular accident few years ago and was on ecosprin since then. He was also a known case of hypertension and had been passing blood in stools for some time now which had caused his Hb to drop to alarming levels of 5gm/dL. After transfusion of 3 pints of blood his Hb improved but that didn't solve the root of the problem so we referred him to the surgery department where they scheduled him for a colonoscopy to find out what could be causing the bleeding.

ENT was a memorable posting thanks to the interaction we had. Some of the professors were friendly and explained more on the procedure and the case at hand, the PGs were approachable and I was excited to find a fellow bibliophile in Sana ma'am and also, it was good to have more interns join us making the work load lighter, fun times more frequent and many light hearted moments during the course of these 15 days!

The next 6 months are the 3 big majors starting up with General Medicine which includes 15 days of psychiatry. I have a lot of trepidation about the coming days but hopefully they will be eased once I get into the thick of action. Here's hoping I can do my best, deliver to the best of the facilities available and assimilate as much as possible from my experiences. :)

A Billion Worlds.

We live in a world of contrasts;
A conglomeration of extremes.
While a little one utters its first cry in a grubby labour room in a village, another is already trending on social media.
While the little girl who studies at the local school dreams of becoming a teacher,
another boy juggles between cricket, guitar and the perfect grades.
While one relishes the chat by the roadside stall as a treat,
another has a brunch at the upscale resort in town.
While one lit the midnight oil in a nondescript town to bring life to those dreams,
another light up to banish those insecurities in a cloud of grey.
While one was blessed with conjugal bliss,
Another was tethered to a lucrative kiss.
While one sweats it out for the daily bread,
another plunders through wastefulness and opulence.
While one surrenders to the elements,
Another challenges them and defies death.
Between these two divides lie the great majority.
In awe of wealth, yet aware of cruel Fate's stealth.     
Cushioned from dire poverty yet embroiled in competitive vagary.
Cocooned from squalor but desirous of glamour.
We live in a world of contrasts;
A conglomeration of extremes.
With a billion stories within us we live,
With hope that some dreams shall fulfil.

Backpacker Diaries

"Seriously?!" she asked me in surprise, "You're going alone all the way to Cochin?"

"Are you really going alone or is there something you're not telling me?" said another with a sly grin.

After my spontaneous decision to go backpacking resurfaced, it wasn't difficult to choose: Kochi or Alleppey since I wanted to travel God's Own Country.

After having a good look at the options at hand, I got the travel bookings done thanks to Abhi and BP, packed my bags for 4 odd days, borrowed some sunscreen and a good power bank and set off on yet another journey to explore!


The journey to Mangalore was a night bus and I managed to catch some shut eye despite the window sneaking in cold air as we rattled our way through the Ghats. The next morning after a quick "Wash and Brush" at the dingy bus stop and a simple breakfast, I headed to Mangalore Central, found my way to the right platform and boarded the 7:20 Ernad Express that starts from Mangalore, traverses through Kasargod, Thrissur, Kannur, Kozhikode, Cochin and Alleppey, all the way upto Tirunelveli. It was a pleasant journey with a scenic view of streams, canals, coconut fields and green fields and I reached Cochin by late evening, found myself an Uber and reached Zostel after a 45 minute drive through the city's bustling lanes, overlooking the lit up port and through the quieter neighbourhoods.

Cochin, the conglomeration of Ernakulam town, Mattancherry, Fort Kochi, Willingdon Island and a few other nearby islands, is historically famous its role as a trading centre, a thriving port town and the epicentre of cultural exchanges back in the day. The earliest visitors were probably the Chinese who are known for their most famous contribution to the city: Fishing Nets that dot the landscape of the sealine. After them, came the Arabs, followed by the Portuguese, the Dutch who brought Kochi to the international limelight as the hotspot of spice trade and a commercial hub. Lastly, the British arrived and mainly used it as a colonial settlement but not before it had made a lasting impression in the international circuit for its trade relations. 



So in retrospect, it made perfect sense to me that I had Americans, South Asians and Europeans as roommates and subsequently interacted with a diverse lot in the following day! I opted to go on a boat ride in the morning and we were joined by new travelers along the way until we reached Vaikom. 

Thampi, our guide, told us about the agenda for the day and we set off in two small boats (or canoes) through the backwaters, gently sailing through the narrower canals even as the tree lined canopy shaded us from the heat of the sun. Water snakes, washerwomen and bathing children greeted us along the way until we disembarked at one of the settlements to have a look at the spices like cardomom, clove, bay leaf and nutmeg. We had a glimpse of how coir was made (Unity is Strength was the take home message) and later had a traditional Kerala lunch on a plantain leaf.

During the course of the day, I spent time with my roomates, Gaby and her friend who were Americans working as teachers in Thailand and we shared some light moments and 'rice crackers', a crispy snack from Thailand. There was Naomi and her friend from England who were friendly and we bonded when I realized Naomi was a doctor and wanted to pursue Tropical Medicine. Then there was blue eyed Robin and his friend Yohaan from Germany who were students on a vacation and Ponya, also from Germany who had traveled across the length and breadth of our country. There was a pretty young girl, Anna also from Britain who was on a gap year after finishing high school. Coming to India was a revelation of sorts for her since this was where her parents met when they were in college. Then there was the All American couple, John and Debbie, who were pleasantly surprised to know that I was from Bangalore and not in IT. I learnt a little about the american healthcare system and also why medical tourism in India is picking up rapidly. The web designer from Paris had some stories to share about his stay in Sao Paulo and Germany while Lee, the American shared his experience and photos of the Aarthi at Varanasi. While he worked as a limousine driver for half the year, the other half was (wisely) spent in traveling across the world. 

Post the boat ride, I met another Asian, Nanthini, from Malaysia who was also on a solo trip and we watched a beautiful sunset by the beachside. I was glad to have a fellow companion as we ventured around Kochi at our pace. Perhaps it was the Asian connection or just two individuals bonding over their love for travel but either way, ai was glad to have found a comrade. In a way, Kochi was and still is, the melting pot of many cultures as it continues to attract travelers, tourists, businessmen and artists alike. 

The following day, Nanthini and I made a neat plan thanks to the folks at Zostel and we began with a visit to the Mattancherry/ Dutch palace which houses intricate murals and a lot of artefacts that detail the era of the Kerala rulers. It detailed the lineage of Raja Rama Varma, the matriarchal system, their weapons, wardrobe and a general preview of the life they lead. 


After this we took a walk down the Jew Town and shopped judiciously for curios. A customary visit to the Synagogue showed us a few paintings that explain the role of Jews in Cochin, their arrival, trials and triumphs. For lunch, we headed to Fusion Bay where Nanthini got her much awaited fish curry cooked in the traditional Kerala style with a hint of Mango while I was content with some Okra Masala and Malabar Parota. Post lunch, we rested awhile at Santa Cruz Basilica, refreshed at Zostel and then headed to Kerala Kathakali Centre. 

Kathakali is an ancient dance form originating in Kerala as a variant of Krishnanattam under the then king's support. It is known for its detailed makeup and costume efforts, intricate facial expressions, mudras (hand movements) that signify different meanings and the enactment of a story from any mythological tale such as the Ramayana or Mahabharatha with drum beats, cymbals and vocals to accompany the performance. Kathakali performances are traditionally known to last for several hours and generally involve only male artists. 

We arrived in time to watch the make up in progress which every performer applied by himself for the most part. We were taken through the basics of Kathakali before we began with the story depiction. With rhythmic drumbeats, spirited use of cymbals and intense expressions, it was a complete performance that left one wanting more. 




After dinner at a nearby cafe and bidding goodbye to my newly found friends, I struck up a conversation with my Uber driver as we made our way back to Ernakulam Junction Railway Station for the Maveli Express. A nursing student, he was surprised that someone would travel alone but I think I made some valid points in my defense and appeared to be more open to the idea by the end of the journey. 

A delayed train journey, some Ideal Gudbud for breakfast in Mangalore and a bus ride later, I was back to the comfort of my room in Shimoga with a cartload of memories and the unmistakable self confidence that comes when you know you are independent. :)

PS: Half the pictures are courtesy of Nanthini's photography skills and the rest are probably the last works of my phone as it lies on its deathbed. :P

C/O Indian Railways.

The next day was the BLS workshop that was conducted by members of the AHA. The Profs were intelligent, interactive with a sparkling sense of humour and even good dramatic skills. It gave a sneak peek into what the teacher student relationship might be out there and I enjoyed every bit of it. We even had written and practical tests to clear before we would be certified as Basic Life Support Providers.

After we explained our predicament of an early train to Agra, the organizers agreed to hasten the examination process for the 10 of us and we got out in time, rushed to the hostels, packed our bags and made our way to Nizamuddin Railway station about 20 minutes away.

Laymos that we were, we should have sorta chilled because trains never really arrive on time (atleast in the North). This train journey was definitely memorable because a vast part of it was solely dedicated to my leg pulling and subsequent amputation (with a fishmouth incision -_-'). What with cute uterus and Philips tubelight jokes, I still crack up at all the shit we spoke. Later on, we began playing dumb charades and antakshari much to the amusement of the co passengers.

When in Agra, you will be fleeced. Just remember that. There will be people right from the moment you step out of the grubby station who will pounce on you with offers that seem like a good deal but with hidden agendas of their own.

Our hostel (Bedweiser (hihihi) was at quite a distance from the station so we (25 of us) took 4 taxis and reached our destination; famished and fatigued. We struck up a deal with the same taxiwallas for the next day that would involve Agra Fort, Taj Mahal and Fatehpur Sikri and back to the railway station by 4.30 and after much negotation we settled for an amount. After this we headed to the nearest (and only open) restaurant and wolfed down a few morsels before crashing into our bunkbeds by midnight.

We woke up after a few hours (4am), refreshed and then headed towards the much awaited mausoleum of love; Taj Mahal. I must admit, it felt so much more appealing in the pristine coolness of the morning; devoid of the thronging crowd and appreciated at a slight distance. We spent an hour or so, admiring the monument and enjoying the relative solitude that it offered.



After this, our cunning drivers took us to a desolate dhaba on the highway (no doubt that he had an agreement with the owner) who served the driest parathas and watery lassis after the longest wait. Our next destination was Fatehpur Sikri and we began our tour guided by a local even as the sun glared down mercilessly.

A few dargahs and many tombs later, we were walking through the palace of JodhaBai and it was indeed an awe inspiring moment; to imagine the royalty who lived in these royal palaces, a princess educated in art and culture, the menfolk upon their horses in all their armoury, the sound of horses racing back after a battle and the opulence in architechture and lifestyle.. another era indeed. :')



After this BP and I headed to Domi for lunch (bliss of something appreciable to the tummi), got back to Bedweiser to pack up (25 guys and girls in about 6 rooms) and then we rushed to the railway station to catch our 4.30 train.

Did I mention that we never learnt our lesson? Our amazing train arrived a good 4 hours late! Exhausted though we were, sleep was scanty. The next morning is one that I will remember. I woke up around 6am to the sight of the green fields of Punjab, cool and pleasant weather and I added some music for good measure.
We passed through Ambala, Chandigarh and Ludhiana but the beauty of the morning persisted. Somewhere in the middle of this long and endless journey, I found my moment of peace.

We reached by noon and the 4 of us took a rickshaw to Wow Backpackers (in some gully of Namak Mandi) while the others deposited their suitcases in the cloak rooms of Amritsar Railway station. We rushed, changed and after some confusion and angry Hindi yelling at the owner for not arranging a cab (by meehehehehe), got an autowalla to take us to Attari Wagah border and then drop us Back at Golden Temple for an agreed sum. While we skipped lunch (after having skipped an organized dinner and breakfast the following day), the rest of the group had lunch and directly proceeded to Attari without checking into the hostel.

The scene at Attari cannot be described; it must be felt. Thousands of people thronging into the arena, from little ones feeding from their mothers to age old couples holding hands to resist the rush of the crowds. Cheeks painted with the tricolor, patriotic songs blaring in the background to outdo any sounds from the opposite sides and young ones running across with the national flag in hand and sheer pride on their face.

But the real prizewinner is the display of military power by our soldiers in the Beating Retreat. The majesty and grace of their moves, the strength in their stride and the grim determination etched upon their faces after years of rigorous training are a sight to behold!

After this, we egged our driver to go faster and made it to Golden Temple. Glowing and resplendent against the backdrop of the starry sky, this place is a lesson in humility and service. We were lucky enough to be served at the Langar. It is indeed a sobering moment as you hold out your hands to receive the sofest roti you have known in days by the volunteers here.

With our batteries down, we depended on the kindness of the localites to help us find our way back to the hostel; pack up and once again rush to the railway station. The train was thankfully not too late and thus began the penultimate leg of our journey. May I take a moment to explain how damn amazingly well I can yell at pushy women who dare to push me and my friend while boarding the train; in chaste and pure Hindi until they finally (decided I was a raving lunatic) let us pass without much scuffle.

The next morning we refreshed, took the direct metro to the airport and feasted for a while before we boarded the flight back to Namma Bengaluru. After two more hours in the Vayu Vajra, it was finally time to sink into the cushions of my own bed, the comfort of my parents home and the efforts of my father's cooking.

Chalo Dilli!

The journey began on 14th of June, we boarded the train to Bengaluru and set off towards KIA after a brief halt at 338. Somehow there was a new excitement in flying, given that we were all by ourselves!
After a journey peppered with Bhindi and Chapathi by Amma, we landed at IGI Airport only to be slapped across by the hot and humid weather of the capital.

Nevertheless, we acclimatized slowly, made our way to the Aerocity Metro Station in a bus where we all got Metro Cards for INR 200 which would basically cover our travel expenditures in the coming days.
With a suitcase and backpack each, we boarded the metro, then changed lines to the Yellow Line and deboarded at the hustling Rajiv Chowk. From here we took autos to LHMC (which was around the maze called Connaught Place, something we slowly began to figure out in the course of our stay)

Tired (and hungry AF) we reached, registered and were shown our rooms. Now LHMC is a government hospital that was started over 100 years ago. Please keep this in mind when you imagine the condition of the girls hostels. Abhi BP and I shared a room along with a few other creatures I do not wish to speak about. The ancient rooms had attached washrooms that resembled dungeons with their gloomy lighting, cobwebs and barely there rickety doors. Nevertheless, we settled down and set off for day 1 of sightseeing.

We covered India Gate and Chandni Chowk on day 1 but our appetites were yet to get a true taste of Dilli but for the 'Dahi Bhalla' that is a legacy.

For some reason, Abhi and I could not join the Uber on the way back (passenger limit) so we did this fairly daring thing of walking through creepy gullies to take the last metro back to Rajiv Chowk and then making our way back to Hardinge dodging creepi doods and asking helpful rickshaw bhaiyyas and not getting misled by Google Maps.

The next day was our suturing skills workshop, quite similar to the one I attended at JNMC except there was the smiley Dr Manju Puri who took us through the sessions and here again, we had resident surgeons giving us some hands on exposure.

Post workshop, we headed to Jama Masjid via metro, rikshaw gaadi and on foot. The last leg of the journey was through gallis filled with hawkers, curious bystanders, worshippers and plenty of pickpockets and 'smugglers' as we were warned. Tall and imposing, it was teeming with visitors owing to the ongoing Ramzan season and it made for a photo opp. After this and after much debate we took the metro, changed lines, took an auto again to the thrift shopping enclave: Sarojini Market. After my previous experience with shopping here, I did not hazard another attempt here save for a dreamcatcher, an amphibian soft toy for Di and some new funky super comfortable T.



Dinner was Dominoes at the nearby mall and we headed back to the hostel after a tiring day. The morning of the presentation arrived and after battling the unkind effect of Dilli breakfast on my poor palate (Aloo Aloo everywhere!), it was time to face the music.

The examiners were the HoDs/ senior doctors in their field and asked a lot of questions (unlike my previous presentation in Kolar). I answered a few, accepted that did not know a few and tried valiantly to defend any inconsistencies that they attempted to uncover. BP was with us the whole time and she managed to give some real time answers to a few must know questions by her quick work. The others from Manipal, Jipmer, MAMC and north eastern college also had many interesting cases to report.

After this, we set off again on our next venture. Agrasen Ki Baoli and Jantar Mantar were the monuments we visited on Day 3. Dinner was a peaceful affair; Dominoes (for Sumzzu) and Saravana Bhavan (The South Indian's answer to all food woes).

After this, I got to work on my slideshow for the next day and the news that two entries from our college made it to the final round made us very happy indeed.

The next morning, Govi Varsha and I (I am the eternal third wheel) headed to Akshardham after breakfast at Haldirams and a metro ride on the Noida/Vaishali Lane. Despite the sweltering heat we did not fail to admire the beauty of the temple complex and the intricate architechture.

After this, we headed back and I braced myself for the upcoming presentation. After a barely there lunch of plain rice (papad-esque rotis are not acceptable to me, you see) it was Time!

The presentation went fairly well and Dr Sharda Patra was the second judge along with the medicine HoD(?) from the previous day. The uniqueness of the subject (Psychiatry) got their attention and my USP was that detailed history taking is still the crux of medical diagnosis.

After a seemingly long wait, the results were declared and I had made it to the second place. The first place went to MAMC for a case of chromosomal abnormality (probably the first recorded case in India and among a handful worldwide) that was well researched and presented.

After the prize (and cash :P) distribution, we (Abhi BP and I) headed to Dunkin Donuts at CP for celebratory donuts and the icing on the cake was a south indian Thali at Saravana Bhavan (again after jumping the queue and sneaking in under the aegis of parcels) served by Kannada speaking annas.

(Do you want me to continue?)

North East Part 2

We reached Gangtok around 8PM and our lodging was Maple Residency, a brand new hotel with good interiors. We got to meet the tour operator Mr Roshan who briefed us on what was in store for us next. The next morning we set off towards Nathu La with all our warm clothes bundled together  for further use. We received the permit on the way and began another journey through the mountains. This time, the gradual change in scenery was evident; from lush green mountains dotted with waterfalls, the landscape morphed into a dry and sparsely vegetative land with mounds of ice lying in heaps. The air was chilly and it continued to drizzle through the journey. We were not alone in our journey as scores of other vehicles were heading in the same direction. One of the locals accompanied us in our journey and she had a stall enroute to Tsong Mo Lake. Like most other people, she lived up in the mountains on most days with her sisters where they served tourists with refreshments and provided warm clothing and boots on rent and returned to their home in Gangtok once in a while. We had another Tea break here (might I add that I was sorely tempted to try some alcohol that would suit the cold climate but then, perhaps that is for another day..) and got some boots for the icy terrain that awaited us. The four of us downed Diamox (Acetazolamide) as the high altitude was bound to make us uncomfortable. We reached Tsong Mo Lake just as the mist was beginning to set in and had some customary Yak photos with Raju, the pink-horned Yak.

In your to visit Nathu La Pass, not only does every individual need permit but the vehicle in which you will be travelling also requires another permit. The vehicle in which we were supposed to travel arrived a good 2 hours late (when we had almost given up hope that it would turn up) and with no way or contacting them (no network in these areas!! Except for good old BSNL which is used by .000000001% of the population) we were a frozen, frustrated lot! When the vehicle finally did arrive along with some more people headed towards NLP, we were all bundled together and began yet another journey through winding lanes in progressively deteriorating weather. When we reached the entrance, the weather was anything but supportive of our quest, and the rain showed no signs of relenting. 

Nevertheless, Athhe, Mama and I began climbing upwards through the ice along with dozens of other tourists. There was no path demarcated and one could not see beyond a few feet ahead. We kept asking for directions until we saw a small café tucked inside the ice. We gulped steaming hot tea and some a few momos that scalded our tongue but the heat was a welcome change from the biting cold. The trenchcoat I was wearing was not waterproof; hence I was now soaked down to my feet. I have never experience such extreme climate in all my life and the high altitude was another factor. A father and daughter duo was returning and the father seemed rather shaken by the ordeal and advised against proceeding further as visibility was too poor to see across the border. With a sense of relief mingled with some regret we returned back to the base where we boarded our jeep and began our journey back. An army truck had lost control and was lodged in a ditch so we were delayed by an hour or so.

I must take a moment to describe our driver for the day, Sanjay. A Nepali by origin, he was plump chap and had the demeanour of a cheeky schoolboy, a sarcastic comeback for every dialogue and a witty sense of humour. Although we were downcast with the weather forecast, he entertained us through the journey and dearest Atthe, who I consider as a shining example of beauty with brains (*cough*) finally found an opponent who could retort with equal sarcasm.

We returned to Maple Residency, freshened up and warmed ourselves and took an uphill walk (it seemed like a 70° incline) towards MG Marg. The tiled road does not allow vehicles and flowery lampposts adorned the median path. The road had a European touch to it and one could not help but admire the smart and well dressed women, the handsome policemen and the absolutely adorable little ones. We shopped a little and I purchased a few trinkets. We took a taxi back to our hotel in time for dinner and headed to bed.

The next day we were denied the North Sikkim Permit due to bad weather and we decided to tour Gangtok. Our driver for the day was Deepak, a football player and he was notorious for asking us to alight a good 1km away from the tourist spot with the blatant lie “Nazdeek Hai”. As most of the places are located on a hill top, we trudged along the steep incline wondering how on earth this was “nearby”. Our first visit was to Rumtek monastery and it was fairly crowded with a lot of people seated in the courtyard, on the terrace and along the pavements. We were later informed that it was a holy day for Buddhists and there were special prayers in progress. We witnessed form of dance/ritual performed with elaborate costumes, a menacing headgear and gigantic white boots. We visited the monastery and then did some more shopping at a souvenir store. After this, our next destination was Namgyal Institute of Tibetology which had a a good collection of Tibetian manuscripts, artefacts and explanation of their various practices. One thing we had noticed at the monasteries (Rather, Atthe noticed and we later realized) was how there were always seven bowls/cups of water placed in front of the deity. It was here that we got an explanation for the same.

After this, we had a good lunch (Cheese Pizza) at Hotlinks and proceeded towards Netuk House. This was a homestay with a beautiful garden and a lot of flowers. It had a homely feel to it and just like the other places; we scammed their WiFi without much delay. :P Mild showers left us worried but we equipped ourselves with umbrellas and headed towards MG Marg. We spent the evening here and then returned back to Netuk House in time for dinner where we met another family from Pune. With hopes for the much awaited Permit, we retired for the night.

The next morning after a lot of anticipation, the prestigious Permit was granted to us and we set out towards Lachen with minimal luggage. Our driver Tenzing, an elderly man, seemed like a no nonsense guy and was working on a timeline. He seemed like a seasoned driver and himself hailed from North Sikkim but somehow we couldn’t establish a rapport with him as with the other drivers so far. Along the route, streams confluenced into a cascade and to the city dweller it was indeed a treat to the eyes as they dotted the scenery. We stopped at Mangam for lunch were we met another Kannada family (coincidentally, it was another Balu!). The drizzle picked up pace and soon it was torrential rain and the waterfalls were swollen. Rocks on the road could only mean that they had fallen from the shaky ground above and the overcast sky could only predict gloom. Nevertheless, our driver was optimistic and hoped to reach us to our destination at the earliest. We stopped at Naga falls where the water roared downhill, cutting through the rocks and flooding the cemented bridge. The road ahead seemed daunting and at times, it didn’t seem like a road but a mere excavation through the mountain that stood precariously. We halted at Chumthang for tea where several other travellers huddled together for some chai in the rain. It was here that our driver informed us that the road back to Gangtok was closed due to the collapse of a bridge but we didn’t realize the magnitude of his words until much later.

 We set out towards Lachen and the road was empty save for the villagers gleefully pointing out “Raastha band hai”. Solitary boulders dotted the road and we passed through rickety bridges even as the chocolate brown water gushed downhill with an alarming intensity. The lack of any other vehicles in either direction did not help matters and we were now beginning to question our decision. A lone army jeep was perched atop the hill and we approached the officer for guidance. He advised against proceeding further as the road had caved in due to landslides at 3-4 places. With a heavy heart we returned towards Chumthang and took a turn towards Lachung (the other place on our itinerary). We progressed about a kilometre only to see dozens of tourist vehicles returning back as the roads had caved in here as well. Fate had ordained that Chumthang was the halt for the night so our driver spoke to the owner of the Chai-Snacks place and we were allowed to stay at their place for the night. If you are wondering why we didn’t stay at a hotel, let me assure you that this sleepy little village had none! Chumthang is just another village at the intersection of Lachen, Lachung and Gangtok with nothing significant except for a beautiful Gurudwara.(which has a history of its own…).

We checked into Chumthang residency with mixed feelings; regret for not having made it but gratitude for having food and shelter for the night. Several other tourists were seen scrambling for a place and some were granted permission to sleep in the premises of the gurudwara. We had a room to ourselves, a few thick blankets, bedding and a candle. The twist of events had left us all in varying states of unrest and each of us reacted in different ways to the same situation. The lady of the house was hospitable and they prepared some Dal, rice and fried vegetables for dinner. Her husband, son, daughters, daughter in law and grandson (which we later realized was a granddaughter), three dogs and two cats all lived in that building and that night they opened their doors to 8 Gujarathis, a family of 3 from Delhi and the four of us. The little one entertained us with her antics and it is sheer sadness that I have no photo of her or the daughters. We later heard that not only had the bridge collapsed and washed way in entirety by the waterfall but another landslide had occurred some distance from the bridge and some unfortunate tourists were stranded between the two points with nowhere to go for the night. The night was long and cold and I had some terrifying dreams I would like to forget asap but the next morning was clear and sunny (a lot of touch wood happened at this observation because we could no longer dare to forecast the weather with certainty).

Our tour operator, Roshan was assured us that they would do their best to get us back to the mainland and we took a long walk along the streets of Chumthang town where we met scores of other tourists who had met with the same fate. At the army checkpost, one of the officers assured us that the army would construct a bridge and even urged us to go the Lachen for the day. We spoke to him for a while and slowly began to appreciate the magnitude of work done by the army which mostly goes unrecognized. After receiving a green signal from an army officer and news that Roshan had reached the site of the bridge collapse, we set out back to Gangtok. The army had constructed a makeshift bridge from tree trunks and it was secure enough to handle the tourists. A young lad transported our luggage across the river and through the slippery terrain even as army officers helped us at every juncture *wink*. Once again, we met the other Balu and his family and we exchanged stories of our ordeal. After waiting in the hot sun, the 8 of us (with our entire luggage) set off in a jam packed Bolero towards Gangtok. 

Echoes from the border.

The wind howled, its cries echoed across the mountains and the clouds overhead rumbled ominously. As Lieutenant Amit Singh swerved the truck over yet another curve, he glanced at the steep fall that awaited him if he faltered on this precarious route. So accustomed he was to the mundane routine, freezing temperature and rugged existence that he seldom allowed his mind to wander. Behind him were thirteen other army trucks, also carrying supplies to the next base camp.

Scores of tourists frequented these routes every summer. For them, it was a dream vacation to experience the biting cold, to endure high altitudes and travel through rugged terrain. He smiled to himself at the irony; his ideal vacation was to spend a week in the hustle and bustle of his hometown, Kanpur with his family.

His reverie was clouded by the looming mist and only the headlights of vehicles shone through the foggy veil. He switched off the engine and embarked from the truck. About 100 metres away, was yet another vehicle that had lost control on the road and was now stuck in a pit. Vehicles from both sides could not move both ways even as the driver struggled to get the wheel out of the trench.

As his colleagues also arrived to find out the cause for the commotion, the crowd became noisier, the honking grew louder and they anticipated a quick fix to the situation. Tourists were impatient and wanted to reach the highest point. Together, they moved the vehicle out of the pit and the road was once again cleared.

As they approached the camp, the supplies were unloaded and he then made his way to his deployment for the next month. By far, the most favoured among his colleagues, being posted at Nathu La Pass was something he looked forward to experience.

The rain did not seem to daunt the tourists as they braved the hail and snow and began the uphill ascent. At 14200 feet above sea level, one can have very few things running in their mind. The body has not adapted to the extreme climate so most of your energy and thoughts are focused on self-preservation. He watched as young men and women climbed eagerly in anticipation of the Indo-China border.

An elderly man hobbled through the snow, unsure of his next step. He extended a hand to the old man to help him proceed further but the old mans stopped short and gave him a quick salute and continued onwards. Such was the sincerity in his eyes that Lieutenant Amit Singh was startled.

As he made his way further up, a family of three was making its way to the pinnacle even as they were soaked completely by the rain and snow. The little girl’s teeth chattered and she shivered violently with every gust of wind. Her hair was tied into pigtails and drenched in the rain, but she continued to plough her way through the snow.

It was at that precise moment that Lieutenant Amit Singh understood why every soldier returned a happy man after their deployment at Nathu La Pass. Maybe it had something to do with how the mind plays tricks when you are subjected to extremes, but as he looked into the big brown eyes of an unknown girl saluting him, he saw in her, his very own Anjali. Although she was far away from him and anticipating his return, he knew how she often told her friends with pride, “My Papa is protecting our country!”.

The little girl shook hands with him and trudged along with renewed determination but Amit Singh stood rooted to the spot, dazed momentarily by swirling emotions within.

True, tourists might seem as an unnecessary responsibility at an International Border but it is during days like this that you realize how it is also a good thing.

The little girl walked away with the memory of an Indian soldier, but the Lieutenant was consumed by the familiar ache, the unquenchable longing for a home he barely frequented, for the family that was fast becoming accustomed to his absence and for his children who were growing up faster than he could keep pace with.

That night, as he lay in his bunker, he opened the letters from home and began reading the untidy scrawls by his Anjali progressing to legible sentences and now, a well-articulated letter. Tears welled inside him as her remembered her first footsteps; the only milestone that he had witnessed.

True, it was a hard life and many continued to question his decision but he believed in what he was doing and he was proud of his choice. He was a soldier of the Indian army and he knew that despite everything, his family was equally proud of his decision to serve the country.

North East Part 1

It’s been ages since I blogged and once again I am at a loss for words. There’s so much I need to fill up on that I don’t think I can even do it!

So the much awaited trip is finally over but I still seem to be in a hangover. There was pre-Trip excitement and now there is post trip euphoria. Will I ever reach steady state equilibrium?

I wish I could be that person who gives a beautiful travelogue chronicling the journey from Day 1 to Day 10 but sadly I simply cannot do it. Or else I’m going to do a really short version of that and then elaborate on some snapshots.

So we started off from Bangalore on 10^th of May around 7.30 towards Kempegowda Airport and had a quick breakfast on the way. The landscaping enroute to the airport has been spruced up to give any person landing in Bangalore a wonderful impression of the city. Broad lanes, flowering shrubs on the sideway and skyscrapers doting the foreground made it picture perfect. :)

Call me a kid but I still am and perhaps will always be excited by air travel. The whole atmosphere of the airport makes you feel you are out to do something big! *me and my silly thoughts*But to be honest, a lot more people travel by flight these days. Our Indigo flight was packed to the brim and it seemed like the AC compartment of BLR-Shimoga train except this was high up in the sky amidst the clouds! After a fairly uneventful journey and some blatant gazing at the airhostesses we landed at the Baghdoghra Defence Airport which is tiny compared to BLR airport. Our Driver for the first leg of the journey, Amrit had arrived and we bundled into the Innova and set off. After lunch at Bihari vegetarian restaurant we proceeded towards Darjeeling through mild showers and through tea gardens on flat land. In the initial leg of the journey, background music was provided by me and it made the journey all the more beautiful as we made our way through the hills. We had a quick Maggie stop and began the first of innumerable “Tea Breaks”. We reached Darjeeling by 8.30 and the drizzle had intensified into a steady shower as we checked into Little Tibet. It was a cute property (as we discovered in the morning) but we were exhausted by a day of travel so we had a quick dinner and hit the sack.

The next day was Darjeeling sight-seeing. We did not visit Tiger Hill (famed for its flaming red view of the Kanchenjunga) as the mist had not cleared after yesterday’s rains so it was unlikely that we would see much. We visited a few places like the Japanese Temple, Peace Pagoda and a tiny art gallery which is promoted as a tourist attraction. We visited the Padmaja Naidu Zoological Park for its main attraction, the red panda where we also happened to meet Likki and her family. Lunch was at this hotel near the zoo and after this we headed towards the Tibetian Refugee Centre where we saw a lot of kids who were probably used to being photographed! Our next stop was Mall Road where we did some shopping and hogging in Pizza Hut (Ah, Bliss!). We visited the famous Glenary’s Bakery. It’s a 1950’s café where you can sit out and watch the mountains over a cup of tea and you will not realize how time flies. After this we walked further ahead on Mall Road till we reached an open air theatre where people performed some acrobatics on one side and on the other side was a screen playing Arijit Singh’s tracks. We spent a good few hours here and then returned to Little Tibet for dinner.

Day 3 began on a drizzly note so we sent up our prayers which were duly answered. We drove out of Darjeeling and made our way towards Pelling. We drove through the hills and children walked along the sides as they made their way towards schools. Dressed to suit the chilly weather, young girls and boys walked under the shade of umbrellas in the backdrop of mountains. For them it was another day, for us it was a memory to cherish. We waved out to them, some waved back and a little boy cried as he watched his geometry box slip and tumble down the mountains.

We drove alongside the Teesta River flowing in all her glory through the mountains. The rains subsided as we reached Melli.  We took the longer round which would give us 5-6 rapids and lasted about 40 minutes. We were driven to the rafting point in a jeep and believe it or not, 16 people were bundled together in a single jeep (including the rafting men hanging on to the sides of the vehicle!). Nidhi and I took the oars (while I strongly believe that majority of the work was done by the pros seated at the back, it was still a tiring job to row through the force of the river but everytime we faced the rapids, it was an amazing feeling as the raft rocked to and fro and threatened to turn over but was expertly maneuvered by the raftsmen  (I made that up lol). So we struck up a conversation with one of the raftsmen and when we revealed that we were from Karnataka, he amazed us with a “Kannada swalpa swalpa baratte” since he’d lived here for a few years. Nidhz and I took a dip in the Teesta River and it was cool and refreshing. I still cannot believe how I was singlehandedly hauled out of the river by the raftsman as though I was just another fish in the river! Post another maggi and chai session, lunch was at Hotel 10zing where I tried the local delicacy of Thukpa but perhaps it was not meant for me! We proceeded further towards Pelling and we reached Norbu Gang in the evening. It was another drizzly evening so we stayed inside our wooden cabins and warmed the room with the heater. We took a long walk in the rain, explored the cute property and then settled down after dinner.

The next morning was fairly sunnier and Mama and I took an early morning walk, spotted a tiny petrol bunk at the edge of a cliff and failed to get a decent cup of tea anywhere. Our new driver was Bittu who had decked up his Xylo with ManU merchandise. We started off towards Rabdentse ruins but did not venture further. We instead visited Pemayangtse Monastery from where we got a good view of the ruins and we spent some time observing the architecture of the monastery and the carvings, scriptures and paintings on the walls. We visited Singshore Bridge which is the second largest suspension bridge at a length of 189 metres. The view was magnificent and called for some photoshoots. As we proceeded further in our journey, waterfalls accompanied us and the joy of watching fresh water cascade downhill is indescribable. Through the course of this journey we had some great music providing a wonderful backdrop against the scenery. From Bollywood to English tracks to even some Nepali numbers, the playlist was just perfect!! We reached Kecheopalri Lake in the afternoon and this is supposed to be a holy lake where wishes made are said to come true. I bought one of those “Om Mane Pe Me Hu” Thoranas and it’s the one thing that I’ve added to my corner of the room to bring some colour. Lunch was at this veg restaurant suggested by the driver and we even saw some legit South Indian food and also CURD (Woohoo. When I say Curd, It was REAL LIVE CURD, not the uggh yuck muck kind of curd they make from the powdered milk! :P

 Kanchenjunga Falls was the next pitstop and it was tucked away in the interior. One of the locals helped us hop nearer to the falls ensuring that we didn’t slip on the way.There really is no word to describe how you feel as you watch pure unadulterated, unpolluted, crystal clear water gushing down in all its glory and splash across leaving a wave of lush greenery around it. That is how nature paints her magic; silently, quietly but so remarkably inimitable.

After this, we travelled further through hills and valleys until we reached Yuksom which is basically the starting point for the Goecha La / Dzongri trek. (DO read about these epic treks lasting for 9/10days entailing sleeping in tents, under the open skies and living it rough until you reach the Goecha La peak) We were to stay at Tashi Gang Hotel (we learnt later that this was actually managed by Danny Denzongpa [the Bollywood actor btw]’s brother). It’s remarkable how useful online reviews are, because the description perfectly matched what we had read on TripAdvisor. True to the review, the hotel was good and the view was promising but it seemed like it was only managed by a couple of teenage boys. Just as we had read, they sat watching the television and much to our (particularly Atthe’s) chagrin, it appeared that there were no other tourists residing In the entire hotel. Black and white photographs of Lepcha and Bhutia tribes of Sikkim taken in the 1800s adorned the eerie walls and bugs and beetles awaited us indoors. Atthe and Nidhi skipped dinner, so Mama and I went down and saw that they had prepared quite a few things (for the only residents of the hotel!). In most places, when we specified that we were strictly vegetarian, you could notice how their face fell by the tiniest fraction. Eggs, Chicken and Meat probably form a vital part of their diet so they were not used to such a ‘plain’ fare. We asleep soon enough and I had the most ABSURD dream. EVER. 

The next morning we woke up a beautiful view in our balcony (as promised by the TripAdvisor review), packed up and left towards Ravangla, Namchi and Samdrupse Hill.

Ravangla has a huge Buddha statue and a shrine underneath with a lot of intricate murals describing the life of Buddha. I purchased a few souvenirs here and we had some hot momos, maggi and more chai. The place was well maintained and flowers of all varieties enhanced the picture perfect frame. After this we headed to Namchi in South Sikkim where a huge statue of Shiva was at the epicentre while 12 temples (of the Jyothirlingas) surrounded it along with  4 Dhams (Rameshwar, Badri, Dwarka and Puri- This does not refer to the traditional 4 dhams as established by Adi Shankaracharya). After a quick lunch of Roti and Subzi, we did our round of the temples and then proceeded towards Samdrupse Hill. It was during the journey that Atthe struck up a conversation with the driver and discovered more about him. It was indeed surprising to know that he was a post graduate and intended to get into the Police force and had already made an attempt. Just like how Appa engaged Tanveer (our driver in Kashmir) with a lively banter, we learnt a lot about Sikkim, its culture and people through these interactions.

Some of the snapshots: 
I intend to share more pictures of our travels but my crappy network does not seem to support this idea. -.-

At the Kanchenzonga Falls

View from 301, Tashi Gang, Yuksom 

At Ravangla Buddha Park

View from Norbu Gang, Pelling

At Peace Pagoda, Darjeeling.

BRB.