Phillip Hughes : Too Soon?

When a person dies before the ripe old age of 60 years, it's called an early, untimely death. It doesn't matter what the cause may be - myocardial infarction, stroke, accident, cancer, or murder. An untimely death is always associated with "he didn't deserve it", "he was so young", "how could this happen?", "miss you forever", "in our hearts forever" and so many of these phrases.

That is exactly what is happening today since the breaking news that Australian Cricketer Phillip Hughes could not survive the injury he received from a bouncer. For a better part of today, I've been confused. First there was a "No!! NO!!" moment, followed by a "but it's simply not true" moment followed by a big lecture to God for ignoring my prayers since Tuesday (yes, I am arrogant enough to believe that God does what I ask him to). Then, after all that, came this confusion. Confusion because I still can't digest the fact that I will never see his name in the national team batting line-up; confusion because I almost expect him to walk out on the Gabba pitch next week; confusion because he's just 25; confusion because I don't consider cricket a fatal game - you may lose an eye, but a life?; confusion because I have watched this player bat since his international debut and I find it hard to believe that I will not be able to see how his career shapes up; confusion because the completeness of death makes me wonder whether all these "you're forever in our hearts" phrases are just empty or face-saving or soul-saving.

I feel that saying all this is our way of saying, "I'm guilty I never thought more about you during your lifetime. Trust me, now that you're gone, I'm so going to do it." I shall be the first to admit that I never thought about Hughes unless and until he actually played in the international team. I am a fan, but I shall not follow the careers of players day in and day out. So hearing the news of his injury made me feel guilty. Maybe if I had paid more attention, this wouldn't have happened. Crazy thought, but something to think about. Then, when he was battling for his life yesterday, I prayed that he survive. Because that was the least I could do. Amongst, the absolute dread of a news like today, I felt guilty for sending up a prayer only when it was the only thing that could save him. I felt guilty for not appreciating this wonderful cricketer as much as I should have before. That got me thinking, is this what is actually the message in peoples' "RIP" thoughts that plaster all the social networks? When a life is cut short, do we feel guilty because we thought we had all the time in the world to appreciate and thank that life? After all, I probably would've said stuff like," You're an amazing cricketer, a fantastic batsman and have been a great part of the team that I love, hope the new path you choose be as successful as the one you're leaving", when he retired. But, who knew, it would never reach that stage.

I've always been a little sensitive about the issue of death. I simply cannot understand why it has to happen. So when somebody so young (just 2 years older than me!) dies, I question nature and it's ways. He did not even get to say good-bye. And, that right there, would hurt his near ones more. He left in the morning to play the game he loves, was probably delighted when he reached his 50 and thought he could even reach the 100. And then out of nowhere, this bouncer decides to trick him. Next thing you know, he's down and gone, and all he must've realised is that he got hit. That's it. No life flashing in his eyes, no last words, just nothing at all. You almost wish he'd regained consciousness to at least let him know that he would be missed, loved, prayed for and thanked for being who he was.

Let's thank him and his talent for those 3 amazing international test centuries to his name, for being a part of the national team, for being such an amazing talent, for his contributions to his state and club, for being the person he was to his family, friends and team mates, for giving fans like me something to cheer about. I wish you hadn't gone away. I wish you were going to play next week. I wish I could watch you open the innings for eternity. I wish the only reason I never got to see you bat again, was because you weren't selected into the final 11. Now, that option seems so much easier to deal with than what we've been given.

Our only solace is that the last thing you ever did was play the game you love and score that 63. That number will never ever be the same again.

  That's how you'll always be....a great life, a great career :-)

Laparoscopy

On this weekend, I had the opportunity to attend a workshop on Basic and Advanced Laparoscopy. We were taught everything about Laparoscopy from the very beginning - how to hold the instruments, what the instruments are, how to suture stuff inside the abdomen, working the instrument with what you see on the camera in front of you, hand-eye co-ordination, where and how to put the ports in....all the stuff that you want to know before you just plunge into Laparoscopic surgeries.
Thing is, I've always watched Laparoscopies. Easiest surgery to watch actually. It is an Air-conditioned OR (yeah, I guess I've started using a lot of American terminologies now. If I plan on doing my residency there, makes sense to use their words instead of ours), you can sit on a comfy stool to watch and you have as good a view of the organs as the operating Surgeon. It's pretty damn amazing. After all, it is tiring to watch a 5 hour surgery standing tiptoed, in a crowd, straining your neck from here to there to get a better view.
So back to the workshop. We started with the Endo Trainer. Its a plastic box with holes for the ports. They keep stuff like plates of peanuts, sugar cubes, Polo pills, match sticks and plastic gloves in it. The instruments go in through the holes. You can get really good training in picking those peanuts up, moving them from one plate to the other. The sugar cubes are a little tougher. You have to stack them on one another. The 2-D image in front of you doesn't help a lot in that. The match sticks and Polo pills are the worst. You have to pick a pill and then loop it into the match stick that's stuck down on the rubber padding. Not as easy as it looks! We also got to learn and practice intracorporeal suturing on the same. I, apparently did not have great instruments. But, wow, was that tough!
The key to good Laparoscopy is to stop working with your hands in your head. This is just my thought. I'm just a beginner. But, from what I saw and did, I realised this. When you learn a new language, for example, you always tend to think in the language you know well. And then, you translate that thought into your new language. It's only when you start thinking in that new language that you actually learn. That's the same principle with Laparoscopy too. You can't keep thinking of how you'd separate tissue or suture an incision with your bare hands and then use those methods with that instrument. You have to allow that instrument to be your hand. The needle-holder is not going to be this 20 inch long instrument that you directly hold and just plunge inside. It's going to have a long handle, a different grip and, most importantly, a really small area to move in. Unless and until you can think in terms of moving the needle holder and picture it as a part of your working hand, you can never get good with Laparoscopy. That needs patience, practice and perseverance.
I personally had a great time. I realised yet again, how much I LOVE surgery, love being inside an OR. I also learnt that I am good at this. Day to day practice and I could make myself really really proud. I like looking back at things I've done and marvel at them. I like saying stuff like, "Wow!! You go girl!". I can do that in Surgery or any surgical field. It's great to know that the love I'd felt during my Casualty posting was not a one time thing. I know I love this and I get a feeling I can get really good at it too.
I thank my luck that I had this opportunity so early on. Experiences like these help mould the clay of my confused mind into a beautiful pot. There is a long way to go, but I'm taking small steps. And, I get a feeling that the beautiful piece of art is not very far off :-)

I'm Back !!

It has been over a year since I made my last entry. Things got very busy after I came back from rural posting in Shirur. We then started with all the heavy postings - Medicine, Surgery, Ob-Gyn. That was followed by a nerve-racking USMLE Step 1, Step 2 CK and Step 2 CS preparation. Amidst all of that, I had the opportunity to complete 2 elective rotations at Yale-New Haven Hospital and Massachusetts General Hospital. I visited my Uncle in California, saw a little bit of LA for the one day that I was there for my CS examination, made a return to New York (this time with my best friend) to fall in love with it AGAIN (why do you do this to me New York?!), met some wonderful people, made some brilliant and funny friends, learnt from smashing residents and Professors, grew up a little (not so much though :-P ), carried all my baggage alone everywhere (trust me, that is my greatest achievement - you know why, because only today morning I dreamt that I left my check-in bag at the security counter at the airport. I was running across the entire length 10 mins before my flight took off, just to get my bag. Such a relief to get up and realise I was in bed, at home and that my airport story ended 3 months back!), gained weight (that was second achievement. a whole 2.5 kg!! in 2 months!) and basically wanted to come back home, but so did not at the same time!!

People do many more things in the time that I spent in the USA, than I did. But, then, looking back, I loved the relaxed life I lived there. Yes, I worked. In New Haven, I was in the hospital from 9 am to 5 pm. In Boston, I was there from 6 am to 6 pm. But, I roamed about, I read, I studied, I watched FRIENDS all over again, I developed newfound love for The Big Bang Theory, I found Chipotle (oh holy God! I loved their barbacoa so much, it hurts to remember it now. Please please take me back there now!!), I loved Boston (that's saying a lot because, frankly, I dreaded being alone in a city without any new friends) Yet my first weekend out in the city, I knew I was going to love it, with all its rain, sunshine, snow and wind. Oh yes, I experienced my first ever snow fall :-) As beautiful as it looked from inside the house, it was tough to walk out there. People may laugh saying, "So excited about snowfall of all things?!" But, hey, I live in a tropical country. The day I left for the US, the temperature here was a whopping 40 degree Celsius. If I see snowfall, I'm going to enjoy it and call it beautiful.

After my posting in Shirur, I'd realised that I don't go beserk with new surroundings. I adapt, without any complains. In fact, it takes me months to realise that I actually enjoyed the change. During my time in Shirur, I never once thought of the stay as wonderful, enjoyable or easy. I just did what I had to do. I had lots of time to ponder (oh yeah, I did, lots and lots of it. My best friends will attest to that.) It was only maybe months down the line that I looked back at that month and classified it as 'Good. I managed to live on my own.' It was the same with my US trip. During that time, I didn't really believe it was amazing or bad. I just went along with the flow, week by week, ticking things off my list. It is only now, 3 months down the line, that I look back and say "wow, I really did it. And I enjoyed every moment." That probably gives me most hope about the kind of person I shall be when I fly out of my homestead.

So what is next up for me? I have decided to go the US way. I'm currently compiling applications, putting together Personal Statements, looking up programs to apply for. If things all work out, next year, at this time, I shall be working my ass off at some wonderful hospital. If things don't, well, I think that is a story for another post. I get the feeling that I'm sounding happy and optimistic in this one. Let's keep it that way :-)

It feels so good to be back. I'm sure I'm going to spend an hour or two going through my old posts, reliving some memories, good and bad. I've missed writing so much. I'm glad I forced myself to take some time off and do this. Now, of course, I shall be itching to write my next post.

p.s. the title of this blog finally makes complete sense!! I've officially become Dr. Pranjali. I'm still not used to it. My parents have to keep reminding me to add that 'Dr.' before my name :-P


Adding a picture of my Italian Brunch In New York. A tribute to the love I developed for eating. The white stuff is the best ever cheese I've had in a long long time :-)