Tuesday, July 21, 2015

Strictly Tongue In Cheek


Strictly Tongue In Cheek



Dear so and so, i am writing to you from Australia. I saw your profile on so-and-so matrimony website recently and i think you would fit my family and myself very well. I am currently working as a senior software engineer in a prestigious multinational company and now currently based on-site in Australia where i have applied for permanent residency. As i am very much particular in my career i want someone who will be home loving as a spouse and i think you have the right qualifications for it.  I have asked my parents back in India to get in touch with your parents and take this forward. If everything goes forward satisfactorily  then i will probably see you when i visit india for my annual vacation in December. I will be staying only three weeks in India so if our marriage gets arranged it has to happen within that time. Now if you agree to all my conditions and are ready to shift over to Australia by December  i think we can proceed further with this. Do mail me at the earliest as i have to finalize many things before my trip to India. Please revert at the earliest.

The Return Mail: 
Dear so and so, thank you for expressing your interest after seeing my profile in the matrimony website. I am pleased that you would consider me as “fit”  for your family and then you- in that order. You know, even my local tailor who has been with me for a decade  finds it difficult to stitch me clothes with a proper fit- but you, from far away Australia, pronounce me as a perfect fit...if i weren't rendered speechless right now i would go around screaming i am fit i am fit , i am fit and a girl from Australia has certified me so.  I am also very pleased that you recognize me as home loving and having the right qualifications, whatever they are, which you are looking forward to in a spouse. Seriously i don't know what they are but i do agree that whatever they might be- i have them, i have them all, don't i? I mean you wouldn't be mailing me from Australia if i lacked even one or two of those sterling qualities you are looking forward to in a man, right? Anyway i have absolutely no qualms in quitting my current job immediately and getting ready for our wedding in the remaining few months till December (how will i get my trousseau ready? Will Rohit Bal be available at short notice or should i try Ralph Lauren or Issey Miyake? Should it be a tux or indian ethnic?). And finally about quitting my job and moving with you to Australia as a house husband- well i just go to a job not to be a burden to my parents, so if you are willing to take care of me financially for the rest of my life as you have written in the mail, i would be pleased to quit immediately and join you in Australia where i can take care of the family while you work in that big important job of yours. I am looking forward to meeting you in December and i think three weeks is more than enough to get married if i can only get a visa within that time to travel to Australia . So do look me up when you get to India in December and and we can take care of a few things in person. I am looking forward eagerly to it. Bye.


(Disclaimer- based on a true story but names/sources withheld for privacy reasons)

Friday, July 10, 2015

Sunscreens – Are You Buying Them Right?

Sunscreens – Are You Buying Them Right?



I read a very interesting research paper yesterday –published in the prestigious New England Journal of Medicine (read here- http://www.nejm.org/doi/full/10.1056/NEJMp1504912) - detailing the current research trends in melanoma – a skin cancer condition. And the research paper in passing touched upon something of interest to all of us- namely how effective were sunscreens in preventing skin cancer. Now the two commonest skin cancer types are Carcinomas and Melanomas. A melanoma (often called a malignant melanoma because it spreads so easily and so fast) is a cancer of the melanin pigment producing cells of our body. Melanin is the protein which gives us our skin colour- dark or fair and and also protects us from the radiation of the sun- in effect its a natural sunscreen. Dark skinned people have an abundance of melanin pigment in their skin naturally and require lesser quantities of sunscreen to protect their skin, while fair skinned people with less melanin get tanned and sun burnt easily and also have more instances of getting skin cancer- melanomas. So with that small introduction let me get onto the meat of the matter.

 Sunscreens as we all know are classified as over the counter cosmetic products which do not need a doctors prescription. But we must remember that cosmetic companies make certain tall claims regarding sunscreens and their effects touting them as wonder drugs as they contain certain chemicals which, in effect prevent skin-tanning, anti-aging etc. Now the American Food and Drug administration has specified certain guidelines for sunscreens based on recent research

1)    Anything less than SPF- 15 is no use for cancer prevention but can only be used for anti-tanning- so this means the FDA has now effectively barred anything which uses less than 15-SPF.

2)    Anything above SPF-50 has been shown to be useless for skin protection- which means that more than that is an overkill and unnecessary.

3)    Both cream and liquid based sunscreens work equally well when applied as a coating- but all of them last for only 90 mins to 120 mins for single application- which means you are protected for one and a half to two hours only with a single application. So covering up exposed areas with adequate clothing becomes important for long term prevention. And there goes my dream of ogling at all those bikini clad beach babes.

4)    Any sunscreen which only protects against UV-A is not effective as anti-cancer but only for anti-tanning. Hence check out for the sunscreen prevents both UV-A  and also UV-B rays from affecting the skin. So only broad-spectrum sunscreens prevent  skin cancer while others are just for the beach.

5)    Ingredients like  ecamsule and enzacamene come under banned substances – no longer safe and effective and hence check out that you are using a product which no longer contains these.

6)    And finally remember that background radiation exists even indoor- so anything which promises anti-aging should protect your skin all the time and not just under direct sun exposure.


So these few pointers should help you choose the best sunscreen for avoiding skin cancer and not be taken in by the tall claims made by cosmetic companies.

Sunday, July 5, 2015

Waiting For The Doctor



Waiting For The Doctor



A friend on twitter was recently moaning about the time she spent waiting outside doctors rooms as some of the most stessful periods of her life. I agree with that sentiment. Never mind the fact that you are anxious to go in there and find out from your doctor whether you have a life threatening disease or not  the very fact that you are sitting surrounded by other obviously sick people with no hope of a happy ending in sight will give the heebie-jeebies to anyone. Including me. I too like everyone else have spent time waiting outside doctors rooms even though its more out of a sense of delicacy on my part not to announce myself as a colleague and just barge in ignoring others waiting in the line.
Anyway this post is not about the people waiting outside doctors rooms but about why doctors make people wait outside their rooms? A few pointers

1)    Ego- Yes the number one reason why you spend hours waiting outside your doctors room is to satisfy your doctors ego- the ego to be wanted, needed and validated as someone worth waiting for. I know this might shock you but its the truth. The reason is, its not easy to get people to wait outside doctors rooms for them to turn up as the competition in medicine is killing and there are umpteen number of doctors out there waiting to see you whenever you want to. To be recognised as a good doctor it takes a minimum of ten years hard work, of hours and hours spent alone in the clinic waiting for that solitary patient to turn up for a consultation, hours spent peeking outside the curtain separating the inner room from the waiting hall everytime a mild footstep is heard imagining that atlast here comes the patient who will pay for this months rent atleast so you can still continue practicing at this same palce next month and so on and on. And after all this long struggle when the doctor reaches a place where he becomes recognised- he turns the tables on the very people he waited for and gets a perverse pleasure in making them wait for him. Believe me when i say that there is nothing to equal the joy felt when you walk into a consultation room and see it full of patients waitng for you. It makes you appreciate the sweet success of having arrived. It stokes the ego and gives you a feeling of being invincible and god-like for the only other place people wait so patiently for a glimpse is at the temple.  So even though doctors know they can manage their time better and stop wasting others time, still to satisfy their own cravings for popularity they will intentionally make you wait hours to meet them. The bitter truth.

2)    The medical representatives- if you see a bunch of medical representatives waiting outside the doctors rooms with you to meet the doctor be assured that your doctor is going to wantonly make you wait outside for hours. The reason is simple- just like politicians need people at their mass meetings to show the media their power and popularity to draw a crowd, similarly doctors need crowds of patients to show medical representatives their drawing power as busy practioners with loads of people waiting to meet them. Medical representatives are by far the biggest gossips of the medical field- they are the ones who go around spreading stories about which doctor is popular with a dozen people waiting outside and which one is sitting alone in his clinic – despite being a good time manger and being prompt in seeing his patients off rather than making them wait. And guess which doctor gets that all expenses paid trip to egypt to see the pyramids – sponsored by the drug company? Yes, its the same doctor who will make his patients wait for hours showing off his overcrowded waiting hall as a sign of popularity.


3)    Other patients- yes this might be a shocker to you but the biggest time waster in any practice is the patient who went in just before you. I have had many patients who have made me want to physically throw them out for wasting my time but have survived because i remembered the hippocratic oath in time. Some women are the worst offenders in this. They come in with their husbands and children and a whole bunch of people and after consulting for a small problem and paying the fees instead of leaving promptly they stand by the door and then casually start discussing the assorted medical problems of the hubby, the first kid, the second kind, the mother in law, the next door neighbour and everyone else on the street on the mistaken assumption thant once having paid a small fee for a single consultation the rest of it should be all free advice on the basis of – well we are just talking, arent we, you re not actually seeing the patient, so it doesnt count- never mind that all this talk consumes the better part of an hour or so just to make sure she doesnt poison someone with her home remedies. So blame those people who troop into doctors rooms with an army of supporters and sympathizers who have no business being there.

4)    The unexpected – yes things like surgeries which can sometimes throw in complications which no one can anticipate- remember every individual is unique with a unique anatomy and blood vessels and nerves can never be found in the same place as shown in textbooks and you can appreciate why surgeons can be late for appointments.  And add the occasional friend or realtive who drops in to talk only at the busiest time of a doctors  practice and can never be got rid off politely and fast and you can see how the unexpected can impinge on your doctors time.


5)    Greed- and now we come to the one reason which can be altered by your doctor if he really wishes to- over selling appointments. If your doctor appreciates that your time is every bit as valuable as his- he will never over book appointments and try to fit in everyoone at the same time. It is simply callous time management and can never be tolerated in any other field. To see three  patients in one hour is different to seeing three patients in three hours. The difference can be life saving for you and can certainly save you a load of money in hospital bills in future if your doctor can spend enough time concentrating on you and you alone for the fees you pay instead of shunting you out as fast as he can to get the next patient in. Believe me,  no doctor – however  popular he or she is-  is worth your time and money if they act like that because they are going to miss catching your disease at its earliest stages if they are in a hurry and you will be paying the price for it later. Its better to change over to a another doctor who even if he dosent have a reputation as the best will atleast lisen to you patiently. Remember its your health and your life and you are paying the bill for it.

So to conclude i leave you with the thought that all that waiting outside doctors rooms is not accidental but a well thought out strategy by your doctor. Doctors are rarely helpless when it comes to efficient time management – they can stop wating your time or not. And if your doctor chooses not to then its time to stop waiting for him or her and simply move on to someone else who knows the value of others time and respects paying patients enough to give them their attention to. So choose a doctor who is satisfied with seeing three patients a day and buying a maruti suzuki rather than the one who sees thirty patients a day to buy a mercedes benz.  The first one might or might not save you but the second one will definitely kill you. Be wise and move on to a better doctor.