Chronic Adrenaline Rush

My life was quiet and peaceful when I was a kid. I managed to get the top rank in school without too much effort, and I did not feel it was a great achievement. Probably the other kids took is easy much more than I did. Even in premed it was equally peaceful. Then I joined a medical college and I changed without knowing about it. There was so much to learn and it was fun too. Thinking back, I realize it was a high that lasted throughout my graduation and postgraduation. It became a habit. I would not walk peacefully even when there was no urgency. I would hurry to wherever I had to go. If there was anything to do, I would start doing it and be at it like a man possessed until it was done. I joined as a Lecturer and progressed to Professor and Head of Department's position at that same pace. The pressure at work, some of it inevitable from the profession I had chosen, some created by administrators who could have done far better but did not know how, kept the pressure on me. It became a habit that made a slave of me even in my personal life. Even when it was exercising or going for a walk, it was always a part of the hectic schedule, to be rushed through so as to be able to go to the next chore.  Now it is 39 years since I entered a med school, and I don't remember any time when it has been different.
The other day I went out to buy a couple of things. After the first purchase, I went on looking for the other thing I needed. I could not find what I wanted. But it was a day different from the other days. The roads were less crowded. There was less noise, fewer obstacles while walking, a pleasant breeze in place of the usual heat and humidity. Walking was not just an unavoidable unpleasantness, it was refreshing. It was at that moment when I realized what I had been doing. I had been on a chronic continuous adrenaline rush, which would continue until it exhausted me. Then I would rest awhile, let the overworked system recover, and plunge right back in. I suddenly understood the meaning of those forwarded emails which told me to stop to feel the breeze, to smell a rose, to listen to a bird sing, to watch a sunset.
I hope those who read this post don't have to do what I somehow did. I understand it is difficult with the rat race on. I just hope they find a method of finding a few moments to feel the breeze, to smell a rose, to listen to a bird sing, to watch a sunset.without any other thought in those moments.

To What End

I was on my way home from the hospital. A very senior consultant boarded the bus just as it was about to leave, and sat down next to me. We chatted a little, about the same things two medical persons chat when they meet occasionally.
"Dr XXXXXX had come visiting recently" the consultant said.
"The preventive medicine person?" I asked.
"No, no. Anesthetist. She was in the same batch as you, she said."
"Oh, yes" I said. I remembered. The name had not made sense at first because I remembered her by her maiden name, while this consultant had referred to her name after marriage.
"How is she?" I asked conversationally.
"Oh, she is fine" the consultant said.
"Is she not in New Zealand?" I asked, straining my memory.
"Australia" the consultant said.
"What does she do?" I asked. There should have been no reason to ask. She should have been practicing anesthesiology. But some of the doctors I had known who had migrated to US had changed their specialties. One had gone from cardiac surgery to radiology. Another had gone from cardiac surgery to gynecology. Another had gone from gynecology to family medicine. Perhaps this one had changed her specialty too.
"She teaches in a school" the consultant said.
"Um..." I was confused. "A medical school, you mean?"
"She teaches children in a school" came the answer.
"But why?" I asked.
"She thought her child would do better in Australia than in India. She did not want to go through residency again in Australia, because she would not be able to give time to her child if she went through the residency".
I kept quiet. I thought of the 8.5 years spent on medical education, finally wasted. I thought of the national resources spent by the government so that she could get subsidized education, now wasted. I thought of loss of one more doctor for my country which needed doctors badly. I thought of the rumors of parental influence used to get her a couple of gold medals over other students who were considered more worthy then.  To what end was all that? I thought and then could not think any more.

Reverse Trend in Hysterectomy for Cervical Cancer

For those who don't know, hysterectomy means surgical removal of the uterus. When the body of the uterus is removed and the lower part called cervix is left behind, it is called as subtotal hysterectomy. In general it is recommended that the cervix be not left behind, because a cancer may develop in it at a later date, and then the treatment of that cancer becomes difficult. Only in difficult situations does one leave he cervix behind, such as when the urinary bladder or rectum is densely adherent to the cervix.
That woman came from a place in north India. Some surgeon had removed her uterus.
"Why was a hysterectomy done on you?" I asked her.
"The doctor said it was the beginning of a cancer in the cervix of my uterus" she said, and showed me her case paper. "But he did not remove the cervix." I checked her papers. A subtotal hysterectomy had indeed been done for cervical intraepithelial cancer.
"But if it was done for the beginning of a cancer of the cervix, the cervix had to be removed" I said with amazement.
"Yes, doctor" she said tearfully, "but he did not remove it. It seems they do hysterectomy like this on all patients there."
I checked the doctor's prescription. His degree was MS in general surgery. I could not understand why a general surgeon would perform a hysterectomy these days. It was the job of a gynecologist.
"Doctor, save me" she said. "I have two small children."
"Don't worry" I said. "We will remove that cervix. It does not look like it is cancerous." It wasn't. I performed a vaginal removal of the cervix. It was a little difficult, because the abdominal structures were stuck to its top, and they had to be protected during its removal. Later on when I related this story to a friend, he said,
"If a young woman has cervical cancer and she desires to have more babies, they perform a radical removal of the cervix and keep the body of the uterus behind. This seems to be exactly opposite. The surgeon removed the body and left behind the cervix which he believed to have a cancer."
"Yes. This is a reverse trend in hysterectomy for cervical cancer. I hope he does not get any more patients like this."

Crying Baby and Mother

This was the experience narrated by a visiting surgeon, not unlike some we also see.
_________________________________________________________________________________
I was waiting near the north window for the first operated patient to be wheeled out of the OT before the second one could be go in. We have this huge window on the north side of the OT, which spans almost all of the wall. The view outside is breathtaking, with a couple of huge trees, a lawn below, the tennis court in the background, and no sounds to mar the view. I must admit the 'no sound' business did not apply that day. A child was crying incessantly outside, and I could hear it. I looked down at the lawn. The child was standing alone, back towards me. His mother was squatting down, looking at the child. She had nothing with her, not even a bottle of water. She tentatively extended a hand towards the child. The child backed away a couple of steps and continued to cry, standing stiff. She waited for a minute or so, and extended her hand again. The child moved back by another two steps and stood crying. After another minute she got up with seemingly great effort and took a step towards the child. The child moved back as before, and cried and cried. Finally she extended her hands offering to pick up the child. The child ran towards her. She picked the child up and put its head on her left shoulder. The child clung to her, not crying any more. She wiped her right eye and cheek with her right hand. She must have been crying. The child became alert and picked up his head from her shoulder. She immediately put it back on her shoulder. She probably did not want the child to see her crying. Then she wiped away tears from her left eye and left cheek. With the wet hand, she wiped the child's eyes too. There was no handkerchief, but the child did not seem to mind They stood there, just holding each other. After a minute, an elderly man stepped forward. He did not look much better off than those two. He offered a small fruit to the child. She noticed this, and turned around, possibly to make the child see what was being offered to him, and possibly to hide her tears from that kind man. The child saw the fruit, took it, and held it in his tiny hand in wonder. The kind man went away. The mother and child moved to a spot I could not see from that window. There were a couple of small shrieks after that, but no more crying. I could not change and go down to see if I could help in any way, because the next patient was already being given anesthesia. By the time I finished for the day, there was no one on the lawn. When I reached the hospital the next morning, I could not see the child and his mother anywhere on or near the lawn.
I don't know why they were in the hospital. I don't know where the father of the child was, or if there was a father any more. I don't why the child was crying, nor do I know why the mother was crying. I don't know where they are at this moment, and what is to happen of that child in future. All I know is that there is a lump in my throat every time I think of the crying child and mother, and the lump does not go away. I don't even want to think of the thousands of such children and their mothers who cry every day, because there is nothing that I can do to stop them from crying.

Educational Resistance Movement

It is a new movement. You won't find it on a Google search or any other search.
I had thought students wanted education. After all, that's what students become students for. Well, a number of students apparently do not seem to think so. They probably just want to get a degree, so that they can make a lot of money to live happily ever after.
I may sound harsh when I say so. Well, I am upset at what happened. That should explain my harshness.
It was my observation that resident doctors did not read much (lack of time? Lack of energy? Lack of motivation?). When thinking about it, I had a novel idea. We publish about 10 interesting case reports every month in our journal JPGO. These articles are written well, after a good amount of research by the authors. Residents did not get to see such cases, not in any one unit they work in. They did not read the journal (lack of time? Lack of energy? Lack of motivation?). So I thought I should make them read it, which would enrich their experience and make them better doctors. I decided to put multiple choice questions at the end of each issue, based on the articles published in that issue. I coded a web form and put the questions in it, each with a radio button for each of the four options for each question. I arranged to have the residents type their names and year of residency in that web form. I arranged for a print facility so that they could print the completed answer sheet and submit them to our office. My colleagues liked the idea. We decided to give the reidents internal assessment marks based on their performance in these monthly tests. They could read the articles while then answered. It was to be like an open book examination. The idea was to just make them read.
The outcome for about 10 residents in each unit is shown below.

Unit	Activity
1	All residents answered honestly.
2	Only one resident took the test.
3	Seven of them cheated. They made one answer sheet and everyone copied it.
4	All except one resident cheated. Only one person made answer sheets for all residents in the unit. They submitted their own answer sheets.
5	All residents answered honestly.
6	Only three residents took the test. They were honest.

The cheating was easy to spot. The concerned residents had the same score, and the same answers wrong. The technique of cheating was found out by questioning. The explanation for cheating, after repeated questioning, was "Sorry, Sir. It won't happen again."

I am feeling sort of numb inside.

"Why do you insist on making them learn if they keep finding methods to avoid learning?" I was asked. "You are just making yourself unhappy."
Did I do that because I was stupid, stubborn, or a hopeless dreamer? Definitely not to trouble them, as some of them probably believed.
"I do that because I believe it is my Karma to do that" I said. I was a teacher. Was it not my Karma to teach and make them learn?

Abdominal Distension - Different Approaches

I don't know which of the following three stories told in a story telling competition that was held during my residency is the best.

Story 1
This one happened when I was doing my residency in Obstetrics and Gynecology many years ago.
There was a 23 year old woman with acute abdominal pain. The surgeons had decided she had a lump in the abdomen that was excruciatingly painful. She was admitted and put on the operation table. It was the middle of the night and they were waiting for an anesthetist. She was screaming with pain so much, that they left her in the operation room and sat at the table outside. Suddenly her screams stopped.
"Go see if she has died or something" the Registrar said.
The houseman went in to check and came out on the double.
"She ...ah..."
"What?" the Registrar asked, suddenly worried.
"She is OK. The painful abdominal lump is gone, and there is a baby between her legs. I don't know what to do about the umbilical cord that seems to be going inside her."
The woman was spared a laparotomy by a busy  or tardy anesthetist. The surgeons had not realized she was pregnant and in labor.

Story 2
The woman was 8 months pregnant. She had a valvular heart disease and was in early cardiac failure. We sent a call to the cardiologists. The cardiology Registrar saw her and advised some cardiological tests. He also advised an ultrasonography of the abdomen.
"A cardiologist wants an ultrasonography of the abdomen?" I asked, surprised. "This is the first time I have seen this happen. Please ask him why he wants one."
My Registrar asked and informed me about it.
"He wanted it to see if there was any large mass or fluid in the abdomen, that would compromise her breathing and cause breathlessness."
Of course she had both a large mass (the fetus) and fluid (amniotic fluid) in her abdomen, just like all pregnant women have.

Story 3
The woman was admitted in the medical ward with severe anemia. Her hemoglobin was 4 g/dL (normal range is 12.5 to 14 g/dL). We received a call from the medicine residents. My Registrar saw her and reported back to me.
"The patient is 35 weeks pregnant and has severe anemia."
"OK. What did they want from us?" I asked.
"Actually their professor asked them to do an ultrasonography and send us a call at the same time. The professor thought she had a uterine fibroid, which was causing the anemia."
"Fibroid causes heavy menstrual bleed loss, while a pregnancy causes amenorrhea (absence of menses)" I said. "You can actually feel the baby at such an advanced stage of pregnancy."
"The professor felt it was a fibroid" my Registrar said.
If we could diagnose a heart disease, anemia, pneumonia, and cirrhosis, the medicine guys should be able to diagnose an advanced pregnancy, I thought. Well, the 'should's may be very well justified, but that does not make them real.

P.S. (29-11-2014)
There was another patient who was single, admitted in the medical ward. She was there for investigations of hepatosplenomegaly. The got an ultrasonography done on her as a part of the diagnostic work up. It showed she was 8.5 months pregnant and had no hepatosplenomegaly. It goes to show that they do not read my blog, or read it just to get angry if there is anything that they think is criticism rather than praise. Well, I praise them for managing so many patients so well despite being understaffed. The purpose of writing such posts is not to criticize, but to try and avoid such happenings in future.

Civic Doctors The Sweepers

The following conversation was picked up on closed circuit camera, at the source of the circular asking doctors to sweep floors of the hospital for 2 hours every week, starting 1.5 hours after going off duty.

Clean India Campaign and Us

It seems the Boss of the country has launched a movement for clean India. Perhaps people expected‘ clean’  to mean non corrupt. But it seems it is physical cleanliness, not the other one we just referred to. The thing percolated down, and the civic Boss ordered the same thing in the civic body. The circular received by everyone states as follows.

Every XXXday, all officers and employees will clean the offices and their surroundings between 5:30 P.M. and 7:30 P.M. An observer will come from head office, and will see to it that people do this cleaning. There was furor over it. The doctors burst out as follows.

"The National Boss started it as a voluntary service. This seems to be a compulsion!"

"Naturally. If the civic Boss makes it a success, he will reach Delhi in some time."

“Who is going to wait from 4:00 P.M. to 5:30 P.M. doing nothing? Does he not know our duty gets over at 4:00 P.M.?”

“Who is going to do a servant’s job? Why is the big idea?”

“If doctors do servants’ job, what will the servants do? Doctors’ job?”

“If they fill up all vacancies of servants, they will not have to ak the doctors to do the cleaning.”

“The patients and their visitors throw things about and make the hospital dirty. We have to clean up after them or what?”

“I employ servants to clean our house. Now I have to do that work here as doctor?”

“Will the servants’ union assault us because we take away their jobs?”

“The premises are clean. Do we have to throw garbage around and then clean it? Like they did in Delhi, and the State Boss did in State headquarters?”

“Why can they stop people from littering, instead of asking us to clean up after them?”

‘It is not a part of my job description. I will file a writ petition against the civic Boss who has ordered this demeaning work be done by us.”

“We will be the first group of doctors in the world who do sweeping, dusting and stuff in the hospital.”

“What will they do if we don’t  do this stupid work? Sack us? Then who will treat patients? Sweepers?”

“Do we actually have to do this, or do we just pose with brooms for taking pictures? Like those politicians?”

“Sir, why are you not saying anything?” someone asked me.

“I have asked the Boss to clarify some points about this business. I am waiting for the answers. In the meantime, I have designed a new instrument for use by the civic doctors. It will look like this.”

“What is it?”

“It is a stethoscope and a broom combined together. I am going to call it stethobroom. All civic doctors will buy it. If I take out a patent for it, I will make enough money so that we can all employ private servants to do this cleaning work in the hospital in our place. Perhaps even enough so that we can all retire and leave the patients’ treatment to the sweepers.”

Another Virtual Oxytocin Drip

When I write about another oxytocin drip, it implies I must have written about it before. I have not called it 'virtual' when I wrote about it before, but it was indeed a virtual drip. You don't actually have to know about that one to understand today's post. But if you are curious, you can find that post at this link.
It was during a departmental meeting when I heard of this virtual oxytocin drip. It was observed in that civic hospital that the Boss' Boss publicly declared as the best of the three civic hospitals. The reason cited was that it delivered so many women, and nothing went wrong. That 'nothing went wrong' was a statement that should have been taken with not just a pinch of salt, but with a sack of salt. Anyway, someone has said 'the boss is always right'. Then the Boss' Boss must always be right, and more than right or more right, or whatever.
"We got over of this patient who was herself a lawyer" one senior senior staff member said. That hospital had a system in which they handed over all patients in the labor ward were handed over to a new unit in the morning. That way the previous unit was free to go away. "Her indoor paper said she had been on an oxytocin drip. When asked about it, she confirmed she was receiving an oxytocin drip, as she had been informed by her doctor. But there was no intravenous line, and no intravenous infusion of anything had been given to her. When asked if she knew what an oxytocin drip was, she said she did not know."
'It was a virtual oxytocin drip' I thought.
"May be she was being given oxytocin through gas' someone joked. 'Perhaps they called some doctor 'Gas' over there' I thought.
"Why did you come to this hospital?" this doctor asked her.
"To get good treatment' she said. 'She must have heard someone like the Boss' Boss' I thought.

Cat Falls for Teddy

Our housing society has a big garden, and a lot of free space. There are a few people who feed cats.Accommodation and food bring cats and cats bring (by reproduction) more cats. One of our neighbors recently took to feeding a stray kitten. They have converted a regular window into a French type window, and they being on the first floor, the kitten has free access to the house from adjacent roof of a shop below. The kitten often plays on the roof and sleeps on it at night.
The last weekend we witnessed this neighbor out of the window on the roof of the shop. There was a huge teddy bear on a weather shed near the roof, presumably of the neighbor's daughter. It had been there for about a month. He was trying to retrieve it using two long sticks. It was fun to watch, as he struggled using the sticks like two huge chopsticks, trying to hold the teddy, like one tries to hold food with chopsticks. It was heard that he had been to China for a long time, but he did not seem to have picked up the method of using chopsticks. The teddy remained where it was. Finally he pushed it down to the ground and asked the sweeper to bring it home. The spectators dispersed (meaning we went back to our work).
The next evening (yesterday) we found that the teddy was back on the roof, and the kitten was curled up next to it. I managed to take a snap of the two together.

Today morning I checked up again. Now the kitten was asleep on the tummy of the teddy. I managed to get another snap.

"It looks cute" my wife said.  "It must be nice to curl up next to something furry and warm like the teddy. The kitten must also love sleeping on something so soft."
"Yes. The kitten seems to be in love with the teddy" I said. "It must have stolen the teddy from their house the previous time too. When the neighbor took it back, it stole it again."
"It is possible" she said. "The other possibility is that the neighbor's daughter must have given it to the kitten and told her daddy that the kitten took it. She is very kind to people and animals."
It remains to be seen when the daddy goes out on the roof of the shop again and retrieves the daughter's teddy.

Innovative Hat Camera

Most of the open surgical operative still pictures and videos are shot using a camera that gives a line of vision that is somewhat different from that of the operating surgeon. The line of vision of the surgeon is the best, because he chooses the best one to operate well. When I worked on an atlas of operative techniques, the camera was held behind and by the side of my left ear, and when the operative field was to be photographed, I would move to the right and the photographer would move the lens of the camera to where my eyes had been before taking a picture. I positioned the video camera at a suitable angle when I shot operative videos. But I remained dissatisfied. When I explained my requirement to my son, who is a software engineer, but also a gamer, he understood the need immediately. There is such a view when one plays 3D games.
"Get a good webcam and fix it to the forehead" he said. "That will give you the view you need. You will not be able to zoom, but otherwise it will be very good."
That was a brilliant idea. The main problem was finding a method of fixing it to the forehead. I asked my wife to lend me her ENT examination mirror. I fixed the camera to the head strap of the mirror and wore it around my head. The view was good, but the weight was too much. I returned the mirror and tried to think of another solution. Google glass was a theoretical option, but not very practical because it was not available in the market at home, and it was terribly costly anyway. A few days passed, and suddenly I had an idea. A 3D image of the idea is shown below.

I took a hat with a visor. It had an adjustment band at the back. I hooked the webcam in that band and wore the hat back to front. It was a little wobbly, because the band was not designed to take that extra weight. So I put a big rubber band around my head, passing over the handle of the webcam. It fitted perfectly, the angle of inclination could be adjusted as required, and the images were excellent. I shot with this assembly about 100 pictures of different instruments and surgical knots for a new book I am working on. It was a bit of a bother when both of my hands had to be in the picture. But there was no one to help. So I placed the laptop near my foot and clicked the left mouse button with my great toe when an image was to be captured. It worked like a charm, except that toe business. I suggest you get an assistant for that purpose, unless you are a Yoga expert and can bend your lower limb joints impossibly.

My Virtual Twin

There is a theme used by many Hindi movies. There would be twin babies, and they would get separated in some calamity. Then they would grow up independently, and meet one day as adults. Such movies were there when I was a child, and I suppose they are there even today.
I know no such thing happened with me. But I met someone today, and I thought, 'my God, if I had a twin, she would have been like this.' I had gone to the bank. The teller asked me to wait. She was an elderly woman, thin, fair, and and with good manners. It was not this description that prompted me t think what I said I thought. While I was sitting on an adjacent bench and waiting, she said in voice that carried,
"Krapash.....Krapash ....."
Krapash came on the third call, which was louder than the first two. He was another employee of the bank.
"What?" he asked.
"Phone...." she said.
"For me?" he asked.
"Yes, for you. You think I would call you to take a call that was for me?"
I wanted to laugh out loud, but managed to stop with a grin. 'My, God, she thinks like me, and talks like me too' I thought. I finished my work, came home, and told my wife enthusiastically, "Hey, listen. There is a new teller at the bank. Elderly, thin, fair."
"What about her?" she asked.
"You know which one?" I asked.
"Yes," she said calmly, "she speaks exactly like you."
"You know that too?" I asked.
"Yes" she smiled.
"If I had a twin that got separated when we were babies, she would have been like her" I said.
"I know" she said.
 I remembered a story, which I had told my wife before. When I ask patients 'when did you get your last period or some such clinical question', some of them ask me back,'who, me?' If I am not overworked or stressed, I say 'yes, you'. But if a lot of them do it to me on a single morning session, I point to another woman standing or sitting at the other end of the waiting hall and say, 'not you. I am asking that woman over there'. Then they get the hint and do not ask 'who me' again. I remembered another story. When I get a call while working in my office and the caller actually wants some other person or place, I say 'this is not him or the place. Some of them are insistent. They ask 'then where has the call reached?' I lose my patient then and retort, 'does it matter where it has reached, when it definitely not reached the person you want?'
I know some of you out there want to advise me to take a course in having patience. I am unlikely to do so, but thanks for the suggestion anyway.

A Neat Trick

We prefer to have no pests in the house. Unfortunately pest control does not take care of everything. We have a balcony garden with thirty plants. Plants bring ants. We are careful not to spill food particles anywhere so as to avoid attracting ants. But they come for something else - water. There is no stopping them.
We fill up water in a container, drawn through UV purifier, instead of switching it on every time we need water. Unfortunately the ants discovered this cache one day, and spread the word. I don't know how they do it. Perhaps they do it vertically genetically. Generation after generation of ants started entering our water container. They would be found swimming on the water surface in large numbers. They would form groups and swim together, like the gymnasts do in Olympics. Here is a picture, in case you do not believe me. We wondered why they would not drink water and go away. They must love swimming, we thought.

We had to throw away that water and fill fresh water again and again. We do not believe in wasting water. But we do not believe in drinking contaminated water too. Then I remembered a story of a patient of my wife. He ran a small home laundry business. He had plenty of rats, not by choice. He could not afford to let the rats destroy customers' clothes. So he kept food for the rats in a dish every night before retiring. The rats ate that food and went away without damaging a single garment. We decided to try that on the ants. We started keeping a saucer with water in it next to the large water container. The ants stopped entering our water container. But they would not swim in the saucer too. We were stumped, though happy that our water was protected. When my vacation started, I decided to find out exactly what was happening. I watched the saucer. The ants would climb into the saucer, drink water, climb back down and go away. They would not stay in the house and trouble us, or get pest-controlled and killed.
"They could not climb up the steep sides of the water container and fell in the water. They can climb out of the saucer" I explained to my wife.
"Good" she said.
"This is great," I said. "not just good. Now we know something about ants that no one else did so far. We have protected our drinking water. We are doing good work by providing water to thirsty creatures. That is increasing our Good Karma. We are also saving lives of those ants who would have drowned. That is increasing our Good Karma even more."
"I hope you are not going to write this on the net" she said, not greatly pleased that our Good Karma was increasing.
"But I am" I said. "It will help someone else out there who has the same problem, but has not yet found the solution to it."

An Offer That Hurt

"Sir, I want to see you for something important. When can I?"
"Sure thing" I said. "This Wednesday would be fine." He/she was my student, who had done MD some years ago. He/she had opted for running a coaching class for aspiring college students rather than practicing Obstetrics Gynecology. He/she was doing very well, probably much better than contemporaries who had gone into private practice. I wondered what he/she wanted from me.
He/she came on the Wednesday fixed for the meeting. Preliminaries over, he/she came to the point.
"Sir, I am expanding."
"That is nice."
"I want you to help me" he/she said.
"Huh?" I was surprised. "Your business is teaching college students. How can I help you?"
"The syllabus is changing. A lot of work has to be done... teaching sets, question and answer sets... I cannot do that alone."
"But you must have assistants" I said. I had an idea where the conversation was going, and wanted it to stop before it did.
"You could do a part of the work. The money will be good."
I was speechless.
"But I must tell you, I need the work done a certain way. Professor XXXXXXXXX had joined me to do this work. But he/she could not do it the way I wanted it. So I had to tell him/her to go."
I knew about this. This professor, a superspecialist in a surgical branch of medicine, had indeed taken up that work, possibly because the money was good. I had heard it had not worked out. Now I knew one side of the story.
"Thanks for the offer" I said. "But I am afraid I cannot do this. I don't need the money. I am making enough to eat four meals a day, commute to work and back, and buy the essentials for living. But even if I did not, I would not do this. I became an Obstetrician and Gynecologist because I loved that subject. I don't want do anything else in life. Best of luck."
He/she went away. I was hurt, not because I had been insulted, but because perhaps I had failed as his/her teacher in instilling in him/her the love for the subject that I had taught, and the values I believed I instilled in all of my students.I wondered where I had appeared inadequate so that he/she believed that I would prefer to do something else to make more money as he/she had done. Or was it the wealth he/she had amassed that gave him/her the idea that he/she could make that offer to me and I would accept it, and if I did not do well, he/she could ask me to go.

The One Who Chaired Many Chairs

"You see that person?" someone murmured while I was trying to suppress my seventh yawn of the morning. We were in the middle of a meeting called by a government agency, and the time was being put to (good or bad) use by dignitaries on the dais making speeches. I looked in the direction pointed at.
"Yes. What about him?" I asked.
"You don't know him?"
"I do. But what is it that you want to say about him?"
"I don't know why he is here. But it cannot be for an academic purpose."
I knew him. I could understand why this speaker said that about him. I kept quiet.
"You know he chaired many important chairs?"
"Huh?" I said.
"Dean of this college, Director of that institute, Director of some obscure department of the university, Dean of that third institute, then chair of his specialty in a fourth institute and so on."
So that was the chairing-many-chairs business.
"That is impressive" I said.
"You must have read about the financial scandal he was in before some minister bailed him out."
I recalled reading that in a newspaper a few years ago.
"I remember a story about him. Want to hear it?"
A story seemed a lot more interesting than the repetitive speeches coming from the people on the dais.
"OK" I said.
"A number of people were called to the university for some work. Both of us were there. When the clerk asked him how he had reached the university, so that he could pay the traveling allowance, he asked the clerk what transport was permitted. The clerk said first class railway fare or taxi fare. So he said he had traveled by railway - first class. The clerk asked him for the railway ticket, to be submitted to the accounts section. That got him in a fix. He thought about it a bit and said he would not take any traveling allowance, without giving any reason for it. The clerk managed to look puzzled and I managed to look not embarrassed for my one time teacher. I knew he had no first class railway ticket, because he had not traveled by first class."
"Ah!" I said. I understood that he was trying to make some money. "What did you tall the clerk about your travel?" I asked just to avoid discussing the embarrassing topic any further.
"I said I had gone there by bus, and gave him my one rupee ticket. The clerk looked embarrassed at the idea of paying me one rupee as travelling allowance. He asked me to keep it and paid me a princely sum of fifty rupees."
The bus ticket to the university located at one end of the town costing only one rupee suggested it must have been about thirty years ago. This person asking for one rupee seemed unreal.
"That must have been thirty years ago" I said.
"Yes. In thirty years his dishonesty has increased manifold as he chaired chair after chair. I am afraid to be under the same roof as him."
Suddenly I was afraid to be on the same academic platform as him too. I managed not to say 'me too'. But it was tough.
(Note: read he/she and him/her in place of he and him respectively. That is to protect the identity of the person concerned. Normally I do it as I type. But this time I did not do it because someone told me it makes reading the article less interesting.)