Professional Tax Chalan

The state government charges all professional people, in service or self employed, engaged in business or otherwise, a tax called professional tax. For salaried people, it is easy. The employer deducts it at source and pays it into the state government's treasury. Others are not so lucky. They have to pay it online in modern times. Until recently, the only way was to fill up a professional tax chalan in triplicate, and deposit it with the tax amount in a bank that accepted professional tax payments. This procedure still works for individuals.

One problem is that the chalan is not available in the bank where one goes to pay the tax. So one has to go to the government's professional tax office just to get the chalan. It would be an easy thing to make it available on the government's website. The government probably does not think so, or has not thought about it at all. So one has to rely on people who have uploaded images of that chalan at various sites on the web. These images are not of a very good quality. Their prints are poor and not easily readable. After struggling to get one year after year, I finally made one (from an original, but only in English) in a word processor, converted it into a PDF file, and now have made it available. It looks as follows (click on it to expand it).

It is available as a PDF file here. Use it at your own risk. I have not asked the professional tax office people if it is OK in their opinion.

Role Model Effect Or Same Horoscope?

There is an ancient text called Bhrigu Samhita (भ्रुगू संहिता) in which the horoscope of every living individual is written down. The predictions given in it are said to be totally accurate. Even without it, there are experts who write horoscopes of people based on their time of birth, and predict their future. I don't know if it is an accurate science or not. What I am going to describe here is an ancient story (folklore) from the times of the famous king who built a hospital for poor people in his kingdom. You can read about it here and here.

There was a Guru (गुरू) in the Ashram (आश्रम) attached to the hospital. He had his own ideas about many things, including how his life should be. He had his own peculiarities, including physical characteristics, quirks, behavioral traits, medical conditions, and fate. He probably had a mentor effect on a pupil (विद्यार्थी) of his, who followed in his Guru's footsteps. His Guru passed away sometime, and the student became older and became a Guru of the same subject. Here is a comparison of the two.

	Guru	Student
Height	Medium	Medium
Weight	Medium	Medium, until he developed a paunch.
Loved to throw his weight around	Yes	Yes
Complexion	Deeply tanned	Deeply tanned
Teachers’ politics	Leader	Leader
Behaved like a boss	Yes	Yes
Had a coterie	Yes	Yes
Treated students like dirt	Yes	Yes
Made students queue up for signatures on homework (ग्रुहपाठ)	Yes	Yes
Wore thick glasses so that one could not make out at whom he was looking	Yes	Yes
Allegedly blessed women students by जादूकी झप्पी (magical hug)	Yes	Yes
Warrior: destroyed people who spoke against him	Yes	Yes
Had king’s illness: राजयक्ष्मा	Yes	Yes
Had rich people’s illness: मधुमेह	Yes	Yes
Had different standards of behavior to suit different people and situations	Yes	Yes
Was loved by people	No	No
Died early	Yes	(* See note)

* The last feature is left blank for the readers to guess. A hint is offered. It depends on whether they had the same horoscope, or the गुरू  was the mentor of the विद्यार्थी. The answer will be yes if they shared a horoscope in भ्रुगू संहिता, and no if it was a mentor effect on the विद्यार्थी. Those who do not want the hassle of thinking can Google ancient folklore for the answer.

Bully Bird

I had never thought birds wold be capable of emotions and behavior more than primitive ones, like grief at the loss of a young one, love for the young one, love for a mate etc. This story was an eye opener for me.

Asian Koel is a big bird. It has angry red eyes. The male is all black and the female is with brownish spots. One hot afternoon last summer I found two of them sitting on a branch of large tree opposite our house. One was a male and the other was a female. They were quiet and probably resting. There was a tiny bird sitting on a branch above them. This tiny bird was quite vocal about something. It was not singing. Actually it sounded as if it was complaining loudly. It must have been its territory and it must have disliked those two birds entering its territory. In the picture below, the black bird is on the right of the center, the spotted one is on the left of the center (white arrow), and the tiny bird is above the black bird (between yellow-outlined black arrows).

After the tiny bird had complained for a while, the big bird perched on a branch below it apparently got tired of the disturbance. It turned its head through 90 degrees and looked up. It gave the tiny bird a full glare of its angry red eye. The tiny bird shut up in a snap. The big bird turned back its head to neutral position, paying no more attention to the tiny bird.. The tiny bird did not utter a single sound until the big birds flew away after some time.

Bullying is not limited to school children. Even birds bully.

Silk Cotton Tree

I have spent almost forty years in my hospital, initially as a student, then as a resident doctor, and then as faculty. In all these years I did not know that a tree called 'silk cotton tree' existed in the world, and there was one in our campus too. I used to look at it and wonder what it was, when I happened to look outside the window of the postnatal ward. It looked like this.

It is as tall as a five-storey building of old times (seven-storey building of modern times). It grows fruit in bunches that look like bananas when unripe. I did not take a picture when it was full of green colored fruit. Finally I took one a couple of days ago. The fruit looked like this.

I could never have guessed what they were. Luckily I found one which had burst open. It showed silky cotton inside, from which it has probably derived its name. It looked like this.

The scale kept next to it shows that each fruit is about 7 to 8 inches long. I have written about it here, because I thought that a lot of people like me would not know about it.

My wife told me it was called Shalmali (शाल्मली) and was used in Ayurvedic medicine. You can learn more about it here.

Storage Door

Conventional wisdom is that a room is for storage and a door is for closing the entrance to a room. However hospital employees are innovative. It is their ability to think out of the box that makes civic hospitals different. Here is an example.

The image shows a metal grill door (yellow arrow) in front, behind which is a wooden door (red arrow) with glass panes (black arrow). The idea of putting the grill door was to provide security. The glass panes could be broken by anyone, and a small person could slip in, steal things and get away. The glass panes were sometimes broken, and people peeped in, which could be quite embarrassing at times for the patients inside. The innovators have put detachable tops of two patient shifting trolleys (green arrows) between the wooden door and the grill door. This has achieved a number of things at one go.

1. Space is found for storage of those trolley tops. As everyone knows, space is very difficult to find in this city.
2. The glass panes are protected. No one can break them with solid trolley tops in front of them.
3. Thieves are kept at bay. If they try to steal despite this measure, they will be taught a lesson. If you note carefully, the trolley tops are leaning on the grill door a little. Which means if an unsuspecting thief manages to open the grill door, the trolley tops will fall on his head.

(I cannot say if the innovators had all of these points in mind when they did this. This is how the things appear to me.)

Different Tomatoes

I have been seeing and eating tomatoes all my life. They always looked the same to me, except that sometimes they looked green (unripe ones, and even ripe ones of a different species). Only when we grew tomatoes in our balcony garden that I came to know that they came in different shapes. Perhaps the vendors removed such tomatoes from their wares so that people with superstitions would not be inhibited from buying those. Perhaps the phenomenon is not very common. Here are some pictures of our tomatoes.

Normal tomatoes.

Conjoined (fused twins) tomatoes with a beak: the top view is on the left, and the bottom view is on the right.

Heart shaped tomato: the front view is at the top, the back view is at the bottom.

Two colored tomato: the front view is at the top, the top view is at the bottom. Half the tomato is red, and the other half is green.

The History Hiders

Medical history is different from usual history. Apathy to the latter in student life is widespread, probably due to students hating the need to remember whatever happened exactly whenever. That cannot be said about medical history. Usually patients remember something about their past medical problems, though very few produce documents related to their treatment. Some of them leave their old papers at native place when they come to us for treatment of a new condition. Some of them leave the papers home, which is somewhat better since they can get them at the time of the next visit. Some of them get angry with the diagnosis of their condition and tear up all papers. After they repent, they go to a new doctor, and the whole diagnostic process has to be started again, including all tests that they had got done and had lost by tearing up the reports. Some women have some medical condition before marriage, and they hide it from the groom and in-laws fearing that the marriage will not take place if they know about it. They hide it from their doctors after marriage fearing that the husband and in-laws will learn about it from the doctor and the marriage may end in a divorce. Recently we had a patient who had undergone a major abdominal operation about four years ago, long before she married. She was pregnant when she came to us. She had no papers of her past operation, because her mother had torn up all of them. The mother did this because the daughter eloped with her boyfriend and got married to him without her parents' wish. Now we were stuck, not knowing what had happened inside her abdomen, and how it would affect her current pregnancy.

I have seen a new trend in the last 15 days. We had three patients, who hid their past medical history from us.

1. The first patient had high blood pressure, for which she was taking treatment from a private practitioner. She came to us with toxemia of pregnancy. She hid the history of this treatment from us and kept taking her pills on her own. She had seriously high blood pressure during childbirth, which we managed somehow. When she was ready to go home, she was seen taking her own pills, and when asked, she said nonchalantly, 'that is as per my other doctor's advise. I am managing that part on my own. So I did not tell you.' She obviously did not know about interactions of medicines, and possible serious effects of her condition on her pregnancy.
2. The second patient was a diabetic. She hid the history that she had convulsions in past. We managed her diabetes during pregnancy and delivered her successfully at term. She had tonic and clonic convulsions immediately after delivery, which could not be explained by her medical condition, and the doctors on duty were alarmed because the convulsions could be due to any of a large list of conditions, most of them serious, and they were prepared for none of them in this patient. It was discovered afterwards that she had this condition in the past. It was lucky the baby did not have any problem and both the mother and the child went home fine.
3. A resident doctor from another specialty brought his mother for uterine leiomyomas. We advised her to undergo surgical removal of the uterus. They hid the history of angina from us, from the anesthesia outpatient clinic doctors, and our OT anesthetists. She revealed it when she was on the operation table and was being administered a regional block. We all almost went into shock, thinking of all the bad things that could happen to her if we operated without diagnosing if she had ischemic heart disease. There was dispute among the son, husband, daughter, and patient on whether she had undergone a stress test. Finally it emerged that she had not run on a treadmill for the test. I had to take her out of the OT, get a cardiology opinion urgently (*which the son managed well, including a stress test) and then operate on her. Luckily she did not have ischemic heart disease, or we could not have operated on her without getting it treated first.

I am quite worried by this new trend. I appeal to all my readers to spread the word that patients should not hide their past medical and surgical history from their doctors, for any reason.

Taking Inspiration From David?

I wonder if the persons involved knew about the story of David and Goliath. But their activities did make me think of that biblical story.

The traffic police of the city are quite active at times. They tow away vehicles parked at places they do not like used as parking places. It is a great revenue generating activity. The towing trucks are owned and operated by private parties, and a traffic cop rides shotgun. It is said he turns a blind eye to alleged illegal activities of the operators like opening locked doors of parked cars by passing in hooks, so that a hand brake can be released and the car can be put in neutral gear, so that it can be towed away. Such nonsense! No government official would do any such thing. Anyway that has nothing to do with this story. I just took the opportunity to say what people say and to praise the government employees.

A monorail track has been built in front of our front gate. The space below the rail is free. No cars can drive there as there are pillars at intervals. It is quite tempting to park cars there, and many drivers do exactly that. Though there is no sign put up by traffic authorities that parking is not allowed there, traffic cops get parked vehicles towed away regularly. A couple of days ago, there was this huge crane parked there. I was wondering what a towing van operator and a traffic cop would do if they noticed this. While I was thinking about it, along came a towing van and was halted at the front end of the crane.

They spent quite some time pondering what to do. A couple of enthusiastic workers on that van fitted their towing chain to the crane and the driver tried to tow it away. They probably needed that one, because they got paid a fixed amount per vehicle and crane would fetch lots more than an ordinary car. The wheels of the towing truck spinned in place, but the crane did not move even by a millimeter. The traffic cop also must have realized that he would not find place to keep the crane in his police station even if he managed to tow it away. So they unhooked the towing chain and went looking for prey more of their own size. If they had taken inspiration from the story of David who had defeated Goliath, they did not do justice to it. David had defeated Goliath, while they went away defeated.

I am not sure if they actually meant to tow the crane or if they were play acting. It is possible one of them wanted to post a video of this on Youtube. I did not go too near to take this picture, because government officials have the power to arrest people for obstructing government servants while carrying out their duties. Taking a picture can be construed as obstructing a government servant in a democratic country.

Bees Share Birds' Water Dish

We have put up a water dish for birds on our window sill. Though there are a number of birds in our neighborhood, only crows drink from it. You can read about it here.

Now the summer is approaching. The weather is such that the crows are quite thirsty, and we have to fill the water dish five or six times a day, while doing it twice a day used to be enough in winter. The dish is quite small, but we cannot put a bigger container on that narrow window sill. Though the crows put off other birds, they have apparently been unsuccessful in putting off the bees. Here is a picture of two bees drinking from the water dish (pointed out by arrows). I wonder where the bees used to drink water before they started to visit our water dish. Actually I had not thought that bees went anywhere to drink water. That is quite silly of me, as I should have known every living thing drinks water.

Technique Of Developing Technical Specifications

You may want to know about the hospital a King built for the poor people in his kingdom. Read all about it here and here.. This post is about the King's prescribed method of procuring equipment for his hospital.

There were a few (actually quite a few) dishonest people in his court, who would buy equipment for the hospital at inflated prices, and the difference between the market rate and the rate of purchase would be shared by them. In order to curb this, the King decided to use a process he called 'tender'. Actually there was nothing tender about it. It was quite complex. You can read all about it here. One of the steps in inviting these tenders was to lay down specific technical features of the item to be bought, so that all persons who wanted to sell that item would offer a similar product. The process of writing these specifications was entrusted to the hospital doctors and one engineer. The king did not know that doctors were not taught engineering skills, because he used to be a political appointee himself with no knowledge of either medicine or engineering. A problem with the engineer was that he would be appointed to this position by seniority in the king's service. So a garbage or sewage management engineer could get appointed to do an electronic engineer's job. The doctors would copy specifications given to them by vendors they liked. The engineer would depend on brochures of three different vendors, taking out their least common denominator. These facts resulted in preparation of technical specifications which left a lot to be desired. Sometimes different points about a single item would be opposite of each other, creating a technical impossibility.

One day the king appointed an engineer to do this job, who was different. He probably hated electronics, or perhaps hated engineering itself, like some medical students hate medicine but join a medical college under parental pressure. He used to collect files in his office until their pressure threatened to push the walls outward. All medical specialists complained that they could get no equipment because there were no specifications. No one could do anything about it, including the king, because of reasons not revealed to anyone. Fortunately almost every problem has a solution. An innovative doctor found it for the problem at hand. This doctor got specifications for seven items approved when others could not get even one. The secret was not revealed. After some time another doctor got specifications for a mega project sanctioned. It is rumored that the engineer asked this second doctor to bring along other projects too, on which he would love to work with that doctor. Though the other doctors were not very good with math, they found the least common denominator of the two doctors who had succeeded where the others had failed. The result was as follows.

The aspirant of technical specifications should have fashionably cut hair, well made up face, pleasant and a little mischievous smile, slim arms revealed by sleeveless top, fashionable dress, and willingness to have coffee.

A New Nightmare

A few days ago, the newspapers had a news item on use of cow's urine as disinfectant to clean government offices. If you missed out on that, you can read all about it here and here.

After the Swachh Bharat Abhiyan (स्वच्छ भारत अभियान) launched by the government, which was adopted by the civic body, all civic employees were told in no uncertain terms to clean their places of employment every Friday between 5:30 P.M. and 7:30 P.M. The civic administration welcomed it with a glad heart - it had given them something to do that did not involve paying money for. You can read all about it here.

With the civic body adopting all of the government's splendid ideas, it was logical to expect that disinfection with cow's urine would be the next one to be adopted. There are cats, dogs, rats and mice in campus. Keeping a few cows would be no big deal. They could graze on the front lawn. That would have two positive points. The food for the cows would be free. The grazing would save on the lawn mowing expenses too.

When it happens, we will have to use cow's urine to fumigate the operation theater (it is called fogging now) and to scrub prior to performing operations, and if there is any surplus urine, drink it in place of tea between two operations to build up energy again. The Operation Theater (OT) would then become Holy Operation Theater (HOT).

Government, Cows and Us

I am a vegetarian at heart. I mean I eat vegetarian food by choice, and eat meat only if I have no choice. I don't eat red meat because it is said to be bad for the heart. I don't eat beef because my religious teaching is not to eat beef. The state government has recently banned slaughter of cows, and possession of beef. The government also promotes drinking cow's urine.  I do not express any personal viewpoint on these issues. There are all sorts of reactions to it from all sorts of people. Here is a reaction I came across.

Not A Day Above Forty

"Hello there!"
I looked up from the history I was writing on a patient's case paper. Normally I would be busy seeing patients in an examination room. But there was a shortage of resident doctors, and I was filling in. I was the unit head, and I had to see that all work was finished in time. Putting on airs would not help do that. That was how that Professor saw me while using my outpatient clinic as a thoroughfare.
"Hello" I said.
"Do you know if they increased our retirement age to 63?" she asked.
"Not yet. But I don't see any point in doing it for surgical specialties. If our hands shake like this" I said, moving my hand in a demonstration of a senile tremor, we won't be able to operate well at that age. It is not as if we have to just sit and write prescriptions."
"Oh, that won't happen. One should eat well, exercise and be fit. Look at me. I am sixty, but I don't look a day over forty."
She held her hand over her upper chest, well in front of the rib cage, as if there was something there preventing direct contact with the rib cage. What was more interesting was that she had made a statement about herself that a third party is supposed to make about a woman well above forty. She waited for me to agree with her, and when I did not, would not, or could not, or perhaps when she saw the answer in my facial expression, she turned and went away. 'Can't blame people who say she is a bit funny' I thought, and went back to my writing of the history of the patient who was sitting there, not understanding a word of what was being said.

No Nonsense Blessing

The story goes back a ways. I was going out of my OT after completing all scheduled operations. Another team of gynecologists was going in for an emergency case. When I went to change from my scrub suit into my street clothes, I found my clothes thrown or fallen down from the hook in the wall where I had hung them. There were a girl's clothes on that hook. I was upset that someone had thrown my clothes down to put up her own clothes there.
"Whose clothes are these?" I asked.
"Mine" said a resident doctor coming forward. She was posted in another unit.
"Why did you throw down my clothes and hang yours there?" I asked.
"I am sorry" she said. "I did not know they were your clothes."
"You should not throw down ANYONE's clothes, not just mine" I said.
"Yes, Sir" she said.
I hoped I had taught her something other than Gynecology and Obstetrics. She qualified subsequently in due course and went away. Before going away, she came to see me once. After we talked about her future plans, she said,
"Sir, I want to say that you remind me of Howard Roark in Ayn Rand's Fountainhead."
"Thank you" I said.
She was young enough to be my daughter. But she seemed to have a maturity beyond her age, and she could speak her mind without inhibition. She went away after I wished her all the best. Five or six years passed. Then she came back again for getting a duplicate of her log book from her residency days signed by me.
"What are you doing now?" I asked. She would have settled down by then, I thought.
"I am a consultant in a corporate hospital in my home town" she said. "But I want to do something better. There is no scope for development in corporate hospitals. I am there because my parents stay there."
"Um...forgive me for saying this" I said. "I thought you would be married and settled by now."
"I am thinking of that too. But there is my career to think of" she said.
Then I could not help saying what I would have said to my daughter if I had one. "I think you should balance your career and family life. If you pursue your career dreams alone, one day you will reach the top and suddenly realize that life has slipped by. At the end you need to have happiness from having lived a good life too."
"Yes" she said and thought briefly. "I want your blessings" she said suddenly.
"You always have my blessings" I said a little awkwardly. I am always awkward when I am asked to bless someone.
"I want your blessings" she repeated and proceeded to bend down to touch my feet. We have this custom in India where blessings are sought from elders and teachers by touching their feet.
"Please don't touch my feet" I said even more awkwardly. I held my hand above her head and said "you have my blessings" hoping that would satisfy her and she would stop touching my feet.
Then she did something unexpected. She looked up, found my hand in the air above her head, grabbed my wrist and put my palm on top of her head. Then she let go of my wrist, happy that she had got my blessings the way blessings are given. I always thought I could think fast, and usually could read people's minds. This student of mine had stumped me totally. She went away to pursue her dreams.
I hope my blessings are strong enough at least this one time and she gets whatever she wants from life.