Twenty years back and forth

         Human life is so short. Homosapiens has been on earth for last 2 lakh years and we have a decent understanding of history only of last 2000 years. And the science tell there is no significant difference between the thinking and understanding capability of humans then and now. So what were those people doing before 2000 years? What miracle occurred which made this rapid progress in human race.
        
        Some times it occur to me that all humans have one spirit and they are recycled. What they make during their life time stays and make their life better for the next cycle. Any big corporate in the world with a long history has been started by a single or group of persons. The story of how they changed hands between generations while the establishment stays and grows is fascinating. Take the case of a castle or an old church. How many generations have lived and prayed there. The walls of church witness baptism, marriage and death ceremony of the same person. The dirt I stand on has been here on earth, millions of years before me.

        There is an out flow of emphatic emotional turbulence when I visit an old fort or museum. The forts and castles that has been build half a millennium ago. What all incidents they must have witnessed. The power of the empire who built it, the people who built it, the wars they have seen, the victory, glory, violence, blood and gore. And now in this twenty first century I am standing on it. The sand on which all this has happened.

       Another thing that is in total contrast with all this development is that still babies are born on streets, eat to stay alive and die of the same disease that killed people 2000 years back. Some people are unfortunate that, even with the fortune they have, there is no cure for what they suffer from. I don't think life was any different for a slave who worked to make an Egyptian pyramid and a immigrant manual labourer who works for a contract builder in a metropolitan city.

       I don't think there is going to be any difference in this cycle of events. Every one has to live his life one way or another. I was thinking what was I doing twenty years back, I was six years old, studying in first standard, some good memories, but school life was always an entrapment. Twenty years has passed and I am still trapped in another place. Where will be I, after another twenty years. How uncertain human life is! Now I am writing this in a laptop, Who knows what technology I will use to write, twenty years from now.

 

Dull winter days

          Grown up in a warm sunny place,  I was not prepared for the winter life. Be specific, the Delhi climate. Delhi has got a climate which swings from one extreme of temperature to other like a pendulum. It is dull, gloomy and grey for a tertile from November and burning red hot for a semester from April.

         The first time when I landed in Delhi, I tried to enjoy the winter, walking with hands tucked in , vapours coming out with each breath and new fashion clothes in the streets. But the enjoyment did not last long. It was difficult even to touch the floor bare foot, the water is ice chilled, the food is cold in two minutes and I cannot live without wearing two layers of clothes.

        This is my third winter in Delhi. I know what to expect. The key in winter is to keep yourself warm. Wear sweater all the time, cover the peripheral parts while driving, change damp clothes as soon as possible, have extra petrol in the bike and a warmer in the room. Rather than the temperature, it is the dampness and humidity that makes life difficult. It is very easy to get respiratory tract and enteritis easily during this vulnerable time.

        More over today I am not feeling out, may be due to last night's duty. But still I felt I has to note this strange moodiness associated with winters. And I miss my Mom's food.

Entero cutaneous fistulas and stomas....

         Today morning rounds was going fine till that bad news came, the patient who underwent resection anastomosis developed an entero-atmospheric fistula. This young guy had undergone 3-4 laparotomies in the past and came to us with multiple entero-cutaneous fistulas. Adding to that his histopathology report has come positive for cancer with positive margins.

        Another young lady, who is the mother of two small kids has got inoperable rectal cancer with rectovaginal fistula, she underwent chemotherapy, radiotherapy, and we did a diverting colostomy for her.

        For some people, normal life is never meant. This is the raw truth of life. A visit to pediatric surgery or oncology ward can make one depressed. They just get crushed before they know what life is like. But these young people, they have tasted the life, they have just grown up and started their independent life and then suddenly it is all shattered.

       Well, seeing patients with stomas and fistulas daily had started to make me think, that it is not that difficult to live with it. But two days of severe gastro enteritis made me realize how tough it is. The embarrassment they has to go through every day. Compelled to live with the smell of stool from unnatural sites and the incontinence, make life tough for the patients and the near ones.

      So what can I do? Direct them to stoma clinic and advice on proper stoma care. Give them motivation and comfort. Try to create good stomas. Yes, there are so many things these patients teach us during these years of residency.