A train ride to remember

The highlight this week was definitely the travelling to and fro via railway to Ooty. We arrived at the railway station on Thursday at 10pm to catch our 7-hour train ride to Mettupalayam. Throngs of local families laid all around the station waiting for their trains to arrive. We were fortunate to get tickets for our trip having been on the waiting list right up to the moment we left the hostel for the railway station.

After an uneventful train ride through the night, we arrived at our destination the next morning.

Ooty was a 3-hour bus ride up from Mettupalayam and the further we went up, the cooler it became. What a refuge from the heat wave back in Vellore!

We spent most of our time in Ooty sightseeing and enjoying the weather.

Chocolate shop

115th Flower Festival

'New Zealand' looking place

Check out the litter on the ground!

Meditation gives you wings...

My Havaianas snapped but I got it fixed with some rafia =]

Rose Garden

Before long, we are on our way back to Vellore. This time, only 2 tickets were confirmed and having no choice but to return for posting the next day, we bought 4 general class tickets. Travelling in general class is strongly discouraged by many online websites and travel books, and we are about to find out why.

At the second stop, the 2 girls went over to the guys who had the 2 tickets in third class, leaving the 2 of us to rough it out for the next 6-hours. It is really amazing to see how the locals manage to find even the tiniest of spaces to sit or lie down. Some even improvised a hammock from their saris to coo their babies to sleep. It was really an eye-opening experience =]

Public humiliation at its best

Time seems to fly by and soon we arrived at our destination; we survived the train ride and are proud of it!

The Heart

Heart: A hollow muscular organ which by contracting rhythmically keeps up the circulation of the blood; the seat of the affections or sensibilities, collectively or separately; the inmost or most central part of a thing; the most important or vital part.

The heart is a very mysterious thing. Being attached to Cardiothoracic Surgery this week, I came face to face with it beating inside a human chest for the very first time. That moment, everything around me seemed less important compared to the perfect synchrony of the dual pulsation made by that muscular machine. The heart is an engineering marvel; it promises you what no other thing can – beating for every single second of your life from the moment you were born till the moment you breathe your last. The heart never fails to amaze me in that it NEVER rests!

However, this loyalty comes at a price. The heart can take years of insult without flinching because it was engineered with reserves. It learns to deal and cope with the numerous atrocities we commit against it until it is too late. I have seen patients with hearts encased in fats and wonder how do us humans treat our bodies? It boils down to one simple truth: we took it for granted.

As with many things, once you start taking something for granted, you stop working at it. When that happens, everything goes downhill from then. Is it any wonder then that matters of the heart also suffer the same fate when we take the relationships we have for granted?

I have learnt something today. Whether be it the heart as an organ or the heart as the other definitions stated above, one must never take it for granted.

My virgin local railway experience

I set off by foot from my hotel at Chennai to Egmore railway station on the suggestion of the counter staff when I asked how do I get to Chennai airport other than by auto-rickshaw.

Before long, I was at the station. The walk there took about 5mins as estimated by my information provider. However, chaos ensued as I was the only Chinese person in the ticketing queue. Every local acted like I did not exist, even the ticketing agent! Even though it was my turn to purchase a ticket, everyone else leapfrogged me and got their tickets. I was seriously pissed. I pushed and shoved the locals to get out of that hell hole and after asking around, realized that I was in the wrong queue!

Ticketing hell hole

The railway system is similar to Singapore's MRT

Gosh. I then made my way in search of the right ticketing counter. That was when I met Prabu, a friendly local who was going to the beach with his girlfriend/wife. We both needed tickets for the same platform albeit our trains travel opposite to one another. He brought me to the counter and even helped me foot the extra 1 Rupee for my 6 Rupees ticket as I only had 5 Rupees spare change with me. He told me to ask around for help in Chennai as the locals are very helpful. This was very true! After spending a week here in India, I have come to realize that as long as you ask, there will be someone who will help you. Everyone here is very friendly and helpful (except for those buying railway tickets!)

For the brief 10 stations journey on my virgin railway ride, I felt like I somehow got the stamp of approval from the locals in the same cabin as I was. I was living India.

I have made it to my destination!

Things in context

I love ice-cream. All kinds of them…Today, after a hot day of travelling, I bought a popsicle while waiting for the bus to arrive. A little local boy saw me and started pestering me. I thought he was begging, hence I passed him whatever coins I had with me. This did not satisfy him; he kept at it, refusing to let me enjoy my popsicle. I chose to ignore him at first, but afterwards, I realized he was pointing to my popsicle and the ice-cream stand.

Therefore, to test my hypothesis that he was like me, an ice-cream fanatic, I took him to the ice-cream stand and got him a popsicle at S$0.30. He was finally satisfied.

It is so ironic that the same S$0.30 that some people would die trying to save could make the day a little better for that little boy. I have no idea whether it made his day, but if I could just make him happy during the time he ate his popsicle, I think that it is a good thing…

Ugly tourist

Since when did travelling become an activity like visiting a zoo where the tourist pays and expects to ‘experience’ something? The tourist adopts a condescending attitude in his interaction with the locals, often oblivious to the numerous insults spoken behind his back (or into his face) in their native tongues. He sees travelling as a service industry – I pay for it, I deserve it.

Since when did saving S$0.30 become of utmost importance that people make enemies out of possible friends? In my opinion, the art of bargaining entails a clause stating that both parties should benefit from the deal. S$0.30 might not mean much to us, but it straddles between the ‘hungry’ and ‘full’ line for some locals. More often than not, the ugly tourist benefits, and the local, in order to minimize his losses, strikes a disadvantageous deal. He has no choice, and the ugly tourist often forces this hand. I like the way Bernard views this issue, “I don’t mind paying that extra bit because it doesn’t amount to much when you convert it back and you make the provider of services happy, adding further to the global positive experience of the whole trip.”

No doubt, tourism has evolved over the years into a sort of service industry. People will do all sorts of things to never experience hunger ever again. Hence if they know that ignorant fools from abroad are coming to throw money at them for something they wish to ‘experience’, they will lap at it. There is however a substantial population of backpackers who have managed to preserve the loss art of travelling. They do not pay for experiences, but often get them via communication, genuinity in interaction and love.

I strive to hold myself to the higher standard of a traveler. The traveler knows that he is but a passer-by in a native land and views the locals as fellow human beings; as equals. He immerses himself into the heartbeat of the native land and connects with its life source. The tourist, high up in his ivory tower, often misses out on this aspect. Even if he claims to have experienced some semblance of an immersion, it might not be as authentic as the cash he paid to ‘experience’ it. Hence, the tourist usually returns back home thinking that the trip was ‘nothing much’. The traveler’s experience can never be bought with any currency in the world. He has with him the arsenal of human interactions and connections. He often returns home a humbled person...

 

"There are no strangers, just friends we haven't met" - Professor Low Cheng Hock

Unexpected...

Riding to the hospital is becoming more and more of a routine for me nowadays. However, this morning was something different. I came across a road block on the route I usually travel on. It was a no go. I then asked the officer which way I could take to get to the hospital, he mumbled something in a language I did not understand (thankfully he gestured too). I figured that there must be a detour from the other side and hence decided to explore a new route to get to CMC from Modale. I turned my bicycle around and rode off in the opposite direction, praying hard that I will eventually arrive at CMC somehow.

The new route has less traffic and the road was smoother. It was like a small winding lane where stallholders are busy setting up their businesses flanking the lane. I rode until I saw something familiar then took a turn unto the main road. I had successfully detoured the road block after about 10-15mins of ‘gut instinct’ navigation. It was a wonderful experience having learnt a new route.

I joined my team at the wards where we completed rounds and proceeded to the clinics. All I wanted to do today was to leave after the morning clinics as I wanted to rest before travelling to Chennai later in the day. Somehow, whenever you wish for time to pass faster it slows down; whenever you wish for time to slow down it passes faster. Time seems to be our eternal enemy…

I thank God that I stayed until the end of morning clinics for I had on several occasion felt like leaving halfway. I left today a humbled person for the patients that came in taught me so much and impacted me in so many ways…

The first case was this man who has bladder exstrophy. Prior to today, I have never heard of such a condition before! Apparently, it is quite rare. There is reading up to do tonight…

The next case was this 12 year-old boy suffering from end-stage renal failure awaiting renal transplant. He looked jaded and frail in his dirty clothes, but his eyes and actions told a different story. He was a fighter. He is fighting to live. I later learnt that Dr Ravi has put that boy’s medication on the department’s tab because he is too poor to afford medication. At that moment, it occurred to me that this boy could very well have been fighting all his life – he has got the survival instinct.

I have always felt that modern human beings have lost the edge. We have lost our animal instincts; the most basic primordial instinct needed for survival. Throw a businessman into the middle of a jungle and I bet you he will not survive. We have been too accustomed to the comforts of life – air conditioners, computers, television, mobile phones, cars and the list goes on. Without these inventions, I firmly believe that many of us find it hard to ‘survive’. However, think about it, are all these necessary for survival? I like what Tyler Durden says about such things in Fight Club,

“The things you own end up owning you.”

“It’s only after we’ve lost everything that we’re free to do anything.”

Human beings are being caught in this viscous cycle of consumerism. We are always on the prowl for the latest, the best. We feel that owning such things define who we are, but do they? Society defines a man to be beautiful when he has status, possessions, and achievements. Now, strip him of all his statuses, possessions, and achievements, is he still beautiful? Does his nakedness, his core still reflect that beauty? Many times the answer is a resounding no, because more often than not we focus too much on the outer man. We heap tons and tons of resources building thick walls on the outside and neglect fortifying the inside. At the end of the day, everyone is just an actor involved in a play called life; everyone is living a double life; everyone has a façade. Are we truly living then?

The next patient who came in presented with a recurrence of his Hodgkin’s lymphoma. When his mother was told the news, she fought hard to hold back her tears, appearing strong for her son who seems to have given up the fight. He appeared nonchalant.

How many of us fail to give thanks for the greatest gift of all every day? The gift of life. We let ourselves be caught up in the rat race, often pushing our bodies beyond what they were created for. Even robots and machines need rest! I find myself to have also at times taken this gift for granted. It is time to cherish what is important and see things with an eternal perspective.

Lastly, there was this 14 year-old boy with a new presentation of a left scrotal mass that has been there for 10 years. I was told to examine him, and I carried out the inguinal hernia CEX. I have never successfully reduced and occluded the deep ring preventing the hernia from re-forming. Today, it worked like what was described in the textbooks! When I removed my finger and told him to cough, the hernia re-emerged confirming my diagnosis of an indirect hernia probably secondary to a patent processus vaginalis. He was listed for a herniotomy =]

Learning here in CMC is a new adventure every day for me. Like a child receiving a Kinder Surprise egg, I find myself not knowing what I will get in a day at the hospital, and I like that feeling…

Paediatric Surgery

I realised something interesting this morning...that I took as fast as the local bus on my bicycle to the hospital. Perhaps it was the early morning traffic where the number of vehicles on the road was significantly lesser compared to the afternoons and evenings. Maybe it could be due to the fact that the bus has to stop at every stop while I rode on. Well...

As I reached the ward, Dr Ravi told me to grab a chair from the nurse counter. I pulled one and was unaware that a computer wire was around one of its legs; the CPU crashed onto the ground and the screen turned hazy. I was at a loss for words. There I was standing stunned in the middle of my team with the senior doctors present. I am so screwed, or so I thought. What came next was a reaction that totally took me by surprise.

"Nice work Norman, I always wanted to do that, seems like you did it for me."

"Great! Now we can get a new computer!"

There was a buzz and soon the attention was taken off me and diverted to the computer. It was really a funny experience I must say. Everyone here is super friendly and willing to teach. Ward rounds are a joy as the doctors explain each case and you really learn a lot from them. One thing I realised today at rounds was that sometimes in life when there is no one the patients can place their hope on, including the doctors, they turn to God (as this is Christian Medical College hospital). I see bibles on beds, people praying in the Chapel and I come to the conclusion that at one's most desperate hour, one will seek a higher power or being for hope.

After rounds, I went to the Operating Theatre where I spent the next 8hrs of my day. As there was only two doctors present in my team today, I was 'hired' for the day. The most memorable surgery I encountered today was this 14 year-old girl who presented with a pancreatic pseudocyst from pancreatitis secondary to gallstones. She was scheduled for a cholecystectomy and pseudocystojejunostomy. I had no idea what the latter was and hence was pretty excited to see it. Apparently, Dr Ravi was going to surgically connect the pancreatic pseudocyst to the jejunum so that the contents of the pseudocyst can drain into the bowel. A Roux-en-Y anastomosis was performed. I was particularly impressed with the skills of the surgeons here. They operate with confidence and have very sleek handling of their equipment. The best part of the surgery was witnessing the two anastomoses being sutured to perfection (such a procedure is usually done using high-tech staple guns in Singapore). One of the main reasons why I chose to do an elective here in India is because I wanted to see how Medicine is being practised in its most fundamental form - no frills. After that operation today, I knew I was in the right place. I always leave the OT learning something new =]

After leaving the OT, I had an early dinner, went to the Chapel and then cycled back to the hostel to settle my laundry before I leave for Chennai tomorrow. The weekend beckons and so the fun begins!