When I was a little boy
My family owned a big bookstore In it we had lots of books For all generations and age groups. Some took us far away Others through mind's passageway Books that told a silly story And those that taught us history. There were picture books and magazines Almanacs, newspapers and quarterlies The bookstore, a first of its kind A big surprise for people to have at hand Skepticism abounded, and many asked "People are illiterate, why a bookstore?" "People are illiterate, so a bookstore!" Was the answer with a smile. At the start, they just passed us by Stretching their necks as they looked inside Then stopped and looked, curiously attracted. Finally, took a step inside, wide-eyed and fascinated Walking around the many isles Wondering eyes and questioning minds "You can read them, if you like." "I don't know how." They said back. "It's OK, hold it in your hand And with you, the book will have a chat." In their hands they held a book, Felt its weight, sense and power too. Cautiously they looked inside, Saw the words along each other's side So clean and orderly they were Page after page, book after book, shelf after shelf. With a sigh, they began to leave. "I wish I could read," said one with grief. "Oh, but you can, do not fret." "There are only 26 letters in the alphabet." "All these books are made of those letters. You can bet!" So it was that people came. Young and old, ladies and men. Teachers came and made connections. Classes started, students trained. Reading became a trend and then. No one passed the store again. The bookstore developed into a home For seekers of knowledge and wisdom. Much developed in that store As was seen in their happy stare, All because they were shown the way And kept their uncertainty at bay. In medicine, too, one can find solace, reward and happiness when treating patients as an individual, not a malady. And for their sake, not their money. Hence, gain satisfaction of being a true physician and a healer. Reza Ghadimi
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The sun this morning was late, waking me
My late start welcomed to a wonderland. Though it is spring, this late winter storm Blessed us with moisture In this desert and dry land. When the earth is parched and sun brutal Life hardens man, plants and beast. So, the snow on the canyon walls Trees and cactus was lovingly met. For, learned we have, to savor the little Wetness in the vaults of our body, well. To drain from the passing mist The mountains reached Into the heavens and pulled down the clouds Into the crevasses of canyons and valleys. A thick fog rolled through the dell and Up the walls. Trying to escape. The fingers of all thirsty life, though Reach deep into the heart of the mist Ensnaring the elusive moisture and drinking Its life-giving gift to heart's content. There is much hunger and thirst The world over, and man and beast Strive for a drop more and a few crumbs To live just another day. To deny them their need thus Is blasphemous. Reza Ghadimi April 2024 It was the third surgical case of that morning and the second knee arthroplasty. It was close to noon, we’d been working since 7AM and were getting hungry. I was assisting Dr. T. A very competent, mild-mannered surgeon. With us was Dr. A. a senior resident from our university orthopaedic department. The patient was in her mid-fifties, an obese and short lady. We had a little difficulty positioning her on the table for the procedure.Dr. A. who was a tall, athletic young man seemed disgusted with Dr. T’s meticulous attention to detail and, with a disdained (rude) voice, murmured something about her being too overweight and needing to lose weight.
“She can hardly walk, let alone exercise,” said Dr. T. in his usual calm and mild manner. “Why don’t we fix her knee, then she can work on losing weight.” Everyone in the room smiled and moved their heads in approval, including Dr. A. The procedure went well, and the patient moved to recovery. Above like objections and protests are familiar and, in today’s hurried and demanding environment, frequent. Sometimes we forget that we are there for the patient, not the other way. Another great surgeon and humane physician, I had the privilege of working with, used to say: In every case, I am grateful that I am not the one on the table. It makes me appreciative of being a doctor, and I’ll do everything to live up to the respect this job deserves. Such reverence makes for a happy and satisfying life. Especially in these days of for-profit practices. Spring arrived on Tuesday, March 19, 2024, at 11:06 PM Eastern and 8:06 PM Pacific time in the Northern Hemisphere, marked by the Vernal (Spring) Equinox.
Noted by many cultures as New Year for thousands of years. Nurooz, which means new day, is celebrated in many parts of the world. Zoroastrians were one of the early cultures that started their year thus. It is a time of purification and setting one’s intention for a new start. Other civilizations, such as the Mayan, also celebrated the Spring Equinox for hundreds of years before the Spanish arrived. Even the western cultures celebrated New Year in the spring till Julius Caesar changed it to January in 45 B.C. Interesting how mankind feels the need to tie everything to himself. Even unchangeable nature’s circle of existence. It is said that "as the seasons form a great circle in their changing, so does the life of a person - from childhood to childhood." Since many of our leaders are acting dangerously childish, perhaps it is time for our younger generation to step up and save our world. So "Arise and start anew, for much awaits to be done. All things evolve from the creator, and all must revolve to complete the circle of life!" It is time to complete this circle peacefully. Despite all the tragedies in our world, I wish us all a better and Happy New Year! May it be a peaceful one! Amen! Today is International Pi Day. No, not pie day, rather Pi (π) Day. The mathematical constant, that is the ratio of a circle's circumference to its diameter, approximated as 3.14159... Although it is believed that the Babylonians were the first to have calculated it to be about 3.125, Archimedes (287-212 BC) is considered to be the first to calculate it accurately. Thus, March 14 or the fourteenth day of the third month of the year (3.14) is celebrated as Pi Day by mathematicians.
This mathematical constant is approximated as 3.1415926535… The decimal number goes on forever. Contained within its string of decimals is every number pertaining to man's life, history, nature and cosmos. And if the decimals are converted into letters, you will find every word that ever existed, spoken and written. All the infinite possibilities of words rest within this one simple circle. In our bodies, too, the ratio of our consciousness or psyche to our physical being could be said to have infinite possibilities. Our body goes where the mind tells it to. Our mind works by the demands of our soul/ consciousness/ intellect/ psyche — or whatever we want to call it. Our actions are dictated by our desires, wishes and wants, which in turn are based on our intelligence, education, experience, and wisdom. The more of these combinations we use, the better will be the outcome of our deeds. The possibilities of our actions are infinite. The choices we make may depend on the advice of others, on our teaching, or on a variety of outside influences. But the end result is where we end up in our lives and what we have to live with. Limited knowledge leads to limited and fewer choices and actions; wiser decisions produce healthier and happier outcomes. Healthcare gives us many opportunities to find answers to our medical and mental challenges. There are many options for the constant of man's needs and our technology adds to those options. Indeed, it is a wonderful time in history we live in and if prudent decisions are made, a bright future will surely be ours. Let’s strive for such future. The ongoing calamities around the world strain rational thinking. Just as we feel that we have the grasp of one tragedy, another explodes. We are being pulled in so many directions, that we may question the very significance of life itself. But if there is anything I know of life, of all the hopes, the happy days and the sad ones, of the days of blue skies and nights of the new moon, of the sound of children at play and the pain of wounded soldiers, the homeless and hungry, is that it challenges the very soul of us, the essence of our being and the audacity of our existence.
But will life remember us? Will our names be recalled in kindness? Will our children have the freedom to run in these woods? Will their children? What did our lives mean? Was it just a passing, or will something remain of it? Though we are just a traveler through these times, we learn from all that we see, and pass it on to others passing us by. Hoping that they too add well to it as they pass it on, for this is our life until we die or live on if we are remembered well. Till then, let's not add to the crisis, let's stay peaceful, heal the needy, keep learning and teaching. Maybe then our existence will be audaciously meaningful. The winds came at night, followed by the rain. Though the elders had warned about the coming calamity, many gave it little heed. By morning, the rivers were full and the rain increasing. Alarmed, many gathered what they could and headed for the hills. Others fortified their dwelling and hoped for the best. The levies upstream, however, could not stand the onslaught and by the end of the day, burst their banks. The flood inundated everything downstream and destroyed or damaged much in its path.
Scenarios such as the above incident are common. More often than not, we tend to overlook the warnings and advice of our elders and experts, with dire consequences. Today, too, many are and have been sounding alarms that our world is at peril. Yet we seem to be numb to it all. Many countries in the world are having their election this year, including sixteen African countries, Brazil, Canada, Mexico, Venezuela, the US and seven others on the American continent. In Asia, eighteen countries, including India, Indonesia, Pakistan, Turkey, North and South Korea, and Taiwan. Twenty-eight countries in Europe, too, are having elections, including the European Union, Germany, Ireland, Italy, Russia, Spain, and the UK. Finally, four countries in Oceania, namely Australia. Sixty-five countries or nearly 50% of the world’s population will be voting in these national elections. More than ever before in history. Many of these countries are in conflict with one another or dealing with internal turmoil. The outcome of these elections will have a far-reaching significance for the future of our world, our children and grandchildren. Added to all this, climate change is gnawing ferociously at our heels. As healthcare providers, we should be alarmed at what is coming our way. For, much like the flood in the above scenario, the tidal wave of the sick and injured is already overwhelming many of our colleagues, in the Middle East, Africa, Pacific Islands, and our own cities with the homeless, displaced, and simply poor. We are living on the edge of disaster. It behooves us to heed and prepare. At the end of a period of volunteer work on a Caribbean Island, a while back, I hitched a ride back on a small plane belonging to a pilot friend on that island. While boarding, I noticed that the plane looked heavily loaded. Concerned, I asked him about it.
“No,” he said confidently. “Even with the two of us, we are still way within limits.” I had flown this very plane several times and trusted it to be in good shape. Still? On roll-out, the plane was sluggish on acceleration. As the end of the runway approached, I had an idea; “let’s use ten degrees of flap!” The flaps helped and we climbed out of there. The reason for the plane’s heavy weight was the many sacks of breadfruit we were carrying for emigrants from our island. If you are grown up eating it, you may crave it, and will pay handsomely for it. So, the existing market and my friend's export of it. We made stops in Montserrat, the Virgin Islands, and finally, Puerto Rico. Dropping off sacks of breadfruit. I was reminded of this event when I was reading the article; Hunting for 'Disease X', by Sam Kiley, CNN, back in December 2020. [The following excerpts are from that article:] The article talks about how diseases like yellow fever, influenza, rabies, brucellosis and Lyme disease pass to humans, through a rodent or an insect. HIV, for example, emerged from chimpanzee, SARS, MERS and the Covid-19 virus from unknown "reservoirs" Experts say the rising number of emerging viruses is largely the result of ecological destruction and wildlife trade. As their natural habitats disappear, animals like rats, bats, and insects survive where larger animals get wiped out. They're able to live alongside human beings and can carry new diseases to humans. For example, bushmeat (game meat of the jungle) is the traditional source of protein for people living in the rain forests, but it is now exported globally to the Americas and Europe." "Disease X" may be ticking away inside any one of these animals. Similarly, in an article by Tiffany Yesavage, PhD, in Genetic Engineering & Biotechnology News, last week (2/1/24); “Antimicrobial Resistance Multiple Threats”, she talks about the rising tide of antimicrobial resistance diseases. How, many of these pathogens are developing ways to resist our drugs. For example: “… Neisseria gonorrhea, the bacterium responsible for gonorrhea, is now showing resistance to many antibiotics. It has developed multiple decoy mechanisms to evade the immune system. For example, it exhibits significant variation in the antigens on its surface proteins and can easily alter its surface structure during infection.” Some pharmaceutical manufacturers are still working on cures; however, their numbers are dwindling due to economic factors. Check out this fascinating article on genengnews (dot) com So, between population growth, environmental degradation, economic incentives and disincentive, etc. we may be fighting a losing battle. Even many innocent actions may have dire consequences in this very mobile and confusing environment. Much like my pilot friend, innocently, potentially carrying unknown pathogens across borders in something as innocuous as breadfruit. We should be warned that “If you go in the forest ... you will change the ecology, and insects and rats will leave this place and come to the villages bringing new pathogens. The solution is clear. Protect the forests to protect humanity - because Mother Nature has deadly weapons in her armory.” I was working at a clinic in a resort ski town, when late one afternoon, a seemingly middle-aged lady of obvious affluence presented with a wrist injury. She wore an elegant fur coat over her ski outfit. On her fingers, she displayed several rings adorned with diamonds and jewelry. The kind I’ve never seen before.
Her wrist was slightly swollen. We got the rings off her fingers. I was worried about osteoporosis, yet X-rays did not reveal any bony injury. However, they surprised me, as they showed the hand of a young person. Her date of birth indicated that she was 27 years old. I was taken aback, as the lady in front of me seemed older. Her face showed age or an arduous life. No other medical disorders were mentioned, and she was not on any medication. Still, I asked if she took any medication – legal or not? No was her answer. I placed her in a wrist brace and prescribed NSAIDs. She asked if she could wait for her husband to pick her up. She seemed uncomfortable, so I had her wait in my office and offered her a beverage, which she took heartily. Her husband never showed up and when we were done for the day, I offered to take her to her hotel. Her husband was waiting for her in the lobby and claimed that he had not received the message about her being injured. He, too, was well-dressed with expensive jewelry adorning his wrists and fingers. He was an elderly gentleman, perhaps in his seventies. I declined the offer of a drink, and after a brief pleasant conversation, I bid them goodnight and left. A couple of weeks later, we received a very expensive radio with emergency weather bands and a card, thanking us for the good care she received and for the “true concern Karen (our nurse) and I showed caring for her!” – her words. Such moments and experiences are normal and common in the practice of medicine. It is what makes our interaction with our patients personal and our work exciting. But many of our colleagues miss it. Rushing from exam room to exam room, treating symptoms and ailments, makes for a tiring and thankless day. At night, all one remembers are sickness, injuries, excrement, and pain. Often, no faces can be recalled of the suffering. BUT if we stop at the exam room door for just a brief moment and consider that at the other side is a person with a lifetime of experience being a human and now has a medical problem, and THEN enter and treat that person, we find our work ever so more rewarding and indeed magical. Appreciate your patients and make them like you! Patients who like you won’t sue you! Grandma used to say: Never go to a restaurant where the cook is not fat.
If you want something done quickly, ask a busy person to help you. Never criticize something you don't do yourself. Look at the poor around you before putting that first spoon in your mouth. A lot of truth to all that. The old timers spoke from experience. Today’s technology, though, isolates people and makes criticizing things we know nothing about, easy. The Chinese vernacular; "to know someone, walk a mile in his shoes." is sage advice. But many of us would rather criticize that person's shoes than to walk in them. Providing healthcare is something everyone has an opinion about. How many books have been written about raising children by those who have none, or on losing weight by slim people? And worst of all, health organizations being managed by lawyers and accountants. But unless you have sat next to a worried mother of a child with a 103 fever or watch hopelessly as the life drains from the face of a fourteen-year-old boy who has been stabbed, you cannot appreciate the enormous responsibility of healthcare providers doing their job. For when the eyes of a desperate mother in El Paso, or a dying teenager in the South Bronx or a wounded soldier in a foxhole is on you, all the politics, rationalizations, logic, excuses, and justifications will matter not. Legislating bodies start work this month. It behooves us to contact our representatives and ask them to help our world by passing laws that benefit everyone. I am sure that their grandmas had similar advice for them. They just need to be reminded of it. |
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