Saturday, February 19, 2011

Another story about Medical malpractice in India

How patients are advised much more expensive options that are actually detrimental to their health...The uterus snatchers of India

"Healthcare experts say the hysterectomy racket has its roots in the privatisation boom in the medical sector back in the mid- '80s.Till star politician NT Rama Rao came to power,healthcare was state-driven in Andhra Pradesh.

"It is around this time that the practice of unwanted hysterectomies first started showing up in the state,'' notes Veena Shatrugna,former deputy director of National Institute of Nutrition.She says the number of such procedures have steadily risen over the last two decades.

In government hospitals,poor patients are never randomly advised hysterectomies because government doctors stand to gain nothing by doing so."But private hospitals are not accountable to anyone and people were willing to pay for the procedure,'' she says.

Private doctors have also managed to wean away the queues from public hospitals with promises of quicker and better care. "

Wednesday, January 19, 2011

nice post from pluggd....

Never regret your decision, Never ever in your life (Unless you betray someone).Here’s something to ponder about. (From my mentor)

Five Regrets – wish you never regret!!! – By Bronnie Ware

For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.

People grow a lot when they are faced with their own mortality. I learned never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.

When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again.

Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me. This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.

It is very important to try and honor at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realize, until they no longer have it.

2. I wish I didn’t work so hard. This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I’d had the courage to express my feelings. Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.

We cannot control the reactions of others. However, people may initially react when you change the way you are by speaking honestly, but in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.

4. I wish I had stayed in touch with my friends. Often they would not truly realize the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.

It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier. This is a surprisingly common one. Many did not realize until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to themselves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.

When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. Choose consciously, choose wisely, and choose honestly. Choose happiness.

Thursday, December 9, 2010

Destructive Emotions - a summary first two chapters

Experiments with lama Oser
Lama Oser is a trained tibetan monk.
- Buddhism offers a route to training the mind as an antidote to the mind's vulnerability to destructive emotions..contentment instead of craving, calm rather than agitation and compassion in place of hatred
- Meditation is not a single exericise, there are many varieties of metal training. Oser performed a series of meditation exercises
  • One pointedness - focused concentration on a single object , beginner's method, prerequisite for moving on to other approaches,
  • Devotion - focus on teachers in which he holds in mind a deep appreciation and gratitude towards his teachers and the qualities that they embody
  • Compassion - bringing to mind the suffering of living beings and the fact that they all aspire to achieve happiness and be free from suffering - compassion for all beings friends, strangers and enemies - an important aspect is that compassion should be directed at yourself too. Compassion is more than just feeling for other, but a heartfelt caring and wanting to do something to relieve the person's suffering.
  • Fearlessness - bringing mind to fearless certainty, a deep confidence that nothing can unsettle- decisive and firm, without hesitation where you are averse to nothing..I have nothing to gain and nothing to lose
  • Open State - thought free wakefulness, mind is open vast and aware with no intentional mental activity..thoughts may start to arise but dont chain into longer thoughts- they fade away
  • Finally visualization - construct a detailed image of a deity.
Compassion triggered a very pleasant mood in MRI studies. Oser had a very acute perception of emotions based on facial signals. He had overcome the startle reflex - he could suppress this - a feat almost never seen. In another experiment talking to a difficult professor over a contentious topic, the level of arousal of the difficult professor decreased over time..he was always met with reason and smiles, he felt something like an aura - could not be aggressive.. returning agression with loving kindness is beneficial to you.
Such extraordinary people have great powers of attentiveness and concentration.The brain is plastic and with enough training (> 10,000 hours) can learn these skills

What is Happiness ?
Happiness involves feeling a certain way or being a certain is a calm state of mind..not necessarily in the sense of a child getting presents
Kant said that it is one thing to be happy and another thing to be good..that it was important to be morally good than it is to be happy. Among Greek Philosphers there is a tradition that reason must conquer emotions...Plato thought that reason should conquer emotions, desire, temperament. Aristotle thought that a set of virtues including courage, friendship and compassion should be in harmonious relation inside the person. Every virtue involves an emotional component for example there is a time when it is appropriate to show anger but the right amount to the right person.
Wat is virtuous ? Western Philosphers fall into two camps - utilitarian and kantian . Utilitarians engage in moral actions since it leads to higher goodness , Kantians argue that you must engage in moral actions regardless of the effects. Utilitarians would act for the majority good, kantians believe in the absolute good.

Buddhist Psychology
What is a destructive emotion ? an emotion that is harmful to the sense of less happiness, less well being, less lucidity and freedom. As we grow up we cultivate the feeling of' 'I' amd we feel thus 'I' is vulnerable and we need to protect it..form that comes attraction and aversion..aversion to things that threaten this 'I' and attraction to things that please it. This is the source of most emotions. These emotions boil down to the five main ones :- hatred, desire, confusion, pride and jealousy.
- Hatred is a deeply felt wish to harm someone else, to destroy their happiness.
- Desire - attachment is an understanding that things are permanent - that friendship, human beings, love, possessions will last.
- Ignorance / Confusion is a mental state that obscures the mind from its goal and prevents a realization of reality.
- Pride has many aspects - feeling superior to others, not recognizing one's defects or others good qualities.
- Jealousy is the inability rejoice in others happiness

Three levels of Consciousness

Are these negative emotions inherent in our basic nature ? According to Buddhist thought there are three levels of consciousness: gross, subtle and very subtle
Gross level corresponds to the functioning of the brain and the interaction of the body with the environment. The subtle level corresponds to the notion of 'I' and the introspective faculty with which it examines its own nature, the very subtle level is the deepest that has the awareness without the focus on a particular object..the awareness of this level is important in Buddhism. These levels should be viewed as the various layers of an ocean.

Freedom from Destructive Emotions

Negative emotions are not inherent to our nature. One approach in Buddhist praactice is for the meditator to look straight at the emotion like anger and try to determine the nature of the anger (not the cause) and you may determine that anger is not what one made it out to be, it is a collection of different events. So the ability to stare back and identify the source without that thought creating a chain of other thoughts should lead you to a clarity so that the thought cannot block your mind, cloud your judgement. The chain reaction of thoughts is what leads to anger, hatred, and malevolence.

As negative emotions take over the mind they transform into traits and a temperament - a universal antidote for negative emotions - is to use the antidote for a given negative emotion .

Love is an antidote for hatred - the human mind is incapable of holding both these thoughts together for a given reference
Similarly if there is immense desire for a given object, contemplate on the unpleasant aspects of that object. For ignorance we try to refine our understanding of what needs to be accomplished - for jealousy we try to rejoice in others qualities, for pride we appreciate other's achievements , open our eyes to our defects and cultivate humility.

One antidote that works in all cases is the realization of the empty nature of all these emotions which we can achieve by evaluative the true nature of these emotions and asking if they have any substance.

When should you deal with negative emotions ?
After they arise - a beginner's approach - use reason to investigate the conequences of that emotion to distinguish the emotions that bring happiness from those that cause suffering so that the next time such emotions can arise you do not give them freedom.
when they arise - this requires some practice - free your mind from an emotion as it arises so that it does not trigger a chain of thoughts that take over your mind - so one stares at a newly born thought and asks if it has shape and substance to discover its true nature of emptiness.

Meditation allows you to familiarize yourself with how emotions arise and go so that you get used to it and when you have had enough experience - you can just see emotions rise and fleet away.

A very trivial example would be that if one has gas - one could pass it, or one could learn to hold it back but ideally with mediation on compassion and lovingkindness - these emotions(gas) may never arise.

The goal is not repress emotions but to harness them - where anger is not expressed in violence but in a constructive approach.

Happiness is not the same as pleasure, and happiness comes from clarity, inner stability, and fulfillment. What are destructive emotions, they are the emotions that cloud this clarity and prevent you from seeing things as they are.

Monday, November 22, 2010

Kala paisa in switzerland

Here are some numbers that continue to boggle the mind...

Various estimates put the illicit money stashed in Swiss banks somewhere between $500 billion to $1.4 trillion.
India's foreign debt - $300 billion
India's GDP - $3.5 trillion

#1 - India's position for deposits made in Swiss banks

Holy Cow !!

Wednesday, October 6, 2010

Fixing Information Assymetry with a Corruption Portal

Once a friend who used to run his own business told me that to get contracts for his business it was important to know who to pay-off in a given company or government office. There were choices that needed to be made at multiple levels – you should not offer to pay folks who were upright and did not like that mentioned in front of them, you should avoid the operators who would take your money and sit on it and take their own sweet time to move the wheels that you had greased and then there were the efficient operators who would know how to work the system for the right remuneration – you needed to know how to get to this set of people. Also there was a hierarchy of wheels that needed to be greased – you start with the right peon, who connects you with the right officer who connects you and so on so forth – see “ well done abba” for a good example of the hierarchy. You would go and talk to the local paan shop to gain this information about where to start and if you are lucky you may be able to get it right.

That got me thinking – if I had to be in my friend’s position did I have the street smarts to be able to figure this out on my own ? Having grown up in god-fearing , wrinkling-my-nose-at-ostentation kind of family I thought it was unlikely that I would be taken seriously if I went to the local paan shop and asked – “bhaia saamne waale office mein ghoos kaun khata hai ?”. Would’nt it be nice if there was a wiki for answering questions like this – you need to get you sales tax filed in Delhi, get your passport from Ahmedabad, get you well dug by the local municipal office – what is the quickest and cheapest way to get that done – and you get your answers crowd-sourced. That is an excellent idea for a India-get-your-work-done / Corruption Portal – you can ask a question in the portal for a price and people who have registered in that portal answer it and get a portion of the price you have paid if you are satisfied with the results. Hell it may even be great idea to keep the portal completely free like wiki-answers for people like me who have no clue but to employ pimps/agents who are in this business just because they have this very information.

Here’ the icing on the cake – once the mystery of these operations is revealed and the operations become available to the general public, is’nt it just a matter of time when the public would ask the tough questions and ensure that the process that encourages these methods get cleaned up. I am reminded of Chapter 2 in the book – Freakonomics – read about it here.

Update - Here's a website that seems to do a lot of what I was thinking about for so many days - kudos to the creators

Monday, October 4, 2010

Work your love or love your work

As a kid I wanted to be a scientist, I would read books about great scientists and marvel at what they had created - but I have often wondered what was the source of my motivation ? Was it the fact that they were really intelligent and famous , or that they had found ways to touch millions of lives with their ideas.
Was it fame or was it the ability to help millions with just your idea the driving impulse in my mind ? The answer was really multi-dimensional - it was not fame alone - I did not want to be a movie star, it was not public service alone - I did not want to be Baba Amte or Mother Teresa - it was a mix of all these - I needed some external validation ( fame) of my capabilities ( mind ) but would gain satisfaction in having some real impact on people's lives
Now that I stand at a cross roads again - having been in a career which has been somewhat fulfilling but has given me really none of the above - I stand looking at new directions, I am questioning myself - what do I really love...and I get that answer again..I wish to have impact on people's lives..but as these thoughts come to me, another thought comes - you cannot keep dreaming of only doing big things - then those things will remain in your dreams...You have to start in your own small way doing little things and the path will become clearer...that is how you work your love !!

Wednesday, April 28, 2010

Indian Zillow

Recently I was hearing horror stories of how you may buy land in India and realize that you paid money to some guy who did not own the land to begin with..for more information see all the checks you have to do before you buy land.
Would it be possible to build a service that checks the title deed of a given piece of land, encumberances etc for you ( maybe scans it keeps it in a repository and sells you the scans for a price) . In addition reports on the quality of roads , conveniences nearby..and real driving times to important landmarks.
Like Google Maps changes its algorithms for India, an Indian Zillow will probably have to do some similar tricks...and given the market in India should have decent traction..
Is there a service like that already ?