Monsoon, yet again!

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It is that time of the year again. This morning, I opened my eyes my eyes to heavy grey skies. Granted that the monsoon has officially entered India about a month ago. But just like a painting whose beauty cannot be appreciated at the beginning, and develops gradually over time, so also the monsoon!

After one wave of heavy rains, its fury had abated for sometime. Giving room for the green to bloom.

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I feel that the rains have moods and feelings. And so also, the place where it rains. For example, I have experienced the rain in London. (Thinking about it, that’s the only country apart from India,where I have experienced the rain). London looks gloomy, upset and sort of ill when it rains. As if it is in a surly mood.

But in India, it is a different story. The rain positively makes everything bloom. And glow. And happy. And Vibrant. I could go on. The green seems to materialize from anywhere and everywhere. Like the cracks between the road and in the walls of dilapidated buildings. Like the green layer of moss that grows on the zinc sheet roofing. Entwined, on the electric poles. On the barks of half dead rotting tree trunks.

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Different shades of green. Literally like a “habba” as they say in kannada. A festival of sorts. Celebrating the arrival of the rains.

Granted that persistent rains have some associated nuisance value too. Especially in a city.Think dirty pavements, dengue ridden puddles, the wet smell of clothes which refuse to dry and muddy footprints on your just mopped floor.

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But just getting out of the city, you experience a seachange in the way you enjoy the rain. Pristine green countryside, green expanse of farms and fields extending into the horizon and waterfalls abound.

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All you feel like is to cycle to some place far far away, settle down under some random tree, listen to good music and watch the rain kiss the earth. Bliss!

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Enjoy the pics and have a great weekend!

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Picture perfect- a photo blog of Ladakh.

It’s been over a month since I went to Ladakh, but its spell does not seem to show signs of abating anytime soon. The minute I get some time on my own, I end up closing my eyes and reliving its beauty.Dragging the memories out from the crevices of my brain and savouring it, repeatedly,like a cow chewing cud! Ladakh is a phenomenally photogenic place. Even the most basic camera can capture frames so amazing that you end with a false sense of pride as a photographer. Sharing with you, a few of my favorite sights.

  1. The view of the Sangam.
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The sangam of the Indus and Zanskar.

The sight of the River Indus converging with the River Zanskar is breathtaking. The Indus coming from China,a bright turquoise green ribbon, abruptly merges with the muddy brown of the Zanskar. Every sangam that I have seen has been replete with a temple, priests and is invariably polluted. What makes this sangam special, is that it is free of all trappings. Absolutely. There is nothing around save a small building which doubles up as a canteen and a ticket counter for rafting.

  1. Each and every view during the one hour rafting.

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Though most people sign up for the more exciting and adventurous wild water rafting, I totally recommend the slower variety. Just gliding over the Zanskar listening to the rhythmic splish splash of the oars, gazing at the huge mountains, maneuvering the sharp turns between the crevices of the mountains and experiencing the otherwise absolute silence is an unforgettable experience.

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Gliding away along the Zanskar

 

  1. Nubra valley.
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The dunes of Nubra.
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An ice cold and picturesque stream in the heart of the valley.

Descending from the Khardungla Pass, is a place akin to the mythical Shangri-La. You are suddenly witness to a valley which is breathtakingly beautiful and full of natural treasures as well as manmade ones! The grey sand dunes of Nubra are home to the Bactrian camels (or the double humped ones) which were a part of the famous Silk Route.

The accommodation at Nubra is given in luxury tents. Having never camped before, this makes for an interesting experience, though the tents were actually more luxurious than many hotels! What makes the stay great is the view that greets you at any time of the day or night. The view of the huge hundred foot Buddha atop the mountains or the view of a million stars in the inky black of the night, it seems as though you are caught in some wonderful dream which you do not ever want to wake up from.

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My first experience of camping.

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  1. The Diskit monastery.

The travel brochures often show a picture of the Diskit monastery covered in snow. What they do not show is the fact that the monastery is perched atop a huge cliff edge,which seems near impossible to climb up on.And appears quite forbidding. As though the monks meant for us mere mortals, to stay away from its hallowed portals. Home to thousands of monks,it also gives a view of the huge Future Buddha who can be seen in his full splendor right across from its windows. What a sight it must be to wake up to!

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Wonder how they even built this place!
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To get things in perspective,the tiny Budha on top is actually a hundred foot tall, and the tiny yellow you spot across, is the beginning of the Diskit monastery!
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Another view of Diskit

Already, tourism in Ladakh has increased exponentially over the years. Unfortunately, the concept of responsible tourism has not. Hope people visiting this pristine land realize the importance of leaving it exactly the way it is, for others to enjoy its beauty!

Have a beautiful weekend.

Do-No-Harm

We doctors, are suspended in a strange state of limbo. Gone are the days when consultants treated patients like minions who had to accept their judgment without questions. Also are bygone the days, when concoctions from bottles of various sizes were mixed together and passed on as panaceas for all ailments.  The compounder who would dutifully carry the doctor’s bag and keep the clinic running like clockwork is also, now an extinct species.

We are now in an era where hospitals are treated like business with business models, plans, huge glassed buildings and air conditioned offices. The targets they have to meet to get such a huge gargantuan venture going, loom large in front of the doctors.

The reason we are in a limbo is probably this- that at heart we are still pompous old world people who believe in our skills and dealing with a patient who does not believe in it brings us crashing down to reality!

A lot of patients now behave as though they have come to a hospital for a business transaction. They give us money and we give them health. When the deal works well, everything is hunky dory, but when things go awry, the doctor bears the brunt of it. And how. He is beaten up, the hospital is ransacked and the staff are manhandled, before the good old police finally reach the scene.

In such a scenario, it is not strange that doctors develop a defensive attitude of not accepting our mistakes. And mistakes do happen. After all we are humans. Only, we deal with other humans!

Though treatment procedures have been standardized for years, first in the lab, then on hapless animals and then tried on humans to prevent any mishaps, we know that patients react differently to different drugs. At least 1 in 10 patients and their illness does not behave as obediently as we expect. According to a study in Australia, about 18000 deaths occur in a year due to medical errors! A lot of times the body plays tricks on us. Placing red herrings, leading us on a merry path to a destination, which is exactly at the opposite end of where we want to be. We have to start afresh then. Slightly more cautious and worried. And rarely, it does happen that we mess up bad. And it does end in the patient’s demise. A valuable but a very sad lesson.

Unfortunately, in our profession, accepting our mistake is taken as a sure fire sign of guilt. We only have the freedom to accept our mistakes when we are doing our residency, when the worst we have to face for this is the wrath of our teacher.

Therefore, when I read “Do No Harm”, by Henry Marsh, a neuro surgeon from Britain, I enjoyed it immensely.

First, because it acknowledges that we as doctors are human and need to get it into our head that failures do happen. He has portrayed himself as genuinely as possible. That, at times, he is guilty of losing his temper, sometimes his decisions have been made by how tired he was or how the weather was behaving! This admission according to me, was extraordinarily brave. l have made some purely selfish decisions, but till date ,have great difficulty in acknowledging it! It is always easier to defend myself. And hence, the greatness of this man, who has actually put it on paper.

Secondly, the book also gives us examples of the times when things do not go as expected. The moral being- catharte, accept, console, move on- but do not forget for next time!

Thirdly, that vice versa can also happen. Those whom we expect the worst to happen, go on to outlive their children and we end up being at the end of condescending glares and living room gossip. So to learn to communicate the truth, but not to give out ultimatums. Instead, to be gentle and as hopeful as possible.

Lastly, but most importantly, the book gives us insights about knowing when to stop our work and accept that nature has to take its course. As doctors we sometimes get carried away by the drama of keeping the patient alive by all means. But the consequences of such survival may be more of a burden than help. Like when the operation is a success, but the patient ends up in coma for years. The relatives are at a loss financially, emotionally and unable to take a decision about the future!

Do no harm is a book which deals with such difficult questions and circumstances which every doctor faces but is unable to voice out. It is honest, upsetting sometimes, but definitely re assuring for two reasons.

One because, it gives a sense of solace that the dilemmas shared by doctors all over, are not unique.

Two, because come what may, being honest with the patient and family, brings alive a bond akin to what was present eons ago- a sense of understanding, and a trust level which allows for acceptance even if we inadvertently harm their dear ones.

How I wish this book was a part of my medical school reading!

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Describing the indescribable- Pangong Tso

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There are times in our life, when we are left searching for words to fill in a near adequate description. And failing. Pangong Tso, is one such experience. Whether to call it a lake or an experience is confusion enough. No adjective is adequate enough to describe the sight of it or the over whelming feeling that goes with it. Yet, let me try my best to tempt everyone to get rid of any inhibitions and get going on the next flight to Leh, before you get too old to combat the altitude sickness!

Not a journey meant for the queasy or soft bummed, a five hour drive on one of the scariest and weirdest roads lead you to Pangong Tso (by the way, ‘tso’ is lake in Ladakhi- and I really love the way it sounds, so Tso it is!). Weirdest because, the landscape changes from one extreme to the other within the span of a few kilometers.

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You just get used to seeing endless barren brown mountains, when with the sudden flick of nature’s fingers, you see really rocky ones (the kind that scare you of an avalanche). This is followed by snow capped peaks near the Changla pass, which is then replaced by dusty ones which blow sand storms. Suddenly, from nowhere are green closed valleys with boggy streams, which are home to handsome, sleek stallions –right in the middle of nowhere leading to nowhere! The valley then turns into a grey sandy desert followed by another green stretch filled with half mongoose half dog like creatures called marmots!Phew!

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Marmots!

 

 

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Boggy streams, with the horses far away!

 

The weather is equally quirky- as if playing with us! One moment you are huddled in sweaters with the windows of the car drawn up to the next, when you are fanning yourself hard with the sleeve of your sweater and then suddenly you are wishing fervently that you have not left your windcheater behind in the hotel!

The only solace all through the journey is provided by the driver stopping over at a small joint for some very much needed and equally yummy honey ginger tea near the Paagal Naala bridge( apparently called so, owing to the difficulty in assessing  the moods of the stream!).

Just when you are resigned to watching the whole spectrum of browns around you-BAM-you are zapped with a sudden sparkle of vibrant blue visible from between the mountains. A blue that is so dazzling that it blinds- the first sight of Pangong between the mountains.

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Pangong means “High Grassland Lake” in Tibetian. Situated between three lands, India, China and Tibet, we get only one third of the lake which then flows into Chinese territory. The line of Control runs somewhere in between the 134 kilometer long lake which is almost five kilometers at its broadest and situated about 14270 feet above sea level.

Seeing Pangong lake can turn an atheist into a staunch believer in God. I say this because, though most things appear to have a scientific backing, there are things which are so extra ordinary that they almost seem impossible.

Take for instance the fact that it is a SALT water lake! Apparently because there is no outlet for the water,  and so salt deposits have built up over the years.

Or the fact that though there are almost NO fish or aquatic creatures in the lake, there are hordes of Brahminy ducks, geese and sea gulls cackling around  looking extremely well fed and healthy! What do they even eat???

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Or the fact that the lake even got formed, because Ladakh gets almost no rain! So how did so much water happen to be?

And the best  lies in the changing colors of the lake which very much looks like the shade card of asian paints. Suddenly vibrant blue to suddenly green to turquoise and then a moody angry grey in a span of two hours –a visual feast.

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I can count atleast five shades of blue in this pic!

You suddenly realize that you are really miniscule in nature’s scheme of things, and begin to understand the vastness of the universe! Though there were a minimum of two hundred tourists around, there was such a sense of tranquility. The others seem so far away and no sound reaches you apart from the soft lapping of the crystal clear waters on the shore.

The only regret about the trip was that we could not stay back to see the sunrise or the sunset, which are supposed to be spectacular! And the fact that, at the beginning of the summer, the lake is still frozen enough that you can have dinner sitting on it (if you are willing to risk a frost bitten back side).

Nevertheless, Pangong Tso, seems as close to heaven as it gets…or probably is actually a small piece of heaven that God sent for us as a sample! Truly, the indescribable!

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A lesson in simplicity from the land of Julley-Leh.

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The first sight of the mountains from the plane-close enough to touch!

Nestled in the midst of a ring of mountains, belonging to the Kunlun region of the Greater Himalayas, is a land whose landscape and ethos are startling different from what we are.-Ladakh.Watching these people makes me feel a tad jealous- because they have mastered the art of living in the most barren and difficult of places without a complaint. Infact, with a smile and a julley(which is hello).

To say that the landscape is barren, would be an understatement. There are barely any trees or water bodies around. For around six months of the year, there is hardly anything to do, but bear the brunt of the weather. Children do not have school for almost four months, in lieu of the winter. Travel is tedious and fraught with the danger of avalanches and bad weather.

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But once you set foot into Leh, you are swept away by the magic that Ladakh is. I have always been a conformist –my idea of nature has been green, lush and abundant. Never in the wildest of my dreams had I imagined that I would include barren, rugged, and stark under the list marked beauty! But then, Ladakh does that to you.

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A place where monasteries dot craggy peaks, the sun shines blindingly bright and all you can see are mountains in varied hues of brown!

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Monasteries right on top of the mountains
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Higher than the monasteries are the living quarteres of the monks

Amidst all this, are the people who are so unassuming, simple and endearing. Going around, we found that there are no glamorous displays of wealth that we are so used to seeing around. All houses looked the same-boxed with wooden windows-basic and minimalistic.

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Most food is barley, cooked in different forms-as bread, stew and beer! Most people rely on tourism for their livelihood. There are no mobile networks for large stretches of land and hardly any hospitals around. But going by the happy pink cheeked faces, you would hardly guess that people lived in such hardship.

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We had the opportunity to visit a Ladakhi home for dinner. The hosts had kept their ancestral home intact-built of mud, stone and wood. The house was three storied, but mainly because of necessity. One floor for living, the one below for storing (you guessed right-barley) and the one above for praying! Apart from the rudimentary but sturdy apparatus for cooking, there was hardly any furniture around.

The only excess was seen in the prayer room which was filled with huge masks, head gear, cymbals and conches- as though the simplicity of their life was compensated for, by their extravagance in praying. Maybe because they have to live at the mercy of nature, they tend to invoke the Gods with as much vigour as possible.

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Apart from this world of difference, the basic concerns of the people seem the same. The lady of the house was taking in tourists to support her children’s education. Huddled in her living room, with hot cups of butter tea, we watched, as her daughter performed a traditional dance for us (albeit in her PJs).Her face glowed when we clapped and praised her child’s performance. She spoke about the long commute her children had to undertake to reach school, and how despite this, her daughter comes first in class.

Experiencing Ladakh does many things to you at a visceral level. You come back changed imperceptibly outside, rather deep inside. You learn to be comfortable with silence. You learn to accept life, as it is without frills and fancy. You learn to calm down. You lose the unnecessary sense of urgency cultivated with years of hurried living. Mostly, you learn a lesson in simplicity. That come what may, you can be happy with the bare minimum that life gives you, and the happy sound of Julley.

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