DO YOU LIKE AIRPLANE FOOD?

 

I you do, let me assure you, you are in a horrible minority. Yes, some airlines serve better food than others like Air France, and some used to serve good food in good old days like Air India in the Maharaja’s reign. But, by and large airplane food is certainly notorious, with the number of people boarding a flight and not complaining about the food by the end of it can be counted on finger tips. With that being said, we must admit that most of us still eat the food served because what other choice do we have? We are in the air, the flight lengthens, and the hunger and boredom begin to sink in until finally, the in-flight meal starts looking like an attractive option...

But if you are already eating airplane food and drinking the drinks served as well, you may very well want to be aware of what you should eat and what you should avoid. This is not my personal opinion, but the opinion of most seasoned travellers:

 

1. This is not home-cooked food, but purely industrial food

If you've ever entertained the illusion that airplane food was prepared in the airline's top kitchen, where the best chefs cook for you, then know that this is a pretense that has nothing to do with reality. Yes, Sahara Airlines used to serve Tunde’s world famous kebabs I their flights, but that was to promote their home city, Lucknow. The food in the aircraft is 100% industrial and prepared in huge kitchens adjacent to the airport which serve many airlines at the same time. In these kitchens, the largest of which are located in Switzerland, Germany and Dubai, hundreds of thousands of dishes are sold daily to dozens of airlines, with the value of this thriving industry touching 10 billion euros a year. The food for the flights is prepared and packed by the kitchens’ production workers and machinery, loaded on to every flight, and then reheated by flight attendants before serving you.

2. Do not trust the "fresh" label affixed to the box

The food on the plane is cooked long in advance Many dishes served in the air carry the label "fresh" but know that the truth is that most meals served on the plane are produced long before they are served to the passengers, often between 12 and 72 hours before the flight originated. The salads, desserts, pastries, plastic cutlery and the napkins that are served on the flight are packed after being prepared and placed inside the boxes intended for them until they are loaded onto the plane just before takeoff. The hot meals are prepared in large pots, then moved to plastic containers, covered with aluminum foil, and are shock frozen at 5 degrees Celsius for about an hour and a half, and then packed into large metal boxes until they are delivered to the plane before taking off.

 

3. Opt for meat cooked in sauce and avoid pasta and rice

If you are a vegetarian, and your flight going to or coming from India, you may have a problem with your choice of meals. There is no concept of vegitarian food in Chinese, Tiwanese and Japanese flights, and you will not get it if you have not pre booked. When the flight attendants reach your row and ask “chicken or fish?” there is only one way to ensure you get a meal that isn’t too dry or bland: find out which of the options contains more sauce. The explanation is simple: meat stews cooked in a sauce, as well as liquid dishes such as soup, are the best options when you are on the plane because they are filled with rich and spicy flavors that compensate for the meager taste of the other dishes served on the flight. Also, choose dishes that include tomatoes, mushrooms or Parmesan cheese, ingredients that’ll make your food more palatable, without the need to add too much salt. On the other hand, avoid noodles, pasta, rice or fried foods because they tend not to keep a uniform texture when reheated on the flight and become a big tasteless lump.

4. Don’t buy a first class ticket thinking you’ll get better food

First class passengers tend to think that, unlike Economy, they get their food fresh and cooked on the spot, because it is served in elaborate, fancy dishes with metal cutlery, sometimes accompanied by a rather persuasive plating ceremony by the polite hostesses. However, this is only an illusion because even the food served in first class is cooked and prepared on the ground, in the very same kitchens where economy class meals are cooked. Airline chefs take care to prepare a guide for the plane's crew, which teaches them how to serve the food in a more convincing and enjoyable manner that will make the passenger believe they are getting good quality food. In addition, there is also the issue of serving with metal cutlery, which has been shown to have a completely psychological effect on the taste of food. People who dine with metal cutlery rate the quality of the portions served as better than people who ate the same food with plastic cutlery. This is information the airlines have acquired from their feedback forms. Therefore, the illusion that first-class food is better is merely psychological and airlines know and take advantage of this fact.

 

5. Bring salt and pepper from home to spice up your meal

Bad taste is not necessarily due to the quality of the food served to us, but also because of the physical conditions we are in; At 30,000 feet above ground, air pressure is very low and humidity drops to less than 12 percent. These factors make our nose dry and our taste buds become numb, which makes assessing the true quality of our food a challenging task. Studies have shown that our ability to taste salt plummets by 30 percent, and the ability to taste sweetness is 20 percent lower than when we are on the ground. So, the next time you board a flight, bring a little salt and pepper in a bag and sprinkle some on your meal to add flavor and compensate for what was lost due to the difference in altitude.

 

6. Politely refuse the stewards' offer of coffee and tea

The sparse air pressure in the passenger cabin causes water to boil at a temperature of only 90 degrees, as opposed to the 100 degrees required for it to reach a boil on the ground, and as a result, the flavor of hot drinks served becomes somewhat tasteless. In addition, the water that is poured into the coffee or tea served to you is not always bottled mineral water, but rather comes from the planes water system, which isn’t necessarily cleaned thoroughly between flights, especially if layover times are short. Bacteria may not die if the boilig point of water comes below 100!

 

7. Bring wet wipes with you and wipe down the folding tray

It may be a bit startling and surprising to hear, but the folding tray, attached to the back of the chair in front of you, is considered the dirtiest surface on the plane, with more bacteria on it than on the toilet seat in the bathroom. Unfortunately, airlines do not take much care in cleaning it, so it is important that you bring a wad of wipes with you and thoroughly wipe it down before eating your meal on it. Also, don’t place your personal items on it, and certainly refrain from placing any food you are about to put in your mouth on it, whether served during or after the meal.

 

8. Drink alcoholic drink early in the flight and opt for something bubbly

If you drink alcoholic beverages on the plane - beers, wines, liqueurs or anything else offered by flight attendants, you do so early in the flight before your taste buds dry up due to the air pressure. If you are among the people who like to sip wine on the flight, know that wine that normally tastes good on the ground can lose its taste completely when in the air. Therefore, experts recommend, ordering high-quality wines, such as Argentinian wine, which is produced at 1,500 meters above sea level, where air pressure is similar to the pressure in the passenger compartment. Champagne and sparkling wines are an even better option for drinking on an airplane, because the flavor distribution mechanism is different from that of regular wines, and the bubbles that rise up the nose and mouth allow the body to taste and smell despite air pressure conditions. In any case, it is important to remember that low air pressure on the plane causes blood thinning in the body, which can lead to alcohol levels being higher in the air than on the ground, so it is strongly recommended to avoid overdoing it with the drinks when flying.

 

9. Avoid eating too much on the plane

Despite the gnawing hunger experienced when flying and the many temptations offered by flight attendants, the bottom line is that you should avoid eating too much in-flight. This is mainly because airplane meals are far from healthy, with every food item containing about 360-400 calories, adding up to an additional 1,500 calories to your body for the whole meal. In any case, due to sharp differences in air pressure, you will likely end your flight a little more swollen in the legs and bloated in the tummy, throw in these extra meals and you’ve got a recipe for a gassy disaster.

Airplane food tastes bad mostly because your body can’t taste it properly. Your ability to perceive salt and sugar drops by roughly 30% at cruising altitude, thanks to a combination of dry air, low cabin pressure, and engine noise that collectively dull your senses. The food itself isn’t always as terrible as you think. Your mouth and nose just aren’t working the way they do on the ground. But, that does not mean that the food is excellent, usually it is average.

KIDNEY DISEASE IN DIABETICS

 

I have been practicing Plastic & Reconstructive Surgery for 40 years now and over the years if ignorance has constantly plagued my patient population it is their understanding of Diabetes. I still see patients who are known diabetic for the last twenty years, walking in with two recent investigations, often totally unrelated to their disease. They know they are diabetic, but they have no idea how diabetes is harming them. They have no information about diabetic endarteritis, and how it affects their target organs – kidneys, heart, eyes and feet, and so naturally they are taking no notice of it. Their constant lament is that no doctor can control their blood sugar levels and the latter keeps on fluctuating constantly! I have in my previous blogs on Diabetes often mentioned about this problem. If you want to read them please click:

https://surajitbrainwaves.blogspot.com/2023/02/diabetes-myths-and-facts.html

https://surajitbrainwaves.blogspot.com/2025/05/are-you-diabetic-let-me-help.html

 

 

In this blog I would like to emphasize how kidneys are at risk in diabetics. For millions of people living with diabetes, the kidneys are quietly working overtime — and often, by the time something feels wrong, significant damage has already been done, because 75% of healthy kidney tissue is reserve, and not needed if the remaining 25% are fully functional. Diabetic nephropathy, or kidney disease caused by diabetes, is one of the most serious complications of diabetes. It can creep up on you almost silently and by the time the patient shows symptoms, the kidneys are significantly damaged.

 

What Is Diabetic Nephropathy?

When blood sugar levels stay high over time, they can gradually damage the tiny blood vessels inside our kidneys — the ones responsible for filtering waste from your blood. The result is diabetic nephropathy: a progressive form of kidney disease that affects a significant portion of people with both type 1 and type 2 diabetes. The condition is more common than many people realize. Roughly 1 in 3 adults with diabetes will develop some degree of kidney disease over the course of their lifetime. It's also one of the leading causes of kidney failure worldwide, making early awareness genuinely life-saving.

 

The condition unfolds in five stages, each measured by something called the Glomerular Filtration Rate (GFR) — essentially a score for how well our kidneys are doing their job.

• Stage 1: Mildly increased GFR, no clinical signs of disease.
• Stage 2: Elevated GFR, significant micro-albuminuria,  potential progression to end-stage renal disease. (Albumin in urine in microscopic amount)
• Stage 3: Overt diabetes, clinical albuminuria, and increasing proteinuria (Significant protein loss in urine)
• Stage 4: Severe loss of kidney function, GFR <15 mL/min/1.73m², requiring  renal replacement  therapy.
• Stage 5: End stage renal disease , GFR <10mL/min, requiring dialysis or kidney transplantation

 

In stage 1, the kidneys are damaged but still functioning well. By stage 5, the kidneys have failed entirely and dialysis or a transplant becomes necessary. What makes this progression so dangerous is that the kidneys are remarkably resilient organs — they can continue working even when significantly damaged, masking the problem until it becomes serious. This is why diabetic nephropathy is sometimes called a "silent disease."

 

The Earliest Warning Signs

Most people feel nothing in stage 1. It's only around stage 2 — when the GFR drops below 89 — that the first, often subtle, symptoms begin to surface. And subtle they are. Patients often dismiss them and attribute them to a bad week or a busy lifestyle. I usually try to look for:

·        Fatigue that doesn't match your activity level

·        Loss of appetite with no obvious reason

·        Persistent headaches

·        Dry or itchy skin unrelated to the weather

·        Nausea or vomiting with no clear cause

·        Mild swelling in the arms and legs

 

I always tell my patients that if any of these sound familiar — especially if they have diabetes they shouldn't brush them off. One particularly telling symptom worth mentioning is foamy or bubbly urine. This occurs when the kidneys begin leaking protein — something healthy kidneys are designed to retain. While it can be easy to overlook, it's one of the more distinctive early signals that something may be wrong.

 

Why should the patients visit their doctors?

A doctor – a physician, an endocrinologist, can detect diabetic nephropathy even before patients feel a thing. Routine blood and urine tests can reveal early red flags, including:

·        Elevated creatinine levels — creatinine is a waste product that healthy kidneys filter out efficiently. When it builds up in the blood, it suggests the kidneys are struggling.

·        Protein in the urine (proteinuria) — specifically a protein called albumin. Its presence in urine is one of the earliest and most reliable indicators of kidney damage.

·        Low albumin levels in the blood — as the kidneys leak protein, blood albumin levels drop, which can eventually affect everything from immune function to fluid balance in the body.

 

In some patients, a doctor may also order a renal biopsy — a minor procedure where a tiny sample of kidney tissue is examined under a microscope to assess the extent of damage. This is typically reserved for more complex or uncertain cases.

 

This is exactly why regular check-ups are so important for anyone living with diabetes. Current medical guidelines recommend that people with type 2 diabetes get screened for kidney disease annually from the time of diagnosis, and those with type 1 diabetes from around five years after diagnosis. My follow up schedule of investigations for my diabetic patients is:

1.      Physician’s consultation (MD Medicine / DM Endocrinology)          – monthly

2.      Blood Urea and Serum Creatnine                                                        - 2 monthly

3.      Blood Sugar – Fasting & PP                                                                - monthly

4.      HbA1C                                                                                                - 6 monthly

5.      Ultrasound of Kidneys, Ureters and Bladder                                       - 2 yearly

6.      Serum Lipid profile                                                                              - 6 monthly

7.      E.C.G                                                                                                  -6 monthly

8.      Fundus examination by Ophthalmologist                                            - 6 monthly

9.      X.Ray Chest                                                                                        - 2 yearly

 

Why is prompt diagnosis and treatment of Nephropathy important?

 If diabetic nephropathy is left undetected or untreated, the symptoms become harder to ignore. These include:

·        Constant fatigue

·        A persistent sense of feeling unwell

·        Shortness of breath

·        Difficulty concentrating

·        Foamy urine

·        Swelling in the hands, feet, and around the eyes

·        Blood pressure tends to climb and this accelerates the damage.

 

 In later stages other kidney functions too get affected:

1.      They struggle to regulate important minerals like potassium and phosphorus. This can lead to muscle cramps, bone weakening, and dangerous changes in heart rhythm.

2.       Anemia — a shortage of red blood cells — is also common, as the kidneys produce a hormone called erythropoietin that signals the body to make red blood cells. When kidney function declines, so does this signal, resulting in anaemia. This leaves many patients feeling persistently exhausted regardless of how much they rest.

 

Who is Most at Risk?

Beyond having diabetes itself, certain factors raise the odds of developing diabetic nephropathy:

·        A family history of kidney disease

·        High blood pressure

·        Obesity

·        Smoking

·        Type 1 diabetes diagnosed before age 20

·        Indians as a race are prone to diabetic nephropathy more than Caucacians

·        Existing eye or nerve damage from diabetes

 

A Vicious Cycle

High blood pressure and diabetic nephropathy form a particularly vicious cycle — kidney damage raises blood pressure, and high blood pressure in turn accelerates kidney damage. So, the real challenge is to break this cycle early, often with medication. This is one of the most important steps in managing the condition.

 

Prevention

While we can't undo damage that's already been done, there's a great deal we can do to slow it down — or prevent it from starting in the first place.

1.      Keep blood sugar in check. This is the single most important thing a diabetic patient can do for their kidneys. Consistently high glucose levels are the root cause of the damage, and studies show that tight blood sugar control can significantly reduce the risk of developing nephropathy.

2.      Manage your blood pressure. Target blood pressure for people with diabetes and kidney disease is generally below 130/80 mmHg. Medications called ACE inhibitors or ARBs are often prescribed specifically because they protect the kidneys beyond their blood pressure-lowering effects.

3.      Watch what you eat. A kidney-friendly diet typically means reducing sodium, limiting protein intake (which reduces the workload on the kidneys), and cutting back on potassium and phosphorus in later stages. Working with a dietitian can make this much more manageable.

4.      Quit smoking. Smoking narrows blood vessels and reduces blood flow to the kidneys, directly worsening their function. It also raises blood pressure and interferes with diabetes medications.

5.      Stay active. Regular moderate exercise helps control blood sugar, lower blood pressure, and maintain a healthy weight — all of which take pressure off the kidneys. A daily walk 4 Km in 40 minutes is ideal.

6.       Avoid NSAIDs. Common over-the-counter pain relievers like ibuprofen and Brufen can be hard on the kidneys. They are called nephro-toxic drugs. People with diabetic nephropathy are generally advised to use alternatives under medical guidance.

 

Kidney damage from diabetes cannot be reversed — but it absolutely can be slowed down, especially when caught early. Treatment options range from diabetes medications and dietary changes to dialysis and kidney transplants in advanced cases. Newer classes of diabetes medications, including SGLT2 inhibitors, have also shown promising results in protecting kidney function and are increasingly being prescribed for this purpose specifically. The most powerful thing you can do? Don't wait for symptoms. If you have diabetes, make kidney health part of your regular medical conversations. A simple blood or urine test and the habit of visiting the doctor every month, even when seemingly in good health could make all the difference — and in this case, catching something early isn't just good news, it's a genuine lifeline.

 

REMEMBERING PROF. K. D. VERMA AND PROF. N. S. BHATNAGAR - AN IDEAL SURGEON - ANAESTHETIST RELATIONSHIP

 

These two friends were inseparable and there is no way I can remember one without the other. Prof. K. D. Verma was a Reader in the Department of Surgeryand Prof. N.S. Bhatnagar was a Reader in the Department of Anaesthesia  in King George's Medical College,  Lucknow when we were doing our MBBS and MS. They offered the perfect example of cordiality that should exist between a surgeon and an anesthetist. I have learned this from these two teachers and have discussed it in great details in one of my previous blogs. If you want to read it, please click: https://surajitbrainwaves.blogspot.com/2019/12/never-argue-with-anaesthetiest.html

 

Prof. Verma was tall, dark and handsome, extremely helpful and always smiling and an very good teacher. His lectures were carefully designed and always to the point. He knew exactly how long to spend on a given point, and he never seemed to rush to the conclusion.  Yet he always had ample time to finish and then ask a few pertinent questions, just to ensure that the subject was clear in our minds.

 

Dr. Verma was trained in Endocrine Surgery from U.K. and was a pioneer thyroid surgeon of our State of Uttar Pradesh, a state which always had a population greater than Europe! So, not only was his Medical College OPD always overflowing with cases of goitre and thyroid cancer, but even his private practice was very busy, predominantly with Thyroid patients. Lucknow being close to the Tarai region of the Himalayas, where iodine deficiency was an endemic then, there was no dearth of goiter patients during our training days.

 

I never had an opportunity to work in Prof. K. D. Verma's unit and so naturally I had not seen and assisted so many thyroid cases as my friends who had worked with him had. But, all that was about to change.

 

After completing my M.Ch in Plastic Surgery and overseas training in four continents, when I returned to Lucknow to start my own practice, I did so in Neera Hospital where Prof. K. D. Verma would regularly operate most of his private cases. He was usually assisted by my two very respected seniors, Dr. Ramakant, who later retired as the Professor and HOD of Surgery and became the President of Association of Surgeons of India and Dr. Ajit Jafa, a senior surgeon doing exclusive private practice in Lucknow then. 

 

One day Prof. Ramakant was held up and Dr. Jafa was out of town. I had just finished my Cleft Palate repair and I did not realize that Prof. Verma was standing behind me, watching me operate. He was very kind with his words of appreciation for my surgery, but little did I know that my luck had struck gold! He asked me if I was free and would I help him with his sub-total thyroidectomy!

 

This started a beautiful relationship of the true Guru-Shishya parampara, and after that I had the privilege of assisting him countless times. What this meant was that an umbra region in my surgical training was suddenly and unexpectedly illuminated by the best guiding light in the world!

 

Right from anaesthesia after seeing the vocal cord movements and documenting it, to positioning the patient's head, neck and shoulders to marking the incision along a horizontal skin crease in the neck with a thread every step was meticulously done in every thyroid surgery.

 

I learned the steps by seeing him methodically follow them again and again. With his original assistants he would never be so verbose, but with me the teacher in him realized that this surgical field was not the one I would often visit. So, he made it a point to explain every step and show every structure.

 

A typical thyroid surgery, a sub-total thyroidectomy will go thus:

• Incision and Exposure: A transverse incision was made in a lower neck skin crease, followed by raising subplatysmal flaps to access the strap muscles.
• Accessing the Thyroid: The strap muscles (sternohyoid/sternothyroid) were separated at the midline and retracted to expose the thyroid gland.
• Ligation of Vessels: The superior pole vessels were ligated first, close to the gland, followed by the middle thyroid vein and then branches of the inferior thyroid artery, often using energy devices or sutures, away from the gland.
• Identification of Structures: The recurrent laryngeal nerve (for voice) and parathyroid glands (for calcium regulation) were carefully identified and preserved.
• Subtotal Excision: Removal of majority of the lobes, leaving a small remnant of tissue on the posterior aspect of the gland to avoid damaging the nerves and parathyroids.
• Closure: Hemostasis was confirmed, and the incision was closed in two lavers with sutures, sometimes placing a surgical drain temporarily, to be removed after 48 hours.

Post operatively the anesthetist, Prof. Narayan Swaroop Bhatnagar would once again confirm the movements of the vocal cords and then the patient was wheeled out.

 

Near the superior pole of thyroid, Prof. Verma would caution me that the Superior Thyroid artery and the external branch of Superior Laryngeal Nerve (EBSLN) travel close together but diverge as they approach the thyroid. So, this artery should be ligated close to the gland, almost abutting it as ligating higher up may damage the EBSLN. This will result in inability to reach high pitched notes.

 

Again, Prof. Verma was most careful while ligating the Inferior Thyroid Artery because of the close approximity of Recurrent Laryngeal Nerve (RLN) and the anatomical variations that can be in their relationship. He would follow the artery to its intersection with the nerve, identify and preserve the latter, and ligate individual arterial branches directly on thyroid capsule, away from the gland. This protected both the RLN and the blood supply to parathyroids that prevented ischemia of parathyroid and resultant hypocalcaemia.  

Once, when I asked how we can diagnose hypocalcaemia he explained:

Low calcium levels cause neuromuscular excitability, leading to:

• Early Signs: Paresthesia (numbness and tingling) in the fingertips and around the mouth.
• Progressive Signs: Muscle cramps, stiffness, and irritability.
• Severe Symptoms: Tetany (sustained muscle contraction), seizures, laryngospasm, and life-threatening cardiac arrhythmias.  

He then went on to explain two tests of hypocalcaemia

- Chvostek’s sign (facial twitching) 

- Trousseau’s sign (hand spasm with blood pressure cuff inflation).

 

Assisting Prof. K. D. Verma was fun. After every surgery there used to be a party, and Dr. N.K. Gupta, who was the owner of Neera Hospital, ensured that food and beverages were never in short supply! Tea, coffee, jalzeera, samosa, bun-makkhan, French toast, cake, pastries, ice-cream, all we had to do was name it……and it was there!

 

Prof. Verma and his anesthetist, Prof. N. S. Bhatnagar shared a unique bond of camaraderie. Their friendship was from their student days and they would unhesitatingly divulge each other's darkest secrets. There are countless stories that come to my mind. The most interesting story, narrated by Prof. Bhatnagar surely was the story of Prof. K. D. Verma's wedding.

 

He was married in a village in Madhya Pradesh, in the once notorious Chambal ravines, famous for dacoits, where no state police ever dared to enter. After the marriage, when he was returning with his newly wedded wife and the baratis, Prof. Bhatnagar being one of them, suddenly they saw a pile of dust in the horizon and heard the hooves of countless horses, getting louder and louder with every passing second. Soon from every direction masked horsemen were descending down the hill and appearing through the ravines. They surrounded the baratis and the newly weds. Everyone was convinced that this was a dacoity and not only will they lose everything, but would be distinctly lucky to escape alive from this mess.

The leader of the pack roared loudly and wanted to know who they were, who was the groom and who the bride's father was? Once he had all the answers he said that they can't go any further and have to accompany them to their Sardar's abode. Left with no choice they all agreed and their convoy was surrounded by all sides by masked horsemen as they made their way through the ravines. At one point they were asked to leave their vehicle, and around 20 horses were provided to them. Needless to say that most of them were on a horseback for the first time, but they were so scared that no one complained. Mercifully the animals did not gallop, they gently trotted and after some time, which seemed to be an eternity, they reached a beautifully decorated house, nestled in the ravines.

 

A huge man, with bushy handle bar moustache was waiting for them at the floral gate. He introduced himself as Malkhan Singh and took them all inside his house where his wife was waiting with an Aarti thali, flowers, sandalwood paste, dhoob and sweets. The bride and the groom were given new clothes to wear. The bride was decorated with sandalwood paste and new set of gold ornaments and the marriage ceremony was again performed. Gifts were showered not only on the groom but on every barati. Gun salutes were given to them and all the masked men danced in gay abandon. Later they were escorted back to their vehicles on horseback. The hosts had refilled their fuel tanks and they came all the way to the national highway to bid farewell to their daughter.

 

Dr. Bhatnagar in his inimitable style said, this was the famous Dacoit of Chambal, Daku Malkhan Singh, who was the bride's tau or bare papa (father's elder brother, not necessarily real brother but even a village elder is tau), and the message to the groom was loud and clear "you are taking my daughter with you, I must never hear any complaints from her!" Then with a triumphant smile he said "Now you know why K.D is so henpecked!" Prof. Verma, to his credit, was a perfect sport and would hit back with an equally interesting story of his own!

 

Dr. Bhatnagar was full of stories, one for almost every occasion and every surgeon. He could keep the atmosphere lively. He was my father's friend but that didn't spare me too. Once he told Prof. I. D. Sharma, with whom I often did breast surgeries, "Let him only reconstruct. Do the mastectomy yourself, don't leave it to him. His 'safe margins' will extend to your next patient." 

 

Prof. Bhatnagar belonged to Banda in Uttar Pradesh and his father was a doctor. My father worked for the Life Insurance Corporation of India, and was posted in Banda. Prof. Bhatnagar's father, Dr. Subbasi Lal, was our family physician and he and his wife treated my parents like their own children. That made me their favorite grandchild, and I remember milking a cow for the first time with Dadi, Prof. Bhatnagar’s mother! Prof. N. S. Bhatnagar and his brother Dr. I. S. Bhatnagar were very friendly with my father and they would often tease me "How will you do plastic surgery, you don't even know how to milk a cow properly. Most of the milk will be all over your face, instead of the bucket!" Prof. Bhatnagar stayed in Mahanagar on Mandir Marg next to the Mayor of Lucknow, Dr. S,C. Rai, a surgeon with whom he regularly operated.

 

Dr. K. D. Verma belonged to a very illustrious academic family. His sister, Prof. Roop Rekha Verma taught Philosophy in Lucknow University for four decades and became the Vice Chancellor of Lucknow University. Prof. K.D. Verma used to stay in Bishop Rocky Street and his house was home to many pet animals and birds. He was a true animal lover and dogs, cats, rabbits, ducks, birds of many variety, roosters and hens and even a pair deer were there.  He was a wonderful host during Holi and he and Mrs. Verma were present in all social gatherings. The couple graced both my wedding and my son's wedding. 

 

Later in life he developed vitiligo and the supremely confident role model that he was, he neither complained nor bothered. After his retirement from this teaching job in KGMC, his practice accelerated. His patients and his students loved him. His seniors too respected his knowledge and skill, and when Prof. P. C. Dubey wanted to get his thyroid cancer operated, he chose Prof. K. D. Verma as his surgeon.

 

We lost Prof. K. D. Verma to COVID. This was an irreparable loss to us, his students and most certainly to his patients. I, being a Plastic Surgeon, never operate on thyroid but because of the blessings of Prof. K. D. Verma, have helped many of my junior colleagues when they needed help in their thyroid surgeries.

A PLAN TO AVOID REGRETS IN LIFE

 

If you knew that your life will end tomorrow, then are you satisfied with the way you lived? Have you done everything you wanted to do? Have you achiever all that you set out for? Have you checked most of the boxes of your /to do’ list? If not, then you are left with a bag of regrets! The commonest regrets – wasted time, missed opportunities, unaccomplished goals, words left unsaid, choosing work over family, not being true to oneself, getting involved with the wrong people and ignoring personal health and happiness are there with almost every person to a lesser or greater extent. You have always known them, but now that I am bringing them to your notice, why not have a plan to avoid them?

 

Regrets can hurt our mental and physical health if we don't accept them. Reflecting on regrets helps us learn from mistakes and become a better person. The biggest regrets often come from not taking action in life. The phrase “if only…” is normally one associated with deep regret, and that’s why it’s incredibly sad when we feel compelled to say it. To avoid having to utter those fateful words, I’ve made a conschious effort and chalked out a plan.

 

1. Always being yourself, and not what others expect you to be.

 It’s a big mistake to always think about other people’s perceptions of you and trying to play up to them, as opposed to just being yourself. If you continuously focus on this, rather than being who you really are, the end result will be that one fine day, you will forget who you are beneath the mask you always try to uphold. Forget about who people want you to be, or how they see you – impress them and inspire them with how you deal with your imperfections instead.

 

2. Never letting others create your dreams

Although the greatest life challenge is the sound discovery of who you really are, the second greatest is finding happiness and peace with yourself. You should always stay true to your own goals and dreams to find happiness and peace. If people disagree with you, it isn’t necessarily a bad thing – it just means you’re standing your own ground and finding your own way. Don’t worry about whether people think you’re doing something crazy. When you find yourself excitedly losing track of time, you’ll know in your heart that you’re on the right path.

 

3. Avoiding the company of negative people

Negative people are best avoided, because they can foist their bad attitudes on you, and even get to you. Remember that keeping the company of negative people is a choice, not an obligation. Once you realize this and begin to keep it in mind, you will open up your world to compassion over anger, generosity over greed, and patience over anxiety. Negative people will sap your energy by their negativism, while a positive circle of genius around you will boost you, improve your performance and bring enjoyment and fulfillment.

 

4. Never falling into selfishness and egotism

A life that revolves around selfish pursuits and egotism is not a life well-lived. You will be remembered by what you have done for others and the world at large, rather than what you have done for yourself. Be selfless, compassionate and try and give back whenever and wherever you can. Our profession gives us an unique opportunity to spread happiness. If we can bring a smile in one face every day, we are touching 365 lives positively every year! And if this becomes our life’s mission, there can never be room for regrets.

 

5. Never fighting change and growth

Change, death and taxes are the only three constant things in life you cannot change. So, don’t fight them as you will surely lose. If you want to know why your life is the way it is, take a look at your past. If you want to know how your future’s going to be, take a look at your actions in the present. You should always leave room in your life for the old to make way for the new. As much as we all like to hold on to that which we know, the truth is that the old is gone, and isn’t coming back. Accepting this fundamental reality and embracing change as it comes will set you up for lasting success.

 

6. Never giving up during tough times

Whenever we fail in life, we should take it as a blessing. This is because failures act as indicators that we need to try something else. Failure is nothing more than a stepping stone towards success. What failures do not indicate is the necessity to give up on what we’re setting out to achieve. Learn what you can from a failure and move on. One baby step at a time is what will get you ahead in life. Eventually, these baby steps build on top of each other and lead to our most glorious and defining moments.

 

7. Never trying to micro-manage everything in life                       

There’s plenty of truth to the notion of creating your own destiny, however this doesn’t mean that you incessantly have to worry about and control everything. Letting go a little will allow you to gain perspective. Once you can see the forest for the trees again, it’s time to take the next step forward. Remember that you don’t always have to be certain that you’re headed somewhere great. Occurrences in life happen in perfect order, regardless of whether you understand that or not. As time goes by in our lives, we all come to understand this principle and see how all the dots are connected. I am not at all suggesting that do not plan in life, those who fail to plan actually plan to fail. What I am suggesting is don’t go into finer details and nitty gritties – they take your time, cause anxiety and in an ever changing world, may eventually turn out to be totally unnecessary.

 

8. Never settling for less than what you deserve

You should always make it a priority in life to let go of what no longer serves you. Sometimes we need to be floored by a bad relationship or other situation, as hitting rock bottom can actually be the springboard we need for us to stand taller than we ever did before. The tears we cry can sometimes clear our eyes so we can see the possibilities that lie in front of us. Remember not to settle for anything less than you deserve.

 

9. Just doing it! Not endlessly procrastinating

We all know life is short, but it’s actually even shorter than you think. If you’re forever waiting for tomorrow, the window for you to do all the things you’ve always wanted to do will silently close, and by the time you realize it has, it will be too late. The choice is yours – do you want to look back on what you’ve achieved with pride, or do you want to make a whole myriad of excuses for the things you haven’t?

                         

10. Being assertive and no just waiting for things to happen

For whatever reason, you may feel hard done by due to the hand of cards that life has dealt you, but that doesn’t mean that you are owed anything – by anyone. Focus on developing a backbone, rather than a wishbone. It’s up to you to take responsibility for what transpires in your life. You are equally important to and just as needed as everyone else in this world. Don’t sit around waiting for things to happen, because they just won’t. Your day is now, it’s here. Seize it and go and create the world you want for yourself.

Life is fragile and unpredictable, and can change petty quickly. To avoid looking back, and wishing that you had done things differently, you need a plan. This blog is that plan.