BOOK REVIEW - Lights! Scalpel! Romance!

Lights! Scalpel! Romance!

Jas Kohli

Rupa Publication India Pvt. Ltd.

Total No. of pages 262

Oh My God! He has done it again! After reading his first book “Anything to Look Hot’ I had a gut feeling that there were many more stallions in his stable and he would be bringing them to the race track one by one. And he has not disappointed. Jas Kohli’s “Lights! Scalpel! Romance!” is a fast-moving fiction based in a busy surgical unit of a teaching hospital. The characters are portrayed with such passion and fiancé that it looks like a truly insider’s job. The day to day challenges, the trials and tribulations, the jealousy and the envy, the anxiety and the ecstasy of surgical residents’ lives has made the fictional plot lively and exciting.To the general public this book is a window into the life of struggle, sacrifice and dedication of a highly qualified professional and could not have been more timely considering the plight of doctors in the society today.

The characterization of the individual members of the teaching staff, the resident doctors, the nurses and the attendants is so real that as a surgeon I felt I was reliving my residency days! Every batch has its own lecherous Nipun, headstrong high on the pedestal Nishtha and the touch me not Ridhi but how a Chief carves a surgeon out of each one of them is truly exceptional. How these different personalities are put in the grind of rigorous professional training, brush shoulders with each other, face the wrath of the Chief, the nagging of their patients and the expectations of their respective families and how all this slowly transforms their personality,has been beautifully brought out by the author. When the reader starts resonating with the author and his creations and is easily transported to the author’s world, then you can be rest assured that the book will be a hit!

The frequent kindling of infatuation in moments of solitude, graduating into a small flicker with a meaningful smile and the subsequent extinguishing of the flame even before it could burn bright by circumstances beyond their control makes this plot a fascinating reading. The author has handled the romance of two age groups and beautifully depicted how their idea of love and expectations from love differ in more ways than one.

This book is a wonderful work of fiction though certain places and characters can be easily identified around us and this again is a unique quality of the author. The showcase narrative is sensitive, meaty, and varied, and the author has not only invested in laying out multiple intriguing plots but has also tried to tie all the loose ends together and you are not left with questions like ‘what happened to that character?’The writing is exquisite. Also, humour gives  a constant  company to the reader. In my opinion it is very difficult to put down the book once you start so keep it for a lazy weekend.

The 272 page book is a paperback and has been published by Rupa Publication India Pvt. Ltd. A very eye-catching cover design matches its fascinating contents. Priced at Rs. 295, it is available in all leading book stores as well as online. I enthusiastically recommend it and I will most surely look forward to his next book.

THREE PHASES OF CLINICAL PRACTICE

Clinical practice is not the same at all ages. I have seen it assume different dimensions at different stages of my career. Many other things have changed too - the country, the laws, the patients and most certainly me, but the fact that my practice has meant different things to me at different times can not be denied.

Back from overseas, after what can be called a Rolls Royce of training in Microsurgery and Cranio-facial surgery, I was sure to get a University faculty position but destiny had better things in store for me. I started practice in full earnest. I was convinced that I will only do Plastic Surgery. I took pride in the fact that I was the only full time practicing Plastic surgeon in the state of Uttar Pradesh, a state with more population than Europe!

The first phase of my practice was 'phase of consolidation '. This was the time to assure the referring community that I could do anything remotely related to Plastic Surgery. Thus whether it was a replant or a free flap, a head & neck reconstruction or a breast reconstruction, extensive burns, non healing pressure sores, facial fractures, hand injuries or even vesico-vaginal fistula and urethral strictures everything was welcomed. We formed teams and we delivered results on a daily basis. This phase brought with itself two huge benefits - confidence and popularity. I was practicing in three large cities and this phase established me as a Plastic surgeon.

I do not know exactly when the first phase faded out and a new phase started but what I remember is that my practice was now in autopilot and I did not have to ask seniors and colleagues for references any more. This was also the time when I realized for the first time how lucky I was to be acknowledged by my patients as competent and dependable because they were now turning out to be my commonest source of referral. This was also the time when the children were growing up and I was truly working for my livelihood. This was also the time I realized that not only the patients but my family too needs my time.

Circumstances taught me to manage time and for the first time it dawned on me that working from 7 AM to 8.30 PM is not the true test of stamina, but coming back home from work and then taking the family out to dinner is. I will call this second phase 'the phase of earning a living'.

Once again I could not fathom when this second phase phased out and I landed in the most pleasant phase of my practice. Now earning a livelihood was not a high priority agenda anymore. The children had started leaving home and after acquiring requisite escape velocity choosing their own orbit and trajectory. We, I and Neeta, had an empty nest to look after. She chose to switch her practice to an even bigger tertiary level hospital and I am still working from 7 AM to 8.30 PM but now in only one city, Lucknow.

But my practice has changed remarkably. I now pick and choose my patients and liberally pass on the politically and socially volatile ones to my younger colleagues. I honour all referrals, attend to all emergencies but I am gradually settling into a comfort zone. To give you an example, after reading Phillip Blondeel's book on perforator flaps I tried my hand in almost every one of them but today I am a microsurgeon with 5 flaps only, those common five with which I am most comfortable, those which I can perform with almost effortless ease! This is also the phase when I am more available for camps and teaching programmes. I feel I am now practicing with two purposes - helping others and leaving a legacy! All the previous stimulants - fame, money, rewards, allocates have weaned off and only one feeling has survived - challenge, and one feeling has been newly acquired - satisfaction. I will call this 3rd phase of my practice, 'the phase of giving back' and I love this the most.

I now have a lot of time to do what I love most. I read a lot. I write a lot. I interact with my friends and school and medical school batch mates on a regular basis and I travel a lot but surgical work still brings the most satisfaction and brings the best out of me.

After I completed my MBBS in 1979 my father told me that my profession is uniquely blessed because it brings with itself 3 benefits or 'prapti' in Bangla - 'sukh prapti', 'yash prapti' and 'dhan prapti' (satisfaction, fame and money). But he also added a word of caution, the day I forget the sequence, Goddess Saraswati will desert me. Now if I go back to analyse my three phases of practice it is the last stage which is giving me maximum 'sukh prapti'!

PERFORMANCE ANXIETY

In international sports as well as in the cut-throat competitive world of business this is what separates the men from the boys. This is what gives one the ‘killer instinct’, a very special attribute which either you have it or you don’t, and there can be nothing in between. But the good news is that you can acquire it.

Performance anxiety is a term borrowed from the narrow field of sexual disfunctions to the wider canvas of life. Typically it is caused by negative thoughts about one's ability to perform well during sexual activity. This may include feelings of sexual inadequacy or the inability to please a partner. But today performance anxiety is so prevalent in work life in the modern day and age that everyone from HR to the cricket coaches is addressing it.

Anxiety is core to our survival as it underpins our fight or flight response, helping us escapes danger, but when it causes prolonged fear, suffering or avoidance it becomes a problem in people’s lives. Can we stand up to that force in our mind that is hijacking the amygdala in our brain, which is programmed to take us to fight or flight?

Performance anxiety is reflective of two different kinds of fear: Fear of failure – “of not being good enough” – and fear of being judged in a negative way. Why was it that in 4 years the Indian cricket team could not come up with a stable middle order? We tried almost a dozen players but didn’t persist with one. So every player who was tried suffered from performance anxiety – fear of failure and doubt of not being good enough!

Performance anxiety is double-edged sword and some surely are more susceptible to than others. Generally people with an analytical mind and depth of feeling are a prize possession for any team. But these two qualities which leads individuals to really do awesome stuff, also makes them more predisposed to anxiety. Public speaking is another arena in which almost everyone except a very few face performance anxiety. Appearing in front of an interview board or in an examination is yet another occasion for performance anxiety.

Performance anxiety symptoms may include:

1. Racing pulse and rapid breathing.
2. Dry mouth and tight throat.
3. Trembling hands, knees, lips, and voice.
4. Sweaty and cold hands.
5. Nausea and an uneasy feeling in your stomach.
6. Vision changes.

Performance Anxiety Treatments

Here are 11 tips to help you overcome your fears and shine on stage, on the field, or at the podium:

1. Be prepared: practice, practice, practice.
2. Limit caffeine and sugar intake the day of the performance. Eat a sensible meal a few hours before you are to perform so that you have energy and don't get hungry. A low-fat meal including complex carbohydrates – green veggies, daal (lentil soup), curd (yogurt), and rice are all good choices.
3. Shift the focus off of yourself and your fear to the enjoyment you are providing to the spectators. Close your eyes and imagine the audience laughing and cheering, and you feeling good.
4. Don't focus on what could go wrong. Instead focus on the positive. Visualize your success.
5. Avoid thoughts that produce self-doubt.
6. Practice controlled breathing, meditation, biofeedback, and other strategies to help you relax and redirect your thoughts when they turn negative. It is best to practice some type of relaxation technique every day, regardless of whether you have a performance, so that the skill is there for you when you need it.
7. Take a walk, jump up and down, shake out your muscles, or do whatever feels right to ease your anxious feelings before the performance.
8. Connect with your audience - smile, make eye contact, and think of them as friends.
9. Act natural and be yourself.
10. Exercise, eat a healthy diet, get adequate sleep, and live a healthy lifestyle.
11. Keep in mind that stage fright is usually worse before the performance and often goes away once you get started.

Confronting your fears and vulnerabilities, accepting yourself for who you are, and not feeling like you have to prove yourself to others, is the first step toward overcoming performance anxiety. Keep in mind that nobody is perfect, nobody expects you to be perfect, and it is OK to make mistakes. The second step is learning how to redirect your negative thoughts, beliefs, images, and predictions about performing in public.

There are many cases where psychological intervention alongside mind-body strategies such as exercise and meditation have produced extremely successful results and almost all professional sports bodies today have understood this. So along with coaches who help the players with their game there are coaches who help them with their minds! Paddy Upton, the South African born Mental Coach of the Indian Cricket team is internationally renowned to enhance performance of sports professionals. Upton redefined his career to begin work as Mental Conditioning coach (in sport) and Executive Coach (in Business) in 2003. He has since worked as Mental Coach and/or Performance Consultant to over 20 professional cricket, rugby, soccer and field hockey teams across South Africa, India and Australia.

In sport, coaches and coaching have been around for ages, probably for a century or more. In contrast, coaching in business has been around for only two decades. In this short space of time, over 70% of managers in the Fortune 50 companies are now benefiting from this new coaching, as the profession has risen to become the second fastest growing profession in the world. Performance consulting is a practice that evolved from the instructional design discipline. It is performed by performance consultants who use more of a systems-thinking approach to resolving workplace performance problems. Performance consulting acknowledges that there are other environmental factors that affect one's performance. While instructional design and the development of training or learning solutions helps to build knowledge and skills, performance consulting takes a more systems-thinking approach to investigate and identify other environmental factors that may degrade one's performance.

While performance enhancing drugs are bad for sports and illegal too, in the business world beta blockers (blood pressure medication that can calm the body) are often prescribed by doctors to fight anxiety. But this administration should be strictly under medical supervision.

FLYING ETIQUETTE

Plane travel has changed. It used to be that you could smoke cigarettes in the cabin. Kids could go up the front and spend time in the cockpit. But modern air travel has put a stop to all of that. The rules have changed. The style of air travel has changed, the cost of air travel has changed, the frequency has changed, and the enjoyment has changed.

It is so easy to spot an annoying passenger who is selfish, arrogant and ill tempered. Misbehavior in a public place is simply unacceptable because you are sharing the space with all other flyers. It is time to lay down some unwritten rules for passengers travelling the world by plane. If you want to be a good flyer, a respectful and courteous flyer who expects everyone around you to do the same, these are the rules to follow.

Turn up in time

Airlines play it on the safe side – they tell you to be at the airport three hours before an international flight; at least two hour before domestic ones. Now, in India this is necessary, given the security procedures. But if you're already checked in and don't have luggage you can spend less time clogging up the airport. Consider the traffic to the airport and the distance and turn up in time.

Don't try to sneak in too much cabin luggage

Modern-day air travel has changed the luggage game, with plenty of carriers charging extra to check a bag, and limiting hand-luggage by weight and size. That also means loads of people are trying to get away with dragging far too much on board, filling up the overhead bins and forcing others to store things at their feet.

Don't queue up to board too early

It drives me nuts when you see a queue forming at the boarding gate with 15 minutes or even half an hour before it actually opens. The more people who queue, the more others are forced to join it to make sure they'll have space in the overhead lockers once on board. It means everyone spends far longer standing in a line than they really need to. Just sit down until you're called – it's better for everyone. Airlines have now started calling you by seating zones, back rows first and front rows last; help them to get this boarding exercise organized.

Wear a shirt with sleeves

You don't have to dress up for air travel like you're going out for dinner. But at the same time, no one really wants to be rubbing up against your bare, sweaty shoulders when they go to take a seat. Wear a shirt with sleeves. Incidentally, ladies too sweat and cramped economy seats makes the situation worse.

Reclining your seat – be considerate

The issue of seat reclining gets people pretty hot under the collar, but to me it's pretty simple: unless you have a medical reason for reclining your seat, don't do it on short domestic flights. On long-haul journeys, keep your seat upright during meal times, and take-off and landing. The rest of the time, you have the right to recline whenever you want but please turn around and forewarn the passenger sitting behind you.

Armrests

Left Seat: aisle with extra leg space and left armrest. Middle Seat: Both armrests. Window Seat: Window and place to lean against and right armrest.

Treat cabin crew like real people

The stewards who serve you in the sky are real people who are just doing a job – be courteous to them and you'll be amazed at how you're treated in return. Just like you they may be having a bad day in office so help them.

Keep your kids under control

I have a huge amount of sympathy for anyone travelling with children, who will inevitably get stir-crazy in the air. That's rough. But still, as a parent you have to at least try to deal with it. Make an attempt to keep your kids under control – tell them to stop kicking the seat in front of them, for example – and your fellow passengers will love you for it.

Don't glare at babies

If you are traveling with a baby it is tough and the vast majority of fellow passengers are kind and understanding. A few, however, clearly feel babies have no place on planes, and give angry glares to the babies in the whole flight. But flying wasn't the kid’s decision. Direct all glares towards the parents, tough guy.

Don't listen to anything without headphones

No one else wants to hear your podcast or your video game or your terrible music choices or religious shlokas. I'm still stunned that people actually do this. There is a science to help you with your audio-visual recreation, use it.

Keep your socks on

This is the cold reality of modern air travel: hundreds of us all have to share a limited space for hours and hours. That experience is made far more pleasurable if people can keep their socks on and not stink the whole place up.

Don't pull the back of people's seats

When you're getting in and out of your seat, yes it's squeezy, but it's really annoying to use the seat in front of you for balance. There's someone sitting in that chair. They get yanked violently backwards when you do that. If you need to hold onto something, use your own seat.

Don't get drunk

Alcohol is free on full-service airlines, and it's readily available. But this isn't a binge party. Go easy on the booze. On international flights you are actually identified by your nationality or even worse, your religion, so be very careful how you behave.

Don't stand up too early

You can tell a lot about a country by how quickly everyone lunges for the overhead lockers once the plane touches down. I've have seen people pulling down huge sacks of goods before the wheels have even hit the tarmac and dropping them on unsuspecting heads. Guys, you're not going to get off the plane any sooner. Relax.

Don't push to get off

Clearly these are also the people who honk their horns in traffic jams. We know that you're frustrated, and everyone wants to go. There's also a reason the queue hasn't shuffled forward yet. So just hang out back there patiently and stop pushing the person in the front.

Stand back from the carousel

If everyone could just stand a few paces back from the baggage carousel, rather than banging their shins and trolleys right up against it, collecting luggage would be a far more pleasant experience.

Relax

You could pretty much take away all of the other rules and just introduce this one: relax. Try to take things easy when you fly. Expect the unexpected. Cut your fellow passengers plenty of slack. Take your time. If everyone does that, modern-day air travel becomes far more enjoyable.

What are your rules for modern air travel? What are your personal bugbears? Any of mine you disagree with?

TEACHERS - WE NEED SUPERHEROES!

I had the opportunity to go through the ASER report and the learning deficit that came out glaringly from it is alarming. Class 5 students not able to read text meant for Class 2 is simply not acceptable. I feel this has to do a lot with the quality of our teachers and for this we need to think afresh. The Medical and the Engineering streams have a 5 years well planned and all inclusive professional courses which usually result in good quality of doctors and engineers who have made us proud both at home and abroad. The legal luminaries too felt that the regular LLB and LLM courses run by universities were not producing good solicitors and so they planned the 5 years professional law courses in National Law Schools, which invariably improved their lot.

I feel time has come to give up our teacher training programmes run by universities and make this a consolidated 5 years professional teachers training course. They will then have a comprehensive training in their subjects, in teaching and training techniques, in communication skills, in assessing skills and in discipline and social skills in the initial years and then in the later years branch out to their specialities like primary school education, middle school education, higher education, adult education, occupational and vocational education and so on. This way we will develop a pool of educators specifically for each set of educational requirement. The schools, colleges and universities will come to these Teachers Training Institutions and hold campus interviews to select the best and most appropriate lot for their institutions. By this we will end up achieving many goals:

1.       We will get a very well trained set of  teachers, specifically targeted for individual needs

2.       As they will come out of a gruelling training programme they will be very proud of what they do and will invariably churn out good students.

3.       We will develop a pool of qualified teachers who can not only meet our domestic needs but also be exported to other countries where they are needed

4.       The monetary remuneration of these teachers will be much more and proportionate to their qualification and performance

5.       When a successful teacher will teach the children, he/she will teach them the secrets of success in life - honesty, integrity and hard work

Teachers are Nation builders. They are actually 'learning designers' as they have to modify their approach to suit individual students. There are no bad students, they are the ones just not interested in what the teacher teaches, and they in turn will have to identify the areas where these students will excel. It is less about imparting knowledge and more about nurturing the so-called soft skills students will need in the workplace of the future, such as curiosity and critical thinking.

In this context it is also important to understand how best we can use the internet and the cell phone to improve the education of tomorrow. Ideas for the future of schooling are on display in Byju's and EduTECH as these tech companies fight for a slice of the billion-dollar global education market and teachers look for ways to integrate technology into the classroom. The government should have a policy of using them to improve the cognitive skills of our children. Today, when the attention span of children is less than that of a goldfish, history can be taught by virtual reality and video games in addition to the mundane history books. But one must not forget that these 21st. century add ons are but just that, add ons. They cannot replace good teachers. And encouraging kids to play video games only and call it teaching is only going to hasten the growth of their waste-line, their reduction in gross motor skills and create a generation of pale-skinned vitamin D deficient anti-social geeks. Surely we do not need them.

The current didactic I-talk-you-listen pedagogy we call 'teaching' is tradition-based rather than evidence-based. Teachers are not only underpaid and undervalued, but also under-trained and under-skilled. This cannot continue. We need proud professionals who will change the sorry state of affairs.