LESSONS THAT SCHOOLS ARE NOT TEACHING

If schools and colleges are under the impression that they are simply in the business of teaching prescribed lessons from the course books, it is time they think again. They are molding the blocks which will be used in nation building in not so distant future and so they must revisit their curriculum. At school, kids learn a lot that isn't going to be helpful to them later in life. While getting an education is important, there is much that kids could be learning that schools aren't teaching. Children and young teens need to be taught life lessons that will enable them to be independent and certain, yet respectful and unique. We need champions and we are not getting them. All that we are getting is a bag of excuses.

The first lesson that a child should learn is to be the decision maker. While parents, teachers, friends and relatives will try to persuade them, but what the student has to know that they cannot decide for him/her. They must make sure that the path they decide to take aligns with their own intuition and desires. It's okay to switch paths or create a new one. 

Patience is about the ability to keep a good attitude while working hard for what one wants to achieve. Being patient gives one the time one needs to reach one’s goal. Patience is about pace, not waiting. It's about timing oneself to work with more than one process around you. 

Making mistakes are part of the learning process and most mistakes are unavoidable. Making mistakes is not the problem, not learning from them is. Remember that behind every great success, is a thousand failed attempts to get there. If students are not making mistakes it is actually a matter of concern. It only means they are not being challenged to their fullest potential and are being taught to play in the junior league only.

Students must be explicitly told not to expect success to come to them just by sitting around. You are what you do, not what you say you'll do or plan to do. All the grandiose plans to succeed and all the cook-books available on these subjects written by the success Gurus will take you nowhere, hard work will. Yes, ‘failing to plan is planning to fail’ but after the planning the required hard work has to be put in, the regular practice has to be done……..and there is no substitute for it. Remember that good things come to those who work on meaningful goals. Ask yourself what's important and have the courage to build your life around your answer. 

Our students should learn to accept all the apologies they never get, this will make life easier. The key is to be thankful for each experience, be it positive or negative. Instead of getting upset at a situation, they should take a step back and say 'thank you for the lesson'. It is vital to realize that grudges from the past are a waste of happiness. When you forgive, you're allowing yourself to let go of your past. 

As a student of a very specialized branch of surgery I have learnt a very invaluable lesson – there are no good teachers and bad teachers. There are teachers who tell you how to do things and there are others who teach you how not to do things. Both these lessons are invaluable and I am eternally indebted to both these types of teachers.

We must teach our students to be brave and walk away from the people who make them feel uncomfortable and insecure. If anybody they stay with makes them feel like they can't be themselves, or if they feel emotionally drained or anxious after spending time with them, we must teach them listen to their intuition and step aside. Hang out with the people who inspire you to be the best version of yourself. 

The things that one owns have no bearing on who they are as a person. A big car does not make you a bigger person than a guy with a smaller one and in the same currency it does not make you smaller than the fellow owning a fancy sailing boat. We live in a hugely consumer-driven culture that gives more importance to material things than meaningful connections and experiences. Teachers must emphasize that their students make it a point to create their own connections without being influenced by what they see on TV, social media or read in fashion magazines. 

A vital lesson to be conveyed is the fact that things and situations change, often spontaneously. People and circumstances come and go. The students must know that life doesn't just stop for anybody. It has the ability to move from calm to chaos in a matter of seconds. Unpredictable events happen and they may happen at any time. So when life is good, they must absorb each moment, enjoy it. And when life gets tough, they must know that these moments do not last forever and they should keep their head above the water and try to fight out of the fix.

When they're young children are taught to be nice to others. But as they get older, they need to be reminded that while it's important to be nice to others, it is important that they be nice to themselves too. They must not see themselves through the eyes of those that don't value them.  They must know their own worth. They must know when to stop being nice to whom and simply walk away. If they value the relationship then they shouldn’t insist on winning the argument but if any relationship reaches a point where continuing with it means a severe compromise with their morals and a serious challenge to their values, then they must call it quits.

We must teach our students never to fear the unknown and shy away from it. They should be bold, be courageous, and never afraid of accomplishing their dreams. At every stage of their life they will learn something new. The very act of learning something new disrupts the way they have always seen things-and the way they have always been. A fresh idea pushes us out of our comfort zone and threatens the very foundations we’ve built our view of the world on. That’s scary for nearly everyone and truly frightening for the vast majority! So rather than experience any form of discomfort of rowing in the turbulent waters of the unknown, most people regress – and return to their ‘Safe Harbor of The Known’. It feels better, seems safer and infinitely more cushy and comfortable. But, in truth, it’s not.

The problem is that refusing to learn and grow is the beginning of the end. Life is all about making tomorrow better than today. The progressive mind is obsessed with the idea of stepping into your next level of excellence with every passing hour. A student should know that to cling to the thoughts and ways of performing that they’ve always known is to resign themselves to being average and mediocre. They are no more playing the game but being  mere spectators.

Our educational institutions must encourage the students to be outrageously ambitious and fantastically innovative. A child who dares to break outside the stipulated outlines in his/her art colour book is the one who will break the shackles of the known and venture into the world of unknown tomorrow. But in order to reach these new lands, he/she must lose sight of the shore-even for just a little while. And we must teach them to dare to be a Columbus or a Vasco de Gama and explore the unknown.

Schools and colleges have the responsibility of making the champions of tomorrow. Champions may or may not think alike, struggle, toil and persevere the same way or their own way, but will have the same never give up attitude and they will all be different and unique. Our educational institutions should start encouraging and fostering this uniqueness and not push the students in the rat-race of marks, grades, ranks and distinctions. Lord Macaulay was creating clerks to run British India with his system of education, India today needs leaders, path breakers and champions and the old system is certainly not delivering.

WHY SHOULD A BRIGHTLY BURNING CANDLE EXTINGUISH ITSELF?

WHY SHOULD A BRIGHTLY BURNING CANDLE EXTINGUISH ITSELF?

First it was my friend Ashok Raj Kaul, an exceptionally innovative Plastic surgeon from Bangalore and now it is T. S. Murali, a celebrated urologist and a wonderful teacher.....within six weeks we have seen two high achievers commit suicide. This made me think why? These are people who have attained success to the point of stardom and yet were surely not happy. They had lovely family life but were surely not contented. So why they opted for this unfortunate choice?  

This question was bothering me for quite some time. I can understand the less focused and the less successful guys, those who have messed up their lives, their family, their relationships and their professions to simply opt out of life…….but why should those who are themselves epitome of success go the same way?

Historical perspective

When I started thinking to get an answer to my question, my mind took me down the memory lane and I was surprised to find that how many individuals, at the peak of their success chose to opt out of life. The farthest I could go was Cleopatra, queen of Egypt and lover of Julius Caesar and Mark Antony. Cleopatra committed suicide on August 12, 30 B.C., following the defeat of her forces against Octavian, the future first emperor of Rome, possibly by means of an asp, a poisonous Egyptian serpent and symbol of divine royalty. Not only Cleopatra but Mark Antony, Brutus, Judas Iscariot, Hannibal and Nero all committed suicide.

Sigmund Freud, Virginia Wolf, Adolf Hitler, Ernest Hemingway, Sylvia Plath, Vincent van Gogh, Jack London, Dylan Thomas, Judy Garland, Rudolph Hess, Pontius Pilate, Socrates, and possibly Tchaikovsky, Elvis Presley, and the one and only Marilyn Monroe all chose to end their own lives! Creator and host of Soul Train, Don Cornelius, the famous fashion designer Alexander McQueen, Musician Freddie Prinze, Nirvana front man Kurt Cobain, World famous WWE wrestler Chris Benoit, Director of hit film “Top Gun,” Tony Scott and comedian par excellence Robin Williams all of them chose to extinguish their own lives and they all were very successful. The Russian poet Sergei Esenin (1895-1925) wrote an entire poem in his own blood that served as suicide note.

The Indian scenario

This is no less gloomy. Vasanth Kumar Shivashankar Padukone, better known as Guru Dutt, the finest director and actor that India has ever produced,  Manmohan Desai, the famous Bollywood producer and owner of Paramount Studios (Filmalaya) who is credited with helping Amitabh Bachchan rise to fame with movies like ‘Amar Akbar Anthony’, ‘Coolie’ and ‘Mard’ , Silk Smitha the famous Tamil film star,  Nafisa Joseph was a popular VJ on MTV, an actress and a model, Viveka Babajee a famous model and entrepreneur with  her own event company called VIBGYOR ENT, she was an  anchor for FTV India and acted in a film ‘Yeh Kaisi Mohabbat Hai’, Divya Bharti, Jiya Khan, Disha Ganguly, Pratusha Banerjee all very talented and successful people committed suicide.

You would not expect a sportsperson to be so un-sportsman like, accept defeat gracefully only to return again to conquer. But sports too have been tainted by this problem. Welsh national team manager and former player Gary Speed hanged himself. Former Queen's Park Rangers' defender Dave Clement, killed himself in 1982 by drinking weed-killer. Cricketers Jack Iverson, "who could have the world's best batsmen at his mercy, if he could spare the time", Jim Burke, the Australian batsman and Peter Roebuck, the Somerset captain and commentator all went the same way. Interestingly, the latter wrote the forward to David Firth's book about cricketer's committing suicide, "By His Own Hand".

Back to the question “Why?’

The word “suicide” comes from two Latin roots, sui (“of oneself”) and cidium (“killing” or “slaying”). Suicide is tragic enough, but it’s particularly bewildering when young people who appear to have it all take their own lives. We are living in a highly competitive world. Those who are successful find themselves in a unique intersection that exacerbates the burden on those prone to mental illness—enormous pressure to be perfect, combined with seemingly having it all going for them, combined with feeling exactly the opposite inside. And social media isn’t helping either.

Successful people tend to be hyper competitive and upwardly mobile and ambitious, which means that they are constantly comparing themselves to people who are even more successful. This type of comparison leads to unhappiness as no matter how much they succeed; there'll always be someone else who's done better. So they need to understand success in a healthy way.

Successful people need to celebrate their success by extending a helping hand and pulling up all those who are struggling to achieve the same success. If instead people pursue success just to get approval and acceptance, it could feel like a long tiring fight. They would fear to lose what they have because of being judged by their failures.  Additionally, it is very upsetting when a "successful" person reach a point whereby they seem to have everything they could ever want, and yet still feel empty, dissatisfied, or disappointed. What would be your next goal in such a situation? If there's none, what is there to live for? Hence my theory: ‘there is no success without a successor’!

Plenty of "successful" people go into depression and ultimately kill themselves because they cannot live a life whereby they are constantly plagued by the fear of being unable to maintain or better their success. This is because they have achieved success but not understood it. Success is not a destination where one has to reach; it is a path which one makes for others to follow. When we help others to achieve success we prepare ourselves of a bigger and worthier challenge……a challenge worth living all over again!

People do not kill themselves "because" they failed in their own mind, or "because" they weren't successful. They kill themselves because the acute pain of suicidal/psychotic depression - an acute, pain almost akin to physical pain, along with the "emotional pain" of the thought distortions and self-hatred that go along with depression finally exceeding their willingness or ability to cope/stand the pain. To the suicidally depressed, killing oneself is in a perverse way their last and final act of self-mercy. And the best way to fight depression is to help those who are less successful and less fortunate.

If you think Wall Street, Dalal Street, Prime Minister’s office or Hollywood and Bollywood are high pressure zones then wait till you fall sick. Nowhere is the macho code of success more evident than in the pressure-cooker situation in which a doctor works, right from his/her medical school days. Attending to patients of all types, getting work done by the juniors, the nurses and the ministerial staff, trying to remain in the good book of seniors, attending classes and clinics, learning newer skills, being abreast with all the recent advances, being polite and considerate to all the patient attendants, hospital administration and lay press…….and doing so day in and day out even at the peak of their careers takes a toll on the personal and family life. They are taught by their teachers in the profession to give.......give time, effort, patience and keep on giving. This turns them into empty shells and the same patients whom they enjoyed treating now become burden - burden of responsibility, work and indeed reputation. They start believing that if we don't help them they are helpless. They forget the real world where they are moms and dads, husbands and wives, friends and relatives and a referee in a football match or a secretary in a Durga Puja committee. Their life becomes monotonous and unidirectional from the kaleidoscopic multi coloured and poly directional as God desires. This is when they stop making intelligent choices and simply burn out.

So, while I may not have all the answers of why creative and successful people end up committing an act hardly becoming of them but I can tell you that it is some complex combination of nature (genes, brain circuitry, chemical imbalance) and nurture (a lifetime of bad experiences piled up high enough) coupled with underlying diseases like depression and a few drugs like isotretinoin (Acutane), used for treating acne hopelessly stack up against a sensible decision making. Depressed and bipolar people can appear to be high-functioning creative leaders—during their manic bursts—and simply moody when they hit the low end. 

Most of us are brought up to believe that success equates to happiness, unfortunately it could be that the pursuit of success is what that drives people to the brink. No matter how you feel, no matter what mistake you think you made, you can fix it. Suicide is the one mistake you can’t take back.

PHYTOCEAUTICALS – EVEN OUR GRANDMOTHERS KNEW ABOUT THEM!

 “Finish your carrots, they are good for your eyes” she would say; the oil in “the orange peel will make you’re your skin glow” she would tell my mother. My grandma was an unsuspecting carrier of a bounty of knowledge, which has today acquired a fancy name ‘Phytoceauticals’!

Phytoceauticals are biological actives obtained from plants and have been known to those practicing Ayurveda since ages. Their use from wound healing to cosmetology and from anti inflammatory to anti cancer therapy are today the ‘in thing’ in medicine, but the fact that they are a part of our glorious heritage and find documentation in ancient books like Susruta Samhita and Charak Samhita cannot be denied.

Today we aesthetic surgeons have formulated a classification for these phytoceauticals as our ready reckon-er:

–        Anti inflammatory – naturally occurring COX-2 mediators to reduce inflammation

•         Turmeric, ginger, papaya

•         Pineapple, Blueberry, sweet potato

•         Kelp, Brown algae

–        Topical bleaching agents –

•         Hydroquinone, Kojic acid, Glycolic acid

•         Lemon / Orange peel – Ascorbyl palmitate

•         Licorice extract

–        Topical anti bacterial agents –

•         Apple stem cells

•         Salicylic acid powder

•         Pumpkin oil

Let us now appreciate how we have used the phytoceauticals all these years:

Cosmetics:

Different Lepās (Masks or applications) were recommended for different seasons for body beautification. The ingredients used during the cold seasons were quite different from those used in warm seasons. In fact Ashtānga Hridaya (a 1500 year old book of Ayurveda) offers six different formulations to be used for the six seasons of the year. Similarly special cosmetic Tailams (Oils) and Ghritas (Clarified butter or ghee) were used for facial beautification. Superfluous hair was considered to be a stigma and a large number of depilatory agents were recommended to get rid of it. Special ingredients were used for hair washes. Many remedies have been indicated for hair growth, prevention of falling hair and premature graying. Hair dyes, fragrant hair rinses and fumigants were also in use. Fragrant bath powders and body deodorants also find frequent mention. Oral hygiene in the form of care of teeth, mouth deodorants and coloring of lips were daily chores to be religiously pursued. Today we are re-discovering them in our tooth pastes in the form of Neem, turmeric, cinnamon, licorice, almond, clove, peppermint and eucalyptus oils.  It appears that the whole range of modern cosmetic usage was conceived by the ancient Indians and was practiced with the help of natural resources then available.

Anti inflammatory:

Turmeric or Haldi is a commonly used spice in our kitchen but its use as a medicine too is not new as it has been used both topically as well as orally. It is a natural remedy for several ailments and is greatly notable for its strong anti-inflammatory and anti-carcinogenic properties, and for its ability to kill bacteria and boost the body's immune system. It's no surprise that it's so widely sought after, given all these benefits and the entire world is keen to patent its goodness when we have known about it since ages! What is most exiting is that mixing it with just one other natural ingredient can turn it into something even more potent?  And that is Honey!

Anti bacterial:

Of all the natural antibiotics nature has to offer, golden honey has been found to be one of the strongest ones ever known. When combined with turmeric, these two ingredients can make a powerful natural remedy, which acts as a medicine for colds in particular, with benefits that may outweigh those of the synthetic antibiotics you're accustomed to.

Unlike other medicines, golden honey has no negative effects on the intestinal tract. But, rather, it improves digestion and increases the activity of beneficial flora in the gut thus acting as a probiotic. It also acting as a wonderful healer in the following cases:

• colds and flu
• respiratory diseases
• weight problems
• arthritis and rheumatoid arthritis

So, when you feel like you're coming down with a nasty cold, golden honey is the first thing you should reach out for. Here are the directions of how to make it:

Ingredients
• 3.5 oz. (100 grams) of raw organic honey
• 1 tbsp. of turmeric powder

Directions
Combine the turmeric and honey, mix well, and place in a glass container.

Dosage instructions
To fight cold and flu symptoms:
• Day 1 – Take ½ tsp. every hour during the day.
• Day 2 – Take ½ tsp. every two hours during the day.
• Day 3 – Take ½ tsp. three times a day.

To fight respiratory diseases:
• Take ½ tsp. three times a day during the week.

How to take it
When ingested, the mixture should be kept in the mouth until completely dissolved. You may even add golden honey to milk or tea if desired.

Do not consume turmeric if you suffer from hypertension, hemophilia, bile disease or other gallbladder problems, since it could cause muscle contractions in the gallbladder.

According to Indo-Tibetan medicine, if you use turmeric before meals - it acts on the throat and lungs, if you use it during meals - it acts on the digestive system, and if you use it after meals - it acts on the colon and kidneys.

Phytonutrients

Plant foods contain thousands of natural chemicals. These are called phytonutrients or phytochemicals. Phytonutrients aren't essential for keeping us alive, unlike the vitamins and minerals that plant foods contain but improve our wellness and health. More than 25,000 phytonutrients are found in plant foods but the six important ones are Carotenoids, Ellagic acid, Flavonoids, Resveratrol, Glucosinolates and Phytoestrogens. More than 600 carotenoids provide yellow, orange, and red colors in fruits and vegetables. They are antioxidants and they tackle harmful free radicals that damage tissues. Alpha-carotene, beta-carotene, and beta-cryptoxanthin are all converted to Vitamin A and are useful for our eyes. Yellow and orange foods like pumpkins and carrots are good sources of alpha- and beta-carotene.

Lycopene give red or pink colour to tomato, watermelon and pink grapefruit and prevent us from prostate cancer. Lutein and zeaxanthin protect us from cataract and age related macular degeneration and are found in green vegetables like spinach, kale and collards. Ellagic acid is found in a number of berries and other plant foods, especially Strawberries, Raspberries and Pomegranates. These protect us from cancers by enabling the liver to neutralize carcinogens. Flavonoids include catechins found in green tea, hesperidin found in citrus fruits, flavonols in apples berries and onions and Resveratrol is found in Grapes, Purple grape juice and Red wine.

Fruits and vegetables are concentrated sources of phytonutrients; other plant foods like whole grains, legumes/beans, nuts and seeds, and herbs and spices also contain phytonutrients. Since many phytonutrients also serve as the pigment that gives foods their deep hues, you can identify many phytonutrient-rich foods by looking for colorful foods; for example, look for foods that are blue or purple like blueberries, blackberries and red cabbage (rich in flavonoids); yellow-orange foods like carrots, winter squash, papaya, and melon (rich in beta-carotene); red or pink foods like tomatoes, guava, and watermelon (rich in lycopene); and green foods like kale, spinach, and collard greens (rich in chlorophyll). Yet, since not all phytonutrients give color, it's important to not overlook some off-white foods as well—for example, garlic, onions, and leeks are rich in powerful sulfur-containing phytonutrients.

Phytonutrients are rich source of antioxidants and are found in whole grains, legumes/beans, nuts and seeds, green vegitables, citrus fruits and herbs. They promote good health and are gifts for us from the plant kingdom.

‘BAPU’ STAMP AND OTHER STAMPS SELLING FOR A FORTUNE

 

Bapu stamp sold for $855,000!

Bapu was in the news Down Under …..not exactly for austerity. A mystery Australian collector paid $855,000 for four Bapu stamps at auction last week. This collector has set a new world record after paying a small fortune for one of the world's rarest and most-mysterious stamps. The collector bought the strip of four 1948 Gandhi 10-rupee purple-brown 'SERVICE' stamps and it is said that only 13 of these stamps exist in private collections around the world.

The price paid is a new high-water mark for Indian stamps. This is the most sought-after stamp in Indian collection. Only two sheets of 50 were ever printed in 1948, with one sheet held in a museum in Delhi. Of the remainder only 13 have been located, four of which are held in the Queen's royal collection. It is not known what happened to the rest of the stamps, with rumours abounding they are being secretly held in private collections, or have been sold by Indian government members or simply lost! The stamp's rarity, combined with an explosion in interest in Indian stamps, underpins the price paid. So you see even after they are long gone Gujaratis fetch a lot of money!!

In the world of high-end stamp collecting, the most valuable stamps are those that have been used on an envelope – known as "on cover". None of the 13 existing Bapu stamps is an "on cover", and most of the collecting communities do not believe any exist.

Penny Black

Postage stamps have facilitated the delivery of mail since the 1840s. Before then, ink and hand-stamps (hence the word 'stamp'), usually made from wood or cork, were often used to frank the mail and confirm the payment of postage. The first adhesive postage stamp, commonly referred to as the Penny Black, was issued in the United Kingdom in 1840. The invention of the stamp was part of an attempt to reform and improve the postal system in the United Kingdom of Great Britain and Ireland, which, in the early 19th century, was in disarray and rife with corruption. 

There are varying accounts of the inventor or inventors of the stamp. Before the introduction of postage stamps, mail in the UK was paid for by the recipient, a system that was associated with an irresolvable problem: the costs of delivering mail were not recoverable by the postal service when recipients were unable or unwilling to pay for delivered items, and senders had no incentive to restrict the number, size, or weight of items sent, whether or not they would ultimately be paid for. The postage stamp resolved this issue in a simple and elegant manner, with the additional benefit of room for an element of beauty to be introduced. As postage stamps with their engraved imagery began to appear on a widespread basis, historians and collectors began to take notice. 

The study of postage stamps and their use is referred to as philately. Stamp collecting can be both a hobby and a form of historical study and reference, as government-issued postage stamps and their mailing systems have always been involved with the history of nations. Stamp collectors are an important source of revenue for some small countries that create limited runs of elaborate stamps designed mainly to be bought by stamp collectors. The stamps produced by these countries may far exceed their postal needs. 

Stamp collecting may seem a bit old fashioned. But with 20million collectors in China alone, you may want to shake the dust off the family albums. Rare stamps are selling for hundreds of thousands of rupees / dollars / Euros/ pounds. A stamp becomes rare when it is really old, when it has a history attached to it, when it gets printed with an error and so are in limited numbers.

Penny Red

The most expensive stamp Stanley Gibbons has sold is a British Penny Red, for £550,000 - not bad for a piece of paper. It’s in really poor condition, but there are only nine in the world. The Post Office decided the printing plate was not up to scratch, so they destroyed it. But one sheet got into circulation.

The Penny Black is one of the world’s most iconic stamps. Because it’s the world’s first stamp, it’s very valuable. Rare Penny Blacks are valued at tens of thousands of pounds and have increased in price for decades.

The British Guiana One Cent Magenta is only one left in the world. At the time, all the colonies had to wait for stamps to arrive from the UK. The boat was delayed, and the postmaster created his own collection of stamps. This stamp was auctioned in New York for $9.5million (£6.4million). It’s in

Guiana 1 cent

appalling condition and it was not even printed on proper Royal Mail stock. The postmaster of British Guiana produced the stamp, which measures at 1" x 1.25", in 1856 as part of a contingency supply while he awaited a shipment of stamps from Great Britain. He created two varieties of stamps: Four-cent stamps and one-cent stamps. While several four-cent stamps from this supply still exist, only 1 one cent stamp exists today from this batch. It was rediscovered in a collection by a 12-year-old boy in 1873, then sold to numerous collectors over the years. It accrued in value until the infamous John Eleuthère du Pont bought it for $935,000 in 1980. Du Pont, a wealthy heir to a chemical fortune, was convicted in 1997 of murdering Olympic wrestler David Schultz. He was sentenced to 13 to 30 years in prison, and died there at the age of 67 in 2010. In his will, which was contested several times by his family members, du Pont designated 20% of the stamp's proceeds to the wildlife foundation he funded, and 80% to former wrestler Valentin Jordanov Dimitrov.

Inverted Jenney

The Inverted Jenney is an American stamp was of a stunt plane and they printed it upside down. Then they realized what they had done and recalled it. The Tyrian Plum was issued in the reign of Edward VII, but it actually came out the day he died. It was immediately withdrawn, but a tiny handful got into the market and is valued at over £100,000. The Roses error was a stamp from 1978 which was worth 13p and is now worth £130,000. The quirk about the stamp is the 13p did not get printed for some reason. There are only three in the world. The Queen owns two. The Whole country is red- This modern stamp was commissioned by Chairman Mao to represent communism over the whole of China. But by a complete error, the designer left Taiwan in white. This was massively controversial - he thought he would be going to prison for treason. The stamp was hurriedly recalled.

Rose error

The Whole Country is Red....but Taiwan is white!

So such errors make a stamp rare, rare enough to fetch a fortune! But honestly, did the loin cloth clad Bapu ever dream of the day when his 10 rupee stamp would fetch $855,000 for a strip of four! Great going Bapu!!

LIVE SURGERIES IN SURGICAL CONFERENCES – EDUCATIONAL OR SENSATIONAL?

There is no doubt in my mind that it's vital to share knowledge and experiences with peers in the medical fraternity. Live surgeries offer educational value and live surgical workshops have become very common throughout the span of the surgical field. However, are we not making this look far more sensational in its 'live' avatar? Why shouldn't the same surgery be presented as a properly edited video, taped while the operator was operating in his own operating environment? Will that not be far safer for both patient and the surgeon? Will that not be far more value for time for the viewing trainees and delegates and lastly will that not be far more ethical for the surgical fraternity? Are we on to something more educational or are we promoting something more sensational?

Using web conferencing as a tool, beaming live surgeries has become one of the most attractive and efficient way to demonstrate, explain and teach surgical or medical techniques to an audience of peers watching it from various locations, often continents apart! In a country like India it is argued that this opportunity brings the rural surgeons closer to their urban peers. This exercise provides a dynamic educational platform for the audience through which knowledge is shared by the experts performing these surgeries with first hand visuals of the operation and the two-way communication with the participants during the live procedures. As participants get an opportunity to observe the live procedure with decisions taken on real time, they are also exposed to unexpected challenges and other unforeseen intricacies of a surgery. However, it is from these unforeseen and unexpected challenges that my objections to these live surgical workshops take birth. The value of video images in disseminating surgical knowledge is immense and unequivocally true, but why 'live' broadcasts? Supporters for these programmes argue that a live telecast somehow brings energy, honesty and the drama and teaches the audience to deal with unexpected complications. However, at the same time this brings sensationalism and thrill at the expense of the helpless patient.

The conference organizers today make the 'live demonstration' the main focus to promote a meeting and create a lot of hype around it. The audience is promised 'a visual treat' and the delegates come with the main intention of watching surgical feats on a big screen. The entire focus of a conference often shifts to the live workshop sessions and there is hardly any audience for the panel discussions and papers. In fact, it is not uncommon for conference organizers to cancel other events when the live operative sessions overshoot the scheduled time. However, it is time to ask a pertinent question - is this visual treat doing any good to anybody? There are three parties involved in this interaction - the visiting surgeon, the learning audience and most certainly patient. Let us analyse with a cool mind who is being benefitted.

The Visiting Surgeon

He/she has come from a distant land tired and jet lagged he often sees patient for the first time in the pre-operative room, although if he was delivering a prior lecture, he might not be even that lucky and the patient may be anaesthetized well before he arrives in the operating theatre. So the pre-operative planning is discussed on still photographs or on a sleeping patient lying supine with no inputs from him/her. Even if he has an opportunity to interact with patient due to language difficulties, he has very little chance of making a clinical assessment of the indication for the procedure. In the OR, an overseas surgeon invariably finds himself in an alien environment, with an unfamiliar bunch of assistants, inexperienced in assisting the proposed surgery and a less than optimal set of instruments, simply because they are not his own. Talking while operating can divert the attention of the surgeon, but this is what he plans to do throughout the surgery! He knows that the physician in him should avoid situations that put patient at risk of harm, but does he have a choice? If multi-tasking is prohibited for mundane tasks like driving, why should it be allowed for more demanding tasks like surgery? It has already been proven that accidents are often caused while talking over a mobile phone. How is a microphone different from a mobile phone in this context? Is sensationalism not overtaking professionalism here?

If a suitable patient or implant was not arranged by the organizers even then the visiting surgeon is under pressure to 'deliver' because he has been touted as an expert and that is exactly what the audience is expecting him to do! He also has his own set of pre-operative preparations and post-operative instructions and he knows fully and teaches repeatedly that both are vital for the success of his surgery, but chances are that he will not be around to monitor either! How many experts have declined to do a procedure because they cannot see a good indication when confronted with patient on the table and an expectant audience? How many experts check on key environmental factors that they take for granted at home - such as local practices for disinfection, antibiotic prophylaxis, sedation and monitoring. If it appears that the local practices are different, should the surgeon insist on his own standards or bend them for the benefit of 'the show'? Can a teacher and an expert afford to make these compromises? Again are all decisions in live surgery workshops taken in the best interests of patient? It is possible that the operating surgeon feels compelled to continue with an operation as it has been advertised by the organizers. So is this live surgical workshop good for the visiting surgeon?

The Audience

The argument that such workshops fill the void created by the inability of postgraduate training programmes to expose students to new operative techniques has its limitations since these workshops are a poor alternative to structured teaching. The planning session with patient in these workshops is either missing or unstructured and anaemic and a detailed discussion on the indications, pre-operative preparation, investigations, post-operative care as well as complications is hardly ever taking place.

Walker and Peyton of the Royal College of Surgeons  [Walker M, Peyton JW. Teaching in theatre. In: Peyton JW, editor. Teaching and Learning in Medical Practice. Rickmansworth, UK: Manticare Europe Ltd.; 1998. p. 171-80] have popularized the four steps to effective learning of procedural skills:

• Demonstration: Trainer demonstrates at normal speed, without commentary
• Deconstruction: Trainer demonstrates while describing steps
• Comprehension: Trainer demonstrates while learner describes steps
• Performance: Learner demonstrates while learner describes steps.

This four step approach ensures that the teacher breaks the process into manageable steps and progress is made from one stage to the next as each step is mastered. Watching a master surgeon demonstrate his/her art is only one step in the process of learning. Divorcing the first step from the subsequent three, whilst may be useful for the few experienced senior surgeons in the audience, can have disastrous consequences for the more junior inexperienced surgeons and their patients. There is a serious danger of some degree of oversimplification of the operative process as, often in well-organized workshops, well-selected patients are operated upon by the best surgeons with the best of equipment and back-up. It is not uncommon therefore to hear of how surgeons try to emulate a certain procedure they have recently observed in a workshop and how the first two post-workshop weeks become most disaster prone for a young and impressionable surgeon. And finally, who all are sitting in the audience? Are you sure tomorrow you will not complain that after a weekend workshop on liposuction your neighboring dentist has now become a body contour specialist? So is this experience good for the training audience?

The Patient

Is the patient clearly told that she/he will be the subject of a 'live' demonstration by a visiting faculty in front of a large audience? Does he/she know that the operating surgeon is unlikely to be available to deal with post-operative complications if they arise? How often does the visiting surgeon himself explain the procedure to the patient and family? Are the principles of a proper informed consent respected in the setting of such live workshops? Is the patient made aware of the fact that the surgeon may be tired after a long flight, harassed by a new band of assistants, hassled by unfamiliar set of instruments and constantly talking to an ever eager audience while operating upon him/her? Is it all right with him/her that he/she is not getting the surgeon's 100% attention, which he/she deserves?

In live surgeries, patient details are announced and patients seen by more people than they may be comfortable with. Often, a patient may feel coerced to consent as otherwise a foreign surgeon/expert may not operate, but is he/she prepared to share his/her medical condition and grief with a hall full of aliens? I have seen overseas surgeons purchasing drills and bits from hardware stores in developing countries and using them in surgery the next day. Was the patient informed about such innovations while obtaining the consent for surgery? So are these live workshops good for patients?

It is also no coincidence that this boom of live surgical workshops has come at a time when technology has entered surgery in a big way; the best examples being the fields of implantology, endoscopy and laparoscopy. A huge and ever-growing medical equipment industry provides the main funds for these workshops as for them it is a ready-made opportunity to display and promote their gadgets and wares. Often, the unwritten trade-off for such funding is the promise of subtle promotion through the medium of the workshop. It can also not be denied that these workshops are essentially a part of a grand marketing strategy for many 5 star hospitals and corporate institutes. Thus, the form and content is often designed to promote the host institution or a particular procedure or equipment or even an individual, rather than representing a well thought out scientific and educational activity. There are a variety of factors that create the background for a certain compulsion on one hand for the organisers and on the other, for the visiting surgeon to 'perform' the procedure in front of an expectant audience and it takes a great deal of courage and conviction for most people to resist such pressure, which has the potential of transgressing both science and ethics.

So what is a better alternative? Edited videos - it would be better for the procedure to be recorded and replayed frame by frame. The surgeon will be in a better position to explain the procedure after it has been completed. However, in edited videos, most experts would gloss over mistakes or difficulties and there lies the human factor in a teacher. Telemedicine, with operations performed by persons in their own environment, is an excellent option but may be beyond the reach of many institutions today. Too often, live surgery contains endless stretches of technical details that have little educational merit. Technical difficulties, delays in the procedure itself and problems with audio-video signal feed add to the chaos. Isn't a well-edited surgical video, with narration and figures, added later by the surgeon, after thoughtful review, a far better alternative. It saves time and teaches more and protects both the surgeon and his patient.

ATITHI DEVO BHAVA – GUEST IS GOD

There is verse from the Taittiriya Upanishad, Shikshavalli I.20 that says: “matrudevo bhava, pitrudevo bhava, acharyadevo bhava, atithidevo bhava”. It literally means “be one for whom the Mother is God, be one for whom the Father is God, be one for whom the Teacher is God, be one for whom the guest is God.” Atithi Devo Bhava, it is not just a catchy line to promote tourism but is a beautiful tradition that is deep rooted in Indian culture. The host-guest relationship in India is truly one of the most revered relationships. The unique practice of giving utmost importance, respect and preferential treatment to the guests is certainly not a practice monopolized by we Indians but we do have a way of going pleasantly overboard and do somethings the guests remember all their lives.  ‘Atithi Satkar’ meaning to welcome the guest with warmth and respect is a practice seen in all villages and all across our socio-economic spectrum.

In our attempt to treat guests like God no distinction is made based on the guests’s nationality. caste, colour or creed and he/she is showered with all love, care and affection the host can think of. Despite high degree of cultural and geographical diversity in the country, these sentiments towards the guests stay the same throughout the vast expanse of our country.

But Atithi Devo Bhava, has lost its true essence and spirit over the sands of time. Today trade globalization that has helped modernize India, but this process has also begun to erode our culture. Today where everything travels the fast lane, how much time do we devote towards our rich, age old culture? Do we truly lead our lives in this spirit? Atithi Devo Bhava, is an important part of the Indian culture which may soon be lost with time and a country with a lost culture is simply without an identity.

Today culture and morality are not going hand in hand and so tourists often don’t find India a very welcoming destination. Whereas 99% of the tourists love what they see and feel, the odd tourist is often left disillusioned by the corrupt and the immoral. Thus India holds a conservative approach towards many issues unlike western countries and also a tendency of taking things for granted, be it a matter of cleanliness or crime, nobody seems bothered.  Theft, robbery, cheating, molestation and roguish acts against tourists were unheard of once upon a time but are tainting our tourism industry today. Promoting your business is one thing, but asking for 10 on 1 is nothing else but cheating. Do we treat our God in this way?

A tourist is not just a tourist; he/she is an ambassador for  spreading a good image of our country's warm, soothing hospitality, culture and safe environment. How shameful for us it would be as an Indian, when western countries issue security warnings for their people visiting India, to remain alert and safe, especially women, as they can be molested in India!

But we must not confuse mindset with culture. Though both supplement and complement each other, yet both are different from each other. The culture claims the concept of "Atithi Devo Bhava", that means the Guest is like God, but mindset is built on a hypocritical approach, where the cultural concept of treating guests like god becomes meaningless.

The Indian Government's "Atithi Devo Bhava" campaign is certainly an appreciable step and very effective one as well, especially for the younger generation. But people with sick mindset seldom watch and heed to such things. Sensitization is certainly important, but strict punishments and timely execution of them is need of the hour.

Let me now introduce you to a perfect example of our "Atithi Devo Bhava" culture. Recently Neeta and I  were in Hyderabad for our elder son Ananya'a convocation in Indian School of Business after the completion of his M.B.A. We arrived the day before the convocation and had an evening off. I was reminded of the fact that three of my friends who went to Kailas with me in September last year were staying in this city. So I picked up the phone and called our friend Bhaskar who, if you can remember from my Kailas blogs, can move mountains and nothing seems impossible for him. As it was expected we were picked up from the hotel in 20 minutes by his nephew Harish and then were driven 60 Km from Cyberabad to L. B. Nagar. It was evening; the sun had set when we entered the locality where he stayed.  We saw a group of musicians playing the drums and Nadswaram, a very difficult wind instrument. We naturally thought it was a baraat (a wedding ceremony where the groom is accompanied by a band of musicians and his friends who keep dancing to the tunes) but to our utter surprise Harish told us that this was an arrangement only for us! He showed us Shyamsundar’s house as we went past it. The musicians led our car to our host's home where we were given a traditional reception with garland, tilak and a warm hug, which will be difficult to forget in this lifetime. 

The musicians sat down and played for us as each member of the two families of my two friends welcomed us. This was followed by a traditional drink, tari, which I most respectfully declined. Tari is a palm wine - an alcoholic beverage created from the sap of various species of palm tree and its inflorescence and is collected drop by drop in an earthen pot as a frothy fluid, which is strained through a piece of clean cloth and served fresh or stored as a cloudy liquid for future use.

Bhaskar, me, Shyam's father, Shyamsunder, his wife and Neeta

My tari was however  replaced by a second beverage, which was more like a herbal tea - coriander, pepper, cardamom, cinnamon, and many other stuff from Shyamsunder's collection. Shyam is Bhaskar's neighbor and we were given a conducted tour of his beautiful home with gorgeous pine wood interior! The dinner at Bhaskar’s place that followed was predominantly millet and was very tasty. We even received a call from our third Hyderabadi friend Venu, who was with us for the Kailas trip. He was caught up in a family function and he apologized profusely for not being present.

With the two families

The families of both Bhaskar and Shyamsunder were very loving and caring. Children were in different stages of education employment and the joy of living together could be felt easily by us who were visiting them for the first time!  4 generations were staying together and language was no barrier as I found Neeta engrossed in discussion with everyone from the elders to the youngest bride to the fantastic children. Shyam's son is a swimmer with Olympic dreams and we hope he brings glory to us all one day!.

What was most impressive about this interaction was that here were two families which have not given up on their traditions, remained in touch with its roots and yet has prospered tremendously and is planning to touch the sky! May God bless them! May God bless our country and may we, despite all odds of modernization, keep the culture of "Atithi Devo Bhava" close to our heart as Bhaskar and Shyamsunder have done so successfully.