Comings and Goings

Perhaps, one day, the winds will bear up,
Accommodate the heavy whisperings
That waft hopelessly into the night sky.
Anonymous, they drift into the passing light
From aged stars thrown through prisms
Invisible in the blinding light of a cellphone screen.
"Do Not Disturb" post-its that I ignore -
A licence to enter your room, and the secrecy
Of every day of your life.
A text message, coffee (because you can't stand tea)
And forgive me when I spill it as I stir
Come look for me as I pretend to work
And we will speak of what we want to.
I closet myself in shortness and impatience
Thinly veiled, but deserting is not an option
Unburden, and what we talk of can bear no repetition
And tolerate no one else's hearing
And if I want to be angry, I don't think I can.
Your exile here is ended, your conscious life
Among walls with eyes and ears
And hushed voices that sit in judgement
Growing upward and outward will take its toll
And I will try my best to ride the wave.
Will you have changed the next time that I see you
Or can we pick up where we left off
And will you stride back in with laughter
That means that nothing matters
Or must I sit at the very edge for very long
And wait for you to drift back into sight?

Recipes - The Student's Guide to Boston Cream Pie

Actual cooking time: 1 hour
Preparation: 2 days

Ingredients:
For the cake:
1. 4 eggs
2. 1 1/4 cup flour
3. 1 1/4 cup sugar
4. 2 cups milk
5. 2 tbsp unsalted butter
5. 1 1/4 tsp baking powder
6. 2 tsp vanilla essence

For the filling:
1. 4 egg yolks
2. Sugar (I forget how much)
3. 3 tbsp cornflour
4. 2 tsp vanilla essence
5. 2 cups milk

For the glaze:
1. Chocolate - lots.
2. Cream - even more.

Equipment required:
1. An oven
2. Something to heat things on
3. Kindhearted friends who will lend you their mothers' cake tins, sieves and measuring equipment.

Procedure:
1. Plan ahead for days to the point of obsession to make sure you know exactly what you have to get. Go shopping for ingredients the day before, forget the butter.
2. Wake up, swear at yourself for forgetting the butter. Borrow the hostel kitchen's keys from the mess secretary. Laugh at the sign that tells you to return them in 4 hours because everyone knows you will take three times as long.
3. Haunt the corridors like a spectre by daylight to borrow a baking tin before everyone leaves for class. Borrow tin, realise that your measuring cups still haven't arrived. Swear again.
4. Walk to friend's house, borrow measuring equipment and sieve. Stop to check your mail, buy butter, return to hostel.
5. Carry ingredients down, open kitchen. Experience a moment of dismay because (a) it's small (b) there is no cooking range, only a hotplate and (c) because there's no source of running water in the room.
6. Realise (c) is not too much of a problem because of the bathroom next door. Experience another moment of dismay when you realise that the only vessels in the kitchen are a few ladles, a wok, a non-stick pan and a sauce pan, and you will have to whisk your eggs with a knife.
7. Arrange ingredients. Switch on the electric oven, to preheat. Switch it off again when you realise the hotplate uses the same plug and you can only use one at a time - a realisation that dawns simultaneously with a knocking sound that seems to come from the oven.
8. Prepare creme filling, stirring constantly. As it cooks, hope and pray that the recipe really does require that it turn into a glutinous tumour-like mass. Take off the heat. Taste. Taste again.
9. Let it cool and transfer to another container, refrigerate. Wash saucepan.
10. Prepare cake batter in wok, whisking eggs and sugar together with a ladle. Substitute knife for ladle because there is no fork to be found this side of the veil. Impale yourself on the knife while rinsing. Swear again.
11. Heat milk and butter, add to egg mixture while praying that it will not congeal. Be glad when it doesn't. Add flour. This time it does. Mix vigorously.
12. Pour into lined, buttered (borrowed) cake tin. Bake for 35-40 minutes at 350 degrees.
13. Prepare glaze - heat an obscenely large quantity of cream, bring to boil. Pour indiscriminately on broken pieces of a chocolate bar in a plastic(!) bowl. Stir. Let cool.
14. Once cake is ready, let it cool. Slice horizontally into two largely unequal parts.
15. Assemble - spoon creme filling onto the bottom half, cover with the top half. Top with glaze, letting it drip down to the sides. Eat any glaze that isn't directly attached to cake, and some that is.
16. Chill in your newly-purchased refrigerator for twenty minutes or until you are ready to serve.
17. Consume, with the gratifying realisation that it actually tastes and looks pretty good. Store in above-mentioned refrigerator, eat for breakfast, lunch, dinner and midnight snack for the next three days.
18. Join the gym.

For a real Boston Cream Pie recipe, check out:
http://www.marthastewart.com/best-boston-cream-pie

The Pitfalls of Evidence-based Medicine

Randomised Controlled Trials are supposed to be the gold standard of clinical trials.

Here's what happens when you carry a good thing too far: http://www.bmj.com/cgi/content/full/327/7429/1459

The Amazing Technical Dreamtown

Gandhi Road, opposite the hospital's second gate, is known for dirt, crowds, an outbreak or two of amoebiasis and the place where most of your shopping gets done. Walking down the small shop-lined street I was dazzled by Dawn Bakery, newly painted, that stood out against the bleak greyness of the sky in bright yellow paint with orange edges. I could be classy and call it marigold with a tangerine trim, but either way it would still hurt.

There seems to have been a revolution in housepaint sweeping the town. Standing on ASHA terrace you can pick out a house in fluorescent green, a pale blue, two yellows and a lavender. From a distance they seem forgivable. Up close, it takes some getting used to. There's a house on the 2 route that's a deep, dark blue. Pleasant, though unorthodox. There's another one that has a hot pink facade. I've heard rumours of a bright yellow one behind Schell, the eye hospital, but I haven't seen it yet. I'm not sure I dare.

Leaving housepaint alone, some of the houses have - interesting motifs on them: there's one, again on the 2 route, that has two huge human eyes carved into its parapets. Or rather, the parapet's carved into eyes, with blank spaces where the sclera ought to be.

Although a lot of house owners seem to be opting for unorthodox colour options, not all of them choose to dazzle - one of the most common is the colour of the hospital - a blue-grey that makes the building look a little like a large, sprawling thundercloud. Superimposed upon this are the temples at the streetcorners, which have large ornate figures of mythological characters mounted on their roofs. All painted. Brightly.

Few of these would meet any demanding aesthetic standards, but they're always interesting to look at. And if they make the people who live in them happy, I suppose that's all that matters.

http://www.bmj.com/cgi/content/full/327/7429/1455

A Change of Mind

I never wrote of love, I never once
Wrote of the things I ever wished to keep.
Never of all I chose to leave undiluted,
Not once among those things I pressed so carefully
The flattened petals among the brittle leaves
Of heavy books, did I count those bouquets
Whose heady perfumes brought to mind
Autumns long past, or longing that was so scarce
I could not afford to adulterate or lose it.

I never wrote of love, I never
Had enough to have enough to give away
Never enough of anybody's heart
To commit to paper, to lose a part,
To leave it behind to gather cobwebs.
They would grow their musty stories
Weave in glistening bands of brittle steel
Wind tighter, tighter still until they snap
And hang in mocking streamers, gather dust.

I never wrote of sunlight as it filters
Through gulmohar leaves, or when it mingles
with the ripples in the stillness
To lap at the concrete of its containment.
I never wrote then, nor when I lay
Enveloped in the true, the rare, the fleeting.
What torrent this that sweeps away the habits
Of twenty years?

A First

My first study proposal - submitted. : )

Run, Rabbit, Run.

I've been catching up on some long-overdue reading with Margaret Mitchell's "Gone With the Wind" (Yes, that long overdue), and have just finished reading the bit where Rhett Butler has the temerity to claim that the Confederates are fighting a losing war, bolstered only by their land and manners and pride.

I don't know enough about the American Civil War or about Southern motivations to take sides. Pehaps all war is the result of political eloquence and mercenary intention, a rush of blood to the head and misguided patriotism; or perhaps rarely it's the only recourse in a situation with little room for manoeuvring, even when you're willing to sustain a loss of face. This debate is an old one and can be discussed at length, but perhaps another time. I know though that it takes some doing, listening to things like those he said and not being afraid to let the scales fall: once they've fallen, something has to be done.

To face a difficult truth includes a tacit understanding of the need to pull through with a difficult course of action. To accept the need for that course of action implies a realisation of the fact that the success of something does not necessarily depend on doing things as they have always been done. To do things at all does not necessarily mean they will make any difference.

There always seems to be too much time, money and energy frittered away on things that will not count two weeks from now in hope of approval that will probably never be unadulterated. I suspect that it will be the same no matter where I am. Does that reek of cynicism? I think it might. But I know for sure that trying to see things for what they are has led to the unburdening of a lot of deadweight.

There's always enough of that to try to unload, but for now I can be happy because I know what I want: to believe in and do what is right; to love and be loved wholeheartedly; to not care about what people who don't count think and to laugh at myself without being offended when other people join in.

New Routes

This Saturday, the bus took a new route to the hospital. Instead of turning onto Fort Road, the driver took a detour that led us past fields, boys playing cricket, and the other side of the Fort, one that I had never seen.
The beauty of living here is that there's always something new to be seen, if only you can keep your eyes open long enough. It can be difficult to gaze serenely out of a window as you fight for standing room on a bus or shield your face against the dust that embeds itself in your moisturiser, but it can be well worth the effort.

A while ago on a line bus on the No 2 route, I saw a family making rope out of coir. It hung heavy and thick, dropping from the slowly cranked spinning wheel in rough-skinned coils. You pass by fringed donkeys, the fire station, chaiwallas pouring out the day's first cups of tea, young girls riding scooters to college and men in lungis who have mastered the disconcerting art of the hoist-and-tuck.

Today there is a group of goats methodically chewing their way through a wallfull of posters, while others recline nearby with that spotted dignity that goats achieve so well. A short distance away there sits the incomplete figure of a woman made of brick. Around one and a half storeys tall, she has neither head nor arms but sits with disproportionately thin legs spread slightly apart and a cinched-in waist. If she had eyes they would look ahead of her into an empty lot strewn with weeds and garbage, and at the goats that keep her company without meaning to. Dilapidated as she is, she camouflages into the background of tyre- and tractor repair shops, the houses with their grilled-in verandahs, into the nakedness of the unpainted sides of small all-purpose stores. Maybe she was meant to be painted and worshipped as a goddess; perhaps that pot-bellied stomach and the height of her imply some obscenely elaborate chimney; I see no explanatory signboards excusing her existence, so I clothe her in conjecture and pass by.

Course to Course

I've been course-hopping this last week, from epidemiology to a three-day workshop on advanced research ethics. So I've been sitting in classes just like I would normally be, except that the other people taking the course are the people who would ordinarily be teaching the classes I'm used to sitting in.

Things have changed since I've left and returned, and the equations I share with people have changed, too. When I left, I thought that at the very least this would be a new experience. I didn't realise how much it would impact my motivations, or that I would change so much in so short a time.

I Didn't Take A Year Off to Write Tests

The Epidemiology course I've been attending's drawing to a close, and tomorrow's the last day. Its main listed event is "evaluation" which I took to mean our evaluation of them, but is of course the other way around. Sigh.

Ribbon-cutting exercises

Yesterday marked a month since my return, and the third month into my year off. It's the only month among the last three where I've actually been expected to do productive work, and I have to admit it hasn't been too bad.

Life led exclusively as a medical student here leaves you with a blinkered view of what actually goes on in this place. Now that I'm out of the loop, I'm finding out things about the hospital and the people who work in it and the projects they work on that I never would have guessed. I even discovered a couple of new departments that I never knew existed.

So far, I've been set on to ideas for research projects, or have thought a couple up on my own and the last month's been spent doing the background research on whether these projects ask questions that really need to be asked, and whether they really need to be answered. Although I have nothing concrete to show for it, I'm now in an appropriate frame of mind to question anything that's said to me. Which is something I hope will serve me well.

I know I'm well into my first post, but here's a little background: I'm in my first clinical year (2nd year) of medicine and I'm taking a year off to do (a) research project(s) as part of a scholarship and an international exchange program. This year ends in June 2008, and I join the class just below mine to resume my career as a medical student (such as it is). Currently I'm in limbo between batches. The implications of that, however, will make another story that shall be told as this blog progresses. At this point in time, I'm trying frantically to get a study proposal together and submitted.