Thursday, July 31, 2014


   I did write about the prayers and it's powers and how it may be working. I was reading an article written many years ago and I thought about it and liked it . It may be an explanation as to why some prayers seem to work, whole others seem not to work.This is similar to the destiny, and how it works.Let me explain.
     When we do sincere prayer ,with full faith and trust , it create positive  deeds. This can be compared to making more money , as it adds to our bank balance of good deeds. But just like the bank balance of money . it can be used for various expenses.If I suddenly get $100,000 , then I can decide to buy new car or new clothes or I can pay off some of my old debt, or I can decide to put some in a bank or invest in something for the future dividend.The same thing can happen for the fruits of our prayers. Some may be used or spent for 'giving' us success. (as if our prayers are answered.)This like me spending some money foe buying new car.Some of the fruits of the prayers will be spent in paying for avoiding the effects of the bad deeds that we might have done and which might have come to fruition in near future.And finally some is left in our bank account of good deeds . The problem is we do not have control on haw this is done in case of effects of good deeds, unlike in case of money, where we have full control. So we can not decide how to 'spend' it , nor we know how much is needed to nullify the effects of past bad deeds ,nor we know how much is needed to get success in what we are praying for . So we don't always see success ,our prayers are not answered ,and sometimes they are . I can not not understate the law of karma in any of these .This may be the deciding factor as to how much of effects of good deeds are used for each of the 3 things that I stated above.There are things that we have done in past or past life , effects of which will manifest and can not be avoided no matter what.And there are things that we can change with some efforts . Then there are some where lot of efforts are needed to change the outcome . So the question is how much is enough?If I want to but Rolls Rice and I have only $20,000, can I buy it? The answer is no .
       So this may be the answer to the question as to why some prayers are answered and others seem to go unanswered. 

Saturday, July 26, 2014


    We are all looking for one and only one thing, happiness.So what gives us the happiness?I have often said that the real happiness is not out side our mind , but in our own mind.Let us say that I like Pizza and it gives me happiness in eating it . So I think that the pizza is the source of the happiness, But when I start eating the pizza , the happiness that I get from eating the first slice is not the same. So when I eat 10th slice I am about to throw up and not getting the happiness that I got with the first slice . So then the happiness is not in PIZZA but it is in my MIND . This is same for many other things , including having sex or listening to a particular music and so on. So why do we feel the happiness.
      There was a story of a king that had heard when I was growing up.He was unhappy.So many doctors came and gave him different medicines , but it did not help.So the king continued to be unhappy.So then came a doctor. He said to the king that the treatment was simple. The king needed to wear a shirt worn by a HAPPY MAN. So the king sent his guards to all over the city , in search of a happy man . They went searching for the happy man one house at at time . Some one was not happy because he had lost a loved one , some one had broken up with spouse, some one had lost job ans so on and so forth. So at the end of day they ran out of houses to go . So the next day they decided to go to the outside of the city . It was early morning . The Sun was rising and a man was sitting on  the banks of a river on a stone doing nothing.The guards came to him and asked him if he was happy.The man answered YES without any hesitation.So they took him to the king. The king asked him the same question, are you happy. The answer was the same unequivocal yes. So the king asked him to to give him his shirt. The man said ,'I don't have shirt, I don't need one '. No wonder he was happy.So the story that I am  going to tell is story of one such happy man.
         I knew this guy , who worked in the hospital where I went . He worked in a housekeeping. I knew him as I saw him everyday in the hospital . He would say hello and I would respond . Then he knew that I was going to Gym , so then he started giving me advice on the body building. He also started telling me about the diet to 'build' muscles.Sometimes he would ask me about health issues.But not too often . He was planning to retire in next couple of years. He told me how much money he had in retirement plan.It was less than what many doctors make in one or two months.But he was happy and never complained about work or life or for that matter anything.
       One day when I was waiting for elevator, he came out of the elevator and  stopped me . He told me , he needed $100. He had to pay some tax. There was no way I could have said that I don't have it . I gave him the money. He had promised me that he will return the money.I continued to see him off and on in next few months . He never said anything about the money . The amount was too small anyway. Then one day he asked me if I could spare few minutes . He too me to credit union bank ,asked the cashier how much did he have in the account. Then asked her to give me $5.Over period of next year, he did this few times . There was no way for me to keep a track of how much he gave me . I am sure that he did give me all $100.I have talked to him after that sometimes Same talks ,same happy attitude, never sad face or complaints. Never asked me for any money.He retired and started doing part time work. This a guy, who had hardly any money, needed $100,but had conscious to return it, and was still very happy. And I see every day people , doctors , who have 10 times more money and are still unhappy .So the happiness is state of mind and not dependent on amount of money that one has nor on any external sources. 

Sunday, July 20, 2014


       I was attending a lecture on Hinduism.The swami coated a shloka from the Bhagawat Geeta, in which the lord Krishna says that whenever there is disappearance of the religious values and increase in non virtuous  behavior., the Lord comes to the earth to 'save' the religion.This is called the AVATAR.In Hindu mythology , there are number of times that the God comes in this world to help good and take care of evil.The Indian believe that there are many saints or swami , who are reincarnation of the lord or Avatar. But there are 10  Avatars which are well known . These are called  Dash avatar. The  God can come in any form in this world. It does not have to be in human form. This concept is seen only in Hinduism and not in any other religion . This may be due to the Indian concept that the everything that is in this world has reflection of the God. Let me explain . If we believe that this entire universe was created by the God and there is nothing which came without him, then everything has to come from him , which means everything has to have HIM in it. I van make a wooden  table. Then I can get a piece of wood, which is not part of me and make a table out of it . The wood is not part of my body . But if the God made the wood , it has to come out of Him as there is nothing outside of Him.So it is not surprising that the Avatars are of various kinds and not all are in human forms.
       So how do you explain this . Well there are various types of Avatars, We believe that all of us of the element of the God, so when someone gets to a higher level, or becomes a Saint, then he is like Avatar, but not a complete Avatar. They are 'born ' to increase the understanding of the religion and increase the good behavior.Then the Avatars like we have the forms which are less than Human beings , are also Avatars . But they are on the earth for only one purpose ans again are not 'complete' Avatars.But what is interesting about the ten Avatars. The first is a FISH form , the second is the TURTLE, the third is Varah , and fourth is mix form of LION and Human.(called NARASINH), then is VAMAN, then is PARSHURAM , then is RAM , and then is Krishna and then BUDHDHA  then is KALA KI.It is interesting to know that in every cycle, there were human beings. But the form that the GOD came in to save the world, was in different forms .Please remember that the there Avatars were not complete . So the 1st one was in form of fish, the 1st life form that came on the earth. The second was the form of turtle , evolution from the aquatic form . The third was an animal form , further evolution , then came half man -half animal , the Narasinh,.Then came a short human being, another evolution, then was the human being with weapons, the Parshuram , then was the king RAMA , another step in evolution.Then was the Lord KRISHNA. So there appears to be a progression in the different forms , almost like what is described in Davin's theory of evolution. I am not sure if this just by chance or well thought out progression or REALLY, REALLY what happened.
       I just wanted to tell you that this is not my idea, but I had read it some where and thought that it was thought provoking . And if the HINDUS thought about this many years ago , they certainly knew about the evolution , long time before the Davin thought about it.The difference between HINDUIS and other religions is that , Hindus believe that all of us have element of the GOD , and all of us have ability to as close to the GOD as was JESUS. Certainly it is not easy and not even one in million may get to it , but in the world of quantum world, where everything is based on probability, we can be as good as JESUS, may not be in this life , but may be in 100 lives down the road.

Sunday, July 13, 2014


      I have been in medical practice for many years. The medical practice has changed in last few years. Many doctors are feeling that patients are more educated and demanding .I feel that educated patient is better than uneducated patient.This does not mean that all the patients are good or bad. I like patients knowing their diagnosis, getting interested in the treatment and know the prognosis. I have had good patients most of the times . I think many or may be most would come to me if given choice . So when someone says 'thank you' ,i like it and it makes my day.I have been given few strawberries, from their backyard to pecans that some one bought for me as they thought that I would love to eat. I have had 84 years old husband of my patient come to my office and show me how to build a stage for a play and offer to do it when I am participating in a play. I have been given books , scripts and many other things as gesture of their good will and expression of their gratitude.I REALLY REALLY DO APPRECIATE ALL THIS AND FEEL PRIVILEGED TO HAVE THESE KIND OF PATIENTS . But the story that I am going to tell is little different.
     I was called to see this patient ,who was admitted to the hospital with respiratory infection.It was 5 pm and I was not very keen on going to the hospital late in the evening. But the patient was one of the doctor's relative . He called me at 5 pm. He had seen her ,the patient 3 days ago for sore throat and given her an antibiotic.She was not feeling any better and so he decided to admit her . So I had no choice but to see her .When I went to see her , I was glad to have gone to see her . She was admitted to regular ward.She was 18 or 19 years old and had no other history. She was not a smoker or alcoholic or drug addict.She had no previous history.She was quite short of breath and her oxygen saturation was low. When I saw her the chest X-ray was done and when I saw it ,I knew as to why she was short of breath.The X-ray showed extensive pneumonia.I called the referring doctor, who was her relative and also put a call to infectious disease doctor. I transferred her ti intensive care unit and after the cultures ,put her on 3 antibiotics.I spoke to the infectious disease MD and he agreed with the antibiotics that I had started . I called the parents and  told them the seriousness of the diseases.I told them that she may get worse and we may have to put her on ventilator.I was however was hopeful that we had started her on treatment soon enough and she being young and with no other previous history, she would improve.I was wrong.She continued to get worse and also had other issues . She was mildly anemic and had developed kidney problem.She ended up on the ventilator and continued to get worse . Her need for the oxygen was getting worse and I had to sedate her . As the need for oxygen and ventilator support got worse that we had to paralyze her.With the need for ventilator getting worse and her lungs becoming stiffer , it blew up and collapsed and we had to put in a chest tube to treat collapsed lung. We had all sorts of consultants on case and we must have put in 4 chest tubes at different times .She needed tracheotomy as we could not wean her down the ventilator for more than 2 weeks. She had several tubes and catheters and lines,that she was on constant sedation drip.All the cultures were negative and the antibiotics were not effective . I had done the bronchoscopy and it did not add any thing to our understanding of her diagnosis. I had started her on steroids and before I  had done some blood tests for a condition called Wagner's disease. This was a long shot and I had thought about it due to the kidney issues and lung infiltrates.Withe cultures being negative I was not sure as to what was happening.
     To my surprise ,the test came back positive . I don't know how many times I must have called the parents and told them that I am not sure if she was going to" make it "We also had to do feeding tube . She was in ICU for may be 6 weeks .I had started her on large dose steroids and she had gotten little better, but not enough. So with the consultation with the kidney specialist, we started her on immunosupresants .There was a risk. Risk of infection ,but also that suppressing ovulation. This was effective and slowly we started seeing an improvement. She did have tracheotomy and was on ventilator and we were able to wean down the support.I was talking to the family on daily basis. This may have been due to the language barrier.The mother did not speak English at all and I did speak her mother tongue fairy well.She was off the respirator and had started feeding on own. Physical therapy was started.She was discharged .and was followed by the kidney doctor. The continued her medication for the Wagner's disease, and steroids were reduced .       She did very well and was off the steroids. She became a nurse and started working in the same ICU where she was admitted for almost 2 months.She got married and moved to PA. I had seen her parents few times , but it was in a social meeting where there were hundreds of people. So the talk was not much. Then I had a call that she was in town and wanted to see me  and if she could come to my house . I said OK and she came to my house . When we opened the door ,I was pleasantly surprised.SHE HAD HER TWINS WITH HER !!. She was off all the medicines and got pregnant and the kids were healthy. She came to my house to personally thank me . This was the biggest reward to me.(from the GOD) 

Saturday, July 12, 2014


      We often say , "what a coincidence".But I think we sometimes use this when we are not expecting and we are surprised to see something ,rather than real coincidence.Or may be both do hand in hand. We are surprised and it is truly coincidence.I was talking to a friend of mine from New Jersey.One of my classmate's daughter was dating a another young man.As they started getting little more serious, he came to see the father of the girl.So the usual conversation progressed,the father asked the boy as to what does his father do ?So the boy answered that he was a physician. Since both of them were Indians , the father asked as to which medical school he went to. It was the same medical school that the father had attended. So he asked the name of the father of the boy. As it turned out , the father of the boy was the classmate of the father of the girl and both knew each other quite well.So the kids of two friends were dating each other and they did not know that the two parents knew each other. Is this a coincidence or did it become coincidence as it was not expected? The story that I am going to tell is one such story.
    It was Saturday .So I was going to go to the hospital late.I got a call on my home phone line . The caller asked if it was xxxxx"s residence .So I said yes . Then he told me that he was so and so and was visiting Orlando. He was from Washington and had some free time and wanted to know if he could come to my house.He got my telephone number from telephone book.We  both were Indians and spoke same language and he somehow knew of me .I agreed and gave the direction to my house. I went to the hospital and when I came home he had just arrived.
     He was a 55 years old , who owned a business and had sold it a larger company.He was consultant for the company. So he was visiting the local manager. He told me about his family and asked me about mine and then we had a lunch. Around 4 pm he left. His manager was living on our side of the town and he got direction from me.(this was at the time when cell phone weighed 10 lbs!!).I have not heard from him again.
      That night I had a call from ICU for a new patient. It was 1 or 2 am and this was a 21 years old girl, who had a cardiac arrest.I had to go to see  the patient.I went to ICU. She was 21 years old , who was at home with her boyfriend and had a cardiac arrest. Many a times in these cases it is a drug related cardiac arrest . The Saturday night, boyfriend -girlfriend together, cardiac arrest, I had seen these cases many a times. But in these cases the boyfriend (or girl friend) usually 'dumps' the patients in ER and are no where to be found.In this case He was there and to my surprise the urine drug screen --testing urine for the drugs was negative .The girl was unconscious,not breathing over the set rate of the machine.The X-ray showed mild congestion.Most of the times when someone loose the consciousness,they may vomit and can get aspiration,i.e.stomach contents going in the lungs . So I started her on the antibiotics. I also ordered the echo cardiogram , ultrasound of the heart and then talked to the family . The both parents were present along  with the boy friend.I told them that main thing was to see how her brain recovers. It may take some time.In between we will 'support'her on respirator.
     The next day I saw her . She was still unresponsive .I got the echo cardiogram report. And I was surprised It showed that her heart was very weak.The pumping action was 10 %.So most likely she had weak heart , which was not known , and that caused the cardiac arrest. (sometimes a viral infection can affect the heart and make it weak. This is reversible in many patients.)But in case of this young girl it  caused cardiac arrest and it has caused the brain damage . Unless the brain recovers , nothing can be done . So the days passed . We had neurologist see her and she had brain wave recording. After about 7 days , there was no change and she was not breathing on her own and brainwave recording was very very slow and was not encouraging.I was  talking to her parents and family.We talked about the prognosis and poor out come.We talked about the withdrawal of the life support.It was very hard for me even when the patients are 'old'. This was a 21 years old patient.I was not too sure how can I console them . In these types of situations , no matter what one says , it is not going to be enough. You can not reduce the grief.But I did bring in the Indian philosophy or the concept of the soul being immortal and the concept that as we change the clothes , the soul changes the body.So the father asked me if I was Indian(Hindu). I answered yes. So then he stated that his 'boss' was Indian too.So asked for his name . He said 'you would not know him as he is not local'.I knew. I asked him if he was from Washington ,and his name was xxxx.I was not surprised when he said yes.
     So the guy who came to my house, whom I had not seen or known before, was his boss. And the manager that he went was the father of this 21 years old patient who was dying(or was dead).
                                   THIS IS COINCIDENCE.

Friday, July 4, 2014


    I have often heard the debate on the health care.We in US feel that there is rationing of health care with HMO or by any insurance company or by government. But we are unaware of the medicine that is 'practiced' in other countries.Again the things have changed in many countries especially India .But many years ago when I was in India it was very different, if not difficult.Please note I am talking about the time when there were no CT scans , or PET scans or even ultrasound examination, not even in US.So the medicine was more clinical and certainly local . In India for example the commonest cause of iron deficiency anemia was Hook worm infestation (and excessive menstrual blood loss),and not gastrointestinal blood loss from cancer of colon or bleeding ulcer like in this country.The commonest cause of fever with chills was Malaria and not other infections . There were limited X-ray plates available for use and not a unlimited quota.So the decisions were made clinically and treatments were also not as advanced or as good as it is today . So I still remember some patients that created' hole ' in my heart RAMILA is one such patient.
    I was working in medical ward.We had admitted a young girl , about 14 or 15 years old ,with abdominal pain.She was cachectic looking and probably weighed may be 50 lbs.She was not eating for last 3-4 months as she was nauseous and when she was forced to eat she would throw up.Her examination showed 'clear' lungs.Examination of belly was interesting. It is called "doughy "feeling . This is reported in Tuberculosis in the intestine or belly. This is not seen in countries where milk is Pasteurized.But in many parts of India people get milk from cow directly and not from dairy . So if the cow has TB,the TB organism will be in milk and are nor killed and can infect the intestines of the human beings that consume the infected milk.Ramila got it.
    We started her on treatment . In those days , the treatment of TB was with 3 drugs in pill form and one injection daily. Ramila had no muscles , but she needed the shots. So we continued them . The pills were of 3 kinds . The dose of one of the medicine was 3-4 grams 4 times a day . These are big pills and you have to take such a dose 4 times a day . Even the patients with TB of the lungs , who do not have any stomach problem or nausea , vomiting , also don't like this drug and have problem with taking it.Ramila had hard time and would vomit.She continued to be treated with some success.After being in the hospital for almost two to two and half month, she was discharged.I had hard time convincing the father that his daughter was ready . She had gained may be 15 lbs.She was able to eat.I told the father that if she had any problem he can bring her back and I will take care of her.
   We use to see patients in ER one day a week . There were 6 other units that were taking turns on taking the ER rotations.About a month after discharge, I saw him in the ER .He had brought Ramila . She was throwing up and could not keep anything down.She looked dehydrated. Her eyes were sunken.I was not too sure as to what I could do . But he wanted me to admit her . He told me that' he was not going to take her home '.He told me that 'she is your daughter and you MUST help.'Think about it. I was 23 years old and he was may be 35 years old . He wanted me to do 'screening'.Since we did not have enough X-ray films, we used to do fluoroscopy , which was called screening.I did the screening or the fluoroscopy.It was surprised me .I saw what is called 'air-fluid levels.'This was indicative of intestinal blockage. I had to admit her , but not under medical unit , but under surgery unit. She was going to need surgery , if she did not get better within 24-48 hours.With her abdominal TB , the hope that she was going to improve was low.
    She was admitted to the hospital. I had personally spoken to the surgical resident I had told him to call me when she would be going for surgery. The first 2 days after the ER call are very busy ,especially since we had no limit on how many patients were admitted . We used to have floor beds.Which meant we had beds in between the two cots . There was award system and there were limited number of cots or beds . If we had more than that number , we would put a mattress in between the two beds . Once we discharged enough patients , which usually occurred in next 2 days , every one got the regular bed.So I got some time to see Ramila after 2 days . I had not gotten the call from the surgical resident, So I had presumed that she must have improved . But when I saw her I was surprised. She was still quite sick and still had abdominal distention.The X-ray had shown that she was blocked . So I was not sure why she was not operated. I spoke to the nurse and then to the doctor. The father HAD REFUSED THE SURGERY. I was shocked. I told the nurse to call me as soon as the father came to see her. I got call that evening . I went to talk to him . He asked me if I was sure that she was going to be cured or we were going to go through the same problem of nausea, vomiting and loosing weight.I was speechless . Only thing that I could 'promose' him was that the blockage was ' likely ' to get better. There was no guarantee with her abdominal TB . He told me that the girl had suffered enough and if the GOD wanted her to 'live' she would come out of this without the surgery. With the passing time I was not too sure as to if she would survive the surgery now or we would just prolong the inevitable.
                                  Ramila died in next 36 hours.
                        Nothing that I could do would have saved her.