“Better” and “The Checklist Manifesto”

I chanced upon a book called “Better” by Dr. Atul Gawande while browsing in a small bookshop in Rangashankara a few months back. The synopsis looked good, and I picked it up for casual reading. And what a find it was!

Dr. Atul Gawande is a surgeon at Brigham and Women’s Hospital in Boston, and has written extensively in The New Yorker and Slate about medicine and public health. I later also read “The Checklist Manifesto” by the same author, and was very impressed with his writing. Some of the content in the books includes material from his essays. Both books are extremely lucid, and very understandable for a layperson like me. I have not yet read his other books like “Complications”, which are next in my to-read list.

Better” contains a bunch of thought-provoking essays, which deal with various important non-clinical issues in medicine. These articles include topics like the necessity of washing hands when dealing with patients, the enormity of the task of polio vaccination and eradication, the surgeons that deal with war injuries, the dilemma of doctors who are asked to administer the drugs for a death penalty, dealing with insurance and litigations, etc.

The Checklist Manifesto” describes his efforts to promote the use of checklists in the healthcare system in the United States. He uses a number of convincing examples from a variety of fields such as flight pilots in the aviation industry, the construction industry, etc. Just making a laundry list is not enough though. It needs to be structured and worded properly so it is actually useful.

One example given in the book has really stuck with me. He talks of a successful revival case study of a little Austrian girl who had drowned in a pond in the Austrian Alps and was beneath the surface for 30 minutes, and whose heart was not beating for 2 hrs. The checklists and procedures that were put in place by the team of doctors in that remote hospital played a crucial role in executing a perfectly choreographed rescue operation involving a thousand different steps to be performed in a particular order. You can read more about this excellent case study here.

If you like reading medicine related articles/books, I would strongly recommend reading “Better”, as well as some of the articles on his website, www.atulgawande.com.

Long Walk to Freedom

One of the greatest leaders of our times, Nelson Rolihlahla Mandela aka Madiba, was born on this day, 96 years ago. On this occasion, Google has put out a beautiful doodle. Last month, I finally got around to reading his excellent autobiography- “Long Walk to Freedom”. This is probably the best autobiography I have ever read. I think it gives a wonderful insight into the life of a charismatic leader.

The book is very lucidly written and flows very smoothly. It is a very candid and detailed account of his life. His vivid descriptions of his early childhood, his college years, his various escapades, his activities in the African National Congress, his numerous trials, his underground life, his militant activities etc are very interesting to read. He has of course described his successes in great detail. But I was very impressed to see him owning up to his mistakes, his prejudices and his shortcomings as well. His political ideologies, and their evolution over time, based on changing circumstances, are penned well.

His descriptions of his years in Robben Island are unparalleled. What stands out is his resolve to not be broken by the 27 years of oppression in prison, and his determination to come out of it with the will to lead a nation on a path devoid of apartheid. A quote from Invictus comes to mind, where Francois Pienaar says of Mandela: “I was thinking about how you spend 30 years in a tiny cell, and come out ready to forgive the people who put you there.”

After Robben island, when he was moved to Pollsmoor prison and later to Victor Verster prison, he had various rounds of negotiations with President De Klerk for the abolition of apartheid. These are covered in good detail, culminating in his release in 1990 and the first ever multi-racial election in 1994, when he became the first non-white President of South Africa. I would have liked his Presidential years to be covered in the book as well. But that period was excluded as this book was published in 1995, and the sequel was never published.

Finally, a quote from the book that illustrates the great person that he was:

Prison and the authorities conspire to rob each man of his dignity. In and of itself, that assured that I would survive, for any man or institution that tries to rob me of my dignity will lose because I will not part with it at any price or under any pressure.

I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one’s head pointed towards the sun, one’s feet moving forward. There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair. That way lay defeat and death.

Mumbai Half Marathon 2014 – A Must-Do for any true Bombayite

In January 2014, I finished the Mumbai Half Marathon, which I think is the best half marathon route to run in India. Of the 21km route, almost 14kms are along the Arabian sea- on the Bandra-Worli sea link, the Worli sea-face, and Marine Drive. Additionally, for a true Bombayite, the sea route, along with landmarks like Nehru Planetarium, Mahalakshmi Race Course, Haji Ali, Peddar Road, Churchgate station, Victoria Terminus (V.T., now C.S.T.) station etc. bring back a flood of memories. It is a very well organized run, with enough provisions of water, energy drinks, glucose biscuits, orange slices etc. I took a long time (3 hours) to finish the route, but every minute was well worth it. It also gives me a good chance to better my personal record next year. Did I say next year? Of course- you do this route once, and you will want to keep going back to it every year!

Mumbai Half Marathon 2014- I did it
At the finish line

 

A more detailed report of the run follows.

After a long hiatus, I got back to some serious running in 2013. Having completed the TCS World 10K run in May 2013, I was looking for a more challenging course. I had heard a lot about the Mumbai Half Marathon, and was thinking of doing it for the last few years. I was finally feeling in good shape for a half marathon, and therefore signed up in September, as soon as the registrations opened up.

Then started a long training season, with my gym instructor, S, assigning weekly workouts, with long runs starting from 5K to 18K. I felt quite comfortable with the training until early November. After that, with a couple of trips, as well as lots of guests to entertain at home in December, I messed up my training schedule. Additionally, I fell ill in January for almost a week, and was feeling rather weak until a couple of days before the run. I was wondering whether I should cancel the trip. But giving up without trying is very uncharacteristic of me, so I decided I’ll run as much as I can and walk the rest of the course. Plus, I really wanted to experience running on this beautiful route.

So with a lot of nervousness, I got up early in the morning on 19th Jan. N’s dad dropped me at the starting point in Bandra, about 45 minutes before the race. Not heeding my friend’s advice of getting there an hour before start costed me a lot. By the time I got there, it looked like all of Mumbai had descended on Bandra. In fact, the lines were so long at the entrance, as well as for the porta-potties that I got to the start line just as the race was being flagged off.

John Abraham flagged off the run, and this whole mass of ten thousand participants started streaming onto the Bandra-Worli sea link. It was the most beautiful sight I had seen in Bombay. We ran in the moonlight on the sea link- a stretch which is never open to pedestrians. The sea breeze was very refreshing and I had covered the 5.5km on the sea link at a good steady pace, moderated by the sea of people I was running with. We saw the break of dawn just as we were finishing the last stretch of the sea link.

We then came to the 4km internal loop in Worli, which according to T was a fun part, with onlookers cheering you on. Although that was true, it was also very boring to run in between tall buildings, with no sight of the sea. I guess the 5km on the sea-link had already spoiled me. Eventually, this internal loop turned out to be surprisingly slow for me. After the loop ended, I picked up my pace as soon as I saw the Worli sea face looming ahead. I ran the 4km stretch to Haji Ali in no time, after passing by Nehru planetarium and the race course.

Then came the most difficult stretch of the run. Anyone who has been to Peddar Road can immediately visualize the huge slope that is a killer even when one is walking. Imagine the plight of a runner who faces the slope after a 14km run. I knew this was going to be my weakest spot; so I gave up running and started walking up the slope. The folks handing out orange slices, water and energy drinks brought a good smile to my face at that point. Finally when I hit the downslope, I picked up the pace to make up for the lost time, until I got to Marine Drive.

By the time I reached Marine Drive, the sun was up (though thankfully blocked for the most part by buildings on the left), and it was getting hot. It was quite difficult for me to maintain pace at that point. There were a bunch of radio stations playing some good music, and I ended up half-running, half-walking that stretch. Finally when I got to Churchgate station, I knew this was the last stretch, and tried to run as much as I could.

In the event, I was happy that I managed to complete the half marathon without any issues. I was happy to see my parents as well as N’s dad and aunt at the finish line. And happier to see my mom finally acknowledging that I could run this distance without getting knocked off. In fact, at the end, I had enough strength left in me to walk another 2km till the car parking area.

Overall, an awesome run- one which I will continue going back to, year after year, as long as I can!

On Cows and Poojas and Apartments

I am back, after a 10-month hiatus. I have been meaning to write some post or the other, but was just too lazy to write. But today, I just had to write; I had no choice on the topic!

About a couple of years back, when we were booking an apartment on the 18th floor of a building in a gated apartment complex, a colleague reflexly and very sincerely asked me (paraphrased)- “But what will you do for the go (cow) pooja? How will you take a cow to your apartment on the 18th floor?” I was totally nonplussed. The question was too funny and weird for me to handle. I just responded that of course we are not doing any of that business!

And then today, this email (from someone on the 10-odd-th floor) lands in my Inbox, on the mailing list of the apartment complex that I stay in (paraphrased)- “We are looking forward to perform our gruhapravesam in XYZ month. As a part of the ritual we need to perform the “Go pooja” (cow pooja). Are we allowed to bring the cow inside the campus?”  This is way too hilarious! I had no clue someone would actually, seriously think of doing something like that!

Google India Women in Engineering Award

The Google India Women in Engineering Award is entering it’s third edition. The goal of the award is to encourage, recognize and reward deserving female students in Computer Science, and to inspire them to contribute to technological advances. Cash prizes of Rs. 100000 will be awarded.

Female students pursuing Bachelors, Masters and PhD degrees in Computer Science in an Indian institution are encouraged to apply. The applications are to be submitted by 31st Oct, 2009. More details can be found at the awards’ site.

This is an excellent opportunity for female students in CS. Please get the word out and encourage eligible candidates to apply.

On Winning the Parent Lottery

The title of this post refers to a statement from the book and the talk, “The Last Lecture“, by Randy Pausch, a Computer Science professor at CMU, who had pancreatic cancer, to which he succumbed in July 2008. In his book, Randy talks about how you have don’t have any control over who your parents are, and how they influence your life the most in your formative years, which in turn determines to a large extent, the shape your life takes.

Recently I read three books on stories of women oppression- “A Thousand Splendid Suns“, “Not Without My Daughter” and “Princess: A True Story of Life Behind the Veil in Saudi Arabia“, based in Afghanistan, Iran and Saudi Arabia respectively. All three are excellent books, and I highly recommend reading them all; especially the first one. I shudder to think what would have become of me if I were to have been born in a family/country that had no concept of women’s rights whatsoever.

I feel *so* lucky to have been born and brought up in India, by excellent, very well educated parents who have been most supportive and encouraging of all my ambitions, my goals and my interests in life. I very much consider myself to have won the parent lottery, hands down.