Have been puzzling over the treatment for cancer that is available for people who are visited by the disease. There is chemotherapy and there is radiation. and if one is lucky, in a manner of speaking, chemotherapy and radiation are prescribed as adjuvant therapies. This means that one can have surgery and excise the cancer growth at any particular site, get rid of the existing cancer and then follow either or both methods to prevent the recurrence of cancer again in any threatening re-infestation.
The good thing about cancer is that if it is detected early, the chances of survival are strengthened. However, the therapies prescribed to help survivors of cancer who have had surgical intervention remain as scary as ever. Chemotherapy is intimidating because the very notion of going in to attack the cancer cells with all guns blazing and bombing every living cell in the body is a terrifying and terrible project. Chemotherapy subjects living cells and marrow to a blitzkreig and creates a collateral damage that is reminiscent of war by a superpower out to annihilate some small voiceless nation which can only cower in fright. Not very surprising, if one were to recall that the protocol for cancer treatment really comes to us from the US and Europe. Alternative treatments, practised outside of the allopathic system, however varied, suffer from inadequate monitoring and documentation and are at best only seen as preventive strategies, never as curative options.
Yet even within prescribed and valorised systems of allopathic cure, grey areas persist. For instance you could have a small carcinoma of the breast and elect to have a lumpectomy. If you have more than one tumor, this is termed multi-focal cancer and usually the total removal of breast is recommended as multifocal cancer indicates an aggressive cancer and normally, after a mastectomy, chemotherapy is prescribed.. There are a series of tests that the retrieved cancer tumor is subjected to. It is checked for IHC, for HER-2 and then there is another test, the latest gold standard that is called the Onco type DX test. Examining tumor tissue at a molecular level, the OncoDX test predicts the likely benefit of chemotherapy and the possibility of the recurrence in early stage cancers of both the breast and the colon.
Cancer treatment is expensive and simple tests like the IHC and the more complex Her-2 are expensive. However, they are now available here in India. Unfortunately, facilities for Onco DX testing for tumors, the Medical Oracle for Chemical Oncologists, do not exist in India. Samples have to be sent to America and some of New Delhi's posh hospitals offer such privileges. The costs of this test are so prohibitive that 79 out of the 80 people who are afflicted by cancer cannot even think of getting an Onco DX test done, which could accurately predict whether they actually require chemotherapy or not. Access to this test would allow them to escape the toxicity of chemotherapy and its attendant traumas , as well as bypass the unnecessary aggression that is waged upon the hapless body.
For me, this is a significant discovery as i learnt recently that a multifocal tumor could have really low scores on an Onco- DX test. Chemical Oncologists in India and the US hastened to tell me that this was a unique occurence. One is too much a product of a scientific age to believe totally in miracles, but i wonder if the uniqueness of my case really lies in my access to this test? What documentation do we have on multifocal node free breast cancers in our country which were subjected to the Onco-DX?
The test itself has only been around in the last few years, but if we are working with Indian demographics, the number of people who may have benefited from this test could have been enormous. Given the fact that breast cancer is one of the more prevalent forms of cancer in our country today, we need to view Onco DX analysis with far more seriousness. It is possible that if this technology had been made available in India. we would have a different set of readings and perhaps a new protocol for treatment based on a different data bank. So a low Onco DX reading in a node negative multifocal tumor might not be a unique case given a different set of statistics. For something like this to happen, or to even move from being a mere idea, we need this technology here and now. We need it to be available, affordable and accessible! Our Medical Research Institutes and Health Ministry Pundits need to do some urgent jugaad in the matter!
Tuesday, October 5, 2010
Wednesday, September 15, 2010
Food From The Head
Our prime minister visited The Golden Temple last year for prayer and thanksgiving. This year while laying assorted foundation stones, he also visited the golden vimana enshrined deity of the Tirupathi Temple. Lends a very nice touch this, the head of a modern nation, recognising the diverse traditions that make up our motley democracy, not being overwhelmed by them and standing amidst temple officials looking as unruffled and calm as he always does while attending to the onerous duties of the state.
Of late though, he seems to have been deeply influenced by two persons, the chap in a suit with a cigar, who first said "there is no such thing as a free lunch" and his savvy long fingered nephew Baxbaum who coined the expression "if you think you have someone eating out of your hands, it would be a good idea to count your fingers!" I can attribute no other reason to the prime minister's recent pronouncement except the overwhelming pressure exerted by the aforementioned fellows. I wonder if this could be the much reviled foreign hand after all. Why else would our Prime Minister chide the Supreme Court for its order that the food which is rotting in the government godowns be distributed free to the poor? Our dispensers of fair justice must have felt like overambitious schoolboys who had mistakenly turned in completed assignments without being asked for them.
When the serene sevadar of the Har Mandir finishes distributing karah prasad (that fragrant, delicious and warm concoction of semolina brown-roasted in ghee and sugar) into numberless stretched out hands, he has never needed to check if he has lost any fingers at the end of the day. This would be endorsed by all the karsevaks at the langar who voluntarily cook for 2000 people every day. The act of providing free food is an every day happening at the countless places of prayer and worship in our country, at innumerable temples and ashrams, where visitors get not only free lunch, but even have free breakfast and dinner thrown in. In fact, one of the good things about most religions is that poor feeding is listed as mandatory activity for all practitioners.
So, Manmohanji, dont listen to these two newly arrived economic advisors who seek to dim your free thinking by loudly humming the right notes on policy formulations. They dont even know that in India we do not own social security cards with which we can claim our due as citizens. This is especially true for that 37 percent population which our new statistics have demarcated as poor. Should n't be so difficult to identify them. By now they should all have their own BPL cards ready.
Please give them the food that will otherwise only decompose in our granaries Manmohanji..
As a gesture from the state it is not even incumbent upon us to ensure that the food is cooked.
It only needs to be edible.
Of late though, he seems to have been deeply influenced by two persons, the chap in a suit with a cigar, who first said "there is no such thing as a free lunch" and his savvy long fingered nephew Baxbaum who coined the expression "if you think you have someone eating out of your hands, it would be a good idea to count your fingers!" I can attribute no other reason to the prime minister's recent pronouncement except the overwhelming pressure exerted by the aforementioned fellows. I wonder if this could be the much reviled foreign hand after all. Why else would our Prime Minister chide the Supreme Court for its order that the food which is rotting in the government godowns be distributed free to the poor? Our dispensers of fair justice must have felt like overambitious schoolboys who had mistakenly turned in completed assignments without being asked for them.
When the serene sevadar of the Har Mandir finishes distributing karah prasad (that fragrant, delicious and warm concoction of semolina brown-roasted in ghee and sugar) into numberless stretched out hands, he has never needed to check if he has lost any fingers at the end of the day. This would be endorsed by all the karsevaks at the langar who voluntarily cook for 2000 people every day. The act of providing free food is an every day happening at the countless places of prayer and worship in our country, at innumerable temples and ashrams, where visitors get not only free lunch, but even have free breakfast and dinner thrown in. In fact, one of the good things about most religions is that poor feeding is listed as mandatory activity for all practitioners.
So, Manmohanji, dont listen to these two newly arrived economic advisors who seek to dim your free thinking by loudly humming the right notes on policy formulations. They dont even know that in India we do not own social security cards with which we can claim our due as citizens. This is especially true for that 37 percent population which our new statistics have demarcated as poor. Should n't be so difficult to identify them. By now they should all have their own BPL cards ready.
Please give them the food that will otherwise only decompose in our granaries Manmohanji..
As a gesture from the state it is not even incumbent upon us to ensure that the food is cooked.
It only needs to be edible.
Saturday, September 4, 2010
Teachers in kind
Kapil Sibal as education minister is very different from his predecessor Arjun Singh although both took office with the Abhayahasta Mudra ( why fear when the hand is there)centrestage. Arjun Singh displayed near complete immobility on most issues while his successor Sibal is from the opposite end of the spectrum. In fact, if Arjun singh has been immovable, Kapil Sibal has been virtually unstoppable.
First he thundered that there were to be no Class X exams. Moment of relief for stressed parents, super achieving kids and all those harassed kids whom the system does everything it can to keep out. Time for a change especially as the first set of class X exams were held in 1977. Ideally over a period of 8 to 10 years, feedbacks need to be collected, tabled and incorporated towards the better functioning of the system itself. It is very possible this has been slow and fraught with difficulties. Given the funds alloted for education in our budget, this should not evoke monumental surprise.
Kapil Sibal, however is a man who will not allow any grass to grow under his feet. He wants change and his notion of change is dramatic, and in keeping with generation Y, is also required to be instantaneous. So change it is! Class X exams are to phased out, made optional and from 2010 onwards they will carry no marks, only grades. One year of such a board process has taken place. I am still quite puzzled as to how the awarding of grades instead of marks will alter the quality of education that we provide and transform it into something truly empowering? Surely as educators we must concern ourselves with the quality of education that we provide? Also perhaps with exactly how this is being dispensed? In the seventies and the eighties, we were educated largely within our schools, both public and state aided. Prodigies who sang and danced received parental support and training largely outside the school. This was also perhaps true of our best sportspersons. Schooling now is a very different ballgame. Schools welcome children as part of a programme to initiate them into the workings of social life. They feed the children, teach them to cipher and to sing, involve them in cultural extravaganzas, have all sorts of educative entertainments lined up for them, introduce them to reading and writing and language and when it is time to really hone interests and provide some direction for the child, they simply let go.
This is where tuition centres step in as indispensable crutches to higher education.
This year too, despite the abolition of marks, tuition centres, individual and group are chock a block with students in each year of their senior secondary education. These are not to be confused with coaching centres for entrances to the engineering , medical and technological colleges. The tuition centres I speak of are helping children understand all the maths, physics, chemistry, economics and commerce they cannot fathom at school. Meanwhile there are personal tutors for the languages, national and international. So today's young student studies by rote almost twice as much as my generation did, because they learn the same thing twice over. It is true that the majority of our school teachers are an overworked and underpaid lot. So if thoughtful parents wish to ease the pressure off regular school teachers and cough up money to tutors and tutorial centres, this gesture of philanthrophic solidarity must not be tampered with.
What we really need to do is to augment the corporate spirit our secondary education has been displaying for some time now.
We could use the occasion of teacher's day to get the government to announce new schemes to bolster the health of secondary education. Maybe we could petition Kapil Sibal and request that tuition shops be declared centres of excellence forthwith. Once this is done, these centres can be authorized to issue CBSE degrees in the subjects they teach, after a requisite written examination. This will enhance the self-worth of the Tuition Centres and the tutors therein engaged and enable them to set new benchmarks and aspire to greater heights. This will also solve the dilemma of numbers that the CBSE Examination Board annually grapples with, namely the correction of an enormous amount of examination papers at breakneck speed under diverse regulations by anyone who is available. We should also authorize our schools to issue certificates stating that their students were part of all school activities, barring specific subjects from nursery to class X or XII, whichever is applicable. This will ensure that there will be no bad blood between schools and tuition centres, since now they can officially feed off each other. Student loyalty, emotional quotient and commitment to core values can be deduced by the certificates handed out by the school while their academic potential or its absence can be gauged by the marks issued by the tuition centres.
Ratna Raman
First he thundered that there were to be no Class X exams. Moment of relief for stressed parents, super achieving kids and all those harassed kids whom the system does everything it can to keep out. Time for a change especially as the first set of class X exams were held in 1977. Ideally over a period of 8 to 10 years, feedbacks need to be collected, tabled and incorporated towards the better functioning of the system itself. It is very possible this has been slow and fraught with difficulties. Given the funds alloted for education in our budget, this should not evoke monumental surprise.
Kapil Sibal, however is a man who will not allow any grass to grow under his feet. He wants change and his notion of change is dramatic, and in keeping with generation Y, is also required to be instantaneous. So change it is! Class X exams are to phased out, made optional and from 2010 onwards they will carry no marks, only grades. One year of such a board process has taken place. I am still quite puzzled as to how the awarding of grades instead of marks will alter the quality of education that we provide and transform it into something truly empowering? Surely as educators we must concern ourselves with the quality of education that we provide? Also perhaps with exactly how this is being dispensed? In the seventies and the eighties, we were educated largely within our schools, both public and state aided. Prodigies who sang and danced received parental support and training largely outside the school. This was also perhaps true of our best sportspersons. Schooling now is a very different ballgame. Schools welcome children as part of a programme to initiate them into the workings of social life. They feed the children, teach them to cipher and to sing, involve them in cultural extravaganzas, have all sorts of educative entertainments lined up for them, introduce them to reading and writing and language and when it is time to really hone interests and provide some direction for the child, they simply let go.
This is where tuition centres step in as indispensable crutches to higher education.
This year too, despite the abolition of marks, tuition centres, individual and group are chock a block with students in each year of their senior secondary education. These are not to be confused with coaching centres for entrances to the engineering , medical and technological colleges. The tuition centres I speak of are helping children understand all the maths, physics, chemistry, economics and commerce they cannot fathom at school. Meanwhile there are personal tutors for the languages, national and international. So today's young student studies by rote almost twice as much as my generation did, because they learn the same thing twice over. It is true that the majority of our school teachers are an overworked and underpaid lot. So if thoughtful parents wish to ease the pressure off regular school teachers and cough up money to tutors and tutorial centres, this gesture of philanthrophic solidarity must not be tampered with.
What we really need to do is to augment the corporate spirit our secondary education has been displaying for some time now.
We could use the occasion of teacher's day to get the government to announce new schemes to bolster the health of secondary education. Maybe we could petition Kapil Sibal and request that tuition shops be declared centres of excellence forthwith. Once this is done, these centres can be authorized to issue CBSE degrees in the subjects they teach, after a requisite written examination. This will enhance the self-worth of the Tuition Centres and the tutors therein engaged and enable them to set new benchmarks and aspire to greater heights. This will also solve the dilemma of numbers that the CBSE Examination Board annually grapples with, namely the correction of an enormous amount of examination papers at breakneck speed under diverse regulations by anyone who is available. We should also authorize our schools to issue certificates stating that their students were part of all school activities, barring specific subjects from nursery to class X or XII, whichever is applicable. This will ensure that there will be no bad blood between schools and tuition centres, since now they can officially feed off each other. Student loyalty, emotional quotient and commitment to core values can be deduced by the certificates handed out by the school while their academic potential or its absence can be gauged by the marks issued by the tuition centres.
Ratna Raman
Monday, August 30, 2010
our chief minister
I think Shiela Dikshit makes for great photo-ops. I love her tussar sarees in the cold season. I like the cottons she wears as well. I wish our president would discuss her wardrobe options with Shiela Dikshit and Sonia Gandhi. Sheila must make for a wonderful aunt. I am sure her near and dear ones are treated to orange lopchu tea with Monaco biscuits or crisp snacks and fresh cake when they visit, but what i cannot understand about her is her public utterances.
When young Saumya Vishwanathan was killed while returning from work Sheila sounded like a distraught grandmother providing interim domestic relief when she declared that young women should not go out in the late hours. She could have scored some brownie points if she had said "young people" instead of women and had drawn attention to damaged body clocks. At least she would have won the hearts and the loyalties of perennially stressed parents.
Then she took on the entire populace living on either side of the BRTS or driving through it. Travelling on the the bus lane ( in the centre of things) Aunt Dikshit declared that no traffic problems were being created by the BRTS. The BRTS is without debate one of the most wretched changes that have been introduced on Delhi's roads. Having given official sanction to the mauling of the premier stretch of Delhi's roads beyond recognition Aunt Dikshit turned her attention to the Common Wealth Games. She worked around the clock to effect clearances but ripped pavements and unfinished exteriors continue to plague our sight while all our service providers ranging from fruit seller to cobbler have been hustled off the roads.
Then after that intemperate brahmin cackled with malevolent glee over impending games disaster Dikshit took it upon herself to announce that anyone who was not for the games was not for the country. A slight modification of the Delhi police ( with you, for you, always)statement, this, but look at the deluge that followed. Enormous siphoning and misappropriation of funds were made public and this even made the British queen testy.Quickly forgetting Britain's hoary colonial rapacity, or perhaps seeing this as a historic occasion for redressal, the Queen denounced the 21st century attempts by her subjects to shortchange the natives.
That imperial command prompted all our investigating journalists to go home to sleep off the attendant weariness. Meanwhile, the rains continued to descend on us. Little water in our taps, but unquantifiable, 24 hour supply of it on all our roads. Driving below flyovers and underpasses, and on any road off the Ring Road equalled the experience of being in Venice on a Gondola. Except for the power that trips and is on the blink and the freshly reincarnated mosquitoes ( bigger and more lethal). But Aunt Dikshit blunders on quixote-like and announces that there are no problems at New Delhi. She goes on to croon Meri Dilli Meri Shaan and announces that we will have the best games ever.
I think i have finally solved the mystery. Aunt Dikshit lives in a wonderful city where the girls being good go to bed early, thereby bringing about a cessation in the crime graph. The civic amenities in this city are taken care of and every single inhabitant lives a happy life with abundant infrastructural support. The countless parks and sports stadia are dotted by storehouses where helpful attendants hand out sports equipment to our gamine young and eminent sports persons coach all our young talent, while the joyous populace serenades its administrators with hosannas. Shiela Dikshit cannot be the Chief Minister of New Delhi!
Ratna Raman
Saturday, August 28, 2010
visits from the magi
Rituparna, Aprameya and Anubhuti come to see me. Like the Magi they arrive, bearing gifts to preside over a new confinement. There are long stemmed red zerberas reaching out to the sky, a gauzy gold and translucent bag filled with chocolates wrapped in pastel metallic foil and chocolate fudge icecream, a flavour wherein Mother Dairy surpasses itself. We move upstairs and settle down and I catch up on their lives. Graduates now, Aprameya and Ritu are moving into top-gear and are enrolled for a Master's Programme In English Literature at Delhi University, while Anubhuti is in her second year of MA at Arts and Aesthetics at JNU and has a musical timbre to her voice that definitely evokes associations with vintage Shubha Mudgal. My life revolves around reading these days and so i tell them about my first blog, initiated by the event of getting my fingers in the way of the whirring mixer grinder.
All of them exclaim then. They had thought that bandaged fingers were part of the treatment for carcinoma. When i tell them it is an independent injury i have contracted they are in a state of disbelief as they had not wanted to draw attention to my "unwellness." Anyway over ice cream and home crafted khakra and tea we quickly laugh and share a host of other details about academia.
They leave shortly and it is time for me to meet my surgical oncologist who has had a long day. He doesn't notice my solidly bandaged three fingers at all, till i draw his attention to it. He is immediately contrite and concerned. Probably the repeated barrage of gauze and surgical cellotape has rendered him immune So while he is pronouncing the health or otherwise of my fingers, i tell him about my visitors of the day. He is very amused that such possibilities of non-knowing exist and he laughs and says "literature walone ki kya baat hai' and suddenly the air is light again.
Driving back home i wonder at the innocence and joy de vivre of my students and their palpable concern for me and the practical efficiency with which Harit Chaturvedi deals surgically with threats to bodily well being and this brings me back to my favourite rumination..,,when we distribute the spoils of education and give all the literature and the humanities to one section of students and all the physical and empirical sciences to another does this choice in effect develop some aspects of personality and push into cold storage other aspects? Should we rethink the paucity of options we provide for our students at secondary schooling levels..?
Ratna Raman
All of them exclaim then. They had thought that bandaged fingers were part of the treatment for carcinoma. When i tell them it is an independent injury i have contracted they are in a state of disbelief as they had not wanted to draw attention to my "unwellness." Anyway over ice cream and home crafted khakra and tea we quickly laugh and share a host of other details about academia.
They leave shortly and it is time for me to meet my surgical oncologist who has had a long day. He doesn't notice my solidly bandaged three fingers at all, till i draw his attention to it. He is immediately contrite and concerned. Probably the repeated barrage of gauze and surgical cellotape has rendered him immune So while he is pronouncing the health or otherwise of my fingers, i tell him about my visitors of the day. He is very amused that such possibilities of non-knowing exist and he laughs and says "literature walone ki kya baat hai' and suddenly the air is light again.
Driving back home i wonder at the innocence and joy de vivre of my students and their palpable concern for me and the practical efficiency with which Harit Chaturvedi deals surgically with threats to bodily well being and this brings me back to my favourite rumination..,,when we distribute the spoils of education and give all the literature and the humanities to one section of students and all the physical and empirical sciences to another does this choice in effect develop some aspects of personality and push into cold storage other aspects? Should we rethink the paucity of options we provide for our students at secondary schooling levels..?
Ratna Raman
Wednesday, August 25, 2010
Mean Kitchen Machine......
Was helping mom with a new garnish that she wanted to add on to chopped pumpkin. So mom took out my small grinder and loaded it with 5o gms of coconut shreds,1 tablespoon raw rice, chopped green chillies and a teaspoon of mustard seeds. She used a Sumeet mixer till it gave up the ghost and had no idea how to use my Panasonic super mixer grinder. This is a highly required gadget for the part time housewife and cook avatars that women don everyday. So i placed my right hand on the lid after the mixerjar was locked in,and switched on the mains. The button at grind one was already depressed and i didn't see it. The machine whirred at full speed, the lid slid off and before i could use my left had to switch off the mains , my right hand slipped and three fingers were efficiently cut into by the chopper. Reasonable blood loss, pain, shock, torniquet , medical attention and after i can now evaluate the damage to my fingers. The forefinger is badly off, some skin has been gouged out and the doctor attending on it recommended stitches which i declined, I didn't want to be sewn up just yet ., the other two fingers are badly cut but the gravity of the injury reduces sequentially as i move from one digit to the other.
Now of course as i type this with six fingers i'm very curious to know..all these machines that we are so dependent on and buy at fairly upper end prices... how much user-safety do they offer.?. I use this shallow dry grinder very often, and i always use it with one hand resting on the lid.. Now bruised I dont see why i should be shy of voicing apprehension about gadget safety. Especially since mine is the last of the prudent generations and we are raising generations of kitchen-gadget-challenged youngsters. This shallow grinder used for dry grinding and for chutneys is completely lethal, as i have realized . In a deeper jar, should such a slippage happen, one's fingers would not be at risk, although i admit that i am deficient in the scientific certitude of what could happen if the lid flew off a deeper container. So how should i treat this mid- morning mishap? As a freak accident, or should one begin to ask why we should stand beside our mini grinders holding on to lids, however feminine or graceful such a pose may seem to the viewer.The further query i have is, have the producers of this machine taken this danger seriously? Or is this a third world situation, where human life is not at a premium and therefore, safety norms can be easily overriden, if not entirely ignored.
Is there any way of finding out if safety norms are adhered to? or if they even exist?
Now of course as i type this with six fingers i'm very curious to know..all these machines that we are so dependent on and buy at fairly upper end prices... how much user-safety do they offer.?. I use this shallow dry grinder very often, and i always use it with one hand resting on the lid.. Now bruised I dont see why i should be shy of voicing apprehension about gadget safety. Especially since mine is the last of the prudent generations and we are raising generations of kitchen-gadget-challenged youngsters. This shallow grinder used for dry grinding and for chutneys is completely lethal, as i have realized . In a deeper jar, should such a slippage happen, one's fingers would not be at risk, although i admit that i am deficient in the scientific certitude of what could happen if the lid flew off a deeper container. So how should i treat this mid- morning mishap? As a freak accident, or should one begin to ask why we should stand beside our mini grinders holding on to lids, however feminine or graceful such a pose may seem to the viewer.The further query i have is, have the producers of this machine taken this danger seriously? Or is this a third world situation, where human life is not at a premium and therefore, safety norms can be easily overriden, if not entirely ignored.
Is there any way of finding out if safety norms are adhered to? or if they even exist?
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