Learning the hard way...

Whenever you see light at the end of the tunnel in research, resist the temptation to run towards it, for it could be a train hurtling down the tracks at breakneck speed

Research = 99(+/-0.8)% perspiration + 1(+/-0.8)% exasperation

Overheard in the lab: 'your argument is well made, very profound... and completely pointless'

Adulthood vs 'sonhood'

When do you really grow up? At 18? When you leave home? When you start earning? When you get married? When you have children?
This has puzzled me a lot. Recently, I came to realize how much I am still my parents' son. Even now, approaching 30, I call them when I have any news, Good or Bad. I call them when I feel confused, I call them when I feel that I need someone I can trust to give an opinion.
Don't get me wrong, I do not always follow their advice or agree with what they say. Ever since my teenage, I have resisted advice fom my parents, but even now, I feel the need to know what they think of my plans, to know whether they agree or not, to know what their point of view is.
When it comes to sharing good news, it is much more straight forward to figure out. My parents will always be proud of their son and I can always count on them for unadulterated joy in my success. In some ways, it is a cycle. I feel happy, so I tell them, they feel happy knowing that I am happy, which in turn makes me feel happy that they are happy about me feeling happy.

Like I said, it is straight forward.

In my mind, I try to rationalise - I am soon going to be 30 years old - an age which I thought I will never get to (God, thirty years old - that feels so... well, so old). But what is my mental age? How old do I THINK I am? Sometimes 10, mostly 16-18, sometimes about 25 - no more. Is this why I still feel very much my parents' son? Should I act and feel more mature? Is it a defence mechanism against acknowledging my true age? If I still feel like a son, then does it mean I am let off being a 'proper' adult?

I remember my Grandmother's death - she was the stereotypical grandmother - cuddly, sweet, full of smiles and hugs and unconditional love. When she died in her 80s, I remember my mother sounding very lonely over the telephone. Lonely at the age of 55, married with two adult sons.

I think I can understand that. Probably, she felt the same - maybe with my grandmother's death, my mother lost a dimension of her existence - she lost her daughterhood.

All this reminds me for some strange reason of Lord of the Flies. When the sailors find the boys in the end, Ralph weeps, he weeps for the end of innocence and the darkness of man's heart and the loss of a true, wise friend. Maybe that is what I am trying to avoid. I cling on to my sonhood for it means there is still innocence in me, for it means there is still someone to protect me from the darkness in my heart and there are still friends who are true and wise, who will be happy for me no matter what and who will always see a son in this adult(?) fast approaching 30.

red streaks on white china

Him: Hey, that looks nice
Me: What?
Him: Don't act dumb, you know what
Me: You mean this?
Him: Of course. What else is there as beautiful as that in your life?
Me: Yeah, that's true
Him: I know you love it
Me: Of course I do
Him: Why the long face then?
Me: Oh, it's nothing
Him: I have noticed, you know...
Me: What?
Him: What you mumble in your sleep...
Me: Which is...
Him: red streaks on white china
Me: My eye is drawn to them, resistance seems futile
him: Why would you want to resist?
Me: Well, it is not pleasant
Him: Why?
Me: Because it reminds me of when it was broken
Him: Just that? surely that was a long time ago
Me: It reminds me of how I struggled to put it back together... so beautiful, yet so delicate
Him: Is that all?
Me: Ok, I admit, it reminds me of the pain
Him: What pain?
Me: The pain when I cut my fingers, again and again on the broken slivers, groping desperately to save every piece, frantically trying to pick every last shattered fragment, dipping my fingers into the pile of rubble hoping to put it all together again
Him: And...
Me: Well, can you see the cracks?
Him: Hmm, I must say, you did a good job
Me: Does it look broken?
Him: Not to me...
Me: What does that mean?
Him: Well, I have my answer
Me: Answer to what?
Him: What you mumble in your sleep
Me: I hate him, you know
Him: I know
Me: I hate him for the streaks more than the cracks
Him: I know that too, you have always been selfish

coming of age?

My brother emailed me yesterday. He was at a proverbial crossroad in his education/career/life. He was worried about the choices in front of him. He was looking for answers, he was looking for guidance, he was looking for more sleep at night. Reading his email, I could not help but wonder whether there is a gene which codes for 'thought process'. it seemed as if I was visiting my brain from the past - the questions that floated up from his email would have been typed by me not so long ago. You see, he is thinking about applying for a PhD and he is not sure. His words jumped off my screen like unruly kids off a schoolbus:
What can I look forward to if I do complete my PhD?
How long will it take?
What if I can't come up with anything for years and realise I have to quit? What do I do afterwards? A research job?
But do I so badly want to TEACH?
Am I any good at it?
Am I good enough for any of this?
and also ...

... What do I want?


I could also identify with his state of mind when he said: 'It's been 5 months and I haven't even done a proper literature survey. I feel I'm not as self motivated or as interested as I need to be for research'. It is uncanny how our thoughts have lined up with no intentional mutual influence, living thousands of miles away.

What do I tell him? The obvious, annoying and easy answer is to say 'there is no right answer'. But you don't need a brother to tell you that. You can get it from the innumerable agony aunts all around you in the media.
But, then, is there a right answer? Maybe there is, I don't know, but what I do know is .. I don't know if there is a right answer.

I began thinking about the one thing I could tell him which might be of use to him - how I coped with these questions that life flings at you with apparent carelessness, but really with an intent to maim or kill.

That got me thinking about my life over the past three years - nothing to write home about, but still, I came to acknowledge a few basic 'facts' as I see them.

After I finished my MRCP, I felt stranded, as if I had lost direction. I ‘knew’ I was not good enough for anything acute, anything exciting. I ‘knew’ I did not have enough knowledge about medicine to ever become a specialist, I ‘knew’ I did not have the commitment and dedication to pursue a career in a competitive academic field. My head was all muddled and I had no obvious path to follow. Till then when I had exams to pass, it was so easy (not being arrogant - I don't mean that the exams were easy, God, did they make me sweat and loosen my sphincters at times). Look at the next exam date, apply and study. Hardly requires any decision making skills. But when I had finished all my exams, it was as if it was the end of my career. What next?

I then thought about my future working life.

It became slightly less muddled over the next few months - it was as if I had finally got down to 'spring cleaning' my mind, airing the cupboards, sweeping up the cobwebs and dusting the carpets. My thoughts started to bear semblance to some kind of order. Somehow, it was as if, I was alive for the first time, just starting out, testing if my brain works or not - very strange after 'living' for 26 years.

I started with what I would call 'first principles' in my work.

A job is defined as work you do for financial compensation

A profession is a job that you do offering a degree of expertise that someone just doing a 'job' cannot offer. This means you have undergone a period of specialist training or education that gives you a better insight into what you do. Yet, it is something you do for remuneration albeit at a better skill level.

Now, there is one more level of work – a vocation. Etymologically, this is related to the concept of a ‘calling’. As if the work calls you, attracts you and you fall in love with it. You have a desire to do it, you want to do it because it is what you would enjoy. Moreover, it is what you would enjoy not just at the age of 28 when you are young and fit and the world is your oyster, but it is what you would enjoy at the age of 65 or 70, when you have arthritis in both hips and problems with your prostate that makes you lose half your sleep running back and forth to the toilet. In other words, it is something you would not tire of doing because you love it.

With this line of thinking came the realisation that choosing my career path was as important as choosing who I live with/marry. Well, even more important, in some ways.

The person you marry might not be there with you throughout your life for whatever reasons, but your work will be with you as long as you are capable of working.

IF you do not choose carefully, you might end up hating what you do very soon – and when it happens, it is as ugly as a bad marriage.

I then imagined this: what would it take for me to jump out of bed into my work clothes at 3 AM … at the age of 65?

The answer was very obvious – cardiology, cardiology and cardiology in that order.

According to a survey which I came across a few years ago, only 11% of cardiology trainees in the UK are non-White, of which 7% are Asian of which 4% are British Asian born and educated in the UK. The situation might have changed, but I do not think it has changed dramatically.

In other words, I knew when I decided on cardiology that I have a 3% chance of making it to a training post. 3 years down the line, I am only half way there (if that) – I still don’t know if I will manage to get a training post. Yet, I would NEVER ever consider doing anything else with my life. Because it would not be physiologically plausible for me to do anything else. You might as well train your goldfish to fetch your morning paper.

People ask me what is my plan B – I don’t have a plan B. The only plan is cardiology ... or sit at home and look after the kids, which is quite attractive, I must say, atleast that would save me having to worry about IVF and elderly primis.

Then comes the question of choosing an academic route – research and all the rest.

It is much more difficult to marry research into work – in any field. Again, it depends on how much you love your field. Applying the same useful office equipment, the 'first principles sorter' (available now, in all good shops):

In any line of work, traditionally, you do three things:

Do a good job (profession)

Teach your apprentices how to do a good job (academics)

Try to see if you can make the job better (research)


Whether you want to do 2 & 3 depends on two things:

How much you want to do it

AND

What are the negative impacts on your lifestyle/quality of life (note: quality of life is defined by you) by choosing 2 and 3.

But then there is a darker side to it, the craving for knowledge (which may turn out to be an ill disguised craving for power, for in academics, knowledge is really power), the desire to be known, to be recognised, to be appreciated, to be immortalised by your work.

Is this just vanity, is this just arrogance?

How should I know, possibly it is just me.

I am still trying to work out how to sift out the dark side. Three things seem to help:

1. Insight - by this I mean an unbiased assessment of oneself - a clincial audit with an 'n of one'. Accept the fact that in a lab with a PCR machine, a pipette, a 200 microlitre pcr tube and you, the imperfect entity is... yes, no prizes for guessing... you. I strongly believe that the more insight you have, the more you question your capabilities. So I am very happy and proud of my brother for raising these doubts about his own capacity and calibre.

2. The project is more important than the researcher - this puts things in perspective. You then come to 'know' your slot in the bigger machine. It gives you the drive to know more, to be excited about what you want to do, it gives you the academic equivalent of a nostril flare response. At the same time, you realise that even if the human race evolved to live to 250 and did away with the need for sleep and developed superneurons with novel aminoacids which give you supermemory, you will only succeed in scratching the surface of your field, the field you really and truly love.

3. Remember your climb up the ladder - as you progress, watch where you step. Try not to tread on feet, especially those of your juniors. It does not take much to squash baby feet with army boots. Try and remember that any comparisons between you and your juniors should be like for like. i.e., be honest and compare your junior's achievements and knowledge to what you were capable of at his/her level in your career. When you appraise someone: be honest, not brutally honest.

Anyway, all this apart, over the next few days/weeks my brother will come to a decision. It might change his entire life. It scares me. Why did he have to ask me for advice? Why not someone older and wiser? Why not someone in his field?

Suddenly I realise, there are questions floating up like good year blimps into my conscious brain...
...and the first one reads:

Am I good enough?

Richard Pryor and his 'niggers'

I am sure I will offend someone with this title. This is the power of words - curiously, more than to insult, it sometimes has power to elicit a 'cringe response' in the readers. I guess the response depends on what concerns the reader more: political correctness or racism.
Anyway, that is not the point.
Richard Pryor died recently. I had seen some of his films, but I was no great fan - he swore too much for my liking. I watched a documentary on him a few days ago. He lead a colourful life, to say the least. The documentary was followed by one of his stand up performances from the 70s. As I watched him, I realised that he was a very talented man and the swearing was just part of his character. There are comedians who bank on a vocabulary of filth to get a laugh. He seemed different - I am sure even if all his swear words were bleeped out, you would still find his jokes funny.
He had this reputation for calling african americans 'niggers'. Now, this is something black men might get away with, but not something a different race could use without repercussions. He in fact called his first stand up album 'that nigger is crazy'.
Anyway, the way he used this word, it seemed as if it was not derogatory, well, if it was, he didn't seem to mind and neither did his fans.
In one of his acts, he describes a trip he made to Africa. The significance of what he said struck me, I could empathise with his feelings when he said this:
'Man, I went to Africa recently. It was amazing, it blows your mind. All around me I saw black men, from the sweeper to the president. As I sat in the hotel lobby and looked around, a voice in my head said to me - Richard, do you see black people all around you? - to which I replied - yeah, man, black all around, I have never seen so many black people in my life. Then the voice said - Richard, do you see any niggers around you? I looked around again and said - no man, I don't see any niggers, only black people'.
I think I know exactly what he means. It is the dignity that a person is entitled to among his countrymen, something that eludes most people who live abroad. Of course most of those who live abroad do so of their own volition, no one has forced them to do it. Yet, there is a constant feeling of 'not being at home'. There are daily reminders of your differences, starting from when you look in the mirror in the morning.
Each person deals with this as best as he/she can. Most get by without thinking about this unless a personal experience forces them to acknowledge it. Work, worries, commitments, goals, targets, family, hopes, fears - well, life in general, carries them forward so that there is hardly any time to waste on whether people think you are a 'nigger' (or a 'paki' in my case - yes, in the UK, there is no distinction between Indians, Pakistanis, Bangladeshis and Srilankans when it comes to racism - we are all 'pakis').
Nonetheless, there are occasions, for instance after you have just returned from a holiday back home, when Richard's words have a special meaning:
'In Africa, there are no niggers, only Black people'

when poverty scared me

A rainy day more than 25 years ago. I was 6, my brother was about a year old then (intellectually, I would argue that he is about the same even now, but that's another story). The monsoon clouds were at it with gusto. Not the type of half-hearted effort made by clouds in England either. The monsoon drowns out everything, including your thoughts. For me, monsoon is a word that always triggers memories of sound and smell and touch more than sight. But there is one sight that comes up in my memory from the past that still haunts me when I think about the monsoons...
... A six year old me sitting in the back seat of my father's car, my parents in front, my brother sleeping, swaddled in a warm blanket on my mother's shoulder. I am engrossed in the strange music of raindrops on the metal roof and the repetitive frantic squeaking of the windshield wipers as they vainly try to keep up with the water splashing all around. I close my eyes and imagine I am underwater, in a submarine (my dad had taken me to see 20,000 leagues under the sea) and I am hiding from the monstrous squid in the safety of my submarine/car. I have an open biscuit packet in my lap (which will not be a surprise to those who know me) and I am deep in my role, when my father asks me to keep a look out behind the car as he reverses into a side street.
Everything changes - it only takes an instant, that's what is so strange about life.
I look around, the side street is empty, except for a boy a few feet behind our car. He looks about 3 or 4, he is drenched so bad that I worry his skin and flesh might wash away any minute in the force of the rain. A dark, thin little boy, in tattered clothes and an expression I cannot describe on his face. Suddenly I am scared to look at him, I desperately try to avoid his gaze, but it is too late. He looks at me and raises his hand to his mouth, a helpless and hopeless mime of hunger.
My heart races, I have never been so scared in my life. I don't know what to do. So I just keep quiet. My father, who has not seen any of this, shifts gears and drives off. I feel compelled to look one last time - and there he is, in the middle of the road, frozen in time, frozen in the rain, his tiny hand still raised to his mouth.
As we drive off, I rummage around in my brain for a 'safe' thought. I desperately want to think about Captain Nemo and my submarine. But all that fills my mind is the little boy.
What scared me was not the thought that it could be me (I don't think I was capable of such profound thought at that age) - what really scared me was that through the rain his face seemed to blur for a moment and it seemed as if my little brother was looking at me, cold and tiny and hungry and frail.
That was the first time I was introduced to poverty, the arrogant, cruel, greedy slavemaster. Since then I have passed him on the street many times, but always managed to escape without acknowledging his presence - and he seemed to let me get away with it. He seemed happy just trampling on the vast army of slaves already under his whip. I have never done anything that would count as charitable (you cannot count the direct debit from your account as anything more than a guilt response - it is not 'charity'). Of course as a doctor, you help in making minor improvements to people's lives. But then, you are compensated well for your effort. I used to dream of doing something really useful, for people who have nothing. Unfortunately, your own selfish thoughts get in the way:
What about my career? my financial stability? my independence after 24 years of living in my parents' house (not that they would mind)? I want to chase my dreams, build my empire and tick all the right boxes. That doesn't leave time for charity, surely.
Like a broken record, repetitive explanatory thoughts play in my mind: 'I will certainly give something of me to people who have nothing, but... but, let me build my life first, because...
...I need security before I can afford charity
...I need qualifications before I can offer my services
...I need experience to build expertise
...I need to complete my training
...I need to beef up my CV
...I need to think of a family
...I need to tick all the boxes

and before I know it, charity and sacrifice have been drowned in my 'needs'. One day, one day soon, I am sure I will help someone less fortunate ... but it seems, I am helping myself before I do that and I don't know when I will be satisfied.

thoughton

april shower,
raindrops cling to leaves for
dear life

cold drink,
chewing gum stiffens on
my tongue

middle of
a signature, my pen
runs dry

potholes in
the road, my CD player
skips a track

sleepy morning,
the hot iron chases away
my shirt creases

darkness gathers round
my night lamp, like old men
around a winter fire

first day of
school, the smell of resin
in my notebook

who's this then?

me: I love her
him: are you sure?
me: of course I am sure
him: but then what about HER?
me: who's that then?
him: you know HER, I am sure
me: oh, HER, yeah well, you know how things are
him: well, maybe you should tell me
me: there is nothing to say
him: but you do think about HER
me: so what, it is silly
him: well...
me: and you know I love her
him: well, she certainly loves you
me: who, HER?
him: ha, you are so predictable, jumping to conclusions again
me: oh, you meant her?
him: what do you think?
me: well I know I love her
him: do you think she loves you?
me: don't play games with me
him: what do you mean?
me: well, why can't you say what you mean?
him: which is...
me: do you mean she or SHE?
him: does it matter?
me: how would I know?
him: well, it's your feelings
me: don't muck around with me...
him: don't worry, you are all mucked up as it is
me: well, I know she loves me and I love her
him: ...
me: well...
him: what?
me: are you not going to judge me? do you not have to slip your forked tongue in between my lines and taste the undercurrent of desire and guilt, you slimy ...
him: wow, someone's upset
me: and you know why
him: maybe, but do you?
me: what do you mean?
him: go figure

ticking boxes one by one...

A wilful move away from work, just to look at the bigger picture. I am sure this is just a passing state of disillusion. I was talking to a friend yesterday. He is an older, wiser colleague and I had approached him for some advice on improving my candidate appeal. it is so difficult to get the job you desire, actually, of late, it is difficult to get anything at all, but near impossible to get what you want. Anyway, as I was planning to apply for a post that seemed quite attractive, I went to him for advice. He took me through all the various issues that an employer looks for in a candidate, but in the end, he said 'it all boils down to how many boxes you tick and how many sections you can fill on an application form'.
Now, 16 hours later, I feel as if I have been sandbagged. Is this my life then? filling boxes... I suppose it starts from the hospital bassinet and for many people ends with a made to measure box.
There is one box that I have not filled as yet in my life. The box that says prizes and honours. It makes me feel rather like a dull 3 year old when I leave this blank, as if I am on a stage with spotligts burning into my brain and I have to own up to the whole world: 'no, I have never won any prizes, I have not once been honoured in all my life'
In a lightning reflex to protect my ego, explanations jump up and slam against the front of my brain: I never tried, I was too bored, I didn't get the right guidance, I was not in the right place, others had less competition (boy, that's especially pathetic) ... the list goes on.
I guess the fact is, I have never been THAT good.
Even as I wrestle with that obvious explanation, a small voice in my head says 'absence of evidence is not evidence of absence'