Dental Gum!

For this blog, I have used the title as Dental Gum (गम in Hindi). गम in Hindi means sorrows. People usually connect dental treatment with fear, pain, and sorrows. First, let me make a disclaimer or two. 

  • My daughter Priya is a Pediatric Dentist 
  • I had my first dental treatment at the age of 65, that too because I went through cancer treatment and had 34 radiation sittings. I was treated for dental caries. 

I somehow have the feeling that a person’s dental health quality is hereditary! My grandmother could eat raw mango (Kairi) easily in her eighties. I have the same ability, but I have a way to go.  

I chose the subject because I read an article about horror stories about dentists, in the US. Well, as in any field some people do not follow the ethics and can be called black sheep. Making a general statement about any whole group of professionals is incorrect. But not that I am not going to tell any horror stories (as I have taken dental treatment only once), but I will share with you some anecdotes shared by Priya with me.  

First things first, I have been brushing my teeth only once a day, I don’t do any flossing. I have never used any special brushes or toothpaste. I have had my share of chocolates and ice-creams, colas and candies. I have a sweet tooth, but now I don’t consume these things. So my heridetary theory should be ok!

Once I asked Priya about her young patients. I asked her, “How tough is it to handle the kids on the  chair?” She said, Baba, once my patients get confidence about me, they are straightforward to handle. It is their mothers who are difficult to handle. 

I am going to share anecdotes about patients, their parents, general situations in dentistry. Sometimes it is funny, many times it is surprising, but probably human behaviour remains very similar in different situations.  

Priya was treating a fouryearboy. He was very cooperative, but sometimes he needed a kid-glove treatment, pun, of course, is intended. One day he came inside, goggles and all; a la Salman Khan. He was a big fan of Salman. He came inside, sat on the chair and Priya started the work. After about ten minutes he signalled to Priya to stop. Priya stopped and asked him the reason. Without replying he indicated her to allow him to get down from the chair. Priya complied, he got down. He put on his goggles, put both his thumbs in the trouser pockets. He danced to the tune of the Hindi song, “Hud Hud Dabangg, Dabangg; after a couple of minutes, he stopped, climbed back in the chair and signalled Priya to restart the work! 

Some patients are too busy to take their kids to the doctor. There was one such lady, the same age as that of Priya. She always claimed that only time she could get her child to the clinic was 8 pm on a Saturday. After all, she was in IT. She would always tell Priya how difficult it was in IT and so on. Once the lady came almost twenty minutes late for the appointment and Priya had her next patient in another clinic. They met on the staircase; the lady started her usual dialogues of being in IT, but her hands were full of stuff bought in the malls. Priya apologised and said that she could not treat her child as her next patient was waiting at another clinic. The lady was upset, and before she could start her diatribe, Priya told her, “Look, I am a doctor, and I don’t know anything about IT. But let me share some personal information with you. My mother is handling Nvidia operations in Pune, my father runs his software business for the last 15 years, and my elder brother is working in Microsoft at Seattle for some time. So, there is a possibility that I may know a few things about IT, by induction. One more thing, when I was a child, my parents used to take me to doctors, whenever it was needed, without bothering about time and the day. Thank you!” The lady never spoke about IT stuff with Priya again. 

One lady came with her child. The child was fitted with a crown, and the child was not supposed to eat chocolates for obvious reasons. While eating the chocolate, the crown came out and was misplaced. Priya told her, “ I had told you not to give chocolates to the kid. Why did you not follow instructions?”  The treatment was done, and the crown fitted again; when she was asked to pay the money, she simply refused to pay saying that it was Priya’s fault, chocolate was incidental. Priya let her go and instructed her team not to give an appointment to that patient again!  

The next episode could be an incorrect diagnosis or was it the socalled horror story; I am not sure! I felt that it was a case of the wrong diagnosis. An eightmonthold child was brought to the clinic; Priya was surprised, as generally such small babies rarely have any teeth. The mother told her the following story. A couple of days back while the mother was cleaning the babies mouth, she saw a gold tooth in the baby’s mouth. She took the baby to three or four doctors, and all of them said that the gold tooth needs to extracted; treatment needed to be done under general anaesthesia. Since the baby was very young parents were not too keen about the procedure. Somebody suggested to them Priya’s name, and they came to the clinic. Priya looked at the child and saw what was inside. She had a small instrument in her hand. She put the instrument in the babies mouth and plucked the golden “Tooth”; it a piece of gold that was stuck in the baby’s gum. Out came a small earring. Priya gave it to the mother. It was the mother’s earring; she had never realised that it was missing. Somehow it had fallen and went into the baby’s mouth and became the “Golden Tooth”! The tears of joy came in the parent’s eyes! The father asked Priya “Doctor what will be the charges?” Priya said, “No charges; I am happy that I could do this without any anaesthesia”!  

How trial by media can affect a professional career can be seen in the following anecdote. A child was being treated by a dentist. He checked up with parents if any medicine was being given to the child. The mother said that they were not giving any other medicines. The doctor gave the local anaesthesia and started the treatment. After some time he felt that the child was becoming listless. They rushed the child, to the next door paediatrician. From there they rushed to the hospital. But the child died. The trial by media started; the newspapers showed the doctors name and the photograph of the clinic. The baby’s parents gave statements and hid the fact that there was another treatment being given to the child! The medical council did its investigations and in the end, found out that the dentist and the paediatrician had followed the correct procedures. But all the media trial and photographs in the newspapers made life very difficult for the dentist. He left Pune and moved to another city!  

Friends, life can be exciting, rewarding and tough at the same time for professionals. But some times, one loses control over the situation, and things do get haywire. Customer is always the king or a queen; the kings and the queens also can go overboard and need to be told so. But at the end of the day, professionals have to remain true to their profession and continue to perform! Don’t forget to show the smiling face, especially when a child is being treated.

 

Your Future Self!

Create-your-future

Yesterday Jaya and I were coming back from the airport after dropping our Son. We had travelled using  an Uber taxi. On the way back, we met an interesting driver. I felt that he was quite enterprising. It was evening time and most roads indicated heavy traffic on Google maps. Not only was he using maps efficiently but at a couple of places when the congestion was too heavy, he took U-turn and changed the route. I praised him for proactive actions to reach the destination as quickly as possible. Then he asked me, “If I ask you a few questions, will it be ok?”  I said, “Go, ahead!”

He said that he owned the car he was driving and he wanted to run a fleet of taxis similar to Ola/Uber model. He wanted to give better service than Ola/Uber. He said he had funds, though of course not unlimited! But he had that aim to be better than the giants. Jaya and I probed him with many questions like what his USP was going to be? He had thought about some things and he had not thought about many things. I suggested that he put things on paper and study, create his plan. I said, “You drive your taxi every day, how will you get time to do these things?” He said that since this plan is his passion and he will somehow find the time, and “trouble” some customer like me. He would take advice from various people but will achieve his goal. So, I said, “The time you will be spending on future is going to be unproductive time for your today’s work and will stretch your daily time schedule to the limit!” He replied, “Yes, I know that I will be required to do a lot of “unproductive” work for my future. If I don’t invest in my future who will?” This I thought was an extremely smart way of thinking. Invest in so-called unproductive things to reach the moon in future! This coming from an Uber driver gave me a terrific feeling.

He was not an MBA from IIM’s nor was he highly educated. I did not ask him about his education level but he must have taken a college degree in some subject. What could be the source of his passion? We talk about business families, business communities. This person was definitely not from these groups. He must be reading something, he must be discussing with some people, he must be watching stories on TV which has led to his thinking. When my ride was over, I wished him all the best and told him not to lose courage and focus because path could be tough. He said, “With suggestions from people like you, my resolve is getting stronger day by day!”

You’re busy all day, working non-stop, multitasking in a misguided attempt to knock a few extra things off your to-do list, and as the day comes to a close, you still haven’t gotten your most important work done. Being busy is not the same as being productive. It’s the difference between running on a treadmill and running to a destination. They’re both running, but being busy is running in place.

If you want to be productive, the first question you need to ask yourself is what do you want to be? Another question is where do you want to go? Chances are that the answers to these questions represent growth in some direction. And while you can’t spend all your time pursuing those objectives, you definitely won’t get there if you don’t spend any of your time pursuing them.

Key to all this is that you need to spend time on the future even when there are more important things to do in the present and even when there is no immediately apparent return to your efforts. In other words — and this is the hard part — if you want to be productive, you initially need to spend time doing things that feel ridiculously unproductive.

My daughter Priya is a dentist. She and her family are in the process of migrating to Canada. They were initially expecting that they will move to Toronto. But Priya felt that as a doctor she should also know French, as Canada is a bilingual country. Even in Toronto, you could get French-speaking patients. So, she decided that learning French would make sense. Hence, she joined Alliance Francaise and took a four-month course. She had a tough time managing the course, her Medical Practice, family obligations and her child. But she did it! As the luck would have it, her husband got a job in Montreal and her so-called unproductive efforts will become productive when she joins him in Montreal!

You want to become a writer or a painter or marathon runner, along with whatever you are doing currently. Your busy mind tries to keep you away from the new stuff, you’re not yet good at and which isn’t yet productive. Sometimes you need to be irresponsible with your current challenges in order to make real progress on your future self. You have to let the present just sit there, untended. It’s not going away and will never end. That’s the nature of the present.

You may not end up with an empty email inbox. You may not have the perfect compensation conversations with your boss. You may not please everyone. I am confident that those who want to invest in their future, will be good enough to do their current stuff at 7 or 8 on ten level, instead of their usual on 9/9.5 on ten level. Some of you might get jitters because of a lower level of productivity, but it is simply not possible to multitask things beyond a certain level.

Once you have clarity in mind of what you are doing and why you are doing, tasks become easier. Once you start seeing at least hazy image of your future self somewhere on the horizon, your jitters level will get lowered. This brings me to my latest theory of everybody requiring to reskill themselves. Reskilling in future is going to be mandatory. This is irrespective of whether you want to do it or not! So why wait? It is going to be reverse of “Back to the Future” movie where the person travels back 30 years in a time machine. Now you will have to visualize yourself ten years hence.

In case of training for Marathon, you may first start with 5 km then 10 and so on! Similarly, the writer in you may be able to write a few things initially. You may paint a few things after 3 months! This step by step progress is what you are looking for! Do it as a passion, but don’t forget that you may have to do it in future, anyway!

Your original training as an engineer, architect or whatever will keep you going. But in both these professions, you also want to add subject knowledge of Costing. This knowledge may put you on a fast track in your future career! The future costing engineer will have to take efforts, today, then you will get the fruits in the future! Don’t lose track of “Your Future Self!”

 

Dr. No…! Or Dr. Knows!

Whenever there is a discussion taking place about medical field, most of the reactions are, “These guys always cheat!” It is like a popular phrase in not so rich a country like India, “All business people are profit mongering thieves!” This sentence is contradictory. Business is an activity of making one’s living or making money by producing or buying and selling products (goods and services). The definition clearly states that it is an activity for making money. It is also said that doing a job is noble thing to do but we forget that when we do a job, we do it for someone who is doing business!

This discussion came about during a chitchat at home where five of the family members were doctors. Subject for discussion was basically how much is the right fee for medical advice, surgery, tests etc. Tests performed are standard procedures where almost identical methods are used for evaluation. The only difference could be a little more automation and sophistication of equipment. So, fees here should be uniform. But ultimately charges are market driven. Consultation and surgery fees will differ as these are dependent on individual skills and expertise.

A doctor friend of mine bought a modern computerized x ray machine. I asked him why did he buy this expensive machine. His reply was very different and interesting. He is my age. He said, “Pramod what is your opinion about my buying this machine.” I said, “Fantastic! Now you will be able to judge patient’s problems better!” His establishment is in the older part of our city where rates for services are generally inexpensive. He told me, “You are one of the very few who has appreciated my going with latest technology, most said what is use if you are not going charge fancy rates.” His further comment was most interesting. He said, “Pramod, consider this as my Mercedes! I would rather move around in a Wagon R as roads in this area are small and congested. I enjoy using this modern equipment, as it helps me improve my diagnosis.”

Among all the pathy’s, we have to accept a fact that only in Allopathy, a lot of research is taking place. All this research is sponsored by pharma companies, who else will do it? It is the business of pharma companies to find new drugs which help improve treatment and rate of cure. Fifty years back, when cancer was detected, death was imminent. There was no chance of cure. This was happening because the equipment of those days, knowledge of doctors, quality of drugs created a situation where it was always too late! But now all these things have improved so much that detection is early, equipment and drugs are better and so is knowledge of doctors. This has resulted in improving cure rate tremendously. When research is done a lot of money is invested. The companies try to get ROI as early as possible (it makes business sense) but when they get competition the prices of new drugs or equipment start tapering off fast. The pharma companies are not thieves; they are investing a lot of money for betterment of themselves and also of the mankind. It is duty of pharma companies to be profitable on behalf of the share holders as they are not a charity organization.

I am not saying that all the pharma companies are saints and there are bound to be black sheep. But this is true in all fields and in all pathy’s. It’s human nature to cheat but this % is generally similar everywhere. Also, like in every field there are checks and balances. There are organizations and associations which track malpractice. I will give you an example. Years back one of the giant pharma company’s sales guy met a doctor in Harvard Medical School. He suggested to the doctor, that if the doctor prescribed certain drugs to patients, they would pay US $ 5000/ month. The doctor promptly reported this offer to his management. There was a court case and the pharma company was fined US $ 940/ million! This still does not mean that such things are not happening but these are not as rampant as they are said to happen.

There is another theory. The threshold values of BP, Diabetes, Cholesterol are changed frequently to suit the pharma companies. This is done with the help of famous doctors. During last fifty years computerization has helped medical field as it has helped all other fields too! These threshold values are not absolute values. Medical fraternity decides this based on the study of large number of patients over a large period of time. Finally, they average it out. What computerization has done is that collecting data and processing it has become extremely accurate and fast. Previously it was taking maybe 30 to 40 years to analyze changes due to manual methods, now this is done every 10 to 15 years! Hence, we notice these changes introduced, as the changes are more frequent! Another reason for this is that in the modern world of internet, news and information spreads really fast!

The fees charged by doctors, medicines prescribed by them, methods followed by them are based on their knowledge and experience; obviously the fees are market driven too! We hear the stories about doctor A squeezes the patients but doctor B does not. The fees charged by these professionals are absolutely market driven. Do you know what fees are charged by Supreme court lawyers? Sometimes these are in lacs per day. I know of one patent attorney who charges about 20 k per hour! Heart Surgeons charge in lacs for bypass surgeries.

Now a new trend has started in medical field about which we all need to be careful. Dental technicians now start their own clinics and charge 1/5 th of the fees charged by the dentists. Many of their patients end up, going to real dentist after wasting money and sometimes with incorrect treatment.  Dieticians suggest diets to people sometimes without knowing medical history of patients. When I said this during a discussion, one of my friends was angry. He said, “Doctors have no clue about diets!” I asked him, “What clue do dieticians have about medical side of the person?” There are certain orthopedic technicians who start their own practice. Physiotherapists have started their own practice. One person has ten bed facility to give traction. I know of someone who has taken 40 plus traction sessions of one hour each, from this person, without medical advice. Traction is suggested by Orthopedic Surgeons based on certain criteria. Many patients take treatment from Physiotherapists without even taking advice from Orthopedic Surgeons. Patients go by treatments suggested by non doctors!

I am not saying that everything is hunky dory in the medical field. Major errors do happen even in case of celebrities. Hema Malini’s mother was operated upon right leg while she had problem on her left leg. That too in a hospital in New York. Mistakes and goof ups are part and parcel of this field. If you want to know first-hand, how things do go wrong, read a book by Dr. Atul Gavande, “Checklist Manifesto”! Atul is well-known Indian born surgeon who lives in America. Dentists have told me patients come to them after being treated by other doctors where they have undergone root canal treatment. On re checking they have found that the cheats had never performed root canal!

I will round up with a very interesting story told to me by my Daughter Dr. Priya. She is a pediatric dentist. An eight-month old baby was brought to her. The parents said that the baby had a gold tooth, yes Gold Tooth! 3 to 4 other dentists had already seen the baby and had declared that this gold tooth must be removed and can be done only under general anesthesia.  Parents naturally did not want treatment under anesthesia. Priya checked the baby and used a small tool to check the “gold tooth”. She just gave a small jerk and out came the gold tooth! Well it was an ear piece which the baby’s mother had lost, stuck in the baby’s mouth. Time taken ten seconds, anesthesia not needed, fees 0.00 rupees!

Friends, select your doctor in such a way that you get a great treatment if needed. And Yes! Don’t be scared, there are goof ups as in any field but % of cheats is also similar to any other field!

Few of my favourite things!!

I was lazing around on a Pune rainy day, and suddenly a thought came to my mind what are my favourite things and here goes the list
1 Lazing around on a Pune rainy day munching on bhajiyas with a hot cuppa
2 Watching Sachin bat
3 Snugly sitting with my grandson Suyash, listening to his discourse on everything under the Sun
4 Sitting with friends and chatting

5 Listening to “Abhi Na Jao chodkar….!

 

6 Listening to ” Jindagi ke safar mein gujar jate hain ….!

 

7 Listening to ” Sapany mein sajanse do batein….!

 

8 Remembering the olden days when we used to play table tennis in Mumbai Police club with the gang; playing all day from one side with the rule “Winner to stay”
9 Remembering walking back home from school in Mumbai during heavy rains and mini flooding of roads
10 Eating only batata bhaaji (and no Puri) at Kulkarni’s opposite Ram Mohan school Mumbai (is Kulkarni’s still around!) while in school
11 Breathing the Khandala ghat breeze in monsoon travelling by train
12 Eating early morning breakfast at COEP mess with Vinya Medhekar (hey Vinya let us do it again)
13 Remembering practising for one-act plays/dramas in COEP (where I met Jaya, my wife)
14 Watching office gang come up with a beautifully simple solution for a complex problem
15 Watching my dentist daughter behaving at one moment like a kid and next moment like the professional she is
16 Watching elegant oratory of Jaya, my wife
17 Remembering my English teacher Mr Mayekar in his finest dhoti and graceful handwriting
18 Remembering my father’s crisp and swift decision making on everything
19 Watching billiards world champion Wilson Jones show his tricks at the Police club
20 Wahida Rehman…..
21 My walks at Pune University with Suresh Ratnaparkhi (at high speed like his fighter jets) and Nilubhau Damle (meandering like a big river on the plains)
22 When all loved ones meet together to celebrate a birthday at home
23 Watching my son Sachin laughing heartily ( and his son too!)
24 Watching a child growing in front of me, my dear Lolo
25 Post monsoon drive from Pune to Mumbai
26 Birds chirping
27 Mother cat teaching the kittens “how to catch prey.”
The list can go on and on….. I should add “making a list of favourite things” to the list!!
Ciao folks!! Send me your list of favourite things