Sea-shore

I am silent
not because it does not evoke an emotion
rather I am speechless
as these feelings cause a commotion
As sea-waves they hit my core
I stand here like the shore!

It is not a river where the water passes and is gone forever,
these waves keep coming back with a tide,
while receding they leave skeletons or beautiful shells
I lap them up in my stride!

I stand here as Sun sets
and I shall be here with each morning
and watch the sea in it's fury and serenity
and be here  and be here till eternity!

Premise of medical management!

Most patients who have common diseases, even in severe form, are refused treatment by Apex Medical Institutions like AIIMS. They are sent to the more earthly hospitals. It is because of the attitude of the Institution that it is supposed to treat only uncommon or rare diseases. This view is not only of the treating doctors but is also endorsed by the administration. These Institutions are convinced that they are above 'mundane' humanity. This stems from the thinking that 'what can we get from the patient' rather than vice-versa. So if a patient has a condition that is worth publishing or presenting in a scientific forum, the patient is quickly admitted and worked-up with special interest, otherwise the patient is sent to another hospital. MCI's requirements that each faculty should have certain number of publications to get promoted has only furthered this situation. It also has the potential for those investigations including invasive ones to be performed that are more useful for publication of a paper rather than benefit the patient's health. Now, this attitude is palpable in faculty of other teaching institutes also. Probably MCI's intention was to promote scientific research in Medicine in the country but a debate needs to be initiated that whether this has lead to callousness towards patients who have common conditions and have nothing to give to a doctor in a government set up.

More and more of the medical journals are becoming paid as each day passes. For many journals, including top reputed publishing groups like BMJ, one can take an annual membership for a fee and publish any number of articles. These paid articles at times may be much inferior to the articles that were rejected as the contributor has not paid the fee. Therefore, we get to read more and more articles that have been paid for. Unfortunately, it is likely to lead to a bias where more articles are published by people who are commercially inclined and see the fee paid for the article as an investment, expecting returns in various forms, rather than sheer advancement of medical knowledge.

These are unfortunate circumstances that are contradictory to the basic premise of medical management. Like other oaths that people take, Hippocratic oath has been forgotten to an extent that Doctors don't even remember that there was such a thing that they took on completion of there graduation. May be because the people who administer the oath, themselves do not remember it. By the way who was Hippocrates????