Sicko!

This is an article I wrote for the annual magazine of the breeding ground of perhaps the single brightest pool of young doctors anywhere in the world (and yeah, I'm proud of being a part of it: but profound, though insidious, developments in the way things are done- in AIIMS, in healthcare; in India, in the US- have seriously dented that pride, that joy of belonging to the most prestigious institute in the most revered profession of being a doctor, a healer) and so, this article is not going to be about
• how obstetrics is drier than some very dry things (ref http://obstetrics-drier-than-camels-turd.blogspot.com/); or
• how FC Barcelona's playing style makes them a joy to watch; or
• how John Petrucci's mastery of his 7-string renders him in the same league as Jimmy Page, Gilmour and Keith Richards; or
• why Richard Linklater is one of the best directors on the planet ( see ‘Waking Life’!); or about
• why the Amazon Kindle is the best dedicated e-book reader there is and why iPod is still Apple’s best product despite the frenzy over the Phone and the Pad; or
• why Amtrak’s Coast Starlight is the best way to travel between LA and SF despite taking twice as much time and costing twice as much as the bus; or
• what unconscious mechanisms do beautiful waitresses work that cause you to pay 25 USD (INR 1250) for a single hamburger which actually costs less than half that amount; or
• why it is almost impossible to find a decent Sushi place in Chinatown and the subtle differences among the Chinese, the Japanese, the Koreans and the Filipinas; or
• why the East Coast sucks monster balls compared to glorious California and of living-to-work versus working-to-live and when the differences fade; or
• whether to go for closed back headphones over open ones and whether we actually perceive the difference between 192 and 320 kbps encoding without “perceptual aids” *wink*; or
• why "Music Has the Right to Children" is undoubtedly the best studio album by Boards of Canada (and among my top 5 albums EVER) ; or
• which of Dilbert, Calvin & Hobbes, Cyanide & Happiness and Chopping Block is the funniest (or darkest) comic strip or is Jon Lajoie funnier than South Park; or
• how NN Taleb does a superb job in his book "Black Swan: The Impact of the Highly Improbable" of explaining how we fool ourselves into believing we know more than we actually do; or even
• why Biostatistics and Psychology (at least Behavioral and Developmental), if not Sociology, should be incorporated in the medical curriculum (I know!!- scrap Anat and Biochem for all I care.)

It is going to be about something that matters (if it doesn't, better start thinking why) to each and every one of us: Why are we here (Not on Earth: I leave that for higher beings- Locke, Hume, Descartes and others) - in AIIMS!! In the medical profession! In Healthcare! Do we have any visions/ any aspirations/ any clear ideas on how to achieve them? What drives us? Or Does Anything? (Scary!) Are we just being taken to wherever the blue bus is taking us? Do we even know who’s driving that bus? Are we ever frightened by the fact that the bus may be automated, like so many of the things these days, and the road might just end? Or are we TOO frightened to even think about it?

My immediate inspiration for this provocative essay, if you will, was the UBER Michael Moore film “Sicko” (hence the title) in which he talks about corporate-insurance-based health systems in the US and shows how they fail miserably in their presumed goal of provision of universal healthcare compared to the less glamorous but far more efficient socialist health systems in Canada, Great Britain, France and even the third-world “evil” communist Cuba. I humbly request you to give this guy 2 hours of your super precious Step 1/2 preparation time: you might just end up reconsidering a lot of things; or at least not blaming anyone for “not telling you” 20 years down.

So What-about-India you ask. What about AIIMS? We practice healthcare-for-all! (What about that sucky book of healthcare policies and programs that we’re supposed to cram in Community Medicine!) We treat patients for free! If the Americans (and our “good” private hospitals) ought to reflect on the latter italicized words, we ought to concentrate on the former. Are we actually giving patients better outcomes, especially in the non-surgical branches? Does the patient actually fare better three or even 24 hours after stepping into the ED or would he be better off bearing his misery on his own; or taking refuge in “unscientific”, but empirically effective, alternative medicine [and remember, empiricism is the basis of all science; ergo the “recent” more scientific Evidence Based Medicine] and not have his veins punctured multiple times by the “eager-to-learn” bunch of white-coat-wearers?

Blasphemy?? Probably! But if Blasphemy is what it takes to set us thinking and question our methods, then so be it. So, What-do-you-suggest-Nikvana, you ask me. Shall we all “run away” from medicine like you or just blame the system and repent that we ever chose Biology/AIIMS over Math/IIT? Neither. We think about what drives us, what makes us content, what we hope to achieve and how we should go about achieving that ultimate goal; at the same time not neglecting our bread and butter (which, since you’re here, will never be a problem). We rank virtue over nicety, honesty over pleasantries, facts over opinions, content over presentation, ideation over memory, satisfaction over materialism and ethic over convention. We travel, we be open to new ideas and new dimensions of thought, we not harbor a go-with-the-flow attitude, we be curious, we question. We be skeptical empiricists (ref Black Swan: Taleb).

Hedonism: the enduring -ism.

Hedonism: the ism which has never, and will never, go out of fashion.
There was Creationism
And then there was Rationalism
There was Socialism, Marxism, Communism
And then there was Capitalism
There was Absolutism
And then there was Reformism and Antiestablishmentism
There was Racism, Sexism
And then there was Equalitarianism and Feminism
There was Regionalism, Nationalism
And then there was Globalism
There was Egalitarianism
And then there was Nihilism
There was Buddhism, Taoism and Hinduism
And then there was Secularism and Atheism
There was Ethisism
And then there was Amoralism
And of course there have always been innumerable other -isms like sadism and masochism. ;)

Everything came and went, or will go some time in the future. The one -ism which will remain; and in all probability, grow from its already obnoxious (according to some pretentious judgmental beings) form; is hedonism.

The dictionary defines hedonism as the pursuit of pleasure as a matter of ethical principle or an ethical system that evaluates the pursuit of pleasure as the highest good.

As soon as you grasp the concept, you question yourself if it is the way to go. Si, senor, it is. You will rubbish the claim from the word Go if you are the type to avidly follow The Speaking Tree published in the Times of India or something similar. They (they being the saints and the mahatmas and the higher ups in the spiritual hierarchy) claim, and they may be right, that only by starving the body of worldly pleasures will we gain higher pleasures. It is at this point that we are unwillingly forced to acknowledge the question of what we are really aiming for: one is tempted to answer in the method ingrained in our psyche, namely, the relatively long lasting low intensity happiness and so called satisfaction (remember, satisfactory is the grade they award to children in primary school below excellent, good and fair; above poor though; before they begin to devaluate childhood in terms of mere percentages). One tends to forget that the period between coming to our senses and senility (nonchalantly referred to as life) is nothing but a series of moments and hedonism is the school which perpetuates the concept of seizing the moment.

One aspect to which a unanimous conclusion can be reached though, is that only by achieving; or trying to exist in a state of; utilitarianism, i.e. the greatest happiness for the greatest number of people, can we derive true happiness out of our hedonistic pursuits.