I am now 25 years old!
I have often wondered as a doctor how it is possible for so many people to be well. I have learnt about hundreds of diseases and conditions that a normal, healthy person seems impossible, yet there are many among us who are healthy and well. The great disproportion and inequality of health. The sick get sicker and the healthy healthier. Although this inequality corresponds to socioeconomic imbalances across the world, lifestyle diseases and geriatric diseases are now working overtime to redress the imbalance.
I know a lot of us are shocked at the way epidemics and pandemics of HIV, Influenza, SARS sweep across the world and have devastated millions of lives everywhere, but often we forget about other diseases and infectious agents which seem even more terrifying than all these diseases put together.

I refer to the epidemic of Marburg virus in Angola which the WHO is finding hard to contain. You obtain a glimpse at the awesome power of this virus when you read the mortality stats. Out of 224 cases reported on the 14th of April 207 died - a 92% mortality rate. WOW!! The virus was identified after an outbreak from a lab in Marburg, Germany traced back to African green monkeys from Uganda. Not much is known about the virus except that human infection is accidental. No animal reservoir of infection has been found.
It is usually transmitted from the bodily fluids of an infected patient with a high viral load by close contact. The virus strikes swiftly and fatal cases die within 7-9 days after infection.

It is diseases like this, Ebola virus, tsunamis, earthquakes that lead me to believe in the Malthusian concept of population. I believe it is nature's way of striking back and redressing the inequality we are trying to achieve towards "health". Unfortunately, all of these disasters and diseases plague those who do not live longer and in a bizarre sort of way it seems like Darwin's survival of the fittest is slowly applying to the human race.

Other news :
B'day gifts this year ( probably the most I have ever received) include :
1. Leonard Cohen - selected poems and lyrics
2. American VictoryX -DVD
3. Henry Rollin - Black Coffee Blues
4. Miniature Music box which plays Happy Birthday tune
5. Toblerone chocolate pack
6. Tintin pack of 3 comics ( still to be received)
7. ipod - to be handed over personally in May

I am alive and well. This is to assuage all the fears that near and loved ones may have following a protracted leave from answering emails. Immunology is a lovely subject and although my lab is not Wimbledon(where I could spend hours together and never get bored) I spend considerable time in the glass encased building which leads to my absence on your inboxes.

I attended a nice lab talk the other day ny my lab-mate and it made me realise how far we actually are from finiding a vaccine for malaria. I sometimes wonder whether all this science is really ever done with that intention in mind. The reason I say this is that we have labs that focus on one area of vaccine work, example T cells and another lab focuses only on Antibodies, and neither lab is actually willing to believe that it might be a combination of the two that is needed most. This makes it much more difficult to actually find a protective vaccine(although that might sound slightly redundant).

In other news, I am being gifted an iPod for my b'day, an event which occurs on the same date every year unerringly. Seems to me the major purpose of b'days is to remind one of their age and although it is meant to be a cause for much celebration, I often wonder what there is to get so excited about. So, in a couple of days time I will be 25( I know Amma, it has been that long since you brought me into the big bad world) but today I am 24!!! Doesn't quite make sense to me...

Aside from my ever ready age rant, I still havent come up with something to do on my b'day. A dinner is boring but evergreen, the problem being that I shall have to spend a considerable amount of time in the lab on Sunday (yuck..I know but my dear experiments are not in a mood to wait for me. Any suggestions?

Finally, may I just say that some of those lines which I put forward as iPod epitaphs were great.
Here is my all time favourite list :

1. Is your journey over, has it just begun? - Man of Sorrows, Bruce Dickinson
2. He say "I know you, you know me"
One thing I can tell you is you got to be free - Come together, Beatles
3. lit a thin green candle, to make you jealous of me.
But the room just filled up with mosquitos,
they heard that my body was free. - Cohen, One of us cannot be wrong

Old Friends

I did something fantastic today. I called up my long-lost sister - the one whose b'day I forgot. Being the lovely sister she is, she forgave me instantly and then proceeded to bring me upto date on all our school friends. I would just love to go back to Delhi now....

Anyway, so my dear friends "Motherliness" and "Geisha" are desparately looking for husbands. They are facing the new middle age crisis facing well educated, ambitious Indian women who cant find a single man out there. So, if any of you know of a nice young(<28 preferably Punjabis or Mathurs) men please let me know.

Other interesting gossip from my past. "Motherliness" says if there was anyone she could marry among us all it might be her orchid loving friend,"Geish" tries setting herself up with "Vishnu" (refer to this) but rejects him because he ordered Lassi for dinner, "Discipline" is getting married to school second sweetheart "Limited" but it all hush hush and I am not supposed to tell and Mr.Film Maker with streaked red hair proposed to "Geisha". Why am I never in the happening place??

I feel elated that all my friends are leading such interesting lives, which I can now cash on and make into a leading soap opera. It seems only yesterday that all of us were in school in blue shirts and pants, laughing, singing with not a care in the world except board exams and everyone's love lives. I dont think I would ever be able to see all of them outside that picture, somehow we are all the same, never really changed although all of us have tried to change, but somehow I feel that we have come one big circle. No doubt, we are different people now, but we are interlinked and bound in the same ways that we always were...

Ok, enough of the senti sob story. Feeling on a high after speaking to both my sisters. One married and planning to have kids on her Europe trip( very excited about her coming here) and the other planning to get married despite parental opposition.

Thats how I am feeling right now:

Such a feelin's comin' over me

There is wonder in most everything

I seeNot a cloud in the sky

Got the sun in my eyesAnd

I won't be surprised if it's a dream

Fishing and the net

I am not a very computer-savvy or even friendly person so when I read that the 7th greatest spammer in the world got put into jail for 9 years for sending out fake emails to AOL subscribers and making millions, I cheered first and then felt slightly worried.
So, I opened my HSBC account and checked whether somehow my account balance was slightly lower than expected. Fortunately, the only dent in my account seems to be due to visits by the little one and self-treatment of depression.
But, I did learn about "Phishing". Before you think that this is another post about the uniqueness of the English language, let me inform you that this is how you are cheated of your hard earned money.
Take notice, other cyberphobes!!
"Phishing" is how cyber freaks-turned-scamsters send fraudelent emails out to people like me in an attempt to elicit our internet bank details which they then use to clean out your account.
Things to remember :
1. Check your account regularly - this has various other advantages like reminding you that overdraft usually has an upper limit(500 quid only).

2. Never reply to emails that even look suspicious - this might mean that you dont meet interesting people often, but hey at least you aren't on the street broke

3. Banks dont send emails to your email account, they usually send secure messages in your internet banking area- another reason to check your account regularly from the net

4. Banks never send emails that have a window popping up asking for your bank details, secure id number or DOB.

5. Finally, dont be stupid! Use some common sense. Dont be like the guy from Coventry who went to The Gambia with 4000 pounds in reply to a fake email by some random guy who promised him a million in return. This rather gullible fellow then went on BBC Radio to protest the fact that he was cheated!!! He probably deserved to be....

I was feeling quite useless in the lab today, so headed back into town early afternoon and decided to do away with my depression by shopping. (Let me give you some advice..this is a particularly dangerous and expensive way of self-treating depression in England). So, anyway I walked into Blackwells, continued my interrupted (only in bookstore) reading of Philip Pullman's Amber Spyglass,the last in his Dark Materials Trilogy, had a chocolate muffin, tea and a coke and then scoured around for cheap books.

What did I finally buy? Short Introductions, Baghdad Diaries, Autobiography of a South African freedom fighter(not Mandela) and Thomas Friedman. Unfortunately, it did nothing to cure me of my lethargy and torpor. So I went back to the trusted formula of popcorn and a good book.
Right now I am reading The Buddha of Suburbia, Hanif Kureshi's debut novel. Its a well written book and looks at race relations in UK from a Indian immigrant's perspective. There is wonderful mix of characters : the Pakistani corner shop owner, the truant and delinquent suburban second generation teenager, the rebellious daughter of Pakistani shop owner who finally succumbs to emotional blackmail to marry a Pakistani man, and the Buddha of Suburbia himself - a suburban Indian middle aged man who conducts Indian philosophy, meditation and spirituality sessions while still coming to terms with his own orthodox views and his affair with a middle class English lady.
I think it is a really good read and aptly captures a lot of the social dynamics in UK at present while coating it in loads of satire and black humour. Its witty, perceptive while being very inconspicuous in its message. I am often turned off by books that spout morals and social theories from page three, which is why I am not such a fan of popular science and political essays. I much prefer books with good storylines which midway through the book make you begin to think of the basis of the book - eg. 1984.
The other good books I have read recently :
1. Alexander McCall Smith - 2 1/2 pillars of Wisdom
2. Bill Bryson - Notes from a Big Country( better than Notes from a small Island)
3. Philip Pullman - my present craze
Now I need to stop reading about social structure in Britain and get back to understanding the structure and function of Plasmodium's Circumsporozoite Protein.

Doctor's Mistakes

By some quirk of fate I read two very interesting articles on the same topic yesterday. One was from Atul Gawande's book Complications( which btw is a very good read) and the other is from the BMJ.

Both talk about mistakes made by doctors. Read this article which is a doctors confession about a mistake he committed in diagnosing an elderly lady with a heart attack because he forgot to read the ECG.
Gawande chronicles the same sort of mistakes made by surgeons during their clinical practice.
My own take on mistakes made by doctors is rather simple and pragmatic. I know that mistakes will always be made by doctors. It would be impossible to find a doctor who has never committed a mistake, and very difficult to find one whose mistake hasn't led to increased patient suffering. Therefore we must try and
a. to reduce similar mistakes in your practice, among your peers and colleagues in the hospital
This is very often done by Autopsy meetings and as Gawande describes the Morbidity and Mortality Meeting, where the entire department, sometimes departments come to together to discuss cases of errors and changes that could be made to avoid similar mistakes in the past.
b. weigh the benefits of revealing the mistake to the patient versus the harm. This must sound very self-preservatory but let me give you an example of how revealing a mistake might cause greater harm than good. Consider an elderly patient in the NHS who has suffered from re-operation after abdominal surgery because the surgeon forgot a swab inside his abdomen. He was told of the error and was obviously incensed and distrusted all doctors. He now presents with Myocardial Infarction, heart attack in emergency and requires an Bypass surgery. Do you think he would give you consent if you were the same surgeon??
I am not in favour of withholding information from patients or falsifying documents, but I think in Medicine where a lot of decision making is based on intitution and experience, informing patients of doctor errors must be a cautious decision

Most commentaries on the subject argue that there is a loss of trust among patients when doctors cover up their errors and the rare one which is publicised makes sensational news. Somehow, I think despite the much publicised and quoted attitude change in patients, most patients who attend public hospitals trust doctors implicitly. I am not sure whether admitting to every doctor error helps in building trust.

The only advantage I can possibly envisage in humanising of the medical profession - understand ing that doctors are humans who commit errors because of the long hours they keep and the tremendous pressure and responsibilty they carry.

So, on the whole I think informing patients about doctors errors must ultimately rely on the physicians judgement. All errors must be discussed within the hospital in an educational manner, and changes in the system must be brought about to eliminate the chances of the error being repeated.

the three indonesian dancers from the tsunami concert

I have always given lab talks with the aim of learning things and informing my supervisor about what I am doing. Talks however serve a very different purpose and most of the time it usually is a job talk. Here are some tips on what you should never do while giving a talk :
1. Never exceed time limit.
2. Never have your laser pointer tracing fractal curves on the walls and screens.
3. Never raise your voice and end every statement with a question, "Is that ok?"
4. Speak coherently, neither too fast or to low.

The BMJ has just compiled an entire list of the series they have published since 1994. Its really good reading and covers almost all topics under the sun. The ABC series is particularly good and very useful as introductory pieces to topics.

Shall now head back to aligning adenovirus sequences to find which part of the E3 region of the genome has been deleted and whether it is of any significance.

Am very excited about europe trip....

The little one has left, and the room once again takes on a lonely gloom. However, we had a great weekend. On Saturday the sun came out and "We followed the sun" to Port Meadows. Port Meadows is as the name states this huge meadow along the course of the Thames in Oxford. It was a nice warm day and armed with muffins, chocolate and some citrus juice we walked an hour and a half to reach the Trout Inn. This is a lovely pub on the river and is one of the major tourist attractions in oxford. We had some fantastic food, after waiting for 45 minutes because everyone in Oxford had the same idea as us.

The first time I had been the the Trout I was rather surprised to see a peacock there .. and it is still there. It seems the owners keeps them as pets.

While walking back I had a terrible experience. As readers of my blog might know, I have deep aversion to references of daily ablutions being made in my presence. I self-diagnosed myself when I acquired a partner who comes from a region of the country who feel no embarassment when talking about their bowel movements.

I am being treated by behavourial therapy in an attempt to cure myself of this affliction. This has been forced by my association with the little one over the past year and a half( Oh God! Has it really been that long! Behavioural therapy for the ignoramuses is where you are slowly exposed to the agent of fear gradually so as to unlearn previous behaviour patterns).
However, my wonderful progress was broken on Saturday by an unfortunate incident. Treatments of this kind progress slowly and the emphasis is always laid on raising the bar gradually. So, we were walking along hand in hand when we ran into a family walking ahead of us with their dog. ( Readers may also remember my continuous aversion to the canine kingdom). So, we walk slowly only for the canine to step off the path and move its bowels.

No problem, I have seen much of that in my home country and have developed a wall to such actions. But, then the lovely lady owner bends down and picks up the $%*! in a plastic bag and loudly exclaims, " Well Done!! Its so good, almost reminds me of easter chocolate eggs!".
( I am now retiring to have a drink of water before my esophagus convulses and throws up the cold piece of pizza I have eaten this afternoon)

Readers may remember that I am coming off a long chocolate lay-off and I was traumatised by people comparing what I love most to what I fear most.... I shudder still thinking off it.

Other than this, we saw the police lift a large backpack out of the water and I decided to write a mystery novel on our outing. Little one and I walk to the Trout with fellow companions and little one dies after eating food. I still need to figure out who killed her, but now that I have the basic plot things shall move smoothly hereon.

Then we got home after another couple of hours of walking and headed straight to bed- the same place that I am going now.

Taking off from my Ganguly tirade, here is a very interesting article written by the Bengali loyalists who provide reasons for not kicking Ganguly out of captaincy. Personally, I think the man must be left out for a series, asked to play Ranji, repair his confidence by hitting some mediocre spinners out of the ground and then asked to return at the helm.

My better half was glued to live BBC video in the hope that the Pope dies and she might be live witness to it. Well the old man finally died at about 19:37 BST, the only time over the last couple of days when the poor girl wasn't watching. Of course, TOI wants an Indian Pope, which I think is slightly wishful thinking especially after 28 years of a Polish Pope. The Italians might just want someone of their own. The Indian cardinal with a chance is Ivan Dias, Mumbai archbishop who seems to have held some important positions in the Holy See.

However,in all this the funniest thing I have read is the manner in which the Pope is declared dead. This is undertaken by a Cardinal Camerlengo and is done by hitting the forehead with a silver mallet and asking the (dead) man in his baptismal name whether he is dead. Seems very odd thing to do for someone who has been on a ventilator and couldn't breathe by himself to cry out his own name, although under duress of a silver hammer coming down on your forehead miracles do happen!! ( this is not meant with any disrespect to the Catholic community, especially after I have fasted long and hard during Lent)

Some fun things to do : go to http://luckfactor.co.uk/Edinburgh/index.html and take part in a really fun experiment. This experiment conducted by the maverick and populist scientist Richard Wiseman is another in line of his famous public pyschology experiments. All you have to do is to identify which among the different pictures shown is a genuine smile. Different pictures are shown and different parts of the photos are cut out.
I got 6 out of 10 right.

Ricahrd Wiseman is running a "Luck School" which is looking at why some people are luckier than others, and as he says there is a huge difference between luck and chance. Hmm..... If only I was lucky enough to chance not writing my transfer report and get away with it!!

To end today's post.. Oh, before I forget. We had some great weather this weekend, and made good use of it. Port Meadows and the Trout Inn on Saturday ( interrupted by a dog shitting just in front of us) and cricket in the univ parks today.

Have to run.. social engagements and hot cross buns call!