So you’re a doc, a foreign cuisine and Corona happened (After vaccinations)

As you may know, I have been a strong advocate for COVID vaccination throughout the pandemic.  On 8th December 2020, a 90 year old from Coventry became the first person to be vaccinated in the NHS. Following that, the campaign for mass vaccination was gradually rolled out to everyone in the UK and with a huge success rate. 

Collectively, we let out a big sigh of relief when the vaccine was introduced to us, following its clinical approval by WHO. It came as a ‘first break,’ from the crunching back pain we were starting to struggle with from the physical and emotional burdens of various sorts that were piling one after another over us. I applaud each of my colleagues and all the essential workers for holding their face up and showing up to work diligently despite those struggles gripping them on their backs. 

In my daily practice, without fail, I have encouraged all of my patients to get vaccinated.  I would say the same for my colleagues. We got vaccinated first ourselves, as we were the primary line of defense between an infected individual and the rest of the community. As I may have mentioned, some of us did have some degree of reservations, as the nature of urgency by which the vaccine had to be developed meant it probably didn’t go through enough rigorous examinations for the risks it might potentially cause versus the curative aspect the drug was providing. At the time, it was important that we kept the faith in our scientists, the field experts and this miracle drug, ‘the vaccine’ they had invented. History says, faith in them saved thousands of us from death, disabilities and deformities.  

Amidst the first wave of pandemic, we were desperate to take control of the situation. From the dreadful outlook charted by the steeply rising death tolls. Morgues couldn’t hold enough corpses. Deaths in communities were slow to report, as some had passed away, alone in their homes while trying to stay away in isolation from clasps of Covid. We didn’t know anything about it, for what felt like ages in the beginning. A lot of things we did learn were picked up from watching vigilantly around us. As it happens in the world of medicine, tallying symptoms, signs and parameters of one patient with another.  Unfortunately in most cases those that died. Why did that patient die? What can we avoid, what can we do to prevent it, how do we know if someone is heading towards a late stage, at what point do we embrace ourselves for it and notify the family? What can we learn from this case so we can save another. 

Only later when they discovered COVID transmission was mainly air borne, it confirmed the suspicion my colleague was raising, why two unrelated wards were having covid outbreaks. The air vents were connected. 

We have come to a time now where we no longer fear COVID to an extent we did in the first wave. We have learned as many of the variants as we could have, about this constantly mutating virus itself and the changing vaccinations combinations we had been administered in the period.    Outbreaks of flu are getting more common and causing more admissions of the aging population now and as clinicians, for COVID we are more focused on infection precautions like personal protection measures & isolation for 10 days. 

We have entered phase 4 of the trial in a sense. Like that for most medicines available out there in the market. Phase 4 trial for any drug means, this is a period where the drug that has proven its efficacy, has been licensed for use by relevant control boards for intended purpose will now be studied on its effects- mainly long term risks and benefits. This is the period where data will be coming in and collected in mass about the minor/major adverse effects/ side effects experienced, complications and sequelae secondary to it. A drug may have completed its phase 4 on research however one can assume phase 4 in the clinical world runs forever. A drug may have certain side effects for a small duration period but may have a completely different adverse effect after years of use on the same patient. By virtue of collective toxicity over prolonged use or by modifying effect of some other medication he might be using concurrently or by adaptation in some forms by his genetics or as his function of organs changes. For example with age our kidney function deteriorates physiologically. That is why our guidelines even for first line drugs after many years of use often changes. When the data collected after long years maybe even decades, prove that the harm outweighs benefits in the contrary of beliefs, it has to be. The drug will either be taken off the market then, used in other diseases where success has been crucial for patients or as a specialist prescription. Every medicine you take comes with a leaflet of  its intended use and series of effects. 

There had been uproars about violation of individual liberties in many instances. Including government mandated vaccinations that was rolled out for frontline workers with patient facing jobs, with risk of dismissal in most cases and possible redeployment if there was resistance. Legal enforcement of activities as such have led and continues to lead communities marching against protest for breach of their human rights. I must say, although I had never been a big supporter of those marches, especially if it meant less vaccinations in the community at the time of outbreak, mandation by law with no redundancy plans for those who wish to leave spoke volumes of where we stood in roles in the scheme of big picture. In world war one, 97% of British soldiers were inoculated with anti typhoid vaccination. Articles I have read infers that most did not know they had the right to refuse it. And although it prevented deaths and infection by typhoid at the time of sanitary status of the wars; military approaches for domination, affirmation, experimentation without consideration of individual choice and rationale for refusing it in the name of greater glory for the service of mankind, is unacceptable. How many have been trialed since? Ideal candidates of the right age in full physical fitness in a controlled environment. The risk here is reinstallment and propagation of the same behaviour in future, mass human trials, without a second of thought for ethical implications of it? 

Most of us experienced local pain, fever, headache and general myalgia with our vaccinations. Similarly, some people had allergic reactions. It is important to remember these vaccines act by modulating your immune system so these effects were to be expected. Most effects were noted in the first few months as that is when immune system is maximally activated against the insult. The later effects, if any because of these insults,  may take time to show. There have been circulating reports of various adverse effects experienced attributed to Covid vaccine although the argument is, they could possibly be related to covid 19 infection itself or subclinical infection prior to vaccination as well that he/she did not demonstrate any symptoms of. Blood clots were detected quite early. Studies are now showing, there has been an increased incidence of neurological conditions like guillain barre syndrome, bell’s palsy. Some reports of inflammation in the muscles of the heart. People’s story of their own experiences with vaccinations are coming forward. Like its impact on fertility after experiencing menstrual irregularities, generalised fatigues, recurrent headaches etc. Accounts from brave whistle blowers are coming forward. There is ongoing world wide surveillance and reporting of the adverse reactions, which I hope will be duly studied before dismissing as mass hysteria.

It is important to be transparent, now more than ever, to keep communities’ faith in our profession, and our continuing faith in scientific advances, pharmacological companies, world leader platforms and the government. And most importantly, it is vital that people standing in power including the government work on their approach to reinforcing the means of ‘greater good’ with respect to individual’s liberty in mind. Endemic, epidemics and pandemics are part of human history. Like seasons have their cycle and place in nature, unless there are outbreaks of bio hazards due to human errors, we should expect nature will find us surprises along our course.

So you’re a doc, a foreign cuisine and Corona happened. (Why the beginning? )

Hey doctor, did you forget to change your face mask?’ Our nurse in charge stopped me before hopping from one cubicle to another cubicle to see COVID patients. ‘Oh, sorry’, I replied immediately, laughing at my forgetfulness. Remembering the time, in the midst of a pandemic when I splashed water in my face without realising I had a mask on.

It is February 28th/2023 today and ‘No, COVID hasn’t gone away yet’. But as I have claimed before, it isn’t as intimidating as it used to be. Juggling your memory again, ‘remember that time? December 2019? When city of Wuhan in China first went into lock down to control the deadly virus from spreading elsewhere.’

I started writing amidst of pandemic waves. Overtime I have talked about lots of things. The beginning of all these parrot tale was a silly story which I have mentioned before. Basically I had a dream. I don’t remember the details of it now, but I do recall ‘sort of being instructed to write’ and ‘sort of being introduced to this title’ and, ‘feeling good about scribbling something in my dream that I have no clue what it was.’ The memory of it is all vague, it has been more than a year. But I do remember mentioning to my ex saying, ‘I feel like I need to write about this, about this pandemic’, that morning. I don’t know if he has any recollection of it. People have all sort of dreams. My friend mentioned once she had a dream where she was a flying ninja fighting crime in the city. Like who sees that? Is that normal? Something about this one though, it planted a sincere and undying motivation, almost like a promise to myself, to sit in front of laptop and start hitting the keys every chance I get, no matter how tired or lazy I felt. I didn’t know where to start but I had to. Am I religious? I don’t know. Is there God? I believe there is. In that case, do I think it’s God’s message then? Certainly not, I wouldn’t go that far. Bonkers! Experts believe, ‘dreams are revelations of your subconscious minds.’ Maybe, somehow I found a way to tap into mine that night.

It was a work at first. I didn’t want to jot the bleak situation of hospital capacities, circumstances of deaths with the virus infection, forlorn eyes of mourning individuals, resentful words of grief stricken families, hateful comments with racial slurs, fears for own health & families safety and physical/emotional burnouts; but those were the realities. Re-living the emotional experience whilst writing when I could push it and shove it down, like an adult, never to be spoken about; may have been an option but I chose not to do so. 12- 13 posts down the line, writing became more easier, sort of a way of venting to express myself and I suppose at that point, it started becoming a selfish endeavour to save myself.

My intention in some ways was also to give ‘the readers’, a peek of life of a medic. A glimpse away to lives inside hospital walls, the ups and downs we face in our career living up to our responsibilities and in our personal lives; in a hope that you see these individuals not just as a professionals but also as a son or a daughter, your friend or your colleague, your uncles or aunts or your father or mother. That you are kind to them. ‘Yes every profession deserves a kindness’, I am not here requesting any more ‘just at a level you would give any individual at your standing.’ The world seems to have forgotten that as a medic in our profession, ‘we deserve some humility and respect too’.

No, it is not right that you curse the nurse in front of zillion other patients when she is not answering your call. She is looking after 9 more patients on her own and, is currently on a drug round. ‘

‘Yes, he does have right to not forgive you after the temper tantrum you have shown for your quote *had a bad sleep*’.

‘We do have every right to refuse to treat you as a doctor as you have a right to be refused being treated by us’.

‘Please cover yourself. It is basic human decency. Not to flash your breasts or penises when we are specifically not examining those parts’.

‘We will attend you, however there are long list of patients waiting before you, unless it is a life threatening emergency. We need not tolerate emotional or physical intimidation because you want to jump the queue’.

And most importantly. ‘No you do not get any excuse to rain down on another individual just because you are sad, lonely, angry or in pain.‘ Would you have tolerated it, if it happened to you in your profession? Why are we any different?

I ask you, would you kindly see me or my colleagues beyond our stethescope on our necks and our badges reading ‘doctors’ and accept us like any other individuals in society with running clocks of our own private lives? Just as you? We are men and women in careers, each one of us with our own personalities and a background of running commentary. Would you see us as humans too? Yes we have certainly adapted to restraining our emotions but we still feel. Your expressions whether its happiness or anger, affects our days. At the end of the day, we do take a lot of emotions back to our homes. We do need a period to switch off, unwind, hit the power button and recaliberate ourselves. It is not fair to be expected to be available 24/7 like movie industries portrays our commitment to profession should be like. It is not fashionable, as it seems. Please don’t expect us to stay another hour individually for your service especially to vent about receiving minimal service and threatening to leave.

The number of hospital admission have sky rocketed compared to 10 years ago in the NHS, I am sure so is the case all around the world. Quality of life has improved on various domains of people’s lives including work environment but I am not sure if that has been the case in our profession. My seniors could argue ‘our lives is much better now’ but, that would be like me arguing ‘quality of children’s lives is much better now’. Children now don’t even know if they are humans or goats. And schools are entertaining drag shows to kindergartners. Look where we are standing in human history.

On 13th March, Doctors in England are doing a 72 hour mass walk out as an industrial action for pay restoration. In the past, I had commented in my post that doctors and nurses were being paid less in significant percentage than they were being paid in these profession, years prior. My phone is blinking continuously now from constant messages posted on junior doctor’s forums, mainly sharing information from different trusts that are releasing intimidating messages to their employees suggesting their will be consequences for their actions. Disciplinary actions, loss of pays. So, everyone including me who has just joined a new hospital in a new rotation are basically sitting on hot seats now.

I came across a very interesting post on tiktok. (Oh yes, since I have returned from Nepal. Now I have started using tiktok. hahahaha). The post (Huw Corness) on 02/Jan 2023 reads ‘When I qualified as a nurse in 2010 my basic hourly wage was £10.83 and freddos were 10p so I was paid 108 freddos an hour. The nurses who qualify now start on £13.84 an hour and freddos are 25p so they are paid 55 freddos an hour’. I hope this gives you some idea of why it is necessary to stand in unity for support. Not to forget, our profession undoubtedly is a big chunk where tax revenue comes from.

You don’t have to necessarily support the cause. I will agree there are plenty jobs which deserves more limelight than us. That I have utmost respect for. But I hope, you will keep in mind when you enter the hospital premises next time that these are the professionals that are trying their best to their jobs, to provide you with help that you came seeking for, at their doors. You are not a prisoner unless of course you were brought in handcuffs by the police. As much as we treat you individually and with respect, please’ remember to reciprocate.

Oh dear… (So you’re a doc, a foreign cuisine and Corona happened)

So, my mom just recently returned from Nepal. She had flew off to the country as soon as the borders were open to travelling following COVID shut down and managed to secure herself a long awaited vacation by herself in peace without dad and us constantly nagging her in the background. As a souvenir she had brought us some waiwai noodles that we absolutely love and 4 gutted water frogs with their half open mouths and outstretched hands & legs that were completely sun roasted with their skin melted to their skeletons. She appeared very smug as she showed it to us holding them by legs almost as one would hold hot dog on a stick and passed it to me. I will be honest, they did appear crispier than a pork jerky but still had quite raw expressions of horrifying moment of death they were preserved at. Not realising in her moment of triumph that we have never seen this, she looked at us in disbelief and said ‘its hard to get these!’.

I had always wanted to try frog legs ever since I saw it in one of the episodes on ‘Travel and living’ channel. Apparently it is one of the French delicacies and is quite popular too as street foods in Asia like in Vietnam. YouTube bloggers who had it for first time compare it to being close to chicken but more juicy and delicious. Unfortunately this memory of mom showcasing her mummified frogs might have put me off from attempting to have that experience. I am pretty sure she was the hunter herself. Mom is opportunistic. Four is just too less of a number for her to buy. Makes me wonder, what kind of other adventures did she have in the village. She promises, they will never end up on our meals. I doubt so. There seems to be one for each one of us. I wouldn’t trust her words. It took me a couple of weeks to find out she has been filling my water bottles with snail water drinks. Apparently some one told her, ‘it is very healthy for gut’. She is the woman who was trying to buy 1 litre bottle of rhino pee from the Zoo determined to bribe the keepers having heard ‘it is being sold’ and ‘it has great health benefits’.

I remember once, coming home and finding grandma standing on our veranda also sun roasting one of the biggest slugs I ever seen in my life. It was pierced in so many directions with tooth picks, god bless, because she couldn’t find bigger skewers… Doesn’t surprise me, my mom is this way. Although it would be great not to have frogs, snail water as drinking water or rhino pee on a soup but hey what can one do right? But again if one of the chefs from lets say one of the high end French restaurants served me ‘would I say No?’. I don’t know.

No. I haven’t had slugs. I have had snails- as a cuisine. And honestly that was great. Hadn’t tried sea foods before until I came to the UK as Nepal is a landlocked country and, some other things. On that note, you never ask for a ‘beef momo’, you ask for ‘buff momo’ in Nepal. ‘Buff’ as in ‘Buffalo meat’ is quite commonly consumed. Please don’t ever ask for cow meat there.

We were laughing one day talking about these experiences about my mom’s weird habit with my close friend when her mom too admitted to her that when her and her sister were little and suffered from constipation, she would go to the old palace ruins to pick up slugs in Nepal. That would later be dried and their powder mixed into their soups. ‘It worked‘, she said. I guess it is not just my mom then, looking for home remedies. Similar to that story, one of my patients in her 80’s recently told me, when she was young and suffered from terrible constipation her mom would tear a cotton cloth, put a soap in it, soak it in the water and give her an enema. ‘It worked’, she said too.

I don’t know what works and what doesn’t to be honest. We can’t go on researching every myths they have out there, can we? Have you heard of all the things people have been doing for home remedy of COVID past years? My uncle and aunt apparently turmeric drinks were great to get rid of the virus. Listening to their story coming from Mom, I am not sure whether their COVID symptoms was severe diarrhoea or it was the concentrated turmeric drink they were taking for their symptoms that was making them go back and forth? Honey drink, tea and hot drinks I can understand. They have soothing effect on sore throat and help expectorate cough. Advised the same to my siblings when they had COVID and I could literally hear my mom roll her eyes in its bony vaults over the phone all the way from Nepal. ‘You don’t know what you are talking about’ she remarked. I wonder if it is a shared problem with every doctor’s in the world or just mine, my family members never seem to take my medical advice. If they did, mom wouldn’t be carrying dead frogs across the oceans in her luggage right?

Anyways, ‘People are drinking alcohol to fight with COVID. It is an antiseptic. So… ‘ A small glass of whiskey everyday on a supposedly based medical recommendation? I know where she is going with it. ‘There are herbal sprays and powders that you put in nose that gets rid of COVID even when you are just starting to develop symptoms’. ‘I don’t want you stuffing anything in your nose again Mom’, I tell her off appearing stern, reminding her of the time when I came back home to find her puffed with a swollen face- nose, mouth and eyelids salivating from one end of her mouth. There was a herbal product called ‘Nos’ in Nepal, I don’t know if it is still circulating around. Both my mom and aunt trialled it to help with their sinusitis problems. You take a sniff of it (reminded me of cocaine addicts they showed on TVs when they did it) and after some time, you start having excess nasal drainage. I don’t know what happened after few days, I swear she looked like the frozen sun-roasted toad she is showing me now.

I feel for people who are now suffering from long COVID symptoms who are desperate to try anything including and not limited to complementary medicines. A lot of our modern day antibiotics and treatment are a discovery or at least in part a derivative of these ancient practices. They have proven benefits in many cases however I would advise caution with any use. I read there are extensive frauds going on trying to sell a miracle cure for COVID, scamming thousands of people. One needs to be really careful in today’s day and age. My dad was at the bank while on the phone with a scammer about to transfer money!! From our last conversation about COVID medications, monoclonal antibodies called Ronapreve (casirivimab & imdevimab combination) has been now removed from treatment guidelines since it was found to be less effective against omicron variant which remains the dominant variant today with its BA.5 variant leading in numbers and some BA.4 variant cropping here and there. Paxlovid has been introduced a while ago which is a combination of Nirmatrelvir & Ritonavir in oral formulation. And I read, both Molnupiravir and Paxlovid are both being studied now under RECOVERY trial. Similarly stem cell therapies is other avenue that is being looked into.

I have now come out of training and do only part time shifts now and then to keep afloat on my rent and expenses. So I have to be honest, I have not and will no longer be keeping track of COVID while on my ‘career break’. I haven’t yet travelled. Thanks to my poor judgement on expenses on romantic and life decisions. Hahaha. Finally got myself a ticket. ‘Is covid still going around in Nepal?’ I asked her as soon as I got the confirmation email. ‘No one is scared of Corona anymore. Its Dengue in Kathmandu all over now. Make sure you are fully clothed top to bottom and carry insect repellents’.

‘Oh dear…’

So you’re a doc, a foreign cuisine and Corona happened (Second class citizen).

The Guardian on 25th June posts on its headline ‘Covid cases on the rise across UK as Newer variants dominate’. COVID is back again. Not that it ever left, but the numbers are big enough to get attention and to deepen our furrows in an anticipation of what it might result to. Like a bad juju. I don’t even allow myself to entertain the thought of going back to lockdown anymore.

It seems to be driven by BA.4 and BA.5 variants of omicron. The cases are mix. They might be quadruple, triple, double, single vaccinated or none at all. Still not as unwell as they were in first wave. Hence the behaviour of general public, ‘not a damn given’. Which is kind of good. Last thing we need is panic driven public in our road to slow steady recovery.

Not surprisingly The Guardian mentions ‘levels are highest in London and among those aged 25-34′. Work and social life isn’t it? Both my brother and sister have tested positive this week too. After all this time since COVID began for the first time. I know many people who have had now by 3-4 times already. My brother is fine, sister is down with terrible flu symptoms; is slowly recovering.

But, moving on from COVID, my attention this time is more focused on page 12th and the 13th of paper. As soon as I saw the headlines, it felt as though someone had slapped me across my face. ‘Biden warns of lives in danger as supreme court overturns Roe V Wade’, ‘Blood in their hands’ Doctors hit out at abortion decision.

There is a lot to follow in the news. For those who are having difficult time to grasp the head end or the tail end of it, I will just copy past a few lines I have been reading through from the same pages.

The US supreme court has overturned the landmark the Roe V Wade case, which granted women in the US the right to terminate a pregnancy.’

The court decided there is no constitutional right to abortion in a case called Dobbs V Jackson Women’s Health Organization. In reaching that decision the conservative-majority court overturned Roe V Wade, from 1973′.

As a result states will ban or severely restrict abortion.’

Twenty six states are expected to do so immediately, or as soon as practicable. This will make abortion illegal across most of the south and Midwest’.

Every women worldwide must have felt that. The slap, I mean. A force across her soft cheek by a sturdy rough hand with a brute force, aimed precisely to cover most of her face and with no doubt with an aim to disfigure her beautiful features. Including the queen.

It comes as shock even to us as health professionals. How a country like USA that is always on the lime light; a country of dreamers, forward thinkers, world leaders and entrepreneurs; that is an image of pinnacle of social acceptance, equality, diversity and freedom to the rest of the world, can make a decision like that. Like the British prime minister Boris Johnson says, ‘a big step backwards’.

In the UK , ‘abortion act 1967’ allows medical termination of pregnancy less than 24 weeks if continuation of pregnancy possess risk of injury to physical or mental health of pregnant woman or any existing children of her family, continuation would involve risk to her life and, there is a serious risk that if the child were to born it would suffer from such physical and mental abnormalities as to be seriously handicapped. Beyond 24 week, there are only limited and specific circumstances justifying it.

None of my male colleagues seem to welcome the idea either. So I am guessing the problem is not with gender bias or hatred of some form for opposite sexes. Yet why does it feel like the punishment was only to us? ‘Has anyone thought about teenage boys not ready to become fathers yet?‘ like my colleague rightly asks.

I hope women advocating for pro-life have strong reasons to stand their grounds because losing this battle is losing basic rights of freedom for all womenkind. Standing at this pivotal time, celebrating victory while marching a movement that will imprison and incarcerate us, our daughters and granddaughter and generations to come; let us pray that they have enough will to forgive themselves when the consequences of it, if not directly but eventually will find its way to them. Those eyes that are too full of self righteousness at present time, that refuses to see the tears and hear screams of underprivileged girls and women, while sitting behind white picket fences while enchanting lord’s name 20 times a day; feels traitorous to look at now.

A decision like that, made by a country like USA has a big impact in the world. It indeed has ripple effect. I cannot even imagine what dreadful events it will trigger in a cascade now, in countries where society is religiously and culturally male dominated. Where parents sell their daughters like goods to pay off debts, where marrying off your daughter is good riddance but with a big cost in the form of dowry to her husband, where women can’t drive, can’t pray in the same hall as men, where women have no right to decision who they can marry or can refuse, where rapes are happening everyday accepted culturally and religiously, and even if they are not; where women don’t have a voice, can’t stand their trial because society won’t let them- without hanging themselves down the ceiling motionless, cold and frozen before her perpetrator. Could be stranger, could be a friend, could be a father. Who cares. With decisions like this, they are the end results. These victims will never be able to run, never be able to ask for help again. As sad as it is, then, it wouldn’t be wrong to say, dogs are better treated than humans even in USA. Classed as second class citizens, women no longer have their basic right to their own body and to their own wombs. Somebody please reassure me that, there will still be access to contraception right?

Are we even allowed to chose our own mates then? That is one big question. Like some villages in Nepal, girls will be openly kidnapped, the acts will be romanticized by men, by society; they will raped openly on the streets. Men and boys will fight amongst themselves to decide who gets to force himself on her first to plant his seed. They know, she will bear him children. Abortion is illegal, what choice will she have. At least justice is done there with blood for vengeance if the intention was not to marry the woman?

What about mothers with babies with severe birth anomalies? No mother should be forced to watch their new-borns struggle for life whether it is just for few mins, hours, days or months. Definitely not to adulthood, completely helpless and dependent on her to sustain breath, suffering every moment of it, hating themselves and her for bringing them to the world in their cruel faith. What about those with still births?

Such a primitive mindset. You’d think with so much scientific developments, technologies, increased literacy rates – world would only move forward. No. Like my friend says agreeing to Boris. ‘We are going back’. ‘Back to no abortions, back to wars and back to plaques’. What is next, will every boys and men who have sired a certain number of children be nipped off?

Its outrageous how a group of bad politicians and their decisions can outstrip humans of their basic right of autonomy of their own bodies. How many among those decisionmakers were ones with uterus and fallopian tubes? If there were any, I am sure they would have considered that there will be rise in crime rates, consequently in girls seeking abortions in black markets, in dingy rooms with unsterilized equipment risking their lives. That mothers will once again grieve at birth of their daughters. And our tomorrows will be on hands of a generation who we’d have failed to protect from physical abuse, emotional abuse and life long neglect from their own mothers right? Is it so hard to see, what the result of their action will lead to? This is not just opinion we are talking about. We are talking about enforcing laws and affecting lives.

PS- Its a 100th post. I had set out that day– with an aim that I’ll stop once I post my 100th. One of those things i had to do from my ’things to do’. I had drafted when I was going through a little difficult time during COVID. And here it is! Any extra I write from here onwards will be a bonus work for myself. I congratulate myself for commitment. Thank you for being a part of this journey. 😁

A COVID pledge? (So you’re a doc, a foreign cuisine and Corona happened)

image source-Wikipedia

And Princess Margaret always had one in her fingers as well, all the time.’ Said my patient huffing as she made her way out of the building’s main door wheeling herself. Once she had parked her chair out in the open which seemed to be her usual spot, she started lighting a cigarette. I could really see how much she enjoyed puffing it. Igniting the lighter, curving her hand next to it so the wind won’t blow off the flame and taking a deep inhale; she was natural at it. Why wouldn’t she be? She had been smoking every day for past 50 years, had managed to knacker her lungs completely with it and now had a condition called COPD.  Chronic Obstructive pulmonary disease which is an irreversible lung condition at her stage. She took a really long breath to suck the nicotine in. I didn’t think she still had it on her. I mean, the physical reserve to inflate her lung that much. She was in a state, where she needed oxygen permanently at home, for at least 18hours a day. She couldn’t move from room to room if she exerted herself because of breathlessness. And her face, mainly her lips and ends of her fingers were sort of discoloured blue, an unhealthy-looking tinge of colour one develops when their body has been deprived of oxygen for so long.

This is one of the very few things I can still enjoy in my life now’, she said.

‘If she hadn’t been smoking that long and was addicted to it, may be there would have been so many other things she could have still enjoyed.’ I thought to myself. Knowing ‘Love of her addiction’ is killing her and despite that, choosing to continue on it; it is hard for me to not wonder what is going in her mind.

She tells me, she started smoking very early at beginning of her teens. Now she is in her late sixties and in a nursing home almost wheel chair dependent in majority of her activities; the cocktail of nicotine, tar and the chemicals has managed to destroy her life. ‘At least I always had my cigarettes’, she remarked, taking a puff and blowing out the smoke very slowly in the air, amusing herself with the cloud of smoke it created. ‘It was a thing you know at that time. All of my friends use to smoke. Everyone had a pack with them, everyone was offered one wherever they went’.

I don’t like the cigarette smell. That doesn’t mean I haven’t tried myself either. Like most children whose parents smoked, I was introduced to it quite young as well. My mom used to be an avid smoker. I guess she developed her habit by following a trend of accepting gifts and complimentary stashes distributed to soldiers very commonly at those times. Naturally the troops wives had access to what their husbands had. ‘Marlboro’ used to be her favourite. As children, when as we saw a cigarette box with bright red on a white colour, we knew it was ‘good stuff, had been imported and either dad or one of her family members who was in the army had sent it’.

There might have been many reasons why smoking became a trend and still is. ‘Advertisement’ comes in mind first. We all know how intrusive and invasive they can be in our everyday lives. An add everywhere in newspapers and billboards, add celebrities into the pictures with their fancy gowns and chic smiles; there you go a generation of brain washed teenagers and young adults who look up to their role models and are desperate to be a part of the rage. ‘To calm the nerves’ as was told to the soldiers, it was mainly sold as an anxiolytic. Papers and the studies preached its wonderful effects too, leading general public to believe ‘it was safe’. Following these slow movements into individual people’s hand, in the world wars the popularity peaked, in few weeks it became sensation. Then a social tradition. ‘To offer a cigarette to a guest or friend as a part of social courtesy’.

I came across a cigarette advertisement made in 1950’s in YouTube. It plays “Doctors in all branches of medicine, doctors in all parts of the country were asked ‘what cigarette do you smoke Doctor?’. Once again, the brand name most used was Camel. Yes. According to this repeated nationwide survey, more doctors smoke Camels than any other Cigarette.”

Imagine the confidence of the company in using ‘Doctors’ as part of their lure to the public. It alone proves how accommodating we were as a profession of cigarettes in our lives then that it used to be acceptable for hospitals to allow smoking in bays and while on consultation with doctors.

It was only much later the long-term effects of smoking was discovered. Lung conditions like emphysema, bronchitis; cancers of various origins like lung cancers, oral cavities/nasal airways, bladder cancer and disease of blood vessels, heart etc.  Anti-smoking campaigns started more vigorously world-wide as result. Strict rules were then imposed and enforced on tobacco companies with heavy taxes, prohibition of smoking was announced on general public areas and now, even what used to be my Mom’s favourite at the time; Marlboro cigarette on its pack mentions ‘smoking seriously harms you and other around you’.

When she learnt passive smoking can be more dangerous than active smoking, my mom left her habit for good. She caught on time about its adverse effects from few minutes of government broadcasts that would often pop on news channel. We were then no longer asked to go and light the cigarette for her. Kind of missed not having to, for some reason it felt exciting thing to do at that age. Initially, it was hard for her to say ‘No’ when they continued to arrive in gift packs and in fancy boxes. But she pushed on her determination and helped some of her friends to quit smoking too. She hasn’t smoked for many years now.  

In Nepal, people mainly used to use firewood to cook. It still is the case in many places. Cities mostly use gas while the villages are still dependent on it. ‘Food tastes better even rice on it’ my mom used to say when she prepared it while blowing air on the stove through a long metal pipe, coughing constantly with irritation. When Joey uses the firewood stove at his place now, to keep the house warm, I remember myself constantly asking her to use gas or the petrol fuelled stove. Most people in the village suffer from COPD lungs in remote parts of Nepal. I am glad, my mom gave up both, smoking and cooking on smoke before damaging her lungs irreversibly. Cities aren’t exception now either with pollution from the vehicles.  If you haven’t been in the autopsy room studying lungs of a diseased Kathmandu resident, you would find it very hard to believe how much of smoke/pollution can affects lungs. Even the visible physical evidence is dramatic.

My patient can’t have oxygen at home because of the hazard risk with fire. Staffs are careful that she doesn’t sneak in any inside and would rather have her move about often as needed when she requests to. At this stage, our intervention is to only support her with oxygen. Cutting out on smoke now will not change her outcome. So, if she finds relief on smoking and feels this is one of the very few things she can now enjoy in life, she should be allowed to. And she is welcome to.

NHS offers ‘quit smoking programmes’ which we suggest to all of our smoking patients. Occasionally patients will spot doctors sneak out for ‘nebulisation’, a term we use to refer ‘smoking’. But knowing the adverse effects and impacts alone doesn’t always determine one’s choice. People choose what they choose for various reasons as long as it is an informed choice.

My friend once suggested ‘try smoking. I smoke now at least 3 times a day to lose weight’. I remember, the hype there was among the teen age girls then.

World Health Organisation (WHO) on its website mentioned ‘The COVID-19 pandemic has led to millions of tobacco users saying they want to quit’, with World No Tobacoo Day 2021 pledge.

This is a good thing. All the best.

A dog story for a tradition (So you’re a Doc, a foreign cuisine and Corona happened’ podcast link

She is 10 years old. Such a shame. It will be one of my biggest regrets. She would have made an excellent therapy dog’. A patient said to me over the phone talking about his Labrador.

I was waiting in the hospital for my appointment, sat on a bench outside with her. When a young bloke sat next to me. He was shaking/shivering when he sat. And he asked me ‘Can I pat your dog?’. ‘Yes’ I replied, and after patting her for some minutes he completely stopped shaking and he looked like a different man. That day I thought, I must put her as a therapy dog. But with all this COVID such a same that she couldn’t.

Although the risk is very low, by now we know that COVID can infect our beloved pets in close contact and vice versa. The symptoms are very similar to us; fever, cough, cold symptoms, shortness of breath, lack of energy, diarrhoea, vomiting, flu like illness. On 10th November/2021 GOV.UK published on press release ‘COVID-19 confirmed in a pet dog in UK’. After the press release and even prior to the press release there has been various interesting studies done surrounding impacts of COVID on pets and their pet owners. Some of the conclusions suggest very positive impact for the owners in terms of having a psychological support in form of companionship during lockdown and on pets-with more pet time from their owners for training and activities. BBC news on 12th March/2021 posted ‘Households buy 3.2 million pets in lockdown‘, mentioning that the main driving factor for rise in the ownership was the ‘social isolation.’

Other studies shows, there may have been a handful of challenges to pet owners mostly in dogs in terms of coping with stress of behavioural problems with their pets, accessing pet services as needed and food supplies. While on the pets especially dogs; less out door exercise and play time. Overall, all these researches on pandemic has highlighted again, why our human kinds has always been very fond of acquiring and keeping pets since time unknown. And how these fury friends continue to help us in many ways and have won special places in our heart.

Joey parents have a cocker spaniel. He has a beautiful lavish fury golden coat. Just like fresh honey stolen out of a bee hive, but a little darker shade. Very handsome little thing. They absolutely adore him. One of the family member is always at home to make sure he is not left alone and on the days they are at work, he dropped at the care centre, where he apparently has made some friends. When he returns from the centre Joey is always super excited. The first thing he does when he wakes up on the weekends is watch out of window to see if his little furry friend that is barely a year old is out on the garden or not.

When we were growing up, we also had a dog. Dogs’ actually. One passed away at about 15 years old and other passed away quite young at about 2 years. We got the second one some time later after the first one passed away, the only male pup from a litter of puppies. He was a gift to us from our relative, who had promised us one when Dorje (my dog) ‘s mom was still pregnant. He had said ‘if only there are male pups’. Luck for us and he had 6 fingers on each legs on his paws!

My mom is very fond of dogs. I suppose I was at some point too. I love them, but not to an extent to emotionally invest on one. It is a big commitment so I try not to get sucked into their bewitching innocent eyes. Someday? Yes may be. But I would like to very much have a Himalayan dog again if I did. The one I had before on both occasions. But Joey tells me after some research, obtaining pet passports, health records, vaccination status and with flights it will cost me fortune. And also introducing a whole different breed of dog to the UK will be a lot cumbersome.

Himalayan dogs are amazing. We call them ‘bhote kukur’ in Nepali. They are generally big dogs, with big broad rectangular heads, black beady or brown eyes, furry, usually on heavy black coats or with brown patches on a black coat. My first dog was call ‘Bhalu’. Because he exactly looked like a black baby bear cub! When I first held him, I could barely lift him properly. Even for a few days old baby, he had massive big paws, very sharp nails. The second one ‘Dorje’ was a quite small compared to Bhalu, but he was also very handsome dog nonetheless. He had light brown/yellowish distinct patches on a black coat around his eyes, on his tail, on his chest and on his paws. It took me a while to like him, but how adorable were his 6 fingers on front paws! 22 total fingers! He was special.

My mom has her own story about her dog. And as I would pass along my little tale and description about the dogs I had, she passed me description and the tale about her dog. And in some ways, the day Bhalu passed away was the story of our start of tradition.

Her dog name was ‘Sindhuli’. She was a very massive black coated dog like Bhalu was, a very beloved family member and a hard working herding dog. Her job was to work with herdsman and guide the cattle up to the highlands called ‘bukhi’ in the winter for grazing and then bring them back down the village after the winter had passed, when some vegetations would have started sprouting back to life. Her job also involved making sure the sheep and the cows didn’t strand far along the route on the way or while they grazed and to protect them from the foxes, wolves and other predators. When the herdsmen made their way to village, mom says, she’d be the first one to appear in the village. With a big bell ringing as it dangled in her neck, everyone then would know the winter had passed, their men and the herd were coming back home.

She was obedient. She did her own thing. She knew what her job was. But, one day, she didn’t return back on time. Then the men came with their drums, beating on it to make an announcement for the village’.

The dog of the Oak family‘, they said ‘has become rabid. It is heading its way to the village now. All people are to stay clear of the dog. It is very dangerous’.

We were shocked. We heard, she had fought with some wolves while on high land and was now infected. When she arrived, she looked dirty, beaten with hunger and exhaustion, as though she was walking semi conscious. Saliva was trickling down her jaws, her tongue was out, her eyes were sticky with clumps of pus/discharge in corners. She recognised us. Would growl when she would come across any strangers but to us, she was docile. But we were scared to go near her. Rabid dogs are mad, they are dangerous and people die… She sat on our verandah and made growling noise every time she heard any noise, mainly water. She was scared of water’. At this point, my mom was crying, wailing like a child that was re-living her painful experience. And while wiping my own tears, missing my a friend of 15 years, I held her hands trying to calm her down.

The villagers were scared. They all gathered and came to us saying, the dog was dangerous and had to be put down. There was no option. A dog dies in 1o days with rabies but no one could wait. So my uncle said, ‘I raised this dog from the day it was born like my own child. I hand fed her, I took care of her. She is a family. So if it has to be done, it has to be me’.

We lured her gently with a meat loaf to a tree’. Mom started wheezing taking rapid shallow breath unable to complete her sentence. ‘Tied her on it with a rope and my uncle shot her in the head.’

The look she gave to him and to us while she understood what we were about to do…’. I was concerned for my mom at this point because she was starting to look flushed with bluish tinge on her lips, her eyelids were swollen and the tears were falling down relentlessly. ‘I can never forget it. The look she gave.. She was so shocked; from the pain, not from the bullet that was about to hit her but from the treachery, from the disbelief of watching her own master/ her family turn their backs and be ready to take her life. Before the trigger went and we heard the loud noise, we watched her close her eyes in defeat. Waiting to be done… Oh what must she have thought, after all these years of becoming loyal, my masters are killing me’.

Mom blew her blocked nose in a piece of tissue and put her hand across her chest trying to control her breath. It was then, I understood the trauma of her loss was much bigger than mine by many folds even after all these years. She is in her early 50s now. She was merely on her teens then. At least, Bhalu passed away of age, it was inevitable. I had some time to say goodbye, I cannot imagine if I could have ever gathered enough strength to put him down, in circumstances like that.

Its a loss of friend after investing so many years of emotions even though they are ‘pets’. It hit me harder than losing a human friend. I didn’t know her that long as long as I had known my dog. So I completely understand the panic it must have created in pandemic with anxieties building up with lack of care facilities and delay in urgent services offered for pets. As far as I am told, most were classed as ‘non -essential’ travels/services. Studies have suggested, there aren’t any robust plans for situations like this COVID pandemic for our pets, who are now very integral part of our lives and societies. Shouldn’t we be working on one now?

I read some stories where people gave up their pets last minute because they were not able to take care of them. I hope they found right homes. Better to give in for adoption than to raise in abuse. I have regrets of my own not being able to give my dogs the right care, not being able to give enough space to stretch their legs in urban city. I could barely hold Bhalu when he ran, he was so powerful, he would drag me sliding from one end of the ground to the other. Eventually I’d have to let him go and return home with bruises in my elbows, legs and face. Then Mom had to go searching, before the whole neighbourhood started panicking seeing the giant running around chasing their little fufu and toy dogs. He was very troublesome. Had a big personality. Loud and very unfriendly to others. But I loved him, we loved him in our own way to pieces.

Impressions (So you’re a doc, a foreign cuisine and Corona happened)– podcast link

 I’ve been living in this flat for about 2 and half years now. And the only times I’ve met my landlord was one when I first took over the key and signed the contract and the second, was a few months earlier at the end of last year when I had locked myself out of the apartment and I needed the master key from him to get in. My first impression of him was, he was a lovely person and quite specific to points he wanted to put across. The second impression was, well I am not so sure. Because he looked kind of grumpy. Understandably because he had to drive on a sunny Saturday afternoon to open the door for a tenant and also because was sat out ready to have lunch when I happened to call. We all know how ‘hangry’ feeling is. As soon as he saw me, he headed for the flat door, unlocked it, got back on his motorbike immediately and drove home without even saying proper hi or goodbye. 

At that time my thought was, ‘well I’ve been living here paying my monthly bills for 2 and half years now so at least you could do me one favour smiling.’

But, by a strange coincidence I met him a few days ago as a patient. And now my whole impression of him has changed. 

I really didn’t recognise him until I saw his name and queried ‘are you my landlord?’. To which he replied, ‘if you are the person on your tag then yes I am your landlord.’ 

The person I saw a couple of months ago and was intimidated with happened to be quite charismatic, polite, kind man in his 70s who had come a long way in his life. It feels as though now after spending an ample amount of time with him, I have now looked into him ‘inside and out’. Still battling through a lot of hardships and pain everyday with his medical condition, he impresses me with his strength of character.

I really wanted to help him that day. Make sure he got the medical attention he was seeking immediately. Basically whatever I can do from my end. 

Sat in the bed, looking at the creamy beige painted walls of his property that I had made home for past years; I can’t help thinking now how different our perceptions of people are in different settings. How our interactions of minutes can leave a lasting impression on individuals and how changeable we are with our presentations and our effects according to our circumstances. 

I suppose in a way that meeting with him came as some kind of unspoken lesson for me, to be mindful enough to not judge a person based on a few interactions. And to be open enough to accept that the best version I felt from him that day was perhaps the real version of him. This reflection also came with an implication in my professional life. My friends say, my expressions are like an open book. My emotions easily shows off in my frowns, in narrowing/lifting of my brows and in my eyes. Sometimes I am hurt, sometimes I am bitter, sometimes I am happy and sometimes tired and frustrated. These are the emotions one goes through when one deals with a number of people as  a job on a day to day basis. ‘People affect emotions’. They are variables you cannot change, unlike following a routine in an office cubicle where you might have some uniformity to anchor on. Sometimes a patient will make your day, you feel like finally you have made a small difference in a person’s life. We ‘medics’ are suckers for an ego boost, desperate to please in service. Other times you have to remind yourself you are professionally obligated to serve. Doesn’t matter why the inmate was in prison whether for a rape or a murder.  So, gauzing my expression when I interact and /or communicate to a patient is an important skill I need to work on.

Oooh you have a perky butt’, a patient in his late 80’s recently commented on me. I didn’t know if I was to laugh, tell him off politely or just walk away pretending I didn’t hear. I just walked off. I had a laugh on my own later thinking to myself,  ‘Oh aren’t we naïve? To feel so protective of the olds like new-born babies with their pearly eyes and lost expressions when we know they may not be as innocent as they seem. They might be entirely different person or live very different lives outside these gates. Some, maybe we approve of. And some, maybe we don’t’.

Professionally we shouldn’t and we cannot judge. And although by human nature, instinctively, first impressions are what we depend upon, to determine whether a person is friend or foe; in a medical world, you will learn to tone down that intuition. I learned it is a skill that you must acquire to be a part of this profession.

Occasionally I meet these amazing people that I love listening to. It may be just 5mins of the day but the interaction leaves a lasting impression. ‘Oh I travelled everywhere. You got to. I have no regrets‘. One of my elderly patient said to me. And immediately then I thought that should be my motto too. I should at least see a couple of wonderful places while I don’t have commitments with family of my own.

‘I haven’t talked to my brother for so many years. But what could I have done, we had to run away, she was the love of my life. She still is.’ Other patient narrated his tale the other day and the way he said it. It was sad yet I was very happy for him at the same time. Difficult to describe those emotions together. He too said, ‘You have a photographic face. Very expressive face.’

Life is happening in the world out there and I too want to be a part of it. Follow the light.

All aside from the point, like our patients we do leave a lasting impressions in 5 minutes allocated time we have to spare them in a list of 15- 20 reviews everyday. It is important to ensure that as professionals we hold our emotions to ground no matter what time it is or the situation is. Our actions should prove that we are there to serve in their best interest. Our goal is to win their confidence to ensure that they adhere to the advice and the treatment given. It is important to build a rapport because, as a patient to their doctor they are emotionally vulnerable to us. Their medical history, mental health history, social history, personal details everything is open to us in our records. Yes, it is like as if we have seen them ‘inside and out’. And that is a lot of trust to give to a stranger.

We aren’t cold hearted with faded, dull and detached personalities. We are very much receptive of our surroundings and very attuned to your needs, we are just better at camouflaging it, being a third party and being objective so we can treat you better. Trust me outside the hospital premises, we too have our whole other lives rolling out.

I was supposed to give a month’s notice before moving from my flat. I am looking to move to a cheaper place which will be costing me half my monthly bill that I am paying at present. I love my privacy and this little flat, however I think at present it is wiser for me to cut back on my expenses than take an extra shift. I am telling myself, if I want to stop dreaming and start making things happen ‘this is the way to go’. The room I will be moving into is quite small, it is a single room in shared accommodation. It is going to take a lot of effort for me to adjust there. But, like everything it is one of those decisions I have to take as a part of accepting my adult life. We all can’t have a house with open rooms and a lovely garden in the suburbs of our own, otherwise who is going to pay the rent/mortgage right?

I contemplated for a while thinking whether it is  appropriate for me to give my landlord a notification now that I know what his situation is. Especially when there is a financial security to think of. But, I did end up sending the notification later. With my training ending soon in a few months, I won’t have any job to rely on for continuous income and any savings on expenses I could cut is going to be a big help.

I have packed my bags today for a ‘girls night out’. 4 of us are meeting after 1 and half years. We are all doctors. It is very rare for all of us to be off work at the same time. So when we do get an opportunity, we make the best out of it. We will be staying in some fancy hotel and be up all night chattering about our lives. Lot to talk about. And there is a free pool! I guess that’s the joy of being working and/or middle class person, when you work so hard to earn you party hard on your spend!!

(Apologies earlier version of this post was rough draft 🙂 )

Finding inner peace (So you’re a doc, a foreign cuisine and Corona happened) podcast link

So Covid is a side story now. No longer a headline news which is probably for better because it means, now we are learning  to live with it. I remember the fear when it first swooped across the continents with red blotches appearing everywhere in the world map one by one, it was intense. There was a moment when each one of us thought humanity was heading towards our doomsday, steadily and there was nothing we could do about it. Now, on 2022  March, it has been completely legal for a Covid infected individual to walk about the streets and give COVID to anyone.

BBC news on 24/02/22 posted the headline ‘Covid: End of legal need to self isolate in England’. It wrote, ‘the changes are part of the prime minister’s Living with Covid plan to transition back to normality’ and summarized the key changes as,

As of 24th Feb:

-People who test positive for Covid will no longer be legally required to self isolate but they will still be advised to stay at home for at least five full days. 

-Routine contact tracing will end, so fully-vaccinated close contacts and those under 18 will no longer be legally required to test daily for 7 days. 

From 1st April:

-Free mass symptomatic and asymptomatic testing for the general public will end, and will instead be targeted towards the most vulnerable. 

-Government guidance on COVID passports will end and it will no longer recommend venues use the NHS COVID pass. 

GOV.UK on its website on 14th March/2022 has now posted, ‘The government will remove the remaining COVID-19 international travel restrictions for all passengers from 4am friday 18th March’. Which means, no one entering the UK despite their Covid vaccination status will need to take Covid tests or fill passenger locator forms (PLF). And there will  no longer be hotel quarantine following arrivals from the end of March. 

It has quoted Health and Social Care Secretary Sajid Javid stating ‘We will continue monitoring and tracking potential new variants and keep a reserve of measures that can be rapidly deployed if needed to keep us safe. We can remove final restrictions thanks to the incredible success of our vaccination programme, which has seen 8 out of 10 adults across the UK boosted.’ has also quoted Tims Alderslade, Chief executive of Airline Uk saying, ‘We’re grateful for the timing of the announcement as we prepare to welcome back passengers this Easter and summer, for which we know there is huge pent-up demand, and for the UK’s leadership in being the first major aviation market to remove all remaining restrictions.’

But Daily mail UK on 16th March/22 on its headline wrote ‘UK’s Covid wave grows on all fronts as another 91,000 Brits test positive overnight: Daily cases rise by a third in a week, hospital admission spike 30% and deaths jump by a quarter.’

Seems like playing pingpong eh? Glad to hear the sky is all free to roam about now without restrictions, hurray! On the other hand, like the dailymail wrote, our bays that were closed to Covid have now started to open again. 

Let’s look back at the past 2 years. Look at all the discoveries we have made in the field of medicine. Of course there are the vaccines, the steroids, Remdesivir, Tocilizumab, Sarilumab, monoclonal antibodies (Ronapreve-for non-omicron variant infections, sotrovimab- for Omicron variant infections ); I am sure there are still many more on various phases of trials. I understand it was and is still hard to stay positive, but a cup half empty is also half full. 

I have now finally managed to get time out of my training. I too have had a good 2 reflective years looking into many domains of my life that previously I had never given enough thought to. Schools, uni, medical school then job. Along the way; there were – Internal wars between Maoist & government, massive earthquake of 7.8 magnitude, COVID the pandemic and now the headlines are reading ‘Ukraine’s NATO concession as air strikes batter capital’. 

It is easier to destroy than to build. To wipe out entire cities of thousands of population in a minute than to help them settle and rebuild lives. All the technologies and science involved into nuclear energies, and we still haven’t found a cure for cancers. A pill a day everyday. Is it really all that can be done or instead of a shot of chemo dose, fuelling everyday chemo pills has better revenues? Personal interests everywhere are costing lives. Destructive forces are more in play than the constructive mentalities. Nuclear energies. I suppose are more lucrative to invest on. How long has the fear of nuclear attacks been haunting us? Iodine tablets are disappearing from markets now, bought in apprehension of inevitable. Everything around us is shuffling in chaos, it is becoming harder to find inner peace. 

So, it is about time I think, I pack my bags and leave for the forests and the hills. Remember, what life is one more time outside of routine, out of timed clock checking in and out and days & night that disappears into mundane with building anxieties. Out of the media, constant emails and the messages popping everyday, to begin again from the point where I started. Regain, re-control my life from dwindling fall. I can only help if I can help myself. I can only extend help if I have a strong hold. With so much that has happened in past few years, I feel like it is getting harder by the day to clutch the reins and control the ride.

30 years from today, if I make it, I hope I can say, ‘I lived my life and survived through it all. And I have no shed of tears or regret of things that I have not done. Yes. I have lived it.’

So you are a Doc, a foreign cuisine and Corona happened (Hunting for Mr Right/ Miss Right) podcast link

Save that photo and the details I gave you just in case the guy I am seeing turns out to be a creep’. 

Okay’ I texted back my friend, holding on to a picture of a stranger on my mobile phone who she is about to meet for a date. Over the past few years I have accumulated a couple of these random people that I have never met, and possibly never will. Of course I delete them over time, once we have established they are indeed who they are and are reasonably mentally stable to accept that ‘the date didn’t go that well’. 

If you go over my phone now, chances are you may still find a collection of random blokes.  Thank God Joey respects personal privacy and doesn’t fiddle around my phone much. And aIso, I do usually tend to show him the random guys that are whatsapped to me.

Why is it that 4 of my most eligible friends are still single? 

When you are used to being self-sufficient by yourself, unless that other person is really worth it, there is no point losing sleep on it. I am looking for a serious relationship’, said one. ‘ I don’t know, there doesn’t seem to be a guy around catching my interest’, said the other. ‘The guy has to be smart to be able to have a conversation on an intellectual level’, said the third. To all the statements above, each one of us nodded our heads synchronously. 

Theme is, all these ladies and colleagues I know that are single, are all looking for someone they are compatible with, can share their views with and have cerebral stimulation of some kind. These are smart ladies, competition is already narrowed. And with each check on the list, the stairs get steeper. 

But here is the catch, as much as intimidating it sounds, these ladies are very open and understanding. They are very emotionally mature and not necessarily tied to the set criterias as everyone assumes. One of my dear friend is muslim and is open to bisexuality, one of the others doesn’t mind travelling through the borders in quest of love, another is willing to invest time as much as it takes to find the right one. 

When I, myself, started first on online dating, I took a different name and put a different profession. HCA or a nurse occasionally, something medical so if conversation ever came about professional status, I could make relatable comments. The idea of mentioning a doctor in the employment category for some reason made me think, whether I would appear intimidating to others. Which I didn’t want. And as I mentioned before, I wanted to know a person, without putting my everyday history taking skills to use. Of Course alcohol, smoking, drug and family history were going to pop out eventually in the conversation but I didn’t want to know it all in the first 10 mins. There is no need to find a medical condition, label it and prescribe a pill here. I was here to get to know a person, make friends and maybe something more. Conversation had to be both ways. 

It was interesting how my friends reported they felt the same. For various reasons, we were hiding our professional status. Which meant, all of us were not set on dating just doctors or lawyers. Anyone really, who related to our thinking, was understanding that we were independent women, had odd working hours and  needed our own headspace.

It was also quite fascinating that some of my friends thought, putting a doctor as professional status would deter  people as they would assume us to be too high maintenance or rob them of opportunities to show their masculinity. I guess, we don’t really portray the ‘damsel in distress’ look for that. 

We love paying our own bills. Our partners don’t have the financial stress of putting food on the table. We like being hands on, taking part in decisions; that way when things go downhill, we are both to be blamed. We don’t want hierarchy in relationships. Yes, we love being in the kitchen but only as much as our partner would love to. And of course we realize, men and women are different, and each one’s individual role has to be respected. 

Occasionally, there comes an amazing person and one’s heart is set  to it. He  accepts that you have a busy life, you have a career, you have a life outside your relationship and your fundamental views also match; but things don’t work out. Because he is in a different phase in life than you, or it is getting progressively difficult to come to terms with your lifestyle-constantly missing out on family pictures and/or most importantly, you are not part of their life as much as is of yours.

‘I don’t know, I don’t think I want to date. I am not ever planning to have kids. I think it’s obstetric rotation that has put me off,’ one of my colleagues spoke in her view about relationships.   

`We both just wanted to settle and get our careers out of the way first then try for pregnancy but it didn’t happen. Took us 10 years with IVF to get pregnant ’, the other reported, sharing her problem, stating having a right partner is not necessarily the end of the problem. 

Decisions are coming. We are all in that phase of life, where we are hyper aware that our biological clock is ticking.. We are all responsible adults. Can’t help wondering though whether we are taking this responsibility burden too seriously. 

Idea of having an IVF baby from a sperm donor is on hot discussion these days. None of us are against the idea of adopting and raising children ourselves  together. A while ago, I was doing internet research on freezing my eggs, luckily there are those options available now. But not with a robust guarantee. So none of us are confident with letting go of our fertility window stringing to the odd chances. 

Answer is, ‘definitely yes’, all of us are looking for commitment. But readiness to commit is still a bigger agenda. The clock plays a part in decision making, but is not necessarily the only decisive tool. The fertility rate across the developed countries are dramatically falling. I guess the problems we are facing, is what women in careers all over the world are facing now. ‘Is it really the right time to have family? And is it really the right person to bear child with?’. Lack of child care provision makes it even tougher in industrialised nation like UK.

So, I don’t question at all, when I get random strangers popping in my message box from my friend’s number. There is an ongoing hunt for Mr Right and Miss Right. It’s a crazy run in a crazy world with crazy crazy people. ‘Oh boy, oh boy’ am I going to be glad when I finally meet the person in real!! Hahahaha

So you are a Doc, a foreign cuisine and Corona happened (Dating today) podcast link

All the nice guys are taken, married /engaged or gays or just not around us’. My friend complained handing me over her phone.

Here, that’s the app’ she said, showing me letters ‘OKC’ on a bright pink background on her screen. I squeezed my eyes a little. It was middle of night and we were hanging out in the sitting room with a dim light on.

‘So how do you start?’

You just find someone you like, if they like you back, you start chatting‘. She said.

Okay. How safe is it though?’

I haven’t had problem. You just have to be careful about who you talk to. If you decide to meet, meet people in open space or public area and do not give them your number if you are not interested.’

So, I started uploading my pictures in the app the same night. Met a couple of matches quickly and began talking.

My friend is beautiful. Also smart. Very grounded and knows exactly what she is looking for. Me? I had an idea but at the time it was not set in the stone.

The first question I was asked was, ‘why is a doctor in a dating app? what is wrong with you?’

Surely enough I had to move on from that conversation. A person who asks, what is wrong with me on a dating app must be here if there was something wrong with him right?

You choose and skip a lot of potential partners with silly questions and answers like that. Although I suppose in a way, it was a good question only the approach was very direct.

‘What do you think?’, I asked my friend and she commented, ‘of course you need to think if something is wrong with them. You meet people and partners through friends, schools, colleges and work space. And if they he haven’t met anyone by now, something must be wrong with them right?’

‘What about us then ?’I queried.

Our situation is different. We had to move in to a different place. We are trying to start from the start here’.

Anyone would have raised their brows if they found out a couple had met in a dating app, in Nepal. Assumption is ‘desperate’, ‘wasn’t able to find a good guy or a girl here’ etc etc. Honestly, I don’t think situation is any different in the UK. Have a feeling, assumption is, online dating apps equates to casual hook-ups in most people’s minds.

Am I suppose to think that, my person, has to be one of 10-15 people I see everyday locally? That something must be wrong with me because I don’t find them emotionally or physically attractive? 7.5 billion people in the world and love of my life is supposed to be the man next door? I won’t find the person if I sit and wait on my fat arse all day hanging out on same corner, going to same work everyday, and talking to same people.

We all live busy lives, sometimes we barely have time to cook a decent meal. Life is stressful as it is. We don’t have time for our friends, where is time for us to make new friends or meet a new acquaintance? If opportunities come, that could give you a chance to meet someone you are compatible with, I think everyone should take it. Dating apps are great in that sense. Its a win win, even if you do not think you are for each other, you get to learn about other individual’s life, hobbies and interests.

I met Joey too in a dating app. I suppose we locked each other right away. Gone are the days of meeting people in the pubs. If you ask me, for me that’d be a warning sign Haha. And gone are the days like my parents, when they would meet up in festivals, sing and dance all day, catch each other’s attention and elope. Too cheeky. I’d be stupid to sneak off with anyone at this age. Why would I? I probably earn more than the guy and treated myself better. It is not the time for blind faith anymore. Who knows what the charming psychopath has on mind?

Most single friends I have are on the apps now. Of course online dating comes with some disadvantages of its own. And all of my friends have a story or two to share. There are inclusive sites as well if one knows the exact description of partner they are looking for according to the profession, race and nationalities. Foreign faces like mine were more into these inclusive dating apps.

You can order a bride on a mail nowadays. Hopefully you don’t have to go too far like that, but if you find happiness and your person one click away of a finger, ‘why not’ right?

COVID dating was difficult‘, my friend said. ‘It was difficult to meet up first, a lot of back and forth messages while there was lock down and social distancing rules. When you did get to meet up, there was face masks, you couldn’t really study a person when they were saying something. You could never get a booking in a decent restaurant. Even if you did, booths were barred with glasses and plastics. It was all weird’.

For me, it was important to know what their vaccination status was’, the other said. ‘I’m reasonable person. I will listen to reasons if they can defend their beliefs. But unvaccinated? People who don’t believe in medicine or science are; no, no. Not for me’.

Seems like some decisions were straightforward easier in COVID times. I don’t know if these apps did include ‘vaccination status’ in their profile. But I think if they did, it would have been quite reasonable.

Anyways those who met in COVID and are still together, I am keen to hear about your story of ‘love in COVID’. Share with us, will you?

So you are a Doc, a foreign cuisine and Corona happened (Isolation -2) podcast link

After day 6, my sore throat started settling. My sleep started getting better which in turn helped my headache and muscle aches. I started moving around the flat, trying to get my legs moving. At back of my mind, I had considered myself to be high risk for blood clots. By this time, it has been established COVID infection did result in clotting abnormalities. So, it was important to keep circulation flowing from calves.

I was nauseous. We know, one of the primary symptoms of COVID was anosmia- loss of smell and ageusia- loss of taste. I remember one of my colleague saying, she couldn’t smell a thing when she got COVID and it took at least a good couple of weeks for her to get it fully back. Another colleague had complained, ‘Prosecco tastes like rotten egg. And I used to love prosecco’. I had heard patients complain distortion of taste and smell to some extent and read others experience about it. Naturally, I was quite curious.

I don’t quite know how to describe my experience of distorted smell/taste perception. It started after my nasal congestion had started settling. For me, I could still smell perfume, candles, foods; my smell hadn’t really gone. It just felt heightened like all these smell I used to like had an off distinct sharp twang that I didn’t like now at all and to top it, all of them had a coated layer of metallic smell / or a smell of mouldy bread. I looked around the room, the flat I live in is quite cold. Most days, I yank up all my heaters to warm it a bit, it drives my electric bill through the roof but after 5-10 mins of switching my radiators off, the flat is still cold again. I saw, they had started developing moulds in corner. So, I took a dry towel and started cleaning. After working for some hours, I was pleased with my hard work. But the smell was still there.

The nausea did not go away. I vomited a couple of times. My appetite had gone. No surprise there. Scientists have claimed, as high as 80% of our taste are the result of our olfactory function. I am a foodie. I love food. Any kind. Having an off taste in food was not helping my situation.

‘Early return to work’ I received an email on my phone. It read, if I am asymptomatic on day 6 I could discuss with my line manager about early release from isolation. The email advised, LFT to be done on day 7 and day 8, if negative I could re-join work on 14th. On another email I was suggested to have step down PCR on day 9 since I was working on a high risk area. It was confusing. Still is. All these protocols. While I read it over, the message popped in my phone again from test and trace, ‘It is a legal duty to stay at home and self-isolate. You could be fined if you do not’. It read. I switched off my phone. Was nice to be away from all those bling bling noises of wattsapp and red streaks on my emails. If you haven’t tried it yet, do it too. Trust me, half of time, our anxiety is all because of our phones.

‘I only want to focus in getting better, in one piece at present.’

I like peace and quietness around me. Watching london so full of life last weekend, might be changing my mind. I wanted to disappear in it like a rat in one of its drains that day. ‘There is so much to do, places to hang out, people to meet, you never feel alone there’.

‘We could make a list of all good restaurants we go to. Taste all the cuisines of different parts of the world. I could meet the right guy here’. My friend had said, trying to persuade me to move in into London as well.

‘Agreed’ I laughed. ‘We’ll tap on the shoulder of next handsome looking guy sitting next to us, ask him if he is single and get his number. It will be a fun for us and hey if it works out, it does and if it doesn’t well we all have something to laugh about’.

‘Yeah. Lets do that. Lets do that!’. We all agreed on it.

London is busy and overcrowded. Streets are narrow. It is no where in comparison to flashy towers I keep seeing of New York city in the TV or the movies. Or Hongkong. Or Singapore. Some people frown asking ‘what is there to see?’. Some are annoyed at the thought of the traffic in narrow roads with big red double decker buses. Joey hates it. Hates the idea of ever finding himself in one of the streets of London. ‘Too many things happening all around’ he says. ‘But I can come there if you want me to, to visit’.

I think, those who love the city, love it for many reasons. Of course there is art, there is history. For me, I feel, there is a comfort in it. A sense of cosiness and a welcome vibe. I see so many people like me, like Joey, people from all over the world with all their uniqueness and talents come together. People I have never met but I’ll some day. Its a hub, a pulse of the thriving lives that holds so many dreams and connects so many stories. Look deeper, the city just reels you in. Like my friend says ‘you are never really alone.’ Feeling lonely however is a different thing.

Isolation, my friend, is necessary sometimes. If you haven’t learnt to be alone with yourself, you haven’t really learnt anything about yourself. Every people we meet and interact with on day to day is changing us in numerous subtle ways. It is important that we know, who we are on our own when we are stripped of all these connections. So isolation sometimes us good, almost like a meditation. But other times, it is missing out on an opportunity to make an amazing memory. And without our memories, who are we?

So you are a Doc, a foreign cuisine and Corona happened (Isolation with COVID) podcast link

06th of February/2022. I have now caught COVID. 2 years and a month after cases first started cropping in the UK in January /2020.

The lateral flow test (LFT) positive on the 06th. PCR on the 7th. Had to walk to the hospital with runny nose, sore throat and temperature wearing a face mask; as hospital policy requires us to have a PCR confirmation. Didn’t feel right walking past the children and elderly people. Luckily the walk for me was not that long, I can’t imagine other people walking through a distance to just get the test done. Those who don’t drive, I mean. I guess, you can always order a PCR at home and post it. But you would still need to walk to nearest the dropout? As long as you have a facemask, I suppose.

Luckily for me, exactly a year ago, I was down with flu symptoms and laryngitis. On Feb 2021. I still had syrups, tussive and analgesics that had dates on them. In fact, I thanked God silently. It would have been quite a struggle to get those supplies on my own, on isolation.

My symptoms were mainly dry cough, sore throat and myalgia. Headache is never new for me, so I try my best never to put in my symptoms box. Mom said ‘my voice was cracking‘. ‘Ofcourse it is, you call me like 6 times a day to talk. And then there is the ‘test and trace’ calling asking my whereabouts for last 3-10 days, the hospital calling me to complete paper works. Let me rest my throat, please.’ I answered her.

‘I am praying for you. All of us are’ she spoke crying.

I’ll be fine. All my friends had it and they are all okay’.

‘Hey, my test is negative and everyone at home is fine’, my sister called the same time and connected me to a group phone call with my other siblings. Everyone was concerned.

I guess, I was too. After seeing my friend ventilated. And I have seen quite a handful of young people die without any underlying health condition. But, I haven’t caught it yet in past 2 years, I have been vaccinated and I recently had my booster on November/2021.

Hey babe. You got Covid finally’. My boyfriend had said to me on the first day, after I texted him picture of positive LFT.

Yeah, ‘ I replied with snot building up on my nose, feeling congested.

You will have 1o days off now’.

I’d hate to admit it, I was a little excited for a minute there like he was. I have had heard my colleagues, being able to catch up with their tv series back to back on seasons and gliding past through the isolation with only mild symptoms, while enjoying a relaxing time. I was hoping for that too. But, I was suppose to start my on calls tomorrow, my lovely registrar was pregnant and we were already a little anxious trying to sort out extra help and the friend I had just met yesterday after 4 years had severe arthritis and he was on immunosuppressive.

It couldn’t have come in worse time. I cursed the yam flavour delicious ice-cream I had the other night. It was cold, we were in london, the city was alive and busy as ever with people lining in front of every restaurants, theatre and pubs were already spilling out. It started raining as I made my way back. Retrospectively, I had made myself an ideal COVID host.

Only a minor sore throat. I was very unwell last year and I never tested positive. I picked a LFT pack on the way back the next day, got into the train, wearing a facemask, flipping through the photos we had clicked last night all the way back to my flat.

After I notified my friend with arthritis who is actually a very chill person, I felt relieved. He had just told us, how tired he was of constant isolation and I did not want him catching COVID again and cursing me all day. Hahaha. Anyways first day felt fine, like Joey said ‘just relax’. I had seen a trend of making a rose on Instagram, thought I’d give a try. Was awake next day till 03:00am in the morning. Trying to be productive.

The next day, was terrible. My throat really hurt, I was feeling feverish, I had muscle aches but I couldn’t lie down. Post nasal drip was tickling my throat. My nose was bunged, I couldn’t breathe through it and neither could I mouth breathe, due to irritation and pain. Couldn’t swallow. Luckily had some herbal turmeric tea.

Missed having some one to take care of me. ‘May be this is how, people become worse and they die’, I thought. ‘In anyways, unless I am really worse and I can’t move I am not going to hospital’ I told myself, which is kind of absurd being a doctor myself. To be honest I was much worse last time with my laryngitis. But I guess, the fear is being alone and knowing this infection has actually killed millions around the world can make any person a little anxious.

When you have nothing to do and you are unwell, one starts pondering about a lot of things. I read this blog once when I was young, where I read this stranger rant and rant for pages. I don’t remember her name or the blog , I don’t even remember the particulars of what she was venting about, mostly family life I suppose, but I remember feeling ‘wow, there are people there who feel like me’. And as you may have guessed, my previous posts on my memories and reflections were result of that. I have been reflecting a lot nowadays and I guess, this isolation comes with more opportunity.

‘You are only as strong, as you mind is. Please stay put.’

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