Children
February, 20,2023
Prof. S. Ramkumar
Be a “friend” to your child; but always, first be a “father” or “mother”.
Never be hesitant, worried or upset to say “No” to a child for things which need not be done : nicely and truthfully narrate why you said No – let her/him realise that your No is a beautiful good!
Appreciate the child for all the good (s)he speaks and does. Never hesitate to compliment on any nice things – irrespective of whether its small or big as you may feel. “Google” your “child’s mind” to give the best. Handhold to understand and explore the world as it is!
That helps make them fit for tomorrow.
A child should be able to open her/his mind confidently to a parent.
Never blast at a mistake of a child in the first instance.
Listen to a child patiently. “Show” the child that you are listening. Even if you are doing something serious, just pause or postpone it for few minutes to give attention to what the child wishes to say: maybe a worry or complain. If you are attending a cell phone, keep it down or away and listen!
If you simply listen, it gives comfort to child. This comfort that you will listen and help/support/guide the child, gives confidence for her/him to tell anything to you.
Listening also includes “‘observing” your child on what is not being told by words. Keep an eye on his/her usual nature, alertness, energy, happiness.. If you feel something is not normal to your child, calmly look into and find why so.
If you are upset and angry with what your child has done or said, hold it, within you. First listen. After listening and soothing, you may add a tough voice to conclude, if needed!
Remember:
“if a child is hesitant in opening her/his mind to a parent, parenting is at flaw somewhere” – examine and change to facilitate the children to come and tell you.
September 3, 2017
Prof. S. Ramkumar
Life
Everything teaches us: situations, people, flora, fauna… what doesn’t? But the contribution of “teachers” in molding us to be what we are, reverberates by the imminent touches of teachers in our daily lives. Good teachers live through, and with the learners, in maybe small but beautiful ways of how they deal and dwell on this planet.
Good teachers have a part of him/her living as a legend with us (the only systematic influence other than the inheritance of genes from parents!). My class mate in school, recently chatted from Panama; the first thing he typed was about Ramachandran Sir who taught us geography and about Panama Canal. My friend was so thrilled (and we all were ) that his efforts live: it’s not the subject, but how he delivered. Compared to the present day opportunities of teachers, we are quite sure that he had not been to Panama at that time!
You become a teacher when you realize that students respect you , not fear you. The respect is the realm of a new love- of freely speaking with a teacher- which evolves to the ideal relationship of a teacher growing to mentor.
“I never teach my pupils. I only attempt to provide the conditions in which they can learn.” (Einstein)
The tools of a teacher are appreciation, compliments, respect, love, care , concern and participation in guidance though the life of the learner. These tools have to be sensibly applied to raise the confidence and capacities of students, so as to make themselves happy in the path of life.
We often remember teachers, and hold them to heart for taking us through tough situations like when students think:
“Marks are less”
Complexity of thoughts like “ I am not as good as him/her”
“What shall I do in life?”
“I am Poor”
“I am not good at this”
“ I have problems at home, do I have a future?”
It’s not History, Chemistry, Computer Science, English, Medicine, Business or Engineering (ie. Subjects) that is vital for us as a teacher but how (s)he creates confidence in the learner to deal with life with the above tools that were mentioned earlier. It’s challenging. In teaching, the subject is only a medium – to create a mind to apply that- is the task of the teacher.
Teach them to walk alone or together in life.
“Do not confine your children to your own learning, for they were born in another time.”
(Chinese Proverb)
This is evident in the present day, when value education is repositioned with lesser priority in Schools and on the other end we need to build “committed citizens” (irrespective of knowledge brains) for building a Nation at a later stage. As Dr. Abdul Kalam envisions in “ A Manifesto for change”, “ we need to have a creative classroom, creative syllabus and creative teachers. The first two are comparatively easy, but the challenge is how to find creative teachers. Finding such teachers is the hardest task.
I remember many teachers (and students too!) for the “lessons of life” they taught me rather than the subjects dealt with. The students are amazing resource in teaching us many things. They remind us of the World that is transitional, lead us to the challenge of debating with ourselves on “right” and “wrong”, change our mindset on perceiving things- all for the better.
Back to teachers, the list for me starts with Late Sister Prosperous, who with her patience probably would have instilled a little something called ‘curiosity’. The list is never ending and can never be complete. But just few examples on the lessons learnt and subjects taught:
Amazing were the classes of Shri. Panikkar Sir in science, but what I learnt is the way of orderliness on his entry into the class, keeping books on one side of the table perfectly in an order, taking time to arrange himself, and his smile.
Prof. W. H. Mackaden, the passionate and Mrs. Radha Padmanaban, the elegant (writer of children’s stories) in Malabar Christian college who taught English, were magnets to whom we were hooked for long, during the “science dominated” courses. Inborn raconteurs. The passion for understanding writings and literature is the lesson learnt for life!
In Veterinary College it’s a long list, worth writing another Strandom!
In University of Reading, UK, again it’s a long list. Remember Prof. Maurice my mentor (a serious but genuine teacher) who taught travelling is learning and Prof Chris, the dynamism of decision making without delay. One of the softest feeling is for Late Gwynn Jones from Wales a real Country man reminding me of a straight innocent grandfather figure from a rural area of India. Was a pleasure to be with him.
Other than Judges in a Judiciary system, probably teachers are the only people who have the attribute of being neutral – to a group of students of a heterogeneous class at any time. Class, colour, community, creed, gender – nothing matters to a teacher who sees only a learner in every one. All are equal, capable (maybe in different aspects) and beautiful.
The onus of identifying, nurturing and creating generation of “responsible humans” largely lies with teacher, whether it’s in the first standard or during his PhD.
04 January 2019
Prof. S. Ramkumar
Lifestyle
Recently in a get together, in the ambience of pleasantry exchanges, a shy participant, hesitantly came to me and whispered, I was a student of yours and you may not remember me sir. His face was familiar, though he had grown up to be plump, mature and stout. He cordially told his name. Then the magic – words flicked my brain, opening the box of identity. Yes, it was almost 25 years back since I called this name (along with many others), regularly for a long period as their course teacher. I could describe his nature, how good he was in some things and how he could have cared some more on certain things as a student. He was surprised and astonishingly asked me how I remembered him ?
Well, it was spontaneous tracing from the memory lane. I also learnt that repeated calls of names for attendance were an interactive meaningful exercise I was undertaking within a short period of time in the beginning or the end of lecture/class. It’s just that you tell a name and it introduces you to certain traits of the students. Calling the attendance – often considered a monotonous and official requirement to calculate the minimum percentage to appear for an exam – has lots more for a teacher. We all have started saying “Yes Sir” for a teacher’s call on our name, from a time when we cannot imagine, even as kids! Now many of our children and grand children continue the legacy.
From Anitha to Maria, Shafy to Venkatesh, Abhiramy to …., it is over three decades that this class room experience has been going on for me.
Marking attendance is a brief but rich opportunity of instant connectivity with the student. The tone (weak, feeble, loud, clear, slow, fast..) of the student, their body language, face expression (the eyes especially- sparks, brightness, droopiness, expectations, hope, frustration), gestures etc speaks a lot within a few seconds during that mandatory “Yes sir”.
As McLuhan said: “the medium is the message”. You do this for 6 months or a year, the name along with the nature imprints within you as a part of you for your life. Well, as a teacher you have additional observations and opportunities to pick and choose from with them. However, we are blessed with the boon of forgetting, and many are kept in the long term repository memory of life. But then what you repeated several times lives within you, and instantly refreshes the feeling of familiarity once someone utters the name. It is just like chanting mantras or verses from a favorite book repeatedly.
Efforts are going on in many institutions, as a matter of fact, in line with present time, to save the time of calling attendance through electronic mode of marking. Understandably if you have more numbers of students it has to be addressed.
For me though, I have felt that the response of “Yes Sir” to attendance-calls as:
1 an amazing experience of varied beauty with which students respond to their names,
2 an immediate perception to their status/mood; and above all, the best one
3 an unique experience to store the names of the wonderful students down your memory lane, which can be opened by a click of name in the future.
January 6, 2019
Prof. S. Ramkumar
Education
“Granny expresses her approval of this attitude (of Swami) and then begged leave to start the story of Harischandra, who, just to be true to his word , lost his throne, wife, and child, and got them all back in the end. She was half-way through it when Swaminathan’s rhythmic snoring punctuated her narration, and she lay down to sleep.”
(Swami and Friends: R. K. Narayanan)
Grandma narrated stories which were short, expressive and emotional, and it’s a great feel of hearing the stories lying beside. The story-telling by my grandmother often took me to a world of imagination from where it took time to get back to the real world. I remember how she told on Krishna going to Hastinapaura to appeal for peace with Duryodhana on behalf of Pandavas, after their 12 years of exile in the Forest and a 13 nth year of incognito. He was to ask the Kingdom for Pandavas! Duryodhana wanted to show his pride, power and ego and wanted to disparage Krishna, in spite of his father and other Gurus advising him not to do so. Duryodhana instructed his court members to sit in their chairs and not stand up as respect when Krishna arrives in the Court. They all sat firm to their chairs. The reaching of Krishna was indicated through the Panchaganyam (the conch) which was blown on his way, in the chariot. The kings and ministers and Duryodhana’s brothers started shivering since their chairs shuddered on the sound of the Panchajanyam, and they started to fall from their seats! What a picture she has drawn on a nine year old and stimulated the art of imagination. The dramatic, exaggerated version had no physical gestures – all were through the gentle voice changes which brought a movie in front of me.
Parents are our ideals.. However children feel they are strict with many schedules (of course aimed at the goodness of children!). At an young age the only person who could overrule my father’s decisions on my freedom was my Grandma. She tried her veto power mainly in my interest for playing (often at the cost of the studies!) and lying idle hearing her stories. The compliments of grandma on our achievements (and non-achieving) are so heart warming.
Remember once my maths teacher, Joseph sir (an old wise man) who came home occasionally to teach me maths , taught multiplication table. One day he asked to recollect the tables and tell him which he taught several times. I could easily say the multiplication tables of one to 12. Tables from 12 to16 required some more efforts from me which I didn’t put in, especially my Grandma being around. He scolded and I started to cry loudly (if it was my parents they wouldn’t mind though). Grandma came as an Angel from inside and told the teacher “your teaching is enough”! Joseph sir couldn’t convince her in any way. My father at that time a Professor of Education came to know of it in the evening when he returned from the College. He talked to his mother and requested her not to intervene in teaching. However she refused to hear him saying “any teaching which makes the child cry” is not real teaching! I was so happy when she reminded my father on how he has studied without getting any scolding or slaps. He had answers but was difficult to explain in front of me!
When I was eight I was to write the Sainik School exam. Grandma told my father that it’s not a good idea since I will be moved away from family to a hostel at a young age. Father had his reasons which were fair and asked me to write that. Though he was serious on me attempting it, grandma had a personal session with me on why that life would be difficult. Anything for her! I made sure I didn’t get through the test! The attitude of taking certain things lightly in life might have been planted in me by her.
Grandma used to explain about the relatives, relations and was open in her versions of who are good and who are not so. They were straight talks- simple and loving – and offered unfiltered joy. I used to enjoy helping her crush the betel leaves (vettila) and areca nuts (paakku) in the small stone, kept for that, which was her most relaxing time.
A grandma’s presence in a home moulds the children, without her/his knowing and, they are often least credited to this personality formation. Grandmas are always a joy – whether we are sad, angry or happy they “talk to” and “feel you”. They hear to all our petty complains and silly stories at home and school, and join us. Grandma to grandchild is a special bond.
Though short, I cherish the best moments of my childhood and now realise the depth of impact it had in me. Above all I loved her nose-jewel stud, mukuthi (the red stones in gold nose stud). She had the aristocracy of maturity, unbounded love, a simple and straight heart.
Grandmas – the invisible evangelists who shape us!
March 29,2020
Prof. S. Ramkumar
Education
It was almost the end of autumn in UK,1994 and winter had already announced its arrival. In my research room in one of the old buildings of the famous International and Rural Development Department (IRDD) of the University of Reading (which is now embedded in the School of Agriculture Policy and Development -SAPD – at present – with a new building), I was with the final assemblage of the thesis document that had to be submitted and defended for my PhD, a research journey which started in 1991! The days of 1994 autumn were satisfying as they indicated an end to my PhD work, arriving at some meaningful conclusions based on the attempt of research. However it was a bit chaotic pulling papers of all sorts to assort, identify and arrange, with impeccable accuracy! Added to that was the thought of convincing the unknown examiners on my study to be offered a Doctor of Philosophy.
I heard a gentle knock, and on opening could see Professor Rolls , my guide with his classic stingy smile, and soft but firm voice asking me “Ram, can we just take a stroll out”. As a senior Professor, and that too a traditional British Educationist, Maurice has always been a role model for me. I put on my winter jacket and we went out only to be wrapped by the chilling cold and the early darkness at 4pm. Maurice had short strides as was his nature with short simple sentences. “Now that you have completed your research study and documented it we are planning to have your defence viva” as we walked he told in this whispering voice . “We have three choices for you as the external examiners :one is Burt Swanson (a well know Extensionist from US ), Niels Rӧling (another extension scientist from Wageningen) or Mr John Howell the Director of Overseas Development Institute (ODI, London)”. I have read, referred and studied many of them since my research started in Reading. Readers who have an exposure to Extension science ( as agriculture, Veterinary, dairy, gender studies, welfare, Home science, Development studies background) may be familiar with popular names.
One theme of Extension that spinned off globally during that period (late 1980s into 90s) was the “Systems approaches” to studying Extension Science, with Wageningen (The Netherlands) and Reading Schools (UK) being the premier proponents . The Wageningen School had lots of useful and interesting theories including the “Actor oriented approach” largely a sociological approach to development (Long et al being the major proponents) and the Agricultural Knowledge and Information Systems (the AKIS) for which Niels was one of the foremost advocate. I was trying to pin this just for the readers who are not aware of Extension science! The Reading School had useful studies on Agricultural Information Systems, the AIS (with Maurice Rolls and Gwynn Jones ) earlier to these. There were active scientific discussions and debates between these two schools on the relevance and utility of approaches. It’s exactly when I walked into the Reading School in 1991 with my ambitious interest of poignant research in University, that too to associate with one of the tall leaders of AIS, Prof. Rolls!
The six months of my review in the amazing wealth of the reading materials in the University and the Department Library, with the silent occasional nods of Maurice seasoned me to put up a third theory of “Actor oriented information systems Approach “ at the philosophical level which had practical application. But then it was a bold step of taking over the theories mentioned, but largely built from them. Maurice was with me, though apparently silent.
As I tried deciphering the algorithms of my research problem over the three years (1991 to 1994), Maurice used to give consultations, wherein he preferred to listen a lot, endorsing the views and airing his doubts. Maurice had never been argumentative or loud in his views or expressions. But he expressed firm beliefs with pleasure or displeasure, if any, in his facial expression – all with soft words.
As we walked along the pathway of the Whiteknights Lake, under the yellow halo lights, he continued, “Mr Swanson who agreed to be the examiner considering your new approach , couldn’t make it since he had an unavoidable meeting in Rome at FAO. And finally Mr Howell, the Director ODI will be coming”. Rolls also told that he, as the main guide will not be in the Examiners board. In fact he is the next person to me who knew in and out of my works for the last three years, with some strong debates between us happening. Now as we walked tearing through the wintry mist, I realised that he was a little tensed on my defence, as the Guide, and advised me not to worry on anything “you have a sound thesis of yours- just explain”. This was a bouquet of confidence he gave me. I knew later that he wanted to ensure that I wasn’t getting worried of the formal thesis-defence, though I had given many seminars and meetings on this which were held earlier. As we walked in to the Department which was warm, he shook hands with me wishing me best of luck. The fifteen minutes of stroll with him has been one of the life time experiences I love.
One, that he selected the best stalwarts of Extension at that time as my examiners and two, he gave the confidence that I can defend my work among any experts just before I undertook it. It gave me the strength not only for that Viva voce, but lessons for the teacher in me on
Epilogue: The thesis was commented well by the Board and the University of Reading was kind enough to offer me a post doctoral bursary (the first of its kind!) to undertake a study on Hillside Forest Information System in Sri Lanka based on our theory of AIS.
August 22, 2018
Prof. S. Ramkumar
Education
Point 2 – That we need to improve the quality at different levels inside and outside the University level.
Point 1 – The stronger perspective is that India was left with the back pack of the long years of colonial rule. And the development that India had in different fields from 1947 to 2018 is remarkable (though one can always ask for better results).
The ranking of Indian Universities as against the Universities of developed nations need to be viewed based on the “Indian context” of the society. From what we inherited (good and bad) and how we addressed these in the field of Education. If we have a yardstick added in the ranking on the entry of underprivileged women, the poor and the rural people then, the Universities of India will be higher in the ranking scales. Performance of any University that exists in a society is linked to the structure and function of the society. (This is again with reiteration of point 2).
If the ranking of Universities takes care of point 2 and point 1, I am sure that many of our higher educational institutes / universities will be in the first 100 of the world
The yardsticks make the steps of the ladder.
Mind the steps!
The ladder to the first 200 Global Universities: an Indian perspective
Remember addressing the PG students of Arts & Sciences of Bangalore University in their Senate Hall of grandeur in 2013. The talk was on the challenges of higher education sector. Following the conclusion was the discussion in which a student raised the doubt on why Indian Universities do not find a place in the first 200 of the world which triggered a long and insightful debate. Educationists and policy makers debate this theme in various media and fora. They suggest methods for Indian Universities/Institutes to slide into the list of first 200 world-ranked Universities.
This article is an attempt to capture the context of education in the “Indian” situation which may help us to understand the “unseen” and often “invisible” good outputs of education in India, amidst the attempts to be a winner within the global rank race.
I have two points and prefer to make it explicit and clear about Point 2, first. Point two is that that there is a lot of room for improvement in quality enhancement of Higher Education institutions, which many are trying to achieve. These improvements inside an University is context-based, dependent on the society in which it functions and on which it is embedded upon. Various articles on this spread in newspapers, reveal its accruing relevance for the present times. What ails our educational institutions (nurturing institution of excellence is a slow and painstaking process) in Business Line July, 24th 2018 by Dilip Ahuja and the thoughts of Raghuram Rajan, an academician and former RBI Governor, in the Business Line on July 25, 2018 are just two examples to quote.
I take my route to Point one of my thoughts from the above( ie. point 2: which is to state in simple terms Universities need to make lot of qualitative charges in areas such as the pedagogy, performance indices, content, interdisciplinary researches, attitude to science and society, need- based research, reformed examination systems etc., to be in the forefront of the Global University Rankings)
However, Point 2 -I feel that not being in the “Nth rank” in a list of Universities which are charted based on internationally set yardstick of higher education, should not be a worry as often thought for; no doubt, it can be a motive to address point one !
For e.g. The “Times Higher Education World Ranking of Universities” has designed the performance indicators of Teaching (30%), Research (30%), Citation (30%), International Outlook (7.5%) and Industry Income (2.5%). www.Times HigherEducation.com. Each of these is calculated with different criteria, like the Teaching has components of Staff to student ratio, Doctorate to Bachelors ratio and Institutional income. The implications of these have different degrees of importance in different countries.
India is unique in different ways. The fabric of Indian Society is rich in its years of culture and diversity; unique in its socio-economic platform on equalities; modeled as the largest successful democracy and above all the second most populous nation of the globe. The development of every society (at macro level) and identity of every individual in society (micro level) is dependent on the “back pack of the culture and civilization history” it carries. Education has a lot to do with fitting into the setting, culture or heritage.
“ Education is the perfecting of life- the enrichment of the individual by the heritage of the race. Let this vital process of transmission and absorption be interrupted for half a century, and civilization would end, our grandchildren would be more primitive than savages” Will Durant: 2014 “Fallen Leaves: last words on Life, Love War and God”. This vision is an example for the macro level identity.
Swami Vivekananda’s advice as “ Education is the manifestation of perfection already in man”, is relevant and simple in making realize the “micro level” identity of individuals.
Very few countries can claim the historical heritage that India has. This is a very broad area of discussion. To make it as simple (which in reality is as complex as the Universe which Stephen Hawking was astonished to explore and reveal) we can start from a portion of history that suits the discussion on ranking of Universities.
India was ruled by the British (leaving the long history of the pre-British Indian era, which have contributed the Nalanda and Takshasila to the world, Gurukul system, community schools etc) and in 1947, we were left with a “colonized education system” of more than 200 years. The great visionary leaders of Indian Independence in their attempt to rebuild India have toiled a great for the growth and development (from a socio-economic perspective) of our nation. Education had a vital role in it. The context included the “back pack of the culture and civilization” like caste, religion, class, tribe – ultimately we wanted inclusion of the poor and down trodden (to address poverty and adopt democracy) in nation building. Gandhian thought of “Compulsory school education” aimed at inclusive development (and nutrition) and he knew that India was best under the British rule.
Education played and plays a vital role in this take off from 1947.
Minoo Masani in his book “Our India” in 1941 narrates the great richness and diversity of India amidst the 16.1% of literacy. We moved from this to 74% literacy in 2011. As Amartya Sen says: “Illiteracy and innumeracy are major deprivations – profound “unfreedom” as their own. Not to be able to read, write and count makes a person less free to have control over one’s life.” British rule have left us with that illiteracy in 1947.
Adam Szirmai (1997) in his book on Education and Development: the dynamics of socio economic development, an introduction, observes that Education tends to be academically oriented and has little relationships with the life situations of most students.
I shall share few of the points of Amartya Sen (devoid of his stylistic explanation!) to take support for my thoughts.
This is from his article (one among the many he wrote on development issues specific to India) on “Sunlight and other fears: the importance of school education” ; in “The country of First Boys, 2015) talks on What’s the point of going to School ?
How many of the top ranked Global Universities (majority in the so called developed countries) have gone through a similar process of Nation building as given in the Indian context.
From 1947 to 2018 India has consistently progressed in all the “a” to “e” factors as mentioned above by Amartya Sen (though one can arguably ask for more efficient outcomes) for which education was pivotal. The ones who have gone through school education- many of them the underprivileged and privileged; girls and boys, poor & rich; rural & urban – enter colleges. This is one of our important yardsticks on progress of education : the number of universities and colleges after the independence and students enrolled in them.
As mentioned in the beginning of point 2, Reghuram rightly says “The raw materials in the form of children were available ………and they could molded.” We could achieve that with vision and implementation of reforms in education sector from Shri Jawaharlal Nehru to Shri Narendra Modi.
India is showing development in terms of socio economic parameters though challenges diversify as decades change.
What did the British rule leave for us:
(The Hunter Commission constituted by the UKK Parliament direction in 1882 has observed that there is no education system in India but only examination system. Students are being prepared for examinations to get a degree certificate to get a job and the prestige in society. The Kothari Commission report of 1952 endorsed the views). The education system in UK during colonial rule in India gave importance to Character building and overall personality development to face real life situations, while in India it was based on getting a certificate for job.
The ranking of Indian Universities as against the Universities of developed nations need to be viewed based on the “Indian context” of the society. From what we inherited (good and bad) and how we addressed these in the field of Education. If we have a yardstick added in the ranking on the entry of underprivileged, women, poor, rural, the Universities of India will be higher in the rank scales. Performance of any University that exists in a society is linked to the structure and function of the society. (This is again with reiteration of point 2).
If the ranking of Universities takes care of point 2 and point 1, I am sure that many of our higher educational institutes / universities will be in the first 100 of the world.
The yardsticks make the steps of the ladder.
April 20, 2019
Prof. S. Ramkumar
Education
Creativity cannot be formally taught
…but can be facilitated to develop in the minds of people by designing appropriate environment.
Curiosity is the foundation for creativity, and it’s the inherent capacity developed as a newborn baby through childhood which makes him/her inquisitive about the world- the light, the sound and taste of a new infant born to the “Whys” that they ask parents, grandparents or relatives in the initial stages of development.
However, formal education in kindergartens and primary schools tend to expect “uniform” answers rather than the “diverse” reflections of curious minds. The tendency to ask “whys” among children tend to decrease as they advance to higher classes. The orientation is strongly conditioned to the decimals of the marks in examinations, rather than allowances of creativity; and many around the child look for measuring her/him based on these numbers (marks!). Added to that is the shaping of the Child’s mind, to the interests, aptitude and aspirations of other actors (parents, teachers, friends!).
“From an early age we are given labels which can so easily define our lives” : Richard Gerver. 2013 .“Change – learn to love it, learn to lead it.”.
The efforts of creativity at a graduate level would be to retain and nurture the ability if they are tuned to, or to develop this lost ability (which every individual is born with).
But then, we need to undo/redo from this conditioning, in medical education to bring out the best of a medical graduate for society and themselves. Explore ourselves to discover, which helps to a holistic and “best of potential delivery” to the society. The programme of Connaissance 3.0 is such an opportunity to pause and reflect on the passionate abilities we would have otherwise forgotten or kept in the uncared corners of mind.
Nissen, Einstein and the cellophane:
The following paragraph is a paraphrased version borrowed from the amazing book “Under the Knife : The History of Surgery in 28 remarkable operations by Arnold Van De Laar (2018).
Rudolf Nissen (who fled Germany owing to 2nd world war), is credited with the operation of Nissen fundoplication ; he performed the first successful resection of a whole lung (1931) and was the first to perform a complete resection of the oesophagus. Albert Einstein needs no introduction. He left Germany in 1933 for reasons evident to history.
In 1948, when Einstein was 69 he was the most famous patient Nissen could have imagined to treat in USA.. Nissen diagnosed AAAA( Acute abdominal aortic aneurysm) in Einstein with Xray studies ( since CT scan and ultrasound scan were not developed). As Nissen performed the abdominal operation on the greatest scientist of the world, he found an aneurysm of the abdominal aorta, the size of a grapefruit.
As the aneurysm was still intact, Nissen applied an experimental method : he wrapped it in cellophane – the same synthetic material used to wrap sweets, bread and envelopes. (Use of vascular prosthetic surgery superseded this in the years that followed). “ and it required guts to wrap the aneurysm of the greatest scientist of all time …” To cut short an interesting and epic story I focus on “guts’.
This “guts” is the confidence what I call a “confluence of competency and compassion” of surgeon/doctor: the quintessence of medical education. The capacity of common sense, improvisations or innovations, timely and quick reactions and above all the ability to comprehend the whole situation and act firm and fine in the best interest of the patient.
Where does it come from ?
Undoubtedly, from the creativity of stretching minds of imagination. Medical education is a confluence of Competency, Creativity, Connectivity (especially in this Google age!) and Compassion. Competencies are built through the well thought of curriculum of five and half years: the Skills. Knowledge and mindset. However, the other abilities are to be nurtured and ignited through an ecosystem favouring liberated minds that will synergistically benefit the community, doctor and above all the profession.
Honing creativity
Dare to think !
It’s amazing how we can study history, anthropology, arts, architecture and many more interesting areas of life through medical science. In the talk that followed mine, Dr. Deepak Agrawal (Professor Neurosurgery, AIIMS Delhi, Co-inventor of World’s Cheapest Ventilator) interestingly explained on how he could see a plot or design of a human brain in a painting of Michael Angelo. This perspective is creativity. He has helped in transforming the corridors of AIIMS to have an art gallery with paintings for the patients and public who visit AIIMS.
This is what creativity does to a doctor, and the reason why creativity and innovation need to be complemented in the period of medical education. It’s the ability to see the same situation in different perspectives.
And in India, it all needs to be approachable and affordable for the common patient.
The algorithm of diagnosis
In this technological era, we are moving from the “Sherlock Holmes method” of diagnosis to “ the artificial intelligence” (AI) methods” like the Magic of Watson’s algorithm (IBM).
“Today IBM will feed a medical Watson, 3000 images, 200 of which are melanomas and 2800 are not, and Watson then uses its algorithm to start to learn that the melanomas have these colours, topographies and edges. And after looking at tens of thousands and understanding the features they have in common, it can, much quicker than a human, identify particularly cancerous ones. That capability frees up doctors to focus where they are most needed – with the patient.” Thomas L. Friedman. 2016. “Thank you for being late : an optimist’s guide to thriving in the age of accelerations”.
The balance between the technology and patient helps to retain intuition, empathy and judgment the vital parameters of a doctor’s life. Retaining the personal qualities in the tirade of technologies is a challenge. Creativity is one of the solutions to the sweeping technologies, which can build on identity!
The key mantra is : Man reins the machine.
Faculty orientation.
The present generation students are born into the fast track of technologies that decide day to day life.
“Subject and wisdom” wise, we assume faculty are experienced. But the faculty need to give a wider and open space for the enhanced capacities of the brilliant students who are a product of the present time and technologies – the Google generation born in to the “smart worlds”. There is a lot about the world that is to be understood from students!
The lateral learning from different walks of arts and science helps in good innovations. Whether it’s a book, movie, music or maverick – creativity sees innovations when we open up interfaces with these.
The disciplined knowledge of the doctor synchronised with the skills and knowledge from different realms of science and arts open up new avenues and innovations.
“Learn – unlearn- Relearn” is the key to open the lock of a closed mind.
Innovation clubs/café
These can provide spaces for students, staff and others (be it patients or outsiders) to discuss on lateral thinking. These can be informal centres of coffee breaks, wherein ideas are shared and the ones are taken forward through a good innovation facilitation centre.
Epilogue: The Top Secret
The secret of the Top is to spin it.
A still top doesn’t qualify to be called a top. We all have been blessed with a top. The question is how many of us has spun it and how many times!
June 28, 2018
Prof. S. Ramkumar
Life, Lifestyle
As my daughter (who is a human(e) doctor by default and nature, and a film story/script writer by passion) coerced me into the much postponed surgery for me, I was learning the “unknown’s indices” and uncertainties of life as a patient. The best thing she did was to identify the surgeon whom she had great regards for. From the first meeting in which the surgeon unambiguously informed after a check up that I needed to undergo an intervention operation and set the target days between as 7 to 10. I haven’t been able to study me as a patient- but I am considered as a worrisome one in that role.
In a time in which we have many doctors and surgeons (especially in urban areas), and options of corporate hospitals to primary health centers, I was impressed by the professional approach of this surgeon- who was more than willing to tolerate my every doubt (which never ended!). I could feel he could have been none other than a surgeon. Professional, simple, straight, energetic, limited but precise and clear in this thoughts and words and above all confidence in what he was doing.
There was sequence of events- pre and post operation- which included regular caring visits every day, listening and reassuring, holding on to my hand in the Operation theatre just before the procedure and assuring that “just relax sir, we will take care of you” and similar mind relaxing gestures which helped me to face the test of time. With a surgeon like him around, I felt comfortably positioned as somebody who is genuinely cared for.
To cut short memories and to the theme of the topic.
As he said after a week after the operation that I can leave, the Hospital did not agree to take the fees from me. My wife who was with me through all nights was surprised. The management said that the Surgeon has made it clear that he was doing the surgery “free” for me. When he himself is not collecting his genuine fee the Management felt that they should not get anything from me (especially so since my daughter worked there for an year and a half and was liked so much there). I was firm that it wasn’t fair. It wasn’t after all just the bill that needed to be paid with “money” but the care, compassion and concern of many others that needed to be acknowledged by me.
I decided to ask the Surgeon on the day of discharge while he gave instructions to me on post operative care , “Doctor, why don’t you please accept the surgeon’s fee, for all the efforts you have been taking?. Before I could complete, he interrupted “No, sir, the top-up you have give me and family has still more space to be charged”. It didn’t click me. As I tried convincing , he stopped me with a smile “still charge is remaining- hope you understand!”
My daughter reminded me of the incident that happened two years back. Her senior colleague – an efficient and respected lady gynaecologist needed a help. Two injured young stray dogs were hurt and abandoned at the gate of their home and were suffering. Their cries were upsetting not only her but also her young daughters. She in some place felt responsible for it and helpless at the same time. They were finding difficulty in identifying somebody who could save, treat and take these dogs away to a secure place. Her concern was genuine. They were constantly disturbed by the painful cries and grumblings of these poor creatures. After talking to her I understood her concern and worry for the animals (and that made me realize how compassionate and good they were!). I tried all official mechanisms to take the animals away from their home for treatment but it was difficult (which I knew!). Finally, I asked one of my students, a good veterinarian, who is a Faculty now for help and he whole heartedly obliged. With much efforts he through an NGO did took the dogs away and treated them.
I had forgotten this incident.
The Surgeon again repeated “ The two nights of disturbed sleep and worry for the dogs are unexplainable. You went out of the way to help us”. The lady gynecologist was his wife. He continued “what I am doing is my duty of sharing knowledge of medicine and surgery”.
I was too awestruck to respond.
It wasn’t the money, but the Glow of Goodness that comes out of the blue that surprises us and spreads a sweet joy of life.
It’s amazing how we could be carriers of this glow, every moment of our life. And how my student, the lady gynecologist, the surgeon- Dr. P.V.Srinivasan, the sisters of Cluny and my daughter could form a loop of this glow that gave this insight to me!
March 29,2020
Prof. S. Ramkumar
Lifestyle
The setting is a family in a home. A relationship that sustains is built on “listening, sharing and caring”.
The advent of technology has ensured that a cell phone or TV is an active added member of the family taking off the time from personal notations between members, shifting largely to impersonal notations. People drive two wheelers in busy streets with the phone sandwiched between their ear and shoulder, as if the acrobatics is an unavoidable emergency , but for which existence is in peril! That’s an attitude. Beware of the same attitude in a different nature which seeps into homes too!
Two decades back it was the common TV which was viewed in common , who was the added member in a family. In one way it used to pull the members around the TV, though choices of programmes slowly crept as an issue. With more channels coming up, the idea has turned disruptive making more TVs to enter a home.
Now every member has an added member in the family- the cell phone or the smart phone. As a one point edutainment tool it is stunning the mass by its potential of omnipresence.
What difference does it make or can make in a family?
The personal bonds between husband, wife, children and grandparents are quite important. They are experienced through the personal notations of emotions. They strengthen the trust and cohesion among members. Whether its smiling, laughing or shouting you are sure to have a response on the other side (non-responding is also a response!). With the active presence of the third techno-member (the cell phone), the nature of these responses is changing. Each member is attached to the appendage of the smart phone and work-stations mushroom inside a home. Sometimes the family members in a room sit, chat or talk on the phone, often without communicating or not-so-effectively communicating between themselves. This would sometimes create a complexity among the receiver of the communication, (whoever it is). (S)he may not be getting the responses as it should have been. This results in annoying, worry, anxiety… for the other family member(s).
The tech invasion
Some common situations in a present day home wherein tech-member puts the knotty knots.
Wife: “I told you”.
Husband: “No, you didn’t tell me”.:
Probably (s)he would have told! But the person who received (or not received) the message would have been in the virtual world with the tech-member and would have not “listened’ actively.
If this dialogue is extended with explanations and counters, its not going to be congenial. The tech-member (the cell phone) has the final laugh!
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Many commitments to self, family and society gets slipped when we dive deep into the virtual world of “friends”, “likes”, ‘shares”, ‘images’ and “videos” which gushes incessantly in a cell phone. A cell phone is a battle ground of facts and fictions. This virtual world should be conscientiously connected so as not to be deceived! Involvement with the cell phone should not grow out as a reason for forgetting many routine commitments.
The requirements of a day-to-day management get sunk in the excessive attention to tech-member. Repetitive “I forgot” is not congenial from the perspective of “other’ member(s ) of the family. Over a period of time this can lead to a lighter degree of insensitivity which can affect the “caring, sharing, and listening” factors of a home.
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The fast advent of technologies over last few decades has created a present mix (segments) of generation from a technology perspective. The heterogeneous segmented generation (Gen) in the present day consists of google/smart phone Gen, Pre Google/cell phone Gen, MTV Gen, Doordarshan Gen, Pre TV Gen, Radio Gen, …Expectations of interactions of different segments could be largely different. Positioning of congeniality is often based on the types of segments which interact. The “right “ and “wrong” has different definitions within and between “segments”.
The opportunities of a cell phone is like that of a “Genie” let free. As far we know and control the Genie its fine; if Genie starts controlling us we will be shortly seeing a new family order and society, which many of us may comment as not congenial.
The personal space of “listening, sharing and caring” should never be allowed to be purchased by a technology. Creating congenitally for family is a responsibility to preserve the order and function of a family for the future.