And Vijay Says…

It’s been a difficult time – my father in law had been in and out of various hospitals for over a year , and couple of days ago he lost his fight . It’s hard to reconcile that we won’t be listening to his soft humming of old Malayalam songs , animated conversations with my daughter , the many trips a day on his scooter to the local grocer and all the little things we took for granted when he was alive . It’s not going to be easy – but knowing he is not suffering any more  is indeed a big relief . My family can’t thank enough the kind words and gestures of love and support from countless folks around the globe . 

Couple of years ago, while I was on vacation in India – I lost an aunt to cancer . We knew it was a losing battle but we spent a significant time at the hospital trying to do everything we can to make it a little less painful for her . To say it was extremely frustrating is putting it lightly . 

There were a few more incidents where loved ones had to spend time at hospitals in recent times . The common thread amongst all these episodes is the fact that hospitals in India have some serious and significant rethinking to do on how they care for patients .

I have the utmost respect for medical professionals. I am proud to have several friends and relatives who are members of that profession  . They are normal humans expected to do superhuman tasks on a routine basis . We generally don’t go visit them under pleasant circumstances – so they need to perform at superhuman levels in front of totally unreasonable clients every single day . In my day job , I am a professional Servcies provider – and I know how hard that job can get even when my clients are not stressed out . So it’s not just respect that I have for doctors and nurses and others in that field – I hold them in absolute awe ! 

I do think from the perspective of sheer skills and competence levels – the medical professionals in India are on par with their colleagues anywhere else in the world , and in some cases a little better too given they get exposure to hands on work a lot sooner in college . Where they have some catching up to do is on their “client facing skills”. 

In the field of medicine – How you do it is just as important , and maybe even more important – as what the outcome is for the patients and their families . Unfortunately the prevailing practice here seems to be that doctors and nurses dissuade patients and their family from asking questions . “Because I told you so” – is a terrible answer . I have experienced this first hand and I know my family has often feared that asking questions will piss off the medical staff to the extent that the quality of care may come down . So out of sheet fear – they stopped asking . 

I have a theory – I think medical professionals here are not trained sufficiently in how to handle the patients on the non medical issues like answering questions from family members , giving them options in plain speak and so on . So the younger professionals just do what their older colleagues do and being rude just becomes the norm . I am sure there are great exceptions to this norm – but the status quo needs to change and it needs to change quickly .
Then there is the actual hospital management . The big hospitals own a blood bank, some labs, a pharmacy and a canteen . You would think that , the hospital would figure out how to make it easy for the patients to get tests done , get food/Meds delivered on time and so on . But that is not how it works . 

There is a sign out side the critical care unit that reminds families that someone should stay there 24X7 to take instructions . A nurse would pop out from time to time and say “here is a list of Meds we need – go to the pharma and get them right now. If our pharma doesn’t have it – go find it from elsewhere. We need it next hour”.  And you have to do it while keeping some one else in front of the critical care because the nurse could come back in few minutes and say “go buy tea and biscuits for the patient and deliver it”. It’s totally common place to also ask for “6 bottles of O negative blood” without any instructions on how to do it or what options exist .

How is this acceptable behavior in a professional setting ? This is not hospital management – it is hospital mismanagement. Within hospitals and across hospitals – the administrators and medical professionals have more ability and skills to provide seamless care than putting the onus on patients and their families . How do you expect the patient’s family to figure out where in the state a rare drug can be found ? I shudder to think that someone will bleed to death if there is no one outside the CCU to go find enough people to deliver 6 bottles of blood . There is no excuse to keep doing this – hospitals should absolutely get their act together . 

Hospitals are not inexpensive . Insurance is not widely used yet . Many patients and their families are ignorant of their rights . And there are possibly a million more excuses why things are the way they are . It’s also possible that grief makes me look at things more harshly than usual . But in the end – the noblest of all professions need to live up to its billing , both literally and figuratively !

Cow slaughter and beef ban news have hogged the lime light for several weeks now in Indian media . Some one even got killed by a mob for eating beef recently in North India . I can’t begin to say how stupid the whole controversy is. But this silliness gets magnified when we read about one rape after another in India . Surely we can give more attention to the plight of women than holy cows ?

I am vehemently against capital punishment – I don’t think it has a place in civilized world . But when I read the news about a two year old girl getting raped in India , I started thinking whether capital punishment is still needed in a minority of cases ( “rarest of rare” as Supreme Court refers to it ). I know it’s a slippery slope if we start supporting capital punishment for some situations arbitrarily but not others – but as a father of a little girl myself , I can’t be totally objective on this matter . 

My own family has some amazingly strong women who bucked the general trend of women in India  – my mom ran multiple small businesses to help raise our family , my younger sister did her masters and anchored for TV channels while working at an IT company , one aunt was the first woman IPS police officer in our state, multiple female cousins did their masters degrees and have great careers and so on . Given this background – for the longest time I didn’t quite have an appreciation of what it “really” means to grow up as a girl in India . 
That said – I didn’t have to look very far to see things were not all totally kosher for women.

When I was a little kid vacationing at my grand parents house annually – the accepted norm was that the men (and boys) of the house would eat before the women (and girls). Most of my aunts and older female cousins were married off really early . There wasn’t really much of an emphasis in educating girls or helping them build a career at that time .
I went to a boys only school . And in engineering college , there was just one girl in our class . So the first time I really sat next to a girl or had a conversation with a girl was when I was in business school . It took me several months to feel comfortable in a co-Ed environment . I know first hand that it took a lot longer than that for some of the girls in our class . And that is a big problem – there is no reason why we can’t have co-Ed classes from kindergarten all the way . When guys and gals get comfortable being next to each other and talking as friends  , a lot of problems go away . With proper education – Over the next generation we won’t need separate lines for women , separate railway compartments for women and so on in India if we start kids on the right path from school .

Next up – we need to set things right on the home front . A dad who doesn’t respect mom and his girl children doesn’t help his son behave any better . I can’t honestly say I am setting the perfect example myself – there is plenty more I can do to share the domestic work load with my dear wife . I am trying to improve though . I do tell my little daughter all the time that there is nothing she can’t do that another boy or girl can do . I also know several friends and family members who look at it the same way . We need to change the attitude ground up – and have some real urgency about that . The duty of Indian dads and moms should move away from “best possible marriage for my daughter” to “best possible education and career for my daughter”.

There is already a lot of attention on equality of women in work place . More things are done to make it right today compared to the past – but it has to be more than just a slogan or a metric to be hit . The few women who have broken the glass ceiling has a big job now to be stellar role models to their younger female colleagues . But to solve the inequality problem meaningfully and quickly  , men have to take direct responsibility . It will be an absolute shame if the male leaders of our generation don’t fix this problem for good .

Coming back to the case of rape – I absolutely think law enforcement needs to kick the offenders butt every chance they get and set an example . But knowing the level of corruption and loop holes in the Indian system – I am not holding my breath on a solution that is primarily about law enforcement. 

As a society – we need to stop treating the victims of rape as bad people . They need support – medical , emotional , financial, legal. We should take away the shame factor in reporting rape . “Who will marry her now?” Is the reason why a lot of families don’t report rape . It’s time we moved on from our Stone Age mindset . 

I have started seeing some folks in social media saying girls carrying guns are the solution to rapes in India . I can’t change your beliefs other than point you to the fact that there are more rapes per capita in US compared to India , while there are more guns per capita in US compared to not just India , but every other country on earth.

There are some controversial solutions being discussed as well – like legalizing prostitution in India . It definitely shocked my Indian values quite a bit – but the more I think about it , this is something that might actually work in India in reducing rapes . I wonder if someone is studying this seriously to put a proposal before the law makers . Given the ruling BJP is extremely right wing Hindu in ideology – I don’t think they will entertain a radical solution like this . 

Let me share two things that happened this week to me , the “Indian techie”.

1. Incident 1

Me , a Caucasian friend and another friend who is visiting from India were on the phone yesterday . Caucasian friend has a team that is mostly in India and the rest of his team in US also is majority Indian. He is a first time manager and wanted our advice on some team dynamics . So for some topic he asked “so is this an Indian culture thing?” . I said “no” and our other friend said “yes of course” at the same time ! 

Dead silence for a minute and then we burst out laughing 🙂

There were four major themes we discussed about that team and three of the four , my friend from India had a different version of what is Indian . 

I left the call thinking I must be from Mars

2. Incident 2

I had some spare time (it’s the first week of new quarter and the only time when I get to do geeky things without worrying about deals and stuff ) and offered to help some younger colleagues with optimizing SQL performance . They sent me the code and I did not have an explain log to see what was causing the performance issue . The one thing I noticed was that there were some subqueries in the code that was on the same table as the original query . So I thought maybe I can rewrite it to a self join and get a tad more performance . Except – what should have taken 30 minutes for a regular developer took me a few hours to make it work . I was miserable – including some yelling , screaming and cursing . 

Here comes the irony . The code did perform better and my buddies were thoroughly impressed that a suit could actually write production quality code . I on the other hand was in extreme depression that I no longer can even do mundane coding very well . That is a big problem since I think of myself as a developer first and foremost . 

So what am I ? Or as I asked myself yesterday in technical terms – WTF am I ? 

I think of myself as extremely Indian . I was born and raised in a a small South Indian town . I speak English with a thick Indian accent . I don’t think of English as my first language . I speak Malayalam at home, and can speak several other Indian languages . I cook and eat mostly Indian food . I hear mostly Indian music and I read three Indian news papers every day on my phone . The only sport I follow is cricket . Yet – I no longer seem to be able to relate completely to the folks who live in India . 

I am an accidental transplant into the world of management and sales . My identity right from school days has been that of an engineer . I try hard to stay on top of technology all the time . Yet – from an “engineer who also sells and manages” I seem to have morphed into “just an executive who can do a bunch of different things”. 

Don’t tell me that “change is inevitable” or “you have to embrace change” . I know it , just don’t tell me 🙂