Friday, September 5, 2008

Railway Toilets-Use and disuse

Traveling, in fact the thought of traveling, triggers off a major shut down in my lower gastrointestinal system. This protective mechanism has served me rather well except on a few occasions.
Despite the fact that toilets in the Indian Railways have improved significantly in the last decade, it is still a bit of a gut stopping experience and that is literal!. One, of course, has a choice between Western and Indian ‘styles’. Do not take the use of the word style too seriously. There is nothing ‘stylish’ about both. The western ‘style’ usually comes without a seat. This is a frightening proposition particularly for some one with a narrow hip and waist, say a child or an anorexic fashion model. On the other hand, the few that have a seat are invariably soiled. Men, as we know, do not care to lift the toilet seats before using it. I know of one friend who carries a newspaper which he expertly cuts and uses as a protective barrier between his butt and the seat. On the few occasions when I have needed to sit/ squat, I have shown immense patriotism by choosing the Indian ‘style’ which consists of two platforms to place your feet on while you squat. Between the two platforms is a metallic receptacle that has a gradient leading to a hole which empties on to the railway tracks. If you look carefully, there is usually a tap in front of the seating arrangement which has a pushing device to dispense water. I have seen no use for it except as an anchor to hold on to while you go about your business. How one effectively uses the water that comes out of it is beyond me. Of late the Indian Railways has provided a mug chained to the tap (or to some contraption at the side). This chain is about a foot long and one cannot expect to use it meaningfully for anything. A longer chain would no doubt have dragged itself over so many undesirable areas making it a messy business. Not having a security chain will understandably result in some one taking it home. My advice is to use toilet paper or carry your own mug if you cannot manage without water (as is the case with most of us Indians). The flush works half heartedly, and certainly does not do its intended work. The Railway however urges you to flush before and after use. The Indian Railway also requests you to not use the toilet while the train is stopped at a Station. It certainly is a reasonable request to prevent passengers at Railway station platforms from having to see unsightly heaps on the track while waiting for their train to arrive. On the other hand it is an unreasonable request on the toilet user. Aiming for a 4 inch hole while the train banks from side to side needs quite some experience. If you are squatting on an Indian style toilet the chances are that you will not only miss the target but may end up soiling your ankles as well.
I have heard of all kind of things going down the chute of the toilets- wallets, glasses and cell phones. A most bizarre story was recently reported in the Indian newspapers. A woman delivered a child and she chose to do so in the toilet of a running train. The mother watched aghast as the new born disappeared down the toilet chute on to the tracks. Hearing the distressed mother, the train was stopped by fellow passengers, who pulled the emergency chain. They found the child on the tracks a kilometer away, a little soiled but without a scratch- alive and kicking. Happy endings are common in India!
George

Tuesday, September 2, 2008

Strange Names, Strange Places, Strange Professions!!

My name is George Paul. I am a Maxillofacial Surgeon practicing in Salem. It might actually occur to some that this is some weird guy with two first names (and Christian ones at that) practicing an ominous unpronounceable profession in Salem. Since Salem (Massachusetts) is historically linked to witchcraft I would not be surprised if people thought that maxillofacial surgery was in some way related to that dubious craft. So let me explain. Maxillofacial Surgery is a surgical specialty of Dentistry/ Medicine and Salem is a ‘witchless’ city (I believe) situated in Tamilnadu, India. But first, the business of the unusual name.
I do not know of any place in the world where people have two Christian first names. It is a unique practice amongst the Syrian Christians of Kerala in India (where I was born). In fact I know a young man who had the not unusual name of M.M. Mathew. Indians in the South of India often prefix their name with an initial. Therefore the name is not unusual until you got him to expand his initials. It turns out that this gentleman from Kerala is indeed Mathew Mathew Mathew. So George Paul is not too bad. I am now a naturalized domicile of Tamilnadu. The name George gets a bit of a battering in these parts. For some reason most people cannot spell it correctly. Those who can, sometimes pronounce it wrong. This is again surprising when one considers that the official seat of Government of Tamilnadu is housed in a building called the Fort St George (a carry over from the British East India Company). In any case I get by with being spelt as Jorge, Gorge, Geroge and other such combinations which invariably involve the addition, deletion or replacement of some vowel or consonant. The only time I was actually offended was when I ended up being spelt as Garage in a hotel register.
Most people (anywhere in the world) would find it difficult to even pronounce ‘maxillofacial surgery’. It is therefore unfair to expect them to know what part of the body gets chopped up by the practitioners of this unpronounceable surgical specialty. In fact the specialty is a fairly complex one- at least as complex as its origins. The Wikipedia, and for that matter most authoritative sources, call it a surgical specialty of dentistry. Dentistry its self has a rather tenuous origin. It branched off from mainstream medicine (and surgery) a spot earlier than it ought to have and established itself as a separate specialty of the teeth (and later the mouth and jaws). Most medical specialties have gone through the mainstream of medicine and then separated out. If you ask me why Ophthalmology or Otolaryngology did not go the way of dentistry, I have no reply. We can only call dentistry an anomaly of medical history. The Maxillofacial region was annexed to dentistry by adventurous dentists who moved their surgical ambitions from the teeth to the gums to the mouth to the jaws and finally laid claim to a good part of the face. This insidious expansion is best captured by the evolution of the specialty’s nomenclature. It went from being called dental surgery to oral surgery to oral and maxillofacial surgery. Here it must be mentioned that the military violence of the two World Wars and the subsequent violence of high speed motoring and bar brawls, with heady ‘spirits’ as a catalyst for both of the latter, contributed to its establishment as a sound surgical specialty. Today maxillofacial surgery involves facial trauma, pathology, oral cancer, cosmetic surgery and more. At the risk of sounding morbid, I must admit that it is a good livelihood in Salem. The chaotic (and often spirited) traffic and the average motorist’s disdain for any protective gear keeps me and my family well fed. Today Oral and Maxillofacial surgery requires a double qualification (dentistry and medicine) in many parts of the world due to its complexity. Thank God, we do not need that as yet in India!!
Now Salem. This Salem that I live in is in Tamilnadu. It has nothing in common with the many other Salems around the world. I know of two major cities/ towns in the USA and there is one little Salem that I whizzed past in Jamaica. Of course Jerusalem has an etymological connection with Salem (Shalem). Other Salems include a popular brand of cigarettes, a rock band in Israel and an accused terrorist who for some reason spells his name as Salem (Abu Salem). Our Salem is a sedate city of a million people. Nothing dramatic happens here. No earthquakes, no floods, no terrorist bombs, no witchcraft (as in Salem Massachusetts); in fact it has nothing that merits ‘breaking news’ kind of publicity. It is relatively clean by Indian city standards. It has better than adequate facilities on nearly all fronts (relative to Indian standards again). In fact it has a surplus of hospitals, eateries and more recently educational institutions. Other surpluses include trucks, HIV/ AIDS and other unpleasant stuff, but we will pass those. The food is unique in these parts. The famous non vegetarian joints serve up some real mouth watering, spicy and biologically suspect food from small innocuous looking joints. The hospitals do good business, thanks to two national highways which intersect here, the chaotic city traffic and its central location, fed by numerous smaller towns and villages. The teaching institutions range from fly by night operations to highly rated professional institutions.
On a personal front my interests range from reading, writing, traveling (I hope there was a way of getting to places without the drudgery of car, bus, train and planes) and surgery to weekend appointments with Bacchus. Thanks to a recent qualification in law and ethics, I have a new interest in medical ethics. I also like talking. That’s right, talking. If I cannot find anybody I just talk to myself. Crazy? Well maybe a little bit of that too!
George