The Times of India on 30 th December 2009 reported an absurd proposal by the health ministry. Dr Meenakshi Gautham, a concerned health activist, filed a PIL in the Delhi High Court seeking to ameliorate the pathetic health condition in rural areas. I agree that it was something that should have been filed decades ago and then not just for the rural, but also for the urban poor. The Health Ministry and the MCI, on the direction of the High Court went into a huddle, in fact many high power huddles and then naively concluded that the magical solution for the rural folk will be to mobilize a new set of ‘doctors’ who are less trained (3 ½ years) as against the standard training of 5 ½ years for a medical graduate. This is not only discriminatory against the rural poor but a retrograde step that will create two tiers of doctors with two practice jurisdictions. The new set of BRMS graduates ( Bachelor of Rural Medicine and Surgery) will of course be expected to practice within the jurisdiction of villages while the others will stride the polished corridors of swanky city hospitals. This is an insult to the already deprived villagers who will now have the official classification of lesser Indians who deserve lesser trained physicians.
I must first pre-empt the usual argument of ‘something is better than nothing’ for these poor rural people and the repeated plaint about doctors refusing to serve in rural areas. The answer to this serious problem is not the creation of a lesser cadre for the lesser privileged but in addressing the fundamental problems in health management and manpower distribution. Most of us think that more doctors is a prescription for better health. Health, particularly at the grass root levels are achieved by education, awareness, prevention and health surveillance. It is no secret that the average doctor (rural or urban) would not be excited about pursuing these less glamorous aspects of health care.
I randomly chose a country in Southeast Asia and compared it with India based on available WHO statistics. Thailand is a much smaller country than India but has an economy that is somewhat similar. Thailand has a lesser physician density (3 per 10,000 pop) when compared to India which has (6 per 10,000) population. However every one of Thailand’s health indices is better. The life expectancy at birth is 62 years for an Indian whereas it is more than 70 for a Thai. About 79 out of 1000 live births are expected to die in India whereas the death rate in the same category is only 8 per thousand live births. Obviously, more doctors did not help the cause of public health in India. The key is commitment to health. This can be seen by the fact that the per capita expenditure on health is about three times higher in Thailand than it is India (Intl $ 109 in India and Intl $346 in Thailand). The density of nursing personnel in Thailand is twice as much as the nursing personnel density in India (28 and 13 for every 10,000 population respectively). Public spending on health in India at 0.9% of GDP is way below the public health spending in Thailand. In short, the health of a nation is not defined by the number of doctors but by the commitment of its Government. Nurses, Para -medics, health workers and maternity care givers are a greater need than poorly trained doctors. Doctors, even if they are called ‘Rural’ Doctors, are bound to chase the more glamorous aspects of health care. Nothing can stop these ‘rural physicians’ from slowly encroaching into the more financially rewarding urban and semi urban regions of the country. No regulatory body can practically restrict their activities to the ill defined concept of ‘rural’. Even legally, the courts will strike down as unreasonable restriction if a ‘qualified doctor’ is told to treat only people in a certain region (rural). It will be an infringement of the fundamental right to freedom of profession, occupation, trade or business under Art 19 (g) of the constitution. If a person can treat a rural person (as a bachelor of rural medicine and surgery) there is no way that he can be prevented from treating an urban person who has the same human features in anatomy and physiology. What is sauce for the goose is sauce for the gander !!!
The Government should focus its welfare intentions on creating incentives for doctors who are willing to serve the rural population. Creating another category of doctors and imposing unreasonable restrictions on their right to work can only be seen as an immature and poorly thought out strategy that has no respect for the sensitivities of the rural poor in addition to being hare brained and impractical.
George Paul
Sunday, January 3, 2010
Friday, October 16, 2009
A Diwali Story
Diwali (Deepavali in Tamilnadu), as everybody knows, is a celebration of the triumph of good over evil. Driving home this evening in heavy Diwali traffic I had time to recall my first Diwali in Salem as an Oral and Maxillofacial surgeon. Festivals have a way of being woven into our lives. This one is about an interesting weave that brought together my profession and the sparkling festival of Diwali. In 1986 I had returned to Tamilnadu after several years in Kerala and a short stint in Annamalai University. It was Diwali time. The festival came and went. The sulfurous odour of expended fireworks and the haze of smoke were still in the air when I got one of my first professional hospital calls. It was two days after Diwali. The young man looked miserable lying in a hospital ward with a broken jaw and several missing teeth. His demure young wife, hardly out of her teens, stood uncertainly near the bed. The boy told me his painful story- literally and figuratively . It must have been painful. Try telling a long story with a broken jaw. I don’t remember his name. Let’s call him Kannan.
Kannan had gone to his wife’s home for the traditional Thalai Diwali. In Tamilnadu the new groom mandatorily spends the first Diwali after marriage in his wife’s place. It is called Thalai Diwali. The young groom is usually given a gold ring by his in laws. Kannan for some reason did not get his ring. I think he refused to stay overnight or something. The young fellow was terribly distraught and went home smarting from the insult and ignominy of not getting his golden ring. He did what most upset young men do. He drank away his blues. At some point he became so maudlin at the loss of face that he decided it was not worth living. He added some pesticide to his hooch. The pesticide apparently did not go well with the liquor and he puked the whole lot onto his living room floor. His cup of woes was full. Now sober and brooding he decided he would not give up. He walked out into the fields and threw himself into a nearby well knowing that he would certainly drown. The well was dry and he fell on hard rock. The next morning a search party found him alive and bleeding in the well. He was inconsolable. He had lost face (and some teeth too). He had failed again. Lying in the hospital room he had time to think and reflect. His new wife and her parents rushed to the hospital. Amidst the crying, hugging and reconciliation his father in law slipped the contentious gold ring on his son in law. Everything was forgotten. That was how I saw him- Repenting in a hospital general ward, two days after Diwali, with a broken jaw and missing teeth and of course a brand new ring on his finger. I operated on him and he had his teeth replaced a few weeks later. They returned many Diwalis later with a grinning child on the wife's hip. I think he had the gold ring on his finger too. They looked happily married. Diwali has a way of letting good triumph over evil- even if it has its twists and turns.
Have a great Diwali!
George
Kannan had gone to his wife’s home for the traditional Thalai Diwali. In Tamilnadu the new groom mandatorily spends the first Diwali after marriage in his wife’s place. It is called Thalai Diwali. The young groom is usually given a gold ring by his in laws. Kannan for some reason did not get his ring. I think he refused to stay overnight or something. The young fellow was terribly distraught and went home smarting from the insult and ignominy of not getting his golden ring. He did what most upset young men do. He drank away his blues. At some point he became so maudlin at the loss of face that he decided it was not worth living. He added some pesticide to his hooch. The pesticide apparently did not go well with the liquor and he puked the whole lot onto his living room floor. His cup of woes was full. Now sober and brooding he decided he would not give up. He walked out into the fields and threw himself into a nearby well knowing that he would certainly drown. The well was dry and he fell on hard rock. The next morning a search party found him alive and bleeding in the well. He was inconsolable. He had lost face (and some teeth too). He had failed again. Lying in the hospital room he had time to think and reflect. His new wife and her parents rushed to the hospital. Amidst the crying, hugging and reconciliation his father in law slipped the contentious gold ring on his son in law. Everything was forgotten. That was how I saw him- Repenting in a hospital general ward, two days after Diwali, with a broken jaw and missing teeth and of course a brand new ring on his finger. I operated on him and he had his teeth replaced a few weeks later. They returned many Diwalis later with a grinning child on the wife's hip. I think he had the gold ring on his finger too. They looked happily married. Diwali has a way of letting good triumph over evil- even if it has its twists and turns.
Have a great Diwali!
George
Friday, March 13, 2009
Aptronyms of Medical Specialists
An aptronym(also called Aptonyms) is a name aptly suited to its owner. I first came across the word in an engagingly funny article by V.S. Jayaschandran in The Week, where he refers to a well known neurologist called Lord Russell Brain who succeeded a Dr Henry Head as the Editor of a prominent Journal on Neurosciences called Brain. I realized that my late father too had an Aptronym. His name was Paulose (a Syrianized version of Paul). The people in Salem (Tamilnadu, India), where he practiced dentistry, ended up calling him Palu loose which roughly translates in Tamil/ English as loose teeth. It certainly helped his profession. I have another friend who is specialized as a Paediatric Dentist. Dr Baby John. Of course it would have been even more apt if he was a Paediatric Urologist.
I trawled the internet looking for some more aptronyms in the medical profession and came up with quite a few interesting ones. Dr Ima Assman’s special area of interest is obvious. He is a Proctologist.(1) Dr Knapp puts people to sleep. He is an anaesthetist (2) just like Dr John Bagwell (3). Dr Au (pronounced ‘ow’) is a dentist the specialty most often associated with pain just like Dr John Payne and Dr David Toothaker (3). There are of course other dentists with esoteric aptronyms. Les Plak who practices in San Francisco is on the preventive side of dentistry whereas Dr Tom Fillar appears to favour restoration of teeth (4)
I would have thought that Charles Butt would be interested in the hind areas but it turns out that he is the spokesman for an anti-tobacco group in Nova Scotia. No Cigarette Butts for him!!
It is inevitable for an Urologist with the name Richard to not be an aptronym. This is because all Richards are referred to as Dicks. So it is not surprising that Dr Dick (Richard) Chop is an urologist with a particularly brisk practice in circumcisions. His practice associate in Austin, Texas is coincidently Dr Hardman. I may assume that he is an Urologist with a special interest in andrology (a personal assumption) who prescribes loads of Viagra. Dr Dick Tapper, Dr Dick Finder etc are the other urologists by virtue of their first names. Urologists appear to be the most colourful of the aptronyms. We therefore have Dr Waters, Dr Gherkin, Dr Splatt, Dr Wong, Dr Wang and Dr Stone (5) amongst others who practice urology.
It would not be difficult to identify an Ophthalmologist with a name like Dr I. Doctor. On the other hand you may be wary of eye specialists with names like Luis V. Nosce (pronounced as ‘no see’) or Dr Wong See !!
No marks for guessing the specialty of these aptronyms - Dr Childs, Dr Small, Dr Bunny, Dr Tickles, Dr Toy and Dr Kidd – Of course they are all Paediatricians (5)
Dr Bonebrake, Dr Butcher, Dr Bones and Dr Bender (5) are all Orthopedic Surgeons. However Dr Dick Bone, though an osteopath, seems to belong to the league of Sexual Medicine, going by his name.
If you have gone crazy reading this article, you may want to look out for one these doctors - Dr Strange, Dr Quirk, Dr Dippy, Dr Moodie, Dr Nutter, Dr Nutt; Dr Looney, Dr Crabb, Dr Dement. Psychiatrists- all of them! (5)
All the names and specializations given above are real ones reported from lists of Medical Practitioners mostly in USA and Canada. The references and citations from where the Aptronyms have been sourced is given below. The author has used his liberty to make a few harmless assumptions for effect.
George Paul
1. http://en.wikipedia.org/wiki/Aptronym
2. http://homepage.mac.com/chapmandave/aptonyms/index2.html#list
3. http://homepage.mac.com/chapmandave/aptonyms/en/list.html#a
4. http://www.strangecosmos.com/content/item/25079.html
5. http://humor.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=humor&cdn=entertainment&tm=19&gps=305_695_1020_632&f=00&su=p504.1.336.ip_&tt=11&bt=1&bts=0&zu=http%3A//www.u.arizona.edu/%7Estoddard/doctor.htm
I trawled the internet looking for some more aptronyms in the medical profession and came up with quite a few interesting ones. Dr Ima Assman’s special area of interest is obvious. He is a Proctologist.(1) Dr Knapp puts people to sleep. He is an anaesthetist (2) just like Dr John Bagwell (3). Dr Au (pronounced ‘ow’) is a dentist the specialty most often associated with pain just like Dr John Payne and Dr David Toothaker (3). There are of course other dentists with esoteric aptronyms. Les Plak who practices in San Francisco is on the preventive side of dentistry whereas Dr Tom Fillar appears to favour restoration of teeth (4)
I would have thought that Charles Butt would be interested in the hind areas but it turns out that he is the spokesman for an anti-tobacco group in Nova Scotia. No Cigarette Butts for him!!
It is inevitable for an Urologist with the name Richard to not be an aptronym. This is because all Richards are referred to as Dicks. So it is not surprising that Dr Dick (Richard) Chop is an urologist with a particularly brisk practice in circumcisions. His practice associate in Austin, Texas is coincidently Dr Hardman. I may assume that he is an Urologist with a special interest in andrology (a personal assumption) who prescribes loads of Viagra. Dr Dick Tapper, Dr Dick Finder etc are the other urologists by virtue of their first names. Urologists appear to be the most colourful of the aptronyms. We therefore have Dr Waters, Dr Gherkin, Dr Splatt, Dr Wong, Dr Wang and Dr Stone (5) amongst others who practice urology.
It would not be difficult to identify an Ophthalmologist with a name like Dr I. Doctor. On the other hand you may be wary of eye specialists with names like Luis V. Nosce (pronounced as ‘no see’) or Dr Wong See !!
No marks for guessing the specialty of these aptronyms - Dr Childs, Dr Small, Dr Bunny, Dr Tickles, Dr Toy and Dr Kidd – Of course they are all Paediatricians (5)
Dr Bonebrake, Dr Butcher, Dr Bones and Dr Bender (5) are all Orthopedic Surgeons. However Dr Dick Bone, though an osteopath, seems to belong to the league of Sexual Medicine, going by his name.
If you have gone crazy reading this article, you may want to look out for one these doctors - Dr Strange, Dr Quirk, Dr Dippy, Dr Moodie, Dr Nutter, Dr Nutt; Dr Looney, Dr Crabb, Dr Dement. Psychiatrists- all of them! (5)
All the names and specializations given above are real ones reported from lists of Medical Practitioners mostly in USA and Canada. The references and citations from where the Aptronyms have been sourced is given below. The author has used his liberty to make a few harmless assumptions for effect.
George Paul
1. http://en.wikipedia.org/wiki/Aptronym
2. http://homepage.mac.com/chapmandave/aptonyms/index2.html#list
3. http://homepage.mac.com/chapmandave/aptonyms/en/list.html#a
4. http://www.strangecosmos.com/content/item/25079.html
5. http://humor.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=humor&cdn=entertainment&tm=19&gps=305_695_1020_632&f=00&su=p504.1.336.ip_&tt=11&bt=1&bts=0&zu=http%3A//www.u.arizona.edu/%7Estoddard/doctor.htm
Friday, February 6, 2009
Turning Fifty
It was a pleasant surprise to learn that Barbie Doll will be celebrating her fiftieth birthday in March. I too am turning 50 in March. We even share the same star. The similarity ends there. Barbie remains svelte and sexy. I cannot say the same for myself. She does not have a streak of grey on her full, blonde head. Age has not been kind to my hair or waist. Like me, Barbie has lived through the fashions of our times. For her it included conservative robes, tantalizingly short mini skirts, dress suits, hippie wear and even a pentagon approved military outfit. I have gone from drain pipe pants to bell bottoms to pleated baggies to whatever is available at our neighborhood ready made show room. Her dresses were designed by Christian Dior and Vera Wang. Mine were stitched by Singaram tailors who recently closed shop due to the chain of ready made outlets that have sprung up all over town. It must be said that her wardrobe is certainly more fashionable, eclectic and expensive than mine. I really cannot afford the underclothing she wears.
When I turned forty I assured myself that I was entering a new phase in life. I looked forward to the next decade as a defining one that would magically mix and blend the adventurism of youth with the experience of age. One wag even suggested that ‘Forty makes people naughty’. I am waiting for the magic and fifty is just a month away. I look forward to the next decade with the same anticipation I experienced when turning forty. 10 years down the road, Barbie doll is going to look the same. No such luck for me. Being a fashionable doll has its privileges.
George
Feb 2009
When I turned forty I assured myself that I was entering a new phase in life. I looked forward to the next decade as a defining one that would magically mix and blend the adventurism of youth with the experience of age. One wag even suggested that ‘Forty makes people naughty’. I am waiting for the magic and fifty is just a month away. I look forward to the next decade with the same anticipation I experienced when turning forty. 10 years down the road, Barbie doll is going to look the same. No such luck for me. Being a fashionable doll has its privileges.
George
Feb 2009
Tuesday, February 3, 2009
The Art of Healing!
Recently, a junior colleague, Prakash complained bitterly about the step motherly attitude meted out to him in a surgical oncology unit where he went to train. As a maxillofacial surgeon he was interested in oral oncology and considered himself competent to be trained in cancer surgery in the maxillofacial region. Prakash was politely reminded by the surgical oncologist that as a dentist he was not equipped to handle the complexities of cancer surgery. The sleight and put down, not withstanding, Prakash proved himself and earned the respect of his trainers. Many medical specialists look down upon other specialties as being less glamourous. Most clinicians tend to look down on colleagues involved in the less sought after para-clinical persuasions of medicine.
Unfortunately I too have ridden the high horse of being a surgeon. Somewhere during training and practice we come to believe that there is superiority in our calling. It perhaps comes from the adrenaline of working directly with blood and danger. The general public too may carry these impressions created by perceptions borne out of dramatization in books and movies. The truth is often understood by an actual patient seeking treatment for his disease. A patient with Psoriasis needs a dermatologist not a neurosurgeon.
My father, a dentist, had practiced his profession for nearly 50 years. He was particularly adept at prosthetics. He made excellent dentures. I never realized how much he was appreciated for this until a month after his recent death. I had operated on a patient with a tumour in her upper jaw a couple of years ago. It required a fairly major surgical procedure involving the removal of part of her upper jaw. After the tumour was successfully removed, I never thought much of it. She was asked to see my father for some kind of prosthesis. In fact I saw her only when she returned for her reviews which included routine inspections of the large defect. She removed her dentures to show me the defect and put it on again. I did not even pay much attention to the prosthesis. She came to visit following my father’s death. She broke down and cried inconsolably. She confessed that she was so desperate after the ablative surgery that she did not even want to live. The anguish of an young woman with a hole in her mouth. My father had apparently comforted her and painstakingly built her an obturator and denture that improved not only her appearance but also her ability to speak and eat. I understood that she felt a greater obligation to my father who restored her function with some good dentistry rather than to the snooty surgeon who removed her tumour. It was a humbling experience which reminded me that every person has a place in the healing profession.
Unfortunately I too have ridden the high horse of being a surgeon. Somewhere during training and practice we come to believe that there is superiority in our calling. It perhaps comes from the adrenaline of working directly with blood and danger. The general public too may carry these impressions created by perceptions borne out of dramatization in books and movies. The truth is often understood by an actual patient seeking treatment for his disease. A patient with Psoriasis needs a dermatologist not a neurosurgeon.
My father, a dentist, had practiced his profession for nearly 50 years. He was particularly adept at prosthetics. He made excellent dentures. I never realized how much he was appreciated for this until a month after his recent death. I had operated on a patient with a tumour in her upper jaw a couple of years ago. It required a fairly major surgical procedure involving the removal of part of her upper jaw. After the tumour was successfully removed, I never thought much of it. She was asked to see my father for some kind of prosthesis. In fact I saw her only when she returned for her reviews which included routine inspections of the large defect. She removed her dentures to show me the defect and put it on again. I did not even pay much attention to the prosthesis. She came to visit following my father’s death. She broke down and cried inconsolably. She confessed that she was so desperate after the ablative surgery that she did not even want to live. The anguish of an young woman with a hole in her mouth. My father had apparently comforted her and painstakingly built her an obturator and denture that improved not only her appearance but also her ability to speak and eat. I understood that she felt a greater obligation to my father who restored her function with some good dentistry rather than to the snooty surgeon who removed her tumour. It was a humbling experience which reminded me that every person has a place in the healing profession.
Where were we!??
Every adult who was alive in the US when John F Kennedy was assassinated will tell you what he/she was doing when they heard the news. I was not alive when the Mahatma was assassinated, but I certainly remember what I was doing when I heard about the assassination of Indira Gandhi and Rajiv Gandhi. I don’t however remember my disposition at the time of Pokhran 1 or 2 but I certainly remember where I was when the twin towers came down and the Babri Masjid was destroyed. I guess we benchmark these occurrences based on how much they mean to us or how deeply we have been affected by them. Today with the TV channels ‘Breaking news’ every 10 minutes, it is perhaps a difficult exercise.
I will never forget the 26/11 terrorist attack. I was in Delhi with a senior journalist friend. In fact I was staying with him. It is always a pleasure talking to journalists because they have such a bird’s eye view on the happenings in the country. This particular journo is one of the best defense reporters in the country. All you have to do is ask a stupid question and you can get some terrific insights into the complexities of their specialty. As a peacenik, I asked him if he ever foresaw the possibility of India being in a situation where there would be no need for a standing army and a significant part of the defense budget being used for development- education and health in particular. He was amazingly prescient when he said that he did not foresee such an eventuality. He predicted that conventional inter-national war will be replaced by intra-national conflict!! The arms dealers will never be out of business, he promised. Terrorism and internal strife will keep our army busy. I retired early to bed. My friend arranged for me to sleep in his extensive library- filled from floor to ceiling with books-mostly about war, terrorism and other conflicts. I was tired yet mellow from a couple of drinks and went to bed in the company of voluminous tomes about war and terror.
When my friend woke me up at midnight I was not sure if it was a dream. Terrorist Attack! Terrorist Attack! He said. I was confused because reality morphed into a dream like trance of battles, guns and grenades. It was surreal. The whiskey did not help matters! I was ready to run out or jump out of the building (8th floor I think). My friend quickly pointed to the TV screens showing repeated images of the TAJ, CST and the other sites. Still groggy I went back to sleep. When I woke up in the morning, surrounded by books of war and the faint memory of some visual action, I was still not sure if it was a dream or reality. Another benchmark etched into my memory reminding me where I was when it happened!
I will never forget the 26/11 terrorist attack. I was in Delhi with a senior journalist friend. In fact I was staying with him. It is always a pleasure talking to journalists because they have such a bird’s eye view on the happenings in the country. This particular journo is one of the best defense reporters in the country. All you have to do is ask a stupid question and you can get some terrific insights into the complexities of their specialty. As a peacenik, I asked him if he ever foresaw the possibility of India being in a situation where there would be no need for a standing army and a significant part of the defense budget being used for development- education and health in particular. He was amazingly prescient when he said that he did not foresee such an eventuality. He predicted that conventional inter-national war will be replaced by intra-national conflict!! The arms dealers will never be out of business, he promised. Terrorism and internal strife will keep our army busy. I retired early to bed. My friend arranged for me to sleep in his extensive library- filled from floor to ceiling with books-mostly about war, terrorism and other conflicts. I was tired yet mellow from a couple of drinks and went to bed in the company of voluminous tomes about war and terror.
When my friend woke me up at midnight I was not sure if it was a dream. Terrorist Attack! Terrorist Attack! He said. I was confused because reality morphed into a dream like trance of battles, guns and grenades. It was surreal. The whiskey did not help matters! I was ready to run out or jump out of the building (8th floor I think). My friend quickly pointed to the TV screens showing repeated images of the TAJ, CST and the other sites. Still groggy I went back to sleep. When I woke up in the morning, surrounded by books of war and the faint memory of some visual action, I was still not sure if it was a dream or reality. Another benchmark etched into my memory reminding me where I was when it happened!
Saturday, January 17, 2009
Travel Stories- Almost a Vietnamese. Almost!
My work as a volunteer dentist in the Philippines required me to spend the better part of the day at the Vietnamese refugee camp. The Palawan First Asylum Camp was a docking station for Vietnamese refugees (boat people) who were trying to get out of their country in the aftermath of the US departure from South Vietnam. My lunches at the Vietnamese restaurant inside the camp were a new culinary adventure. The camp dished out authentic Vietnamese home food replete with their amazingly spicy sauces. Even my brave South Indian tongue turned red at their potency. One gets used to the food in a short time but the journey from the bowl to the mouth was an arduous one. The Vietnamese are a proud people, like most Orientals. They are also finicky about their table manners. Chopsticks are ‘de rigueur.’ In the early days, they often looked at me pathetically as I struggled with a fork to discipline the slippery noodles, which were distinctly different and certainly more difficult than the user- friendly Chinese variety. At least the one’s we ate in India. A significant conversation, a few days later with Van Phuc Trinh, my translator and chopstick coach, told me that I should learn how to use their tool if I must earn their respect. Trinh and I were dining at the canteen a couple of days after I started work. Trinh leaned forward to interrupt my futile attempts to trap the noodles, which seemed to have a mind of its own. I could not, for the life of me, believe that you could actually tame these slippery spools of wormy noodles with two sticks that were perfectly smooth.
“Doc, do you know that the Filipinos have no eating manners!?” She whispered
“No” said I, distracted and struggling with the two sticks whose tips would never come together. I had always sensed an undercurrent of silent hostility between the Vietnamese refugees and their hosts, the Filipinos.
“They do not know how to eat properly,” she announced with a trace of condescension.
I had this strange feeling that she was hinting at my ineptitude. Orientals have a way of being round about in their conversations.
“They cannot eat with a chop stick…” she hesitated realizing that I had stopped my fervent attempts and the noodles were smoothly unwinding back into the bowl. “ or even forks…” she trailed away, seeing the look of guilt and embarrassment on my face. She then leaned forward as if to reveal a terrible secret and said, “I have seen Filipinos eat with their fingers…!” She waited to see the horror on my face. She obviously did not know that Indians, particularly south Indians, not only used their fingers but their whole hand. Licking streaks of curry or curds from their wrists or even forearm was considered perfectly good manners in Tamilnadu, my home state. However, I decided to show significant alarm at her revelation. It was clear that her issue was with the Filipinos and she did not care about my chop stick expertise.
“Don’t tell me…..” said I, in mock revulsion.
She nodded sagely while I got back to my struggle with the chopsticks.
Over the next few days I learnt to pick up large chunks of food with my chopsticks. My eyes had grown chinkier. Hell! I almost became like them. Well almost….. My real test came a week later. Here goes!
The cook at the Vietnamese camp was a celebrity of sorts. He was an important cultural link to their homeland. So when he had a toothache it was a real emergency. He was allowed to jump the queue - to have his tooth extracted by me. No one complained. The next afternoon, the cook, now relieved of his pain decided to honour me by making a special appearance in the service area of the canteen. He came to my table, which I shared with my interpreter, Trinh and an American intern George Davendorf. In his hand was a plate of meat, which Trinh (who obviously knew that I was being honored) explained, was courtesy the cook. He put the plate of meat in front of me and bowed low saying “Doc”
“Thanks” said I and dexterously picked up a piece of meat with my chop sticks, whose use was becoming more familiar to me. While Trinh my interpreter joined me in eating the rather delicious meat preparation, George, my other table- mate politely declined. After having eaten a couple of pieces, I asked Trinh what the meat was.
“Doc” said she.
“What is the meat?” I asked again, thinking that she had not heard.
“Doc” came the reply.
Seeing my puzzlement the American intern George clarified for me. “Dog” he said. “ It’s a delicacy they reserve for important people,” he laughed.
The chopsticks slipped from my hand as my interpreter went on to explain how a wayward dog had found its way to my table and my stomach. With increasing revulsion, I listened as she explained how the dog had created a ruckus the previous night and the cook had it killed and served up for lunch. Last night’s nuisance became today’s gourmet lunch! Two birds in one shot if you like. The cook who understood no English stood by smiling proudly at his accomplishment. “It was kept a secret” she said sotto voce. The Filipinos like most people did not find the idea of killing dogs for dinner a friendly eating habit. More importantly there would have been a stampede amongst the Vietnamese, for dog meat was a delicacy in great demand at the camp. I tried to say something appropriate to everybody around. It came out sounding like a bark. I motioned to Trinh and asked her to share it with her people at the next table. I could never look a dog in the eye….. ever again.
George
April 1990
“Doc, do you know that the Filipinos have no eating manners!?” She whispered
“No” said I, distracted and struggling with the two sticks whose tips would never come together. I had always sensed an undercurrent of silent hostility between the Vietnamese refugees and their hosts, the Filipinos.
“They do not know how to eat properly,” she announced with a trace of condescension.
I had this strange feeling that she was hinting at my ineptitude. Orientals have a way of being round about in their conversations.
“They cannot eat with a chop stick…” she hesitated realizing that I had stopped my fervent attempts and the noodles were smoothly unwinding back into the bowl. “ or even forks…” she trailed away, seeing the look of guilt and embarrassment on my face. She then leaned forward as if to reveal a terrible secret and said, “I have seen Filipinos eat with their fingers…!” She waited to see the horror on my face. She obviously did not know that Indians, particularly south Indians, not only used their fingers but their whole hand. Licking streaks of curry or curds from their wrists or even forearm was considered perfectly good manners in Tamilnadu, my home state. However, I decided to show significant alarm at her revelation. It was clear that her issue was with the Filipinos and she did not care about my chop stick expertise.
“Don’t tell me…..” said I, in mock revulsion.
She nodded sagely while I got back to my struggle with the chopsticks.
Over the next few days I learnt to pick up large chunks of food with my chopsticks. My eyes had grown chinkier. Hell! I almost became like them. Well almost….. My real test came a week later. Here goes!
The cook at the Vietnamese camp was a celebrity of sorts. He was an important cultural link to their homeland. So when he had a toothache it was a real emergency. He was allowed to jump the queue - to have his tooth extracted by me. No one complained. The next afternoon, the cook, now relieved of his pain decided to honour me by making a special appearance in the service area of the canteen. He came to my table, which I shared with my interpreter, Trinh and an American intern George Davendorf. In his hand was a plate of meat, which Trinh (who obviously knew that I was being honored) explained, was courtesy the cook. He put the plate of meat in front of me and bowed low saying “Doc”
“Thanks” said I and dexterously picked up a piece of meat with my chop sticks, whose use was becoming more familiar to me. While Trinh my interpreter joined me in eating the rather delicious meat preparation, George, my other table- mate politely declined. After having eaten a couple of pieces, I asked Trinh what the meat was.
“Doc” said she.
“What is the meat?” I asked again, thinking that she had not heard.
“Doc” came the reply.
Seeing my puzzlement the American intern George clarified for me. “Dog” he said. “ It’s a delicacy they reserve for important people,” he laughed.
The chopsticks slipped from my hand as my interpreter went on to explain how a wayward dog had found its way to my table and my stomach. With increasing revulsion, I listened as she explained how the dog had created a ruckus the previous night and the cook had it killed and served up for lunch. Last night’s nuisance became today’s gourmet lunch! Two birds in one shot if you like. The cook who understood no English stood by smiling proudly at his accomplishment. “It was kept a secret” she said sotto voce. The Filipinos like most people did not find the idea of killing dogs for dinner a friendly eating habit. More importantly there would have been a stampede amongst the Vietnamese, for dog meat was a delicacy in great demand at the camp. I tried to say something appropriate to everybody around. It came out sounding like a bark. I motioned to Trinh and asked her to share it with her people at the next table. I could never look a dog in the eye….. ever again.
George
April 1990
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