Priceless Onam

For one reason or another, having Onasadya at home had become a distant memory. I would often sit helplessly, watching the family enjoy their feast over lunchtime video calls. It’s not that sadya or Onam are rare in the UK—with so many Malayalees around, there’s no shortage of celebrations—but nothing compares to sharing the meal with parents. As the old Mastercard ads used to say, “There are some things money can’t buy.”

This year, though, we finally got the chance to celebrate Onam at home. My lady insisted on a family picture in traditional attire (though the fashion diva herself went for a Rajasthani saree—one world, no borders!). I tried to push the idea to next year—there’s always that selfish part of me imagining an improved fitness routine leading me toward the six-pack hero from the Pardesiya song. But then came her vajrayudha: “I’ve been saying this for a while, and see, Amma isn’t here anymore.”

Achan, to my surprise, was completely compliant—after all, apart from the 70s, the only other time he wore a proper traditional mundu was for my wedding!

Long story short: it turned out to be the best Onam I’ve had in years.

The Taste of Rajinikanth

Basha might have been the first Rajini movie I ever watched. It took me almost an entire evening and most of the night to finish it, thanks to the endless TV ads that popped up every few minutes. They were annoying enough that Amma gave up on the film much earlier. Rajinikanth movies, if I remember correctly, used to be a Diwali exclusive on Sun TV. It wouldn’t be an exaggeration to say I often preferred watching him on screen to bursting firecrackers with my family! My vocabulary back then wasn’t rich enough to know words like swag, but I was already hooked on his presence.

For someone who smirked at others’ film reviews and proudly declared himself a critic even as a child, I always suspended judgment when it came to Rajini. His larger-than-life aura and thunderous dialogues silenced the nitpicker in me—I’d just sit back, wide-eyed, pestering my cousin to translate the Tamil lines I didn’t understand.

Watching a movie is a personal experience, much like enjoying food—don’t let others’ opinions ruin it. Taste buds differ. I still remember queuing up to buy Hyderabadi biriyani from a “highly recommended” hotel during my college tour, only to realise it was nowhere close to the chicken biriyani (sans egg!) that Supreme Bakers back home in Kollam served.

Of course, there were a few Rajini films I couldn’t last through, but long story short—now that I’ve started living a solitary life in Cardiff (thanks to training-related hospital rotations), watching yet another Rajini movie, first day first show, brought back a flood of childhood memories. Clichés and plot holes aside—critics may devour Coolie—Rajinikanth was a feast to watch on the big screen. That said, films like Petta, Jailer, and Kaala were far more fulfilling for me as a fan boy.

Movies, like biriyani, are best judged by your own palate—and Rajini, to me, has always been that unbeatable Supreme Bakers’ chicken biriyani.

Wedding anniversary:Today, she’s still here. And she’s everything.

30th June marked 12 years since we got married.

Life has never been easy — nothing certain, nothing predictable. But through all the chaos, she’s been the one constant.

We’ve faced more than our share of twists and turns, and the road’s been anything but smooth — yet somehow, we’ve held the wheel together. Twelve years in, she still hasn’t run away.

If anything, she’s the one who fights tooth and nail to make sure I get where I want to go. She didn’t just stay in the story — she made it worth reading.

I’ve always lived in my own dream world, often finding myself limited to a very particular set of skills — skills I’ve acquired over a long career (though definitely not the kind Liam Neeson had in Taken). And because of that, I’ve always needed someone to look out for me — to fill in the gaps I couldn’t see.

Losing Amma four years ago left me defenceless in more ways than I expected. That’s when she truly became my guardian angel — my fiercest protector, or as she lovingly calls herself, my emotional support bird.

We’ve loved each other from the very beginning — back when I was a clueless 26-year-old with more ego than wisdom, and she already carried a calm strength I’m still learning from. Time passed, and through it all, she stayed.

Today, she’s still here. And she’s everything.

Vishukkani in a Foreign Dawn

As I woke up today, my phone’s gallery threw back a photo taken on this very day, five years ago—when most of us were asked to Stay Home, Protect the NHS, and Save Lives. Having moved to the UK, for the past five years, my daily Vishukkani has been my beautiful better half—except on days when one of us was on a night shift! She’s been my world for the past twelve years, and during the Covid era, she even became my personal hair stylist.

Growing up alongside a genuinely devout Amma and an ‘almost atheist’ Achan, I guess I could be branded a ‘neutral Hindu’. Without the slightest disapproval, Achan would always buy flowers to help arrange the Vishukkani, and it would always be there to greet me each year on this auspicious day. Though our display was never as vibrant or elaborate as those in other Malayali households, Amma would still wake me up and gently guide me to the Kani. It would brighten my heart (and indeed, fatten my wallet by the end of the day with all the kaineettams).

Amma isn’t here anymore, and Achan is 17 hours of flight away — but the memories stay, always.

Wishing all my dear ones a Vishu filled with light and love.

---

For those wondering what on earth is Vishu, Vishukkani and Kaineettam:

Vishu: A traditional Hindu festival, like Kerala’s version of New Year’s Day, mixed with Thanksgiving vibes.

Vishukkani: A beautifully arranged display of auspicious items, set up the night before and meant to be the first thing one sees on waking.

Kaineettam: A custom where elders give money to younger members of the family as a form of blessing and to wish them prosperity for the year ahead. (Not sure if Gen Z has QR codes for this now!)

Superhero? Nah, Just the Anaesthetist

 I was walking back after doing a pre-op assessment on a patient in the ward when a voice from the opposite bed rang out:

“Doctor… doctor, please come!”

Before I could even turn around, a healthcare assistant from the corner jumped in — trying to save me from the chaos — and shouted,

“No no, he’s not a doctor… he’s an anaesthetist!”

While I generally prefer to stay invisible, I wasn’t sure whether to thank her… or update my CV.

Achan & Kochu

My favourite pastime ever since I’ve come home on a short trip happens to be making endless arguments with my Achan regarding his medicines. Each fight lasts for a few minutes and ends up with his question, “which fish fry do you need for lunch”, or “what shall I get you for dinner”? 

He’ll easily win the ‘simplest man in the world’ award if there’s one. And his smile is all that’s needed to win every heart in the town. At the end of each fight, I look into the mirror only to find myself questioning my decision to stay miles away from him for the sake of a career. 

There was a time when I used to wait at the arrival zone at Trivandrum International Airport, getting ready to run and hug Achan as he came out with a trolley. All the world’s a stage and we just switched our roles. 

He’s all that I have and more importantly I’m all that he has. 

Happy Bday Amma

Amma used to be the first person who’ll wish everyone in the family on their birthdays. To find how old someone is, you just needed to ring her and tell the name.

But if we asked her age, she’s bluff saying her official records are wrong!

She used to take me to Hidas photo studio on all my birthdays and get a picture taken.
But then after all those years, it was after Lakshmi’s entrance into our lives that we first celebrated her birthday with a cake cutting. That was truly a surprise for her.

During the last few years when she was restricted to the walls of our house she would dedicate songs for her loved ones via the All India Radio and Radio Benziger on their birthdays. If I was away at Cochin, she would ring me and hold the phone close to the radio and make me hear the whole song.

Well today’s her birthday.
67?
(Lol, yeah yeah I know you are younger than that)

She should be having a great time, with her father, mother, sister, brother in law and many of her dear ones.

Missing you lots Amma,
It is really hard to live in your absence.
Happy B'day to you.

Theatre fright സഭാകമ്പം

സഭാകമ്പം തീരെയും ഇല്ലാത്ത ഒരു മനുഷ്യൻ ആണ്. എന്നിട്ടും ഇന്നൊന്നു വിയർത്തു. 

കാര്യം നിസ്സാരം. ഒരു സിസേറിയൻ സെക്ഷൻ.

പക്ഷെ surgeon സ്വന്തം ഭാര്യ...! Anaesthetist ആയി പാവം ഞാനും.

അതും ആദ്യമായി ഒരേ തീയേറ്ററിൽ വച്ച് കണ്ടു മുട്ടുകയാണ്. 

നാട്ടുകാർ (തീയേറ്ററിലെ മറ്റു സ്റ്റാഫുകൾ) ഉറ്റുനോക്കുകയാണ്. 

(Tense music in the background)

നാറുമോ? 

ഇനിയിപ്പോ സ്‌പൈനൽ കുത്തിയിട്ടു കിട്ടീല്ലേലോ?

ഇനി മരുന്ന് കുത്തി വച്ചിട്ട് ഏറ്റില്ലെലോ?

ശെടാ, അവൾക്കു ഞാൻ ആയിട്ട് ഒരു നാണക്കേട് ഉണ്ടാക്കേണ്ടി വരുമോ?

ധാരാവിയിലെ തീയേറ്ററുകളിലെ സകല കേസുകളും  ഒറ്റ രാത്രി കൊണ്ടു അനസ്തീഷ്യ കൊടുത്തു ഒതുക്കിയ ഞാനാ, എന്നിട്ടാ ഈ പരുങ്ങൽ.

അവസാനം പടച്ചോനെ കാത്തോളീ,

എന്നും പറഞ്ഞൊരു കുത്തങ്ങു കുത്തി.

സംഗതി ഏറ്റു. Success.

അഭിമാനത്തോടെ ഭാര്യ ബാക്കി സർജറി പൊളിച്ചടുക്കി. 

അതേയ് കൂട്ടുകാരെ, അങ്ങനെ ഞങ്ങൾ ഒരു മോർണിംഗ് ലിസ്റ്റ് അങ്ങു ചെയ്തു! 

Godsend

Contrary to what the media try to assert, this world isn’t that bad and we aren’t living through some of the worst days. There are a lot of kind hearted souls living among us and it is not tough to find them. All you need to do is to be ‘good’ and they’ll appear at the right time, Godsend. The whole Multiple Myeloma saga that my family went through taught me that there indeed is a mystical force that controls everything. Well, this post is not meant to be another chapter in Chicken Soup for the Soul. 

 

1

It was in the midst of all the covid chaos that Amma had a relapse of myeloma and got admitted. Her condition kept getting worse, it was certain that a count down timer had started to tick, and I was stuck in the UK unable to travel. And then Dr Roja would keep saying, “Don’t worry, we’ll keep her safe for you”. She kept updating me all the time. Finally I managed to catch a flight to India, but then there was this wearying layover at Bengaluru airport. Amma had already been shifted to the ICU. Had Dr Roja not given me a video call at that time to show Amma, whose eyes brightened seeing me on the phone, I would have collapsed out of stress. I had never met Dr Roja prior to all this, but she took care of my Amma and was a real guardian angel. I am sure there won’t be many who can be as modest as her. 

2

Amma is now in the ICU in a sinking stage, we still have no idea about the infection that is killing her. It should be around 11pm, I stand in the corridor with a heavy heart, clueless. My brain is too befuddled to make any more decisions. And then this angel walks in. Dr Govind took the helm from that moment onwards. I can’t explain how relieved I felt from that moment onwards. I didn’t have to worry about the medical part anymore. 

There comes this moment, the wee hours of the 25th of May, when I collapse on to a chair in the ICU, Amma is lying on the bed, she is no more. Govind gives me a call, “Just take Amma home. I will deal with all the hospital procedures, don’t worry about running behind the bills or anything at all”. 

Govind is a rare blend of knowledge, diligence, compassion and emotional intelligence. Ah, well, he carries the genes of Gangadharan sir and Chithra ma’am and hence it is hardly a surprise :) 

3

Anything I write about Dr Anupama would be an understatement. To me, she is an avatar of God. While Dr Gangadharan gave my Amma, an otherwise 'poor prognosis advanced multiple myeloma patient', a new lease of life ten years back, it was Anupama ma’am who watched out for her all these years. It was the faith I had in her that gave me the courage to move to the UK, for I was sure, Anupama ma’am would always take the best medical decisions for Amma. It would take a whole book if I keep on writing about ma’am. 

4

Remember Jai & Veeru from Sholay? That’s what Gayathri and I transformed into during the final hours of Amma. It would have been impossible for me to deal with the situation if she wasn’t there. Amma had crashed, and I was juggling between being a doctor and a son. Well, I’m still not bold enough to type in all those harrowing moments here, for it has been the most traumatic experiences I have ever had in my life.

5

Lakeshore, has been my second home for ages. It is the one place that always makes me feel special. The security guard who didn’t even let me pay for valet parking, the attender chechi or brother who would always enthusiastically usher my amma & achan even when I’m not around, my colleagues who rushed to blood bank in the wink of an eye...the place is full of people who keep showering love on me. 

Nahas used to run hither and thither managing Amma’s OP visits in my absence, well I once even turned green with envy when Achan ‘wrongly’ rang me and told, “Oh, I thought I dialled Nahas, we reached Lakeshore just now” (I was in Liverpool at that time). My family in the department of anaesthesia that include Radhika (kili), Anupriya (missworld) and Elizabeth (chungy) used to make sure that my parents never felt my absence during their follow-up visits. Even to this day, when I can’t hold my tears, I just take my phone and ring Jaya ma’am or Mallie ma’am. Naveena turns out to be the sister I never had.  Though notorious for forgetting names, my Achan still asks about Naveena. She was a huge support for my parents during the recent hospital admission. Nita ma'am & Tina ma'am used to fill me with confidence and they gave me the strength to take tough decisions. I used to feel guilty for having gone far from my parents and it was Mohan Mathew sir who made me feel better. 

It would be unfair to ‘thank’ all these people. Shwetha ma’am (matha shwetha) who kept visiting me at the oncology ICU once said, “Don’t ever thank your friends”.

(It's been four months since my Amma left. I have been waiting for a chance to get a picture with these gems. Missed Gayathri & Nahas though.)

#sobhanacharitham

The first prize goes to

“Everything is ceremony in the wild garden of childhood.” Pablo Neruda

Jawahar Balabhavan, Kollam.

(Can’t recollect the year, probably between 1988-1991)

The prizes get announced

തവളച്ചാട്ടം, first prize goes to Nithin Jayan

കസേരകളി, first prize goes to Nithin Jayan

ഓട്ടമത്സരം, first prize goes to Nithin Jayan

Prize distribution

And then the photoshoot.

This is one of the most priceless pictures that Amma had saved for me.

It features Amma teacher (Irene teacher) who passed away recently and Rasna, my first ‘best friend’. I lost contact with her once I left the nursery and have no idea where she is now. Hope she still remembers me.

I can hardly recollect the names of others except for Karthika and Manikandan. 

Myself, obviously the handsome lad, is fourth from the right, and Rasna is third from the right. 

The first prize was a stainless steel dinner plate :) I got three of them. Yoohoo.

(ശരീരം അനങ്ങിയുള്ള ഒരു ‘സ്പോർട്സ്’ പരിപാടിയിൽ ആദ്യമായും അവസാനമായും പങ്കെടുത്തത് ബാലഭവനിൽ വച്ചായിരുന്നു)

 

The Mosquito

I am a Hindu and I do believe that it would be wise to believe in the existence of a supreme power that can be thanked for all the good things or blamed for all the bad things that happen to you. Though a student of science I would continue to cling on to that belief until proven otherwise. My Amma was a strong believer while Achan is an atheist (‘almost an atheist’ would be a right description). Well, there’s this mosquito who inhabits the crematorium at Polayathodu, Kollam, Kerala. While I don’t care about its religious inclinations I can definitely certify that this creature, a Ghoul on wings, would be the most selfish and cruel being that inhabits Mother Earth.

Having not slept for almost a week and tired from all the stress I hardly had any energy left in me to perform the last rites of my mother. I should admit though that these rituals following death did bring me a sense of completion. I did, however, secretly curse the priest who ordered me to circumambulate the pyre thrice with the body! It was not just because I needed to do some strength training, the platform that hosted the pyre was very unscientific. And to add to the misery, it was raining cats and dogs. The priest was a very strict person and kept giving me and Unni (my cousin) clear instructions or ‘tasks’ which we executed with near perfection. Braving the sinister puddles without waking up the demonic snakes to pay our obeisance to the legendary Harishchandra whose temple is near the graveyard will remain in my memory for ever.

The wicked mosquito did not trouble me on the day. It was definitely not out of compassion for me. I was never still, my hands were mostly free and there was a lot of heat. It waited for the fifth day when we returned to collect the ashes. It was early in the morning, dark. Unni and I were asked to hold a cloth and keep it spread out as the priest diligently prepared the ashes.

We weren’t supposed to move. ‘That’s it. Now’s the time,’ I could hear the ominous laugh. The ruthless creature jumped on to my left arm and pierced my skin with its proboscis. It plunged deep and started sucking my blood. I couldn’t shake it off as I would lose the grip on the cloth. Neither could I blow off the mosquito, thanks to my 3 ply face mask (I sincerely believe that the whole sinister universe had been conspiring for this very moment and COVID was part of the plan). The mosquito sat still and nothing could interrupt its feast. Minutes felt like eons. Did Indra choose to be a mosquito rather than a bee?

I can’t remember exactly when the rascal flew away. I had tried to rub my arm against the priest as he inched closer to me during the ritual. Either that or a full stomach persuaded the creature to return to hell. With a sore and red bump on the skin I moved to Thirumullavaram to immerse the ashes in the Arabian sea.

The pointed fiend still looms over, I am sure, waiting for its moment!

(image courtesy: https://mahabore.wordpress.com/2013/11/01/karna-the-curse-of-parasurama/)

Soorarai Pottru starring Bommi

The way the creators have carved out the character ‘Bommi’ aka ‘Sundari’ outshines every other positive aspect of ‘Soorarai Pottru’, a wonderful movie that deserves a lot of applause. The inspirational story of G. R. Gopinath serves just as a backdrop for Sudha Kongara’s attempts to break many stereotypes. 

I did love the return of Surya after 12 long years (The last time I enjoyed him on screen was when I watched Vaaranam Aayiram). 

Felt heartbroken with the desperate attempts of Maaran to secure the air tickets to fly to his father. While those scenes are sure to last in my mind for quite sometime, it’s Bommi that’ll stay forever. 

 

I’ll say that this movie is a must watch. 

#SooraraiPottru

(The bright side: സ്വന്തം ഭാര്യയോട് കടം ചോദിക്കുന്നതിൽ യാതൊരു നാണക്കേടും വേണ്ട എന്നുകൂടി ഈ ചിത്രത്തിൽ നിന്നും നാം പഠിക്കേണ്ടി ഇരിക്കുന്നു- *AKDHF 😉😉)

*All Kerala Dharidra Husbands Federation-Liverpool Wing 

Nostos plus Algos

2005: It’s been hardly a week at Medical College Trivandrum and I call Amma, says that I’m badly missing home, that I’m quitting this course and I’ll take admission at TKM Engineering College so that I can stay at Kollam. 

2019: I’m searching for a place to stay at Liverpool. 

‘Moving away from my family to take care of my family’ will be the toughest decision I’ve ever taken in life. 

2005: Amma says a firm ‘NO’ to my ‘quit Medicine plans’ (Achan still in the Middle East taking care of us)

2019: Amma says ‘Yes’, not a firm Yes but a weak one. (Achan gave up his work to take care of his better half who bravely fought a cancer)

Thanks to this society for making it really difficult for Doctors to make a living, specifically the ‘young-growing up’ ones. 

NB: Well, this is just a random thought that drove into my mind while having dinner, and it isn’t a trigger for a debate of any sorts. 

(Latest thought that’s flashing right now: അമ്മേടേം അച്ഛന്റേം സ്നേഹം UK ഇലായാലും കിട്ടും, പക്ഷെ അവർ ഉണ്ടാക്കുന്ന ചോറും ചമ്മന്തിയും ചാള പൊരിച്ചതും ഒക്കെ എങ്ങനെ കിട്ടും?)

(അല്പം ചീഞ്ഞ) ഒരു ഉള്ളികഥ

പറോട്ടയും ചില്ലി ചിക്കനും കഴിക്കണമെങ്കിൽ സിലോൺ ബേക് ഹൌസിൽ പോകണം.

പോയി, എം ജി റോഡിലെ കടയിൽ തന്നെ പോയി.

നല്ല ഒന്നൊന്നര പെറോട്ട, രുചിയേറിയ ചില്ലി ചിക്കൻ. എന്ന പിന്നെ പോരട്ടെ ഒരു ചിക്കൻ 65 കൂടെ.

എല്ലാം കൊള്ളാം. ആസ്വദിച്ചു കഴിച്ചു കൊണ്ടിരിക്കുമ്പോളാണ് ചിക്കൻ 65-ഇനോട്‌  ഒപ്പമുള്ള ഉള്ളിക്കു ഒരു രുചി വ്യത്യാസം തോന്നിത്തുടങ്ങിയത്.
കൂടെ വന്ന സച്ചിനും അത് സ്ഥിതീകരിച്ചു. സംഭവം ചീഞ്ഞതാണ്.

വെയ്റ്ററിനെ വിളിച്ചു.

ഞാൻ: ഇതിലെ ഉള്ളിക്കെന്തോ പന്തികേടുണ്ടല്ലോ? ചീഞ്ഞിട്ടുണ്ട്
തികച്ചും നിർവികാരനായി വെയ്റ്റർ: ശരിയാരിക്കും സർ. കാലത്തേ അരിഞ്ഞു വക്കുന്നതല്ലേ, കേടായി കാണും.

പ്ലിങ്

ഞാൻ: സഹോദരാ, നിങ്ങളുടെ മാനേജറിനെ ഒന്ന് വിളിക്കാമോ?
ഭക്ഷണം ബലേ ഭേഷ് എന്ന അഭിപ്രായം കേട്ട് 100 വാട്ടിന്റെ ബൾബ് കത്തിയപോലത്തെ മുഖവുമായി പുള്ളിക്കാരൻ പോയി മാനേജറിനെ കൊണ്ട് വന്നു

ഞാൻ: ഈ ചിക്കൻ 65 ഇലെ ഉള്ളി ചീഞ്ഞതാണ്. ഇങ്ങനെ പഴകിയ ഭക്ഷണം തരുന്നത് മോശമല്ലേ.
ക്ലോസപ്പ് ആത്മവിശ്വസത്തോടെ  മാനേജർ: പഴകിയതല്ല സർ. അത് ഇന്നലത്തെ ഭക്ഷണം അല്ല. ഇന്ന് കാലത്തേ അരിഞ്ഞതാണ്, കേടായിക്കാനും ശരിയാ. പക്ഷെ പഴകിയതല്ല സർ.

വീണ്ടും പ്ലിങ്

ഇതിപ്പോ എനിക്കു വട്ടായതാണോ അതോ ഈ ഹോട്ടലിൽ ജോലി ചെയ്യുന്ന എല്ലാവര്ക്കും വട്ടായതാണോ എന്ന കൺഫ്യൂഷനിൽ ഞങ്ങൾ  നാരങ്ങാവെള്ളവും കുടിച്ചു ബില്ലുമടച്ചു വിടവാങ്ങി.


നാളെ കാലത്തേ തീയറ്ററിൽ കേസ് സ്റ്റാർട്ട് ചെയ്യാൻ പറ്റുമോ എന്തോ. എന്റെ ors പരമ്പര ദൈവങ്ങളേ കാത്തോളണേ.
(വയർ തടവുന്നു)

A Tryst with Ganga

Dear Bala Sir,

My Tryst with Regional Anaesthesia
I never expected to so madly fall in love with the subject when I took up anaesthesia. Kudos to my wonderful teachers, for they are the ones who showed me the beauty of this subject. Having gone through three years of gruelling yet thoroughly enjoyable post- graduate training I began to ask myself, ‘what next’?. It didn’t take me long to choose my path...regional anaesthesia. My better half asked me, “when all your seniors chase critical care, cardiac anaesthesia and neuroanesthesia, why regional?”. Endearing and challenging, that’s my answer.
I had grossly ignored the wonders of regional anaesthesia during my post graduate training. Plenty of neuraxial blocks and a few PNS guided nerve blocks, that was it. Even while getting updated with journal articles, I was blind to this sub specialty (isn’t it a super specialty?)
Having cleared my final DNB exam and stepping into the real world of practice, I gauged my extent of ignorance. My armamentarium was weak sans skills to deliver apt nerve blocks. Patients complaining of pain post operatively began to make me feel bad. I realised that’s it’s mandatory that I learn the art of nerve blocks. I began to read journals related to regional anaesthesia, and I was surprised to find the rapid pace at which this subject was growing. Ultrasound guided blocks began to fascinate me. Then came the nagging problem of failed blocks and grinning surgeons. Well, I won’t stop now.
How to gain better exposure to the subject? My mentor from my alma mater advised me to chase the European Diploma in Regional Anaesthesia examination. Thus I started my new quest. I read, read and read again. So where did I reach? Cleared the first part. What next? Practice. But how to learn and where to learn the ‘best practices’?
I learnt about the Inland Fellowship by AORA-Fujifilm Sonosite from a friend of mine. I was lucky to clear the entrance exam for the same (AORA 2018). When asked about my preferred centre for the week long training, I didn’t have to think, the Mecca for regional anaesthesia- Ganga Hospital, Coimbatore, Tamil Nadu was my first choice.
After discussing with my department (Department of Anaesthesia & Critical Care, VPS Lakeshore Hospital, Kochi, Kerala) and Dr. Balavenkat Sir (Course Coordinator), I chose the second week of October for the programme.

The Week at Ganga Hospital
It nearly took me half a day to get oriented with the working atmosphere at Ganga. I had a couple of good friends (Dr. Teena, Dr. Vinod Kumar SP, Dr. Tasneem and Dr. Tuhin) who made it easier to adjust (Thanks to Dr. Elayavendhan Sir for the lunch!). Still I was apprehensive since I didn’t know if I was allowed to ask questions/ doubts and disturb the extremely busy bees at Ganga. There are too many stalwarts at this place. So I stayed silent, but then I was surprised. The H.O.D (Dr. Sekhar Sir) himself started demonstrating blocks for me. In the days that followed, I started to feel pampered! Whenever a nerve block happened in my vicinity, the senior (special thanks to Dr. Gurumoorthy Sir and Dr.

Vipin Goel Sir) performing the block made it sure that I understood the sono-anatomy. It was a delight listening to Dr. Maheswari madam describing the evolution of regional anaesthesia at the hospital, how it grew from paraesthesia techniques to PNS to USG guided blocks.
I spent most of my time at the trauma theatre complex, and occasionally visited the plastic surgery theatres (whenever alerted by my friend about ‘blocks happening’). Bala sir did his best to make me feel comfortable, he kept asking me for a feed-back every day. The basics of USG was rekindled through discussions (thanks to Dr. Tuhin); I observed nerve blocks that ranged from the most basic ones to the most advanced ones (especially the QL blocks, PENG blocks and newer ones like supra axillary blocks). It was a real experience watching each consultant performing a block with his/ her own personal tweaks and listening to the rationales for the modifications.
So sound is the concept held by the practitioners here at Ganga that their techniques are perfect and many have already published their own block techniques. I will never forget the brain storming sessions I had with Dr. Kartik. He almost spent an hour every day teaching me concepts. Having listened to him I realised many of the mistakes that my techniques had.
The six days at Ganga was a refreshing experience; the hospital is a rare blend of workaholism, perfection and affection. Despite a never ending case list there is harmony and efficiency. The regularity of academic programme for trainees here in the midst of all the heavy work load is amazing.
Special thanks to Dr. Vinod Kumar R, Dr. Nikhil, Dr. Arti, Dr. Santhosh and the hard working nursing staffs and technicians at the trauma pre-op room.

The AORA Fujifilm Sonosite Inland Fellowship Programme: Suggestions
The fellowship programme is an excellent initiative from the organisers. It provided an excellent opportunity for a regional anaesthesia enthusiast like me to experience the work done by a centre of excellence like Ganga Hospital. The financial support/ sponsorship is a boon to the candidates who would otherwise be reluctant to go to distant places.
I hope every centre that is part of the programme has a structured one week schedule for the selected candidate/ observer. At Ganga hospital, I was fortunate enough to have Dr. Bala sir for making sure that I saw almost all the relevant regional blocks before the week was over.
I hope the programme will extend to a week long hands-on training in future. It would be too much to ask for, I know, since it would be technically difficult for a hospital to provide hands-on to a candidate who will be there just for a week. But I am sure that the idea of such a training initiative can be developed by AORA.
It would also have been nice if the seven selected candidates were given an option to enrol in the regional anaesthesia fellowship programmes that happen under the aegis of AORA, the Ganga Fellowship programme for example.
I sincerely hope that this programme happen every year so that more and more candidates can benefit, just like I did.

What lies ahead for me?

It’s a difficult question to answer. It’s a long road I realise. With the freshly rekindled concepts I will definitely improve my practise of anaesthesia, and try to free patients from pain as much as possible. In the long run, I wish to clear EDRA and FRCA. The second target that I have set is to gain expertise in the management of difficult airway.


Yours Truly, Dr. Nithin Jayan