When numbers betray and the wheel sinks

There are days in medicine when you feel like Arjuna—sharp, accurate, and victorious. And then, there are days you feel like Karna—valiant, overprepared, tragically noble... and betrayed by your tools at exactly the wrong time.

Let me explain. But first, a quick recap of mythology for the gastroenterologically inclined.

Karna, the glorious underdog of the *Mahabharata*, was the kind of guy who got cursed just for trying too hard. He lied once (just once!) to learn archery, and bam—curse. Disguising himself as a Brahmin just to get into warrior school with Parashurama—who had a strict no-Kshatriyas allowed policy—Karna poured his heart into mastering archery. And he was good. Too good. But karma (or Karna's luck) had other plans. One day, while his guru napped on his lap, an ant bit Karna. Hard. Bleeding and silent, he didn’t flinch—because, respect. But Parashurama woke up, saw no Brahmin would endure that much pain quietly, and connected the dots. Furious at being tricked, he cursed Karna: “Someday, just when you're in a life-or-death situation, everything you’ve learned will go poof.” On the battlefield, when all eyes were on him, his chariot wheel sank, his memory blanked, and his arch-nemesis Arjuna landed the final blow. If there was ever a poster child for “Wrong time, wrong place, wrong curse,” it was Karna.

Now, cut to modern medicine. Our chariot is a wheeled ultrasound machine. Our Brahmastra? The *SAAG*—Serum-Ascites Albumin Gradient.

If you aren’t a medic, don’t worry. SAAG is a clever little test we use to figure out why someone has fluid collecting in their belly—a condition called ascites. We take a bit of the fluid from the belly and compare its albumin (a type of protein) to that in the blood. If the difference—this “gradient”—is *more than 1.1*, it usually points to liver-related causes like cirrhosis. If it's *less than 1.1*, we start thinking about infections like TB, cancers, or other sneaky causes.

It's like asking, “Why is your room wet?” and checking whether the water came from the ceiling (a leaky pipe) or the floor (someone spilled a drink). SAAG helps us decide whether the problem is inside-out (like liver pressure) or outside-in (like inflammation or cancer).

In theory, elegant. In practice, well… let's just say SAAG has its own *vastra-haran* moments.

Just when you think you’ve nailed the diagnosis—cirrhotic, ascites, high SAAG, done deal—the patient turns out to have peritoneal carcinomatosis. Another one walks in with nephrotic syndrome and a SAAG that does the cha-cha. You suspect TB, but SAAG throws you a number—**1.1**.

Not 1.0. Not 1.2.

**Exactly 1.1.**

Like Karna’s curse, it waits for your moment of maximum confidence—then strikes.

You stare at the lab report like Karna staring at his chariot wheel. “Wait, you too?” you whisper, betrayed.

SAAG, in all its mathematical smugness, gives you a value so borderline it could be a philosophy major.

But here’s the thing. SAAG, like Karna’s mantras, is great. Until it isn’t. It works wonderfully—until the story gets complicated and then it doesn't. It chokes quietly, leaving you to explain why the patient's abdomen looks like TB but behaves like Budd-Chiari. The wheels quietly sink into the ground. 

And that’s where the philosophy of failure begins to echo.

Karna didn’t forget his mantra because he lacked intelligence. He forgot it because *life sometimes chooses irony over logic**. You didn’t misdiagnose because you skipped a page in the textbook. You misdiagnosed because reality is often more layered than any algorithm. The number 1.1 is not a failure of math—it is a mirror. A reminder that the world is not always binary, not every problem lends itself to a neat answer, and some truths live in that narrow space between what we expect and what, actually unfolds.

Failure in medicine, like in life, is rarely total. It is not a collapse, but a misstep—a lapse in certainty, a reminder of humility. It tests whether we can continue walking, knowing that we’ve been tripped by something we couldn’t see. Like Karna, we often find ourselves armed with knowledge, prepared by training, backed by experience—and yet, still left vulnerable by timing, luck, or fate.

But failure is rarely about the test (or the event) alone. It is about **the scenario in which the test is interpreted**. A value of 1.1 has no power in isolation—it derives meaning from context. A TB patient in Ladakh and a cirrhotic in Chennai may share the same SAAG, but not the same story. Tests (like events) appear to be a verdict but are not so. They are shadows influenced by light, perspective, and the surface they fall upon. These (light, perspective, and surface) are together called the clinical scenario in medicine and life in general. The test alone can't have any value.

This is why medicine is an art dressed as science. We fail when we hold on to the tests. We cling to numbers for certainty, but numbers don’t feel. They don’t hear the cough, see the weight loss, or sense the futility in the caregiver’s eyes. And so, we fail—not because we’re not good enough, but because the number seduced us into thinking it was the whole story.

Medicine, like war, is full of uncertainty. And the physician, like Karna, must navigate a world where knowledge is powerful—but not always enough. Sometimes, the wheel sinks despite all your effort. Sometimes, the number mocks you from the lab sheet. And in those moments, it is not your brilliance that defines you—but your balance, your poise, your willingness to stay on the field with or without the wheel.

So next time SAAG misleads you with its signature betrayal—"1.1 g/dL"—take a deep breath. Smile. Order a CT if you must. But also remember: failure is not always a diagnostic error; sometimes, it is life’s way of teaching humility.

And perhaps that’s the final curse of Karna—to be right too late. May we learn to forgive ourselves in time. To accept that even the sharpest among us sometimes hold the right weapon but face the wrong moment.

And if Karna had been a gastroenterologist, he’d still be cursed—but his case presentations would be stirring, his stent placements flawless, and his journal club discussions legendary. He would cite guidelines, quote epics, and still—at some cruel cosmic moment—find his SAAG reading exactly 1.1. And with a resigned smile, he’d sigh, “Ah, not again,” jot down *‘clinical correlation advised’* (out of habit, not faith), and wheel his chariot toward the next diagnostic dilemma—forever valiant, forever just a little too late.

Perhaps Karna understood this better than most. Perhaps every 1.1 we encounter is not just a diagnostic dilemma, but a whisper from the past:

*Fight on, even when the wheel sinks.*

Permission to Grow, Sir?

    You could grow a beard on civvy street. No one would care. In the army, a clean-shaven face isn’t just expected—it’s enforced. The day begins not with the sun, but with the sound of running water and the scrape of a razor. It doesn’t matter if you’ve had three hours of sleep, stood night duty in freezing rain, or are recovering from viral fever—if you can lift a hand, you shave. It’s not vanity. It’s muscle memory. A ritual that prepares you for the uniform, the salute, the responsibility. The moment the razor touches your skin, the civilian is gone. The soldier stands ready.

    And then there are our brothers from the Navy. God bless them. They can keep beards. Real ones. Groomed, shaped, elegant. I once told a naval officer, “You’ve cheated the system, sir. Beard and uniform—too much style in one man.” He smiled, tugged at his magnificent salt-and-pepper beard, and said, “Sea air demands insulation, my friend. And dignity.” I looked at him with real affection. And deep, helpless envy.

But the moment I go on leave, I stop.

    Not dramatically—just gently. I take off the stars, slide my boots under the bed, and drop the razor into a drawer like a prisoner slipping out of handcuffs. A day passes. Then two. A faint stubble emerges, hesitant at first, like it’s unsure of its welcome. I look in the mirror and nod. There you are. 

    My wife notices around day three. “You’re growing a beard again?” she asks, like she’s watching a rerun. “I’m letting it grow,” I reply. “Small difference. Big meaning. She shrugs. She’s seen this many times. She knows it’s not about the beard.

    The next day, my daughter reaches out and runs a finger across my chin. “Papa, your face is scratchy.” I grin. “I know. It’s freedom.” She looks at me, puzzled. Freedom, to her, is no homework on Sunday. One day, she’ll understand that there’s something deeply symbolic about freedom (of not shaving). It’s not laziness—it’s liberty. The kind that doesn’t need a speech or a salute. It’s a small, silent protest against routine. A man reclaiming his face, one prickly inch at a time. And this joy of not shaving becomes so precious that even on a Sunday, if it’s a day off, and if we know we won’t run into the Commandant—we sometimes risk it. We sit in the house, sipping tea, sporting our one-day stubble like a medal. In case we meet someone from the unit, the leave (मैं छुट्टी पर हूं.....) is automatically implied. No one asks us, but everyone notices.

    Still, when leave ends, or Monday arrives, I shave. No grand farewell. Just the razor meeting skin, sweeping away the freedom. The soldier returns. But inside, a part of me still carries that Sunday feeling. The warm defiance. The soft rebellion :)

    And I promise myself, as I rinse the blade and dry my face, that when the next Sunday comes—if the stars align and no duties call—I will let it grow again. Just for a day. Just for me. Because it’s not about the stubble. It’s about a choice. In the army, our days are ruled by structure: wake-up calls, drills, uniforms, salutes, orders. We don’t choose what to wear, when to eat, or even how to walk. And that’s okay—it’s the price we pay for being part of something larger than ourselves, something which makes us better than the rest. Discipline is the spine of the Army. It builds trust, cohesion, and efficiency. It shapes men into teams and transforms intent into action. Without rules, there is chaos—and we soldiers know that better than anyone. And in that rigid world, choice becomes sacred. A choice made not by command but by instinct. Something small. Something silly, perhaps. Like not shaving.

    So when you wake up on leave, or on a quiet Sunday, and your hand reaches for the razor—and then stops—that’s not laziness. That’s liberty. That’s your mind whispering, “Today, I decide.” The beard, the stubble—it’s not beautiful in itself. But it carries the sweetness of stolen freedom. Of breaking a small, invisible fence. It’s a rebellion that harms no one but heals something deep inside you. Like kids hiding chocolates under pillows, we guard that single day of unshaven bliss—not because we need it, but because it’s ours.

    That one-day stubble doesn’t disrespect the Army—it reaffirms our humanity within. It reminds us that beneath the uniform, there’s still a thinking, feeling man. A man who serves with conviction, but also breathes with longing, rests with gratitude, and occasionally looks in the mirror and says, “Today, just for a while, I’ll be me.” These moments don’t weaken discipline—they strengthen resilience. They renew the soldier's mind. They soften the hard edges of service, allowing us to return to our duties not resentfully, but willingly.

    So even if it lasts only a Sunday, even if it vanishes by Monday morning’s inspection, that fleeting taste of freedom matters. Not because it challenges the system—but because it restores the self. And then, razor in hand, we return to the rhythm of the Army. A little lighter. A little more whole. In a world of orders, disobedience (even tiny, harmless ones) reminds you that you’re still human. Still capable of choice. Still your own.

And that, perhaps, is why it feels so nice.

Seat of the Problem – An Aisle Seat Adventure

    It was a bright Sunday morning, and I was armed with my sacred document—the boarding pass. Seat 18C. Aisle. The seat that offers freedom, dignity, and the ability to visit the loo without pleading with strangers or climbing over knees.

I reached my row. Lo and behold! I find it already occupied. A family of three had taken up the entire stretch—uncle at the window, aunty in the middle, and a young man (clearly their son) lounging comfortably in my aisle seat. I stood at the seat and checked the seat number with my boarding pass. There was no mistake. But when I looked down, none of the three passengers occupying the row seemed to notice me. You know the feeling you get when you walk in the interview room and the examiners are talking to each other without looking in your direction (like you were not there). I felt the same.

The son, bless his cochlea, had earphones in—with music blaring so loud, I briefly wondered if it was meant for him or for public broadcast. I couldn’t decide whether to tap his shoulder or shake him out of his musical dreams.

“Excuse me, I think that seat belongs to me,” I said politely.

No response. Not even a twitch. The music didn't let my voice through into his ears. Nor did it reach the mom and dad.

“Excuse me', I was louder, "I think that's my seat,”. This time adding a light tap on his shoulder—gentle enough not to alarm, firm enough to imply I wasn’t offering snacks.

He looked up with the casual indifference of someone who’d just been asked to pass the ketchup at a family dinner—mildly inconvenienced, vaguely surprised, and entirely unbothered by the concept of seat numbers.

Him (removing earphones): “Oh, sir! Yes… but would you mind taking a seat three rows ahead? It’s a middle seat, but same class, same legroom… even closer to the front! These are my parents and I would prefer sitting with them”

He said it like he was offering me an upgrade to business class. I stared at him, blinked once, and tried to process the proposal.

Me: “So… you want me to give up my aisle seat and voluntarily choose a middle seat? Out of the kindness of my heart? For the cause of family togetherness?”

He nodded, smiling, as though this was a moment of great emotional sacrifice on my part, and I should feel proud. I smiled back, politely. That smile we reserve for people who cut lines at buffets and then ask if you’ve tried the gulab jamun.

Me: “I’m sorry, but I really need the aisle seat. I paid extra. Also, I’m not emotionally invested in keeping your family together at 30,000 feet.”

There was an awkward pause. The smile disappeared from the son's face. Aunty looked at me like I’d just personally cancelled her Netflix subscription. Uncle, meanwhile, remained at the window, pretending to admire the closed terminal gate with intense dedication.

"I just wanted to say....." (he persisted)

"No!" said I. Sounding like Amitabh Bacchan from 'Pink'.  

The son sighed dramatically, like he was auditioning for a daily soap and looked at me long enough to make me uncomfortable..

Him (muttering): “Fine, I’ll go.”

He stood up, slowly, as if each vertebra was filled with emotional burden, and marched off—three rows ahead—to his actual seat, taking along with him the shattered dream of airborne family unity.

I took my rightful place on the aisle, claiming it like a war hero reclaiming ancestral land. The air was heavy with unspoken judgment. Aunty was clearly displeased. She did that silent thing where she “accidentally” elbows you while adjusting her seatbelt. Twice.

Just as I was settling in, along came another passenger—a gentleman of determined posture and undeniable confidence. He pointed at the middle seat.

Him: “That’s my seat.”

I felt a déjà vu shiver. The tension returned like a sequel nobody wanted.

The couple tried the same charm tactic.

Aunty: “Bhaiyya, woh piche ek accha seat khaali hai. Woh bhi middle seat hi hai!”

Him (blinking): “I booked this seat, madam. I like the middle.”

Even I raised an eyebrow at that. Who likes the middle seat? That’s like saying you prefer decaf.

The man held his ground. There was a standoff. Aunty looked at uncle. Uncle looked at the emergency exit like it might offer answers. Eventually, aunty stood up with the grace of a martyr who’d been wronged by the system.

She left for the back, mumbling under her breath—something about sanskaar and “kya zamana aa gaya hai.”

Now it was me on the aisle, Mr. Middle Seat in the middle, and Uncle at the window. Balance had returned.

Or so we thought. 

Enter: Third Passenger. Cool, confident, boarding pass in hand.

Third Passenger: “Excuse me, sir, I believe that seat is mine.”

Uncle froze. His smile collapsed. There was a long silence. And then, almost simultaneously we all understood the game.

They hadn’t actually booked seats. No paid selection. Just a good old-fashioned web check-in and blind faith. Their plan was simple: identify the first fully empty row, sit down with confidence, and hope that charm, guilt, and inertia would keep them together.

A bold strategy. Unfortunately, one that relied heavily on the kindness of strangers and a complete absence of passengers with boarding passes.

Uncle sighed, gathered his things with theatrical reluctance, and went off in search of his assigned seat. Somewhere far away from his wife and child.

As the aircraft taxied down the runway, I couldn’t help but smile. In that short time, I had been part of a real-life soap opera, complete with betrayal, in-flight politics, and the ever-enduring question: Why are families like this?

Convenience vs. Rights...

We love convenience, don’t we? We often talk about convenience as if it's a virtue. In a fast-paced world, convenience has become the default setting—food delivered with a swipe, cabs summoned with a tap, even conversation sometimes conducted through voice notes and emojis (because who has time for full sentences?). But beneath this smooth surface lies a delicate balance between what is easy and what is ethical. And that balance was hilariously disturbed.

Take my aisle seat saga, for example. What seemed like a minor seating disagreement on a domestic flight unfolded into a small but significant parable on everyday entitlement.

The family in question wasn't rude. They weren’t angry. In fact, they were charmingly pushy. Their entire strategy was built on the soft power of smiles, suggestions, and the hope that others would quietly surrender what others had booked, paid for, and rightfully owned—for the sake of convenience. The guilt, that way, is on others. This is the precise tension: 

When our personal convenience begins to depend on someone else’s compromise, it crosses a line.

The Unspoken Social Contract

    Air travel is one of the few remaining rituals in modern society where rules are non-negotiable. There's order. There's protocol. There’s the fine art of boarding zones. And there’s the cardinal truth: your seat is your seat. That pretty much applies everywhere. Still, people try to hack the system—families hoping to sit together without pre-booking, aisle lovers stealthily taking window seats, or passengers "forgetting" that middle seats also exist. This isn’t about one family. It’s about a mindset: The mindset which says that it’s okay to bend rules if we’re polite about it, or if no one makes a fuss. 

Its convenience camouflaged as harmlessness.

But here's the problem: when politeness becomes a tool to override others' rights, it stops being polite—it becomes manipulative.

The Silent Weight of Saying ‘No’

    What made this situation profound — but also quietly amusing (in hindsight) —was the discomfort I felt in asserting my right. I had the legal, logical, and literal boarding pass to claim the seat, and yet, the moment I said no to their request, there was a brief social tension. A pause. A mild guilt.

    Why? Because in our culture, especially in India, “adjusting” is considered noble. We are conditioned to give up space—for elders, for women, for families, for anyone with a louder plea or a sadder story. Saying "No, this is mine" is often confused with being selfish, especially if done calmly and without apology. Defending your rights doesn’t make you difficult—it just means you’re not disposable.

Convenience We Can Afford vs Cost We Shift

    In their desire to sit together, the family was asking others to fragment. They weren’t paying the price of their choice of seats, but expecting others to absorb the cost. This is a pattern you’ll see everywhere:

• On roads, when someone jumps a signal and causes gridlock.
• In coffee shops, when someone gets ahead of line because all he wants to buy is a bottle of water whereas everyone else wants coffee and things.
• Socially important patients who feel they can bypass the OPD line and consult first
• In daily life, when people ask for “small” favors that come at “big” inconvenience to others.

    Every time someone chooses personal ease over shared fairness, someone else bears the invisible burden. And most people do—silently because it feels easier to adjust than to argue. We may ask that if everyone adjusts then isn't it nice? No! When everyone adjusts, the system stops being fair—it becomes random, chaotic, and biased toward the pushy or the persuasive.

What’s the Way Forward?

    We don’t need to be rigid or robotic. Life demands a little give-and-take. Of course, we can swap seats, help strangers, or occasionally sacrifice comfort.

    But here’s the principle: Let it be voluntary, not expected. Generosity should be a gift, not a social debt. And perhaps, before asking someone to adjust for our convenience, we should ask ourselves:

Am I asking for kindness—or am I asking for someone to give up what is rightfully theirs?

---

In the End…

    As the plane took off, each passenger finally in their allotted seat (after a series of musical chairs), I looked around and smiled. Not because I had “won” the seat, but because I had learned something about human nature, about entitlement dressed in charm, and about the quiet courage it takes to politely say: “No, this is mine.”

    In a world that often rewards the loudest voice, there's still value in the firm but gentle stand for what is fair. And sometimes, the battle for the aisle seat becomes a surprisingly beautiful metaphor for life.

The Price of an Uncredited Thought

    It started quietly—an idea that formed not in a lab, but in the mind of a gastroenterologist. Anand had been noticing something strange: patients with gastrointestinal cancers were already wasting away before starting treatment. CT scans showed muscle loss even when body weight seemed stable. He dug deeper—sarcopenia. A name for the silent decline. Sarcopenia was evolving as a determinant of prognosis in frail patients. So, one afternoon in the hospital café, he ran into Dr. Nathan Sinha, a medical oncologist. Slightly junior to him, they had been together during MD. An energetic physician, he had gone to complete his DM from a prestigious institute. He had started to be known for translating clinical insights into research papers with impressive speed.

    “I’ve been thinking,” he said, stirring the tea. “Sarcopenia might be a silent predictor in GI malignancies. We don’t screen for it, but it could affect chemo tolerance and survival.” Nathan’s interest was immediate. “That’s actually very relevant. Especially in our patients. You’re onto something.”

    Anand explained his plan: “I want to do this in two phases. First, observe the incidence of sarcopenia in patients with Gall bladder cancers. Then, follow those patients to see how it affects survival outcomes and treatment responses.”

Nathan nodded thoughtfully. “Interesting. But I’d want to include all GI malignancies to get broader data.”

    Anand smiled slightly. “Let’s stick to carcinoma gall bladder. We have a huge patient load, and it’s a particularly aggressive cancer. It makes the study more focused and manageable.” Nathan agreed. “Makes sense. Novel and focused. Let me know how I can help.”

    Anand was encouraged. Nathan asked a few questions about imaging protocols, nutritional assessments, and follow-up schedules. Truly speaking, Anand was very excited to have Nathan's interest. If Nathan was interested, he thought, it sure is a hell of an idea.     

    He wrote up a detailed concept note, outlining both phases—the baseline study and the survival follow-up. He had already started training a resident for evaluating the CT to detect sarcopenia as he did not want to over-burden his radiology colleagues. Over the next months, Anand approached Nathan two more times to discuss logistics and initiation. Each time, Nathan was polite but distracted. “We’re swamped with clinical work. Maybe later.”

Then, silence..... for a long time. 

    Anand thought about bringing it up but somehow did not get the opportunity. He did send a couple of recent articles to Nathan to revive his interest. Nathan showed interest but nothing beyond. Without Nathan, Anand could not have started the project, as the patients were in the Oncology OPD.

    A year later, at the annual departmental thesis presentations, Anand's heart sank. The resident, Dr. Omar, was presenting the proposal for a thesis which hit him like a bolt. A thesis titled “Sarcopenia as a Prognostic Marker in Carcinoma Gall Bladder". And the guide was Nathan. Slide after slide echoed Anand's original proposal—both phases clearly outlined, the focus on carcinoma gall bladder, the same imaging and survival endpoints. His name was nowhere.

    He confronted Nathan. But Nathan dismissed his concerns. Nathan claimed Omar needed a project and that the idea hadn’t been formally pursued by Anand. He added, "I get a dozen such ideas daily. So what's the big deal in getting an idea. Execution is more important than merely getting an idea". Anand just did not have the energy for an argument. He did not want to beg. 

    Anand had understood then that the idea he had nurtured, shared, and worked on had been quietly taken away without credit. That night, Anand opened the folder on his laptop. The original file with a number of connected literature was still there. He was heartbroken, when he deleted the file. The story of his idea in four words was Dated, Detailed, Discussed and Deleted. An idea stolen in slow motion. No formal violation. No institutional breach. Just erasure.

    He didn’t report it. He didn’t confront Nathan. He chose not to spend energy proving something that everyone in that room might already suspect but never say aloud.

    Instead, he turned to something new. He reworked the sarcopenia question, this time framing it around some other disease where he would not have to involve another OPD. He registered the study independently, recruited through his contacts, guided his own resident, and laid down the work on his own terms. A year later, he presented it at a national forum. 

His slides, His voice, His data. The applause, this time, belonged to him alone.

But the theft still lived somewhere quietly in his memory. 

    Because ideas don’t bleed. They don’t leave bruises. When they’re taken, there’s no code to cite, no ethics committee to approach. And yet the damage is real.

    The story of what happened between Anand and Nathan reflects a truth that many in academic medicine know intimately: while data and execution are prized, the fragile birth of a clinical idea often occurs in conversations, notes, quiet insights. In such spaces, ownership is defined not by paperwork but by trust. That trust, once broken, leaves behind something more corrosive than bitterness—it leaves behind a sense of invisibility.

    What Anand experienced is far from rare. The academic world is filled with unspoken understandings about credit and collaboration, but it is also riddled with gray zones where power imbalances and informal exchanges make ethical boundaries difficult to enforce. Nathan, though junior, held the key to the patient population needed for the study. This positional advantage gave him leverage that, unfortunately, he chose to exploit. Without access to Nathan’s oncology OPD, Anand's idea could not practically move forward. This asymmetry turned his intellectual property into something fragile, vulnerable to appropriation.

    The ethics of credit in research is not just a matter of professional courtesy but of fundamental fairness. Giving proper credit acknowledges the labor of thought, the courage to propose new ideas, and the risk inherent in pioneering untested questions. Even if Nathan felt the project was not formally underway, the idea remained Anand's intellectual creation until he explicitly relinquished it. To present that idea as a new thesis without acknowledgment betrays not just his trust but the very principles that underpin collaborative science.

    Institutions often lack clear policies to protect early-stage ideas or to mediate disputes arising from such intellectual misappropriations. Unlike data fabrication or plagiarism of published work, stealing an idea during the incubation phase is more insidious and harder to prove. This creates an environment where silence and inaction become the default response, especially for those with fewer institutional resources or lower hierarchical power. For Anand, speaking up risked professional discomfort or backlash; staying silent meant quietly losing credit for something that was rightfully his.

    His choice to start anew, while courageous, highlights a painful truth: resilience does not erase wrongdoing. The academic community must recognize that protecting ideas and ensuring ethical conduct at all stages is crucial—not only to encourage innovation but also to sustain trust among collaborators. Celebrating those who rebuild should not overshadow the need to hold accountable those who appropriate ideas without consent.

    In the end, Anand's story is a reminder that research is not just about data collection and publication. It is about respect for intellectual contribution, trust in colleagues, and safeguarding the invisible labor that underlies every breakthrough. Without such respect, progress risks becoming a hollow race where ethics are optional and ideas become commodities to be claimed by the loudest voice or the most strategic player.

    The mind that conceives a study deserves protection as much as the hand that executes it. And only when this principle is honored can science truly advance with integrity.

For in science, credit is not a courtesy — it is a currency of truth.

Lessons from a Fracture That Healed More Than a Bone

    A six-year-old boy moves through his day with the gentle rhythm of childhood—waking up to familiar voices, dressing in the comfort of routine, eating breakfast with sleepy-eyed calm, and setting off for school where the hours unfold with predictable cadence: lessons, chatter, a lunch break under the sun. But on this particular day, amidst the ordinary, something unexpected disrupts the flow—he falls. Children fall often, skinning knees and brushing off dust, but this fall is different; the pain is sharp, deep, and immediate, striking a note in him that he’s never heard before. He knows instinctively that something is wrong—terribly wrong—long before the adults around him catch on, and the tears come more from fear than from pain.

His teacher, startled and sincerely concerned, rushes to his side with comforting words and anxious eyes. She cradles his small shoulder and calls his mother, offering calm but cautious reassurance: “He’s had a fall, but I don’t think it’s anything serious.” The mother, trying to suppress the rising worry, calls her husband—a doctor—relaying that their son is being brought home by his teacher, adding, “He’s quiet… no visible injury, but something’s not right.”

When the parents finally see their son, it is the absence of his usual spark that speaks louder than any words. The father’s medical instincts quietly override his emotions, and with a few precise questions and a gentle examination, he suspects what the X-ray will soon confirm—a fracture of the humerus, most likely a supracondylar one. There’s relief that nerves and vessels are spared, but the urgency remains: surgery will be needed, and soon.

The hospital visit follows in a blur—imaging confirms the diagnosis, the fracture is displaced, and the plan is clear: he will be taken to surgery at the earliest available slot. As the logistics begin to fall in place, the little boy—sensing the shift in atmosphere—turns to his father with wide, searching eyes and whispers, “Papa, let’s go home. I don’t want to stay here.” The father’s heart breaks quietly, but he nods with a gentle smile, saying, “Soon, son… just a few formalities.” It’s the first of many lies he tells that day—lies born not of deception but of love’s desperate attempt to shield innocence.

A sling is placed, painkillers administered, and when another injection looms, the boy pleads, “No more, Papa. Please.” His father, holding back the weight of helplessness, replies again with soft falsehood: “This is the last one.” The child eventually succumbs to exhaustion, falling asleep with tear-streaked cheeks and a fragile trust that never wavers.

Night begins to settle, tense and restless, but then a quiet knock disturbs the silence. The orthopedic surgeon enters—calm, composed, a figure of quiet authority and grace. He takes a seat with the parents, speaks gently and without haste, explaining the procedure again, not just for clarity but to comfort, answering even the questions the father, as a doctor, already knows. He listens, never brushing aside their fears, and as he rises to leave, he offers a simple assurance: “All will be well.” The words, said without flourish, sink deep into the father’s heart, a steadying anchor amid a storm of sleepless thoughts.

The mother stays with the child; the father returns home, but sleep escapes him. His medical mind, usually precise and detached, now swirls with every possible complication he’s ever read, witnessed, or feared. Morning arrives not as a new beginning, but as the seamless continuation of a night never truly lived.

Back at the hospital, the boy—now dressed in a surgical gown—looks up, confused and scared, “Why, Papa?” he asks. The father lies again, more tenderly this time, “Just a small check-up, son.” They move toward the operation theatre. Thanks to professional familiarity, the child is listed as the first case of the day. The surgeon meets them again, greets the mother, and offers the same soothing confidence: “It’s a straightforward procedure. We’ll be quick.” She walks her son to the pre-op area, holding his hand until the very last step, before masked strangers—gentle, but strangers nonetheless—take him in. As the doors close, the parents are left behind, their imaginations tormented by thoughts of what their son might be feeling: fear, confusion, abandonment.

Forty minutes later—the longest stretch of time the father has known—the surgeon returns with news: the surgery has gone well. The fracture is reduced, the dislocated segment neatly wired into place. Relief floods in, sudden and immense. The anesthesiologist, with a smile, quips, “Quite a handful you’ve got here.” The father manages a nod, words caught somewhere between gratitude and fatigue.

    As a doctor, he has treated many illnesses. Cured diseases. Performed procedures with clinical confidence. But in this moment, he realizes he has often failed to treat the dis-ease—the anxiety, the uncertainty, the quiet panic of being human. The orthopedic surgeon taught him that night the art of healing beyond medicine. His presence, both the night before and right after surgery, was a balm to the soul. That day taught him humility. As doctors, we often become mechanical. We interpret questions as doubts, doubts as disrespect. We forget that illness is not just a physiological event—it’s a deeply emotional one. That day reminded him to listen. To soften. To care. 

    Another lesson shone through: our children are far stronger than we are. Despite the pain, the fear, and the many small lies, his son never once withdrew his trust. After the operation, he reached out—still wanting his father’s arms, his comfort, his presence. That pure, unquestioning faith was a revelation. 

    Since that day, the father tries to mirror that trust. In his children, his patients, his friends, his family. And even toward those who may never return the same. He chooses to trust them still. To love preemptively.

Disclosure: But the experiences taught me some more. I have tried to summarise them in six lessons:

Even doctors feel the fear

No amount of training prepares you for seeing someone you love in pain. When it hits close to home, we’re not doctors—we’re just people, trying to hold it together. 

Healing’s not just about fixing the body

Treating a patient isn’t only about the diagnosis. It’s about the worried family member, the unspoken fear, the little things that make someone feel seen and cared for. 

Kind words are powerful medicine

Sometimes, the right words at the right moment do more than any pill or procedure. A calm voice and a little reassurance can change everything. 

Kids forgive with their whole hearts

Children love freely and forgive quickly. And sometimes, when we soften the truth to protect them, it’s not about hiding—it’s about loving them the best way we know how. 

Experience teaches what textbooks can’t

If you’ve waited outside an ICU or signed a scary form, you get it. That kind of experience builds a quiet kind of empathy—and makes you a better listener and a kinder doctor. 

Loving unconditionally takes guts

Trust and love aren’t just reactions—they’re choices. Choosing to love without expecting anything back? That’s real strength. And honestly, it heals both ways.

    

    Amen.

Back to Hyderabad: Echoes of a teacher and a gentleman

    Hyderabad greeted me with its usual blend of chaos and charm. The traffic was as unpredictable as ever, and the heat? Still enough to make you question your life choices. But this time, I wasn’t attending a conference with a group—I was on my own. And yet, my mind was still full of the memories of the last time I was here, back in 2010.

    At that point, I had just completed my MD in Medicine. I was freshly minted, a bit dazed, and, frankly, still trying to figure out how to be a real doctor. So when the opportunity arose to attend a two-day gastroenterology conference in Hyderabad with VK sir, I jumped at the chance. He was a teacher we all looked up to —calm, confident, and a veritable fountain of knowledge. Meanwhile, I was just trying not to panic whenever someone asked me a question.

    What made it even more memorable was the fact that we flew to Hyderabad together from Pune. I couldn’t help but feel a mix of awe and anxiety, sitting next to him during the flight. Here was this towering figure in medicine, and there I was, hoping my seatbelt wasn’t the only thing I could manage to keep together. But he was relaxed, as always, talking about everything from case studies to casual observations. His calm demeanor making me realize that there was no rush in this journey we were on.

    Once we arrived, we stayed in the same hotel. I remember walking into the lobby, pretending to be cool and collected, while internally screaming. While I was just trying to keep it together, he was casually engaging in conversations with the everyone around. It was like watching a Jedi at work—completely unflappable and always two steps ahead.

    That evening, after a long day of lectures, we ended up in the hotel restaurant together. I was convinced that I was supposed to keep the conversation academic—“So, sir, about that case study on IBD…” But instead, he asked me what I thought about the conference, about where I saw myself in the field. He made it clear that while knowledge was vital, so was finding your own path. It wasn’t just about what you knew—it was about how you approached the journey.

    During the conference and on numerous occasions afterwards, I learned a lot more than just gastroenterology. VK sir had a knack for making complex concepts seem like they were second nature. But what really stuck with me were the brief moments and quiet encounters in our association, where he would subtly guide me through the complexities of both medicine and life. He didn’t rush, he didn’t push; he just shared his wisdom in a way that didn’t make you feel overwhelmed. And that made all the difference.

    Now, walking through Hyderabad again, I can’t help but feel a mix of gratitude and sorrow. VK sir passed away a few months ago, and with his passing, a part of my own journey feels a little quieter, a little less guided. He wasn’t just a mentor to me, but to almost every gastroenterologist in our organization. I can confidently for all gastroenterologists in out organisation and many physicians that he would have met that his teachings shaped the foundation of our practice, and his influence lives on through us. I laugh at my younger self, thinking I needed to have all the answers, all the time. But VK sir showed me that sometimes the most important thing you can do is ask the right questions and, more importantly, take your time.

    This visit to Hyderabad isn’t just a trip down memory lane—it’s a quiet homage to a teacher who, without saying it out loud, taught me more about life and medicine than I ever realized at the time. His legacy lives on in the lessons he imparted and in the many lives he touched. I carry his wisdom with me every day, and though he is no longer here to guide me in person, I will always remember the quiet strength and brilliance that made him so extraordinary.

The Eighteenth Fairway

They called him Doc

Not just because he fixed stomachs in the city hospital, but because he had a way of diagnosing a defect in a golf swing with surgical precision. But out here, among dew-draped greens and wind-swept fairways, he wasn’t a doctor. He was a seeker. A man among friends chasing rhythm and stillness. But something was off this past week. His swing lacked soul. His presence—usually so grounded—felt scattered.

On Sunday, he chose solitude, as he had on a few occasions before. No scorecard, no stakes, no audience. Just a bag of clubs, a mind crowded with memories, and a heart full of questions. 

The first hole did not offer any comfort. The swing was stiff. The rhythm felt foreign. Shots veered to the left or the right. Putts lipped out. Small flaws—but enough to unravel the thread. The silence, usually soothing, only echoed his unrest.. The quiet, usually soothing, only echoed his doubts. By the seventh hole, he considered turning back.

Tired, he sat on a low stone by the edge of the fairway. The breeze moved through the grass like a whisper. He watched a squirrel pause, look at him, then continue on, untroubled.

And slowly, so did he.  Slowly. Not untroubled but moved on. 

His mind drifted—not to the course of wind direction, but to last Monday. but to last Monday. A 28-year-old woman. Pain abdomen. A young mother of two. She had come in so ill. Too ill. They had tried everything—he had. And still, they lost her. He had given his best. His team had done everything. But it had been futile. And the result was adverse. The kind of results that haunt you in the quiet. The kind you carry into the rough when your tee shot goes astray. He hadn’t let himself grieve—not fully. Not with his team watching, not with the next patient waiting. But now, every missed putt brought it back. Every mis-hit reminded him of outcomes he couldn’t fix.

He stood at the edge of the fairway, gripping the club too tightly, the round already slipping through his fingers like sand. The scorecard felt heavier than it should. He swung hard. And watched with despair as the ball disappeared deeper into the woods. 

Medicine and golf—his twin devotions. Both required presence. Both were, to him, forms of meditation. He had been a doctor for 25 years and a golfer for 15. His father—also a doctor, also a golfer—had taught him that. Taught him the swing, yes, but also the silence between shots. But, today he was missing something. He looked harder inside his head (and his heart....) 

Then—like a whisper breaking through the noise—he remembered something his dad once told him.

“Just like medicine, Golf isn’t really about the swing or the score,” Dad had said, during one of those long walks between holes, the kind where the sun was kind and time felt slow. “We chase both like they matter most, but what the game is really about… is presence."

He remembered his dad pausing, watching the wind stir the trees. “It’s about showing up. One shot at a time. Standing over the ball with your full attention. Feeling the ground beneath your feet, the breeze on your skin, the rhythm of your breath. Not caught in the last mistake. Not rushing toward the next hole. Just—here. It's always presence.”

The words settled in him now like a deep breath. 

He stood. No adjustment to his grip. No practice swing. 

Just breath.......... Just Presence.

Hole by hole, something shifted. He stopped forcing. Stopped correcting. He started allowing. The 11th hole gave him a perfect 7-iron shot. The 14th, a chip that kissed the flagstick. By the 17th, his stride had softened. The swing was still imperfect, but it had feeling again. He was present in the game.

Then came the last hole.

The sun had climbed now, warming the fairway, chasing the last of the morning’s fog. He looked back at the path behind him—each hole a reflection, some jagged, some smooth.

He swung. The ball flew—not perfectly, but true enough. A gentle fade, landing just short. He smiled. As he walked, he noticed the wind had picked up. The scent of grass, earth, and distant rain filled the air. The wind seemed to whisper—not advice, but approval. Not for his score, but for his showing up. For staying. For trying.

He reached the green, lined up the putt, and paused—not to analyse, but to feel it. Then, with a stroke light as a breath, he sent the ball home. The putt dropped.

No celebration. No relief. Just a nod to the sky. A quiet acknowledgment of what he’d carried — and what he’d let go.

The game was over. The round complete. But somehow, he felt like it had only just begun. 

Presence

(What Dad told me)

It’s not about the swing,

though you’ll spend years chasing it.

Not about the score,

though you’ll glance at it too often.

He said,

“Golf teaches you to show up.

One shot at a time,

one breath, one stance,

right here, right now.”

The wind may shift,

the green may trick you,

your hands may falter—

but presence,

that’s what steadies the soul.