Jan27
Monthly Archives: January 2009
Jan26
Molokheiya, sandesh and payesh
This weekend I made sandesh and payesh. Not quite as good as my momma’s, but good enough.
I had molokheiya (Egyptian spinach) and chicken and lamb over rice made for me. It tasted good with a bit of lemon juice sprinkled on top. Then I fell asleep on a very comfortable bean bag.
Sweetness and tanginess. A prelude for taking a risk and a chance.
Jan24
Memories of Kolkata
Being born and raised in America came with its perks, but no birthday has ever compared to birthdays in Kolkata.
Birthdays in America were filled with candy, cake, opening colorful presents, wearing a blindfold and trying to pin the tail on the donkey, hitting the pinata, grabbags, and being disappointed by the plethora of Barbies and the lack of EasyBake Ovens; the glory of getting a 64 piece Crayola set and building yet another Lego skyscraper 
Birthdays in Kolkata were filled with fresh fried fish, goat curry, fragrant basmati rice with ghee, payesh (a sweet spiced rice pudding; also called kheer), gulab jaman, watching the tik-tikis (geikos) on the wall, watching old Bengali movies on my grandfather’s television, the scent of incense and camphor and watching kites compete in the sky. When one kite flyer would cut another’s kite, you could hear the screams of VOKARTA! To this day, I don’t really know what that means, but I have distinct memories of holding my cousins spool of kite thread, following his instructions about how much to let and when to hold back, and rejoicing in his glory when he cut someone else’s kite.
I remember the monsoon seasons in Kolkata, reveling as to how everything would be covered with water. Watching, protected from the altitude of my grandfather’s verandah. Not realizing that there was human life that was probably devastated by the very same thing that amazed me.
I remember landing in India, wondering how everything felt so “tropical”. People looked different and acted different. They stared at me. Clearly I was the American who was traveling to India to see the long lost relatives. I remember my solo-trip to India when I was fourteen. My nevous mother packed a suitcase full of Poland Spring water. When the immigration’s officer opened my suitcase, he muttered to his other colleagues with a smirk, “American Memsahib”.
I remember traveling around Kolkata and wondering why there was European architecture in certain parts of the city. It took me another few years to learn about colonization and British rule, Mahatma Gandhi, non-violence and cottage industries. I had a lot to learn.
I remember traveling to my father’s village. I was only five but I looked around mesmerized at the sparse surroundings where my father grew up. I couldn’t imagine my father growing up here, in comparison to the father I know that has melded into American society and wakes up everyday to catch the 6:05 AM train to go to work in the city.
Although I wouldn’t advocate being around slaughter houses anymore (avian influenza), I visited one as a child in Kolkata. I wanted to have chicken and my older cousin and I went to get one. I thought it would be like going to ShopRite and picking up a packet of Perdue. Instead my cousin pointed to the one he wanted to the guy behind the counter. The guy came out and picked up the chicken by the head, swung it around a few times and then CHOP! The chicken’s head was still bobbing up and down and the eyes were pink. I didn’t get scared, but that experience should have told me that I was heading towards a path of medicine. Needless to say, that night I had the best chicken curry that I ever had in my life.
I remember spending August 15, 1976, Indian Independence Day in Kolkata . I was mesmerized by the display of fireworks. I have a vague memory of looking up in the sky and seeing the Indian flag and Mahatma Gandhi.
I can’t wait to go back.
Jai Hind! Jai Bharat!
Jan21
What is Soma?
A very inane and insane poem was written to me by a French-Lebanese poet entitled “Soma and the Brain”. The poet asks,
What is Soma?
WHHEEEELLLLLL ………….
SINCE YOU ASKED.
Soma is many things both here and there.
Here:
1. It’s women’s intimates apparel.
2. Yes. It’s a muscle relaxer (a.k.a. Carisoprodol).
3. It’s the Student Osteopathic Medical Association.
4. It’s a song by the Smashing Pumpkins.
5. It was written about by Aldous Huxley in Brave New World.
6. It’s San Francisco’s South of Market neighborhood.
7. It’s a massage institute in Chicago.
8. Soma, in Greek, means body. The soma of a neuron (nerve cell) is often called the cell body.
There: (taken from Wikipedia)
1. In Hinduism, the god Soma evolved into a lunar deity. The moon is the cup from which the gods drink Soma, and so Soma became identified with the moon god Chandra. A waxing moon meant Soma was recreating himself, ready to be drunk again.
2. Monday is called Somvar in Sanskrit and Sanskritic languages, such as Hindi and Marathi, and alludes to the importance of this god in Hindu spirituality
3. In the Vedas, Soma is portrayed as sacred and as a god (deva). The god, the drink and the plant probably referred to the same entity, or at least the differentiation was ambiguous. In this aspect, Soma is similar to the Greek ambrosia (cognate to amrita); it is what the gods drink, and what made them deities. Indra and Agni are portrayed as consuming Soma in copious quantities. The consumption of Soma by human beings is probably under the belief that it bestowes divine qualities on them.
4. The Ninth Mandala of the Rigveda is known as the Soma Mandala (!!!!!). It consists entirely of hymns addressed to Soma Pavamana (“purified Soma”). The drink Soma was kept and distributed by the Gandharvas. The Rigveda associates the Sushoma, Arjikiya and other regions with Soma (e.g. 8.7.29; 8.64.10-11). Sharyanavat was possibly the name of a pond or lake on the banks of which Soma could be found.
5. The plant is described as growing in the mountains (giristha, cf. Orestes), with long stalks, and of yellow or tawny (hari) colour. The drink is prepared by priests pounding the stalks with stones, an occupation that creates tapas (literally “heat”). The juice so gathered is mixed with other ingredients (including milk) before it is drunk.
Growing far away, in the mountains, Soma had to be purchased from travelling traders. The plant supposedly grew in the Hindukush and thus it had to be imported to the Punjab region. Later, knowledge of the plant was lost altogether, and Indian ritual reflects this, in expiatory prayers apologizing to the gods for the use of a substitute plant (e.g. rhubarb) because Soma had become unavailable.
SOMA
Jan20
Laughter Poem
You know…
The kind that splits your sides open?
You feel like you can’t breathe?
You start wheezing and coughing?
You try not to think about it, but that makes you laugh even more?
Your shoulders start convulsing?
Mikey says that you laugh like a hyena? 
I can’t take it anymore!
HAR HAR HARDEE HAR HAR !!!!
-Somaspeare
Jan19
Oy vey
This past week, I felt myself getting irritated with many people:
1. My housecleaner. I left her a message NOT to come on Friday to clean. She didn’t listen to her voicemail and came anyway and wasn’t able to get in. She then left a nasty message on my voicemail. Needless to say she is now my ex-housecleaner.
2. Patient called calling to complain about why he has to pay for office visit and lab services. Wrote back to tell him his insurance didn’t cover it. Betcha he doesn’t complain about paying for his martini on the rocks after hours.
3. Medical assistant (for the third time) didn’t tell me that a patient had arrived and waiting for me to see them.
4. Patient’s mother called stating that she needed to know her daughter’s blood test results. I’m not a pediatrician.
The Serenity Prayer
God grant me the serenity
To accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference.
Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
As it is, not as I would have it;
Trusting that He will make all things right
If I surrender to His Will;
That I may be reasonably happy in this life
And supremely happy with Him
Forever in the next.
Amen.
–Reinhold Niebuhr
In loving memory of
Jan13
Protected: The Royal foot-in-mouth disease
Jan11
Please bring it back home
Some patients have a “pre-existing condition” clause in their health insurance policy. This means that when they first see the doctor and a “diagnosis” is coded, the insurance company won’t pay for it until the patient fills out a form that verifiies that this is not a condition that they had prior to their active policy. Simple? You would think so. I have a patient who has ignored repeat notices from my office requesting that the form be sent. I finally had to call the insurance company myself to find out the status of this whole situation:
Call placed
UnitedHealthcare customer rep (in India): Good morning, thank you for calling United Healthcare. How are you today ma’m?
Me: I am well, thank you. How are you?
UHC: I am well. Thank you for asking. How can I help you today?
Me: I am calling regarding a claim that was sent on 6/23/08. I received notice from UHC stating that the patient has a pre-existing condition clause and I am calling to find out if the form has been completed and received by UHC.
UHC: Yes, sure.
At this point he takes some patient information from me and puts me on hold
Waiting
Waiting
Waiting
Waiting
Waiting
Waiting
Waiting
10 mins.
Finally….
UHC: Yes, hello ma’m?
Me: Hello.
UHC: Thank you for holding.
Me: Sure.
UHC: I have looked into the claim and have found that there is a pre-exisiting condition clause and this is why the claim has not yet been paid.
I mean, you’ve got to be f-ing kidding me. I’ve spent ten minutes waiting only to hear what I’ve already known?
Me: Why did you put me on hold for this long, not even answering the question I had in the first place.
UHC: Well, uh, sorry ma’m, I mean, we have to do research before we can answer any questions.
Me: But you didn’t answer my question.
UHC: Oh
Me: All I want to know, and you better not put me on hold again, is if UHC is in receipt of the form that the patient has to fill out.
UHC: No, we are not.
Me: Thank you very much (fuming).
So, I know I will be pissing off my Indian contemporaries (in India), but this is a classic example of why we need to bring jobs back to America. American people who are trained to deal with insurance issues, more specifically. How can you have someone answer these questions when they’re not even in the same country? They don’t even have a f-ing concept of what the hell is a “pre-existing condition” clause. How can I expect them to answer anything else? This is a layer of the problem with healthcare as well as the American job market. Bring it back home. We need to train Americans how to deal with patients, consumers and clients and how to do it effectively. A waste of 10 minutes may not seem much to you, but to me, it’s three more phone calls I could have made to patients. It’s ten more lab reports I could have reviewed. Trust me, ten minutes is a lot of time in a small medical practice.
In the case of this particular patient, it took 6 months before I received any payment from United Healthcare. I had to call the patient twice, he informed me each time that he had already discussed and sent in the paperwork to UHC.
As a daughter of an expatriate, and someone who is also proud of their Indian heritage, I am happy that India is prospering. But there are some things that we need to bring back home.
Jan7
“It tastes just like chicken!”
When I was a first year medical student, my school had a contest to see who could produce the most interesting logo/theme for our Class of ’97 shirt. There were probably 4 or 5 entries, but the one that stuck out for me was made by one of my classmates. His theme was a few medical students standing around a cadaver, one of the students holding up his finger to his mouth saying, “Hmmm. Tastes just like chicken!” Okay. It was funny at the time. I think I was the only one who voted for it. Martin, the classmate who made the logo, did not win 
He also told me years later that even he did not vote for his own logo.
A few months ago, I went to a fancy restaurant in Gramercy Park. The waiter spoke nothing but French and kept coming out with trays of different appetizers. 10 years of Spanish and a crowded room really didn’t help….but I later realized that I was eating foie gras de bunny rabbit. Yes, Thumper on a little piece of toast. But, if no one had told me, I would have thought that I was eating a very lean piece of pulverized chicken (liver).
Today, I opened a can of Bloc de foie gras de canard that was given to me as a present. First off, I’m definitely not from the Hills, I belong in the Valley. So I had to google the individual ingredients. I knew it was some sort of either duck or goose liver.
Canard: duck Eau: water Sel: Salt, Sel nitrite: curing salts, poivre: pepper, sucre: sugar
Doesn’t taste like chicken, although saltier and richer than the rabbit foie gras.
Buen provecho or Mmm Mmm good (as we say in the Valley)
Bon appetit! (as they say in the Hills)
Jan6
