National MRI Musings

They taught us parts of the respiratory system in class six. And I had nothing but the greatest admiration for the poetic rhyming tendencies of the guy who decided to name the Larynx (voice box) and Pharynx (gullet/neck part of digestive tube).

The larynx engineering was a bit beyond me, but for many years after that , our family doctor always ended up hearing how my pharynx was inflamed, while ordinary folks cribbed to him about sore throats, and infections.

Then I found out that doctors have a different way of expressing things. Preferably in illegible style, and in desperate abbreviations, inspired , possibly from Latin, which , clearly, is not part of the medical curriculum.

I've mixed up FUO(fever of unidentified origin) with UFO(Unidentified flying object), and UID (Unique Identification numer) with IUD(Intrauterine device), and wondered why the nurse read something-something STAT and promptly gave me an immediate oral injection dose of vit D3, when I was kind of actually mobilizing to face a deep poke with a needle in the arm.

Having said that, I can see how one can apply these secret words in daily life.

Like, say, (possibly tongue in cheek, or , as they say, "glossal" movement in the "mala" ) a doctor mother , seeing off her doctor daughter on her first day of her first job might say :

Coffee ad lib , agit aq ft, cf b.i.d

B.M a.m

Wash e.m.p. ex aq, B.S.A, a.l., a.s., a.u., o.d, o.s., o.u., ft soap emuls., NPO, NTE 10 minutes, rep.

admov. pulv. makeup, ad lib.

If NKA, admov perfume nebul. prn., chewing gum p.o.(NTE 4) , admov.

gtts o.u.

si op. sit cash q.s., disp. U.d.

Sometimes s. a.


would mean :

Use coffee freely, mix in water, and make coffee, twice a day. A morning bowel movement recommended.

Wash as directed with water, body surface area, left ear, right ear, then both ears, left eye, right eye, both eyes, make a soap emulsion, nothing by mouth (don't swallow), not to exceed 10 minutes. Repeat.

Use powder makeup freely (as much as you want) . If no known allergies, apply a spray perfume , as needed. Chewing Gum, by mouth, not to exceed 4.

Apply drops in both ears.

If there is a need for cash, use sufficient quantity, dispense , as directed.

Sometimes use your judgement ! (Exclamations mine. I don't think doctors do exclamation marks)

If you thought that was difficult, wait till you see what an MRI report of a certain Mr Suresh Kalmadi indicated. He , the Chairman of the Commonwealth Games Org Committee, is currently in jail on corruption scam charges, and consequent to feeling dizzy after several tete a tete's with the chief jailor, was sent to hospital for an MRI scan of his brain, with several folks talking about Dementia.

Which is a very creative thing to do.

Earlier our politicians took recourse to chest pain, uneasiness, breathlessness, and got themselves admitted to ICCU's, complete with their security apparatus.

In these e-days, when a scam is not a scam unless it is in thousands of crores, it is in the fitness of things that we talk about MRI scans instead. That' s like a step up. ( You need to keep still and unmoving as the scan proceeds. I should know. I had one done and wrote a post, " MRI Rock, " about it . And possibly, if you move even a bit , the picture could be conveniently misleading).

His report says. :

......he is suffering from 'diffused cerebral atrophy with old ischemic changes in brain parenchyma with calcified granuloma in caudothalamic groove on left side (of his brain)'.....

This is like describing the Mumbai roads MRI scan and saying :

.... the road is suffering from diffused unidentified potholes, with old plumbing related age-related problems with the road body (parenchyma = tissue). Occasional tar and stone granulomas(inflamations) , have calicified (become pucca). About the caudothalamic grooves on the left side, its pointless to say anything because our roads have developed so may grooves everywhere. .....


Of course, one is an assesment of a person for dementia, which, not too surprisngly would include interesting abilities like the ability not to remember things, and cognitive difficulties. The other is the description of a real endless malaise affecting the Mumbai roads and therefore, its million hardworking citizens.

Luckily ,( for us, that is, ) Dementia is not based on MRI reports alone. There are many other check ups and evaluations involved, and these will be done. I guess one needs to have a massive road scam, for someone to take the Mumbai Roads MRI report seriously.

Today's paper, in addition to citing latest research from George Washington University about how our brains become smaller as we age , has also indicated some eminent opinions on Kalmadi's dementia question , also mentioning his diabetes, and hypertension , which could cause the above enunciated changes as in his MRI report.

I was beginning to get worried.

I mean Mr Kalmadi is just a bit older than me. I have one of the afflictions (not dementia) , that he has. If a walking,talking, scheming, shoe-dodging person can have such problems , what about me ? An ordinary woman, who still gets confused when asked how many zeros in a crore ?

But I digress. I now have hopes for the Mumbai roads. If they can solve Mr Kalmadi's problems, they can solve Mumbai's road problems.

After all the reports are so similar, na ?

Unraveling tangles and knots गुंतता मार्ग हे ....

It has been my secret wish, that all the Maharashtra ministers should shift residences to the suburb where i live. It is scenic, has a lake, hills, forests, crocodiles, fish, temples, churches, masjids, gurudwaras, 5-star hotels, malls, and whats more, is close to both airports in Mumbai ; a very important thing when you always need to fly off to the capital , sirens blaring.

Why ?

(Aeons ago, I lived with my parents in some proletarian government flats, in one of South Mumbai's poshest areas, which looked down on a huge expanse of ministers villas, with endless lawns, numerous cars with beacons, and pilot cars to clear the roads. If you were in a BEST bus lumbering behind such a car, you always reached office early. And if there was a hint of a pothole in the morning, by evening the road would be smooth as, as Lalu Prasad Yadav says, Ms. Hema Malini's cheeks.)

That is the only way, they will stop digging the roads here. Earlier it was like a hobby, with telephonewallas being the most skilled exponents, closely followed by the water pipe entrepreneurs. My visitors from abroad have never seen a normal road on their way to our house, and have remarked on it. In all the excitement of handing out lucrative contracts to various diggers , footpaths have become totally unfashionable. We now have roads in the midst of potholes, rather than the other way around.

And so , hope sprang (eternal ?) in my mind when I heard of the impending visit to our campus by the First Citizen of the Nation to preside over the special Convocation. I had visions of my autorickshaw gliding over smooth roads, something I never expected would happen in my liftetime. Someone said the First Citizen of the Nation would come by helicopter. I fervently hoped against that.

All of a sudden, we started seeing more police jeeps on campus, carefully driving around; cops keenly observing people ,(like me, carrying 500 gms of karela and two papayas) , with tough,questioning , unsmiling looks. A mother in a hurry, zipping on to the road in front of the jeep, with 4 kg of vegetables, and 3 school children riding pillion, was given pitying looks; they were now other things to worry about. (See ya later, ma'am). Everyone entering campus was questioned. My household help was worried; six different chaps checked her id-card, and one of her friends was not allowed in at all, because her id-card( kept in a bag she tucked into her waist,) fell off somewhere when she got off a hugely crowded bus in torrential rain, a day earlier, and now she had nothing to show. Mumbai police had those metal barricades put up on our very low traffic-density campus, just in case a primary school kid on his trainer-wheels bike decided he had to cross the road, during his lunchtime trip home, regardless of the Occasion. Whistles. Walkie-talkies, terraces populated by plain clothes types, serious faces, a systematic identification of every participant in the day's program, photo passes, rehearsal drills. Very exciting.

I now realise, that either the municipal types have a hotline to the weather gods, or they are just good statistical forecasters. One day to go for the great First Visit.The potholes, and craters on the roads outside continued to proliferate. No action. Earlier a trip to the market would be rewarded with the acrid smell of burning tar mixed with the smell of wet earth, diesel exhaust, and frying wada pau flavours. This time the tar was missing.

Then a day before the First Arrival, traffic was thrown into chaos by sudden large scale pothole repairs, , nay fillings. No one knows what they were filling the potholes with, given that that a proper blind eye is always turned to such activities by our city managers. A day later, after the First event, and another batch of heavy rains, all the stuff got washed away and we were back to roads in the middle of craters. Some guys went laughing all the way to the bank, and some folks on motorcycles, ladies riding pillion, limped home holding their backs.

Given all this hype , the actual Convocation event was a lesson in common sense, as opposed to pomp and ceremony. The First Citizen of the nation, arrived with State dignitaries in ordinary Ambasaador cars, not hitherto known for their shock absorbers and suspensions The weight of the State rests very amiably on the First shoulders. A dignified walk at the head of the academic procession, the resounding National Anthem sung by the students, and the First citizen took her seat on the dais, , smilingly looking at all the excited parents and guests. Awards of ,medals and prizes. Names announced. Students coming up to have medals placed around their necks. Some touching the First feet , like one would for a grandparent. Restrained applause, in august company.

And then it happened. One of the medal ribbons got tangled. Knotted inadvertently. The scholar stood patiently, seeing the search for a solution of this terribly low tech problem, in a high tech technological ambiance. The head of the Institute tried . No success. Then the First fingers automatically took over. The picture of the Head of State trying to unravel a knot, using an expertise of so many years of attending to her children, was just what was needed to bring a fresh spray of lighthearted fun into the proceedings. First there was a hint of applause. Then it grew. The students thought it was wonderful. Parents joined in. BUT THE KNOT REFUSED TO UNRAVEL ! The President thought there had been enough effort, and she simply smilingly handed over the medal to the student, patting him , as the way it was knotted it wouldn't go over his head. He would probably remember it all his life, and never hear the end of it from his classmates. The applause was deafening.

Several speeches later , the First Citizen departed, across potholes ready to shed their fillings .A noticeable reduction in tension. Several deep breaths. The police cars are now where they should be, monitoring traffic jams at junctions, and testing the salutes of the constables, as they struggle to manage the traffic, with one eye on a possible sahib who might just whiz past, beacons flashing. Occasionally a two wheeler will get special attention.

Cars and two wheelers, dipping sideways as they manoeuvre the freshly washed away fake-filled deep potholes. Vehicles coming to sudden standstills, and folks veering suddenly to avoid six inch ditches.

The First Visit is over.

The battle of the Pothole has just begin.

There is going to be some tangle of traffic. Someone will try and unravel it.

Unlike what happened earlier to a First Knot, I just hope this time the knot is completely unraveled.

Lessons from the chutney stone: Mastic-ization of Mumbai Roads...रस्त्याला टाकी लावा......

Takes me back to the days when chutneys were still ground on stones. My mother must have been the last of those loyalists who looked down their noses at folks trying to make lassi in mixers, pretending that dahi became buttermilk solely due to blender brilliance, and of course those who thought that metal blades making a mess of coriander and chilles was something to be thrilled about.

There is something about fresh moist coriander, chopped finger burning chillies, fragrant fresh coconut, refreshing sprigs of mint , some lashings of kairi, all this oozing aroma as it lies on a dark flat stone, being crushed and dragged under another smaller cylindrical stone, getting enriched with jeera,salt, and other things.

So much so, that, about 30 years ago, I once lugged a biggish chutney stone from Pune to Mumbai , in a tough shoulder bag , in a crowded second class ladies compartment in the first train of the day, and won the everlasting admiration and encouragement of those hardworking women (who commute to work in Mumbai daily), who were so impressed that they even helped me carry it towards the compartment exit, as I battled entering passengers, trying my best not to injure them , and also myself, as I jumped out in a gravity defying manner , all this in the standard 30 second stop at the station.

It instilled in me a healthy respect for weight bearing exercises , as well as my clavicles. and subscapularises, and my subclavicles.

One of the things one needs to do as maintenance from time to time , on these stones, is to ensure a roughened surface. As you grind more and more chutneys, and various lipsmacking fluids kind of overpower the surface, gradually smoothening it with spicy wear and tear, a time comes, when you need to do what is called , "taki lavne" in vernacular, but simply means that you call someone to hammer the surface with a special nail in a special manner, so as to create the correct rough surface once again.

Unfortunately, the folks at the Municipal Corporation of Greater Mumbai(MCGM), almost all of who grew up , undoubtedly in traditional chutney households, have been so wonderstruck with mastic and asphalt, that they have forgotten this simple friction principle.

So we have 136 accidents on the Eastern Express Highway in the first 5 days, of a monsoon, that has started this year, in a fury reminiscent of the 2005 deluge. Roads were treated with mastic and asphalt, to avoid fast creations of potholes, which is the norm for our roads. This time the roads became too smooth, and vehicles skidded, many people were injured, and vehicles damaged. A van returning with a marriage party skidded , killing an entire family , with the exception of the father.

I wonder if the MCGM knows that Ireland resurfaced its mastic-ed roads into a non-mastic-ed state , and restricted the mastic-asphalt stuff to roads where the speed limit was 30 mph. Police did trials on these roads before foisting it on the public, and were aghast at , what is called skid resistance. Tests initiated by the National Roads Authorities (NRA) in the Irish Republic raised questions about the materials' ability to provide enough friction for tyres at higher speeds.

Turns out that the Highways Agency of the UK , doesnt agree. Even though BBC reports mentioned police in Debyshire doing a test and agreeing with the Irish. Germany also has reservations about the use of this, and they actually were the pioneers of this mastic asphalt stuff.

Then there is this high cost of what is known as filler and binder material while laying the asphalt-mastic stuff. Science says that Stone Mastic Asphalt( SMA ) mix must be cooled to 40°C to prevent flushing of the binder to the surface, and it is this binder stuff on the surface which needs to be worn off so prevent skidding.

It may be even necessary initially to do to the road, what we did to the chutney stone. In road parlance it is called applying a small clean grit.

In many ways, thats what it takes. Grit . Determination.

To do excellent scientific supervision. To ensure that the epidemic of easy money, consequent to contractors using cheaper fillers etc, is handled strictly. To ensure, that when an adverse experience is indicated in Indian conditions, technology be adapted to our situation. Maybe the roads should have been masti-asphalted at the end of the last monsoon. So the binder on the surface would have nicely worn off by this monsoon, given our huge traffic density and vehicle variety.

Our corporators gift themselves laptops. They go on junkets to Europe , ostensibly to study governance. Presumably with eyes and ears closed. Pockets open. I wish they would surf and see this .

What is interesting is that the country(UK) whose governance model we apparently follow, had apparently banned the use of this mastic-asphalt, only to overturn that some time later.

BBC did a campaign. No change. Rings a bell ?

A police seargent in Debyshire testing the surface said "It was a sunny day in August. I jumped on the brakes and the car just kept going and going.Instead of the scream of tyre on road and a cloud of smoke there was just a gentle hiss as I passed over the road, and I skidded far further than I ever expected to."

Back to Mumbai

Those 136 accident cases in 5 days.

The marriage party where a skidding vehicle killed all but one family member.

Maybe, like the sergeant said, there was a gentle hiss.

But is the MCGM listening to the screams of those that are no more?