deponti to the world

my 2 cents

Filter kaapi is made, 180118
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At any
Darshini restaurant in Bangalore

the south Indian "filter kaapi" (coffee that has been percolated through a filter, and always made with milk) is first poured into the glasses, where the colour gleams invitingly in the sunlight.

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Then, boiling, frothing milk (with or without sugar , as per the customer's requirement) is added. One is one, the other one waits....

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This was taken at Vidyarthi Grand, on Kanakapura Road, one of my favourite post-birding-outing favourites. (We'd been to the Valley School area.)

Location, location, location!
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Where, oh, where can I  say that I saw

In the capital city of Karnataka....

Those rare ornithological specimens that I  click.

Usually not in the city, but far!

I worry, you see, that others might spy

And click ...and disturb...those beautiful birts.

But I don't want to keep the location to myself.

So of course,I  say, "Bangalore Outskirts."

Whether it's the hills, the  forests or the valley

Or any of the few remaining lakes...the wirts

That are written under those superb photographs, are always

Those teasing ones: "Bangalore Outskirts".

Bangalore-for-birders is a shy maiden: Not for her

Those see-through tees or off-the-shoulder shirts.

You may get only a peep at  some shy part of  a birt

Under those far-reaching "Bangalore Outskirts".

So I feel happy I'm sharing the info with the world

Of fellow Bangalore-birders till it hurts:

But still I know I will never give away

The actual location of those "Bangalore Outskirts".

I rest easy in mind; I am the only ethical birder.

All the rest of them are irresponsible disaster-alerts.

Let them try to find the bird I found! I defy them

By telling them I found it in the "Bangalore Outskirts".


On the passing away of Mythri, 100118
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Every moment that I live,breathe, look, sigh...
May be someone's last moment on earth.
So tough to understand this, but it is true.
More and more often, when I hear of young people dying
I wonder why there is no logic in life or death.
Why should I, having lived a full life, and with no regrets,
Not be taken, and a young life,
Full of talent, hard work and promise,
Not be spared to the world?
Why should old sere trees, their uses long gone,
Creak on, moaning of the past to the world,
While young saplings,which we hope will grow
And mature into giants,
Be cut down in a lightning swathe of random fate?
I do not understand life...or death.


Bird-name puzzles
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1. Most rich people can travel to see this bird. (7)....

Ostrich (it's in the sentence). 

2. Tailless pipe...it is the bird. (5)....

Pipit (Tailless "pipe" is pip, and add "it") 

3.The pigs got in a mess, wallowing in the mud.(7)....

Swallow (it's in the sentence). 

4. Bird you can see in a bowling alley (3)....

Owl. (It's in the sentence).

5. Bird makes endlessly boring mixture.(5)....

Robin.  (Endlessly, "boring" is "borin" and a mixture of that is "robin".

6.According to some people, this bird sounds like a "moo"...

Coucal (some pronounce it "cow call")(6).

 7. Colourful wolf pea? (7)...

Peafowl (anagram of "wolf pea"). 

8. Will it give you an e-rebate? (3,5)...

Bee-eater (anagram of "e rebate") . 

9. Part of the Gretel and Hansel story? (5)....

Egret (it's in the sentence). 

10. Brawler roughing it up? (7)....Warbler (anagram of brawler). 


Nature walk for Munchkins Montessori, Puttenahalli kere, 151217
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Letter to Chanda of Munchkins:

Hi Chanda,

The walk went very well. It was very nice to meet Priti, Mythili, Anna and others.

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List of various beings seen:

Birds:

Cormorant, Great

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Cormorant, Little
Egret, Cattle
Egret, Little
Heron, Pond
Kite, Common
Moorhen, Purple
Sunbird, Purple-rumped
Tailorbird, Common
Warbler, Greenish

Butterflies:

Bob, Chestnut
Cerulean, Common
Castor, Common
Emigrant, Common
Jezebel, Common
Lacewing, Common (eggs)
Leopard,Common
Pansy, Lemon

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Lime, Common
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Tiger, Plain
Tiger, Striped
Yellow, Common Grass

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Fishes:
Tilapia

Insects:

Bees
Damselflies
Dragonflies
Spiders
Wasps

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Trees and Plants

Bougainvillea
Badminton Ball
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Date Palm
Fig Tree
Honge
Mahogany
Neem
Pride of India
Sampige
Singapore Cherry

I talked about leaf composting, clearing weeds in the lake, the way birds' beaks have different shapes, water and woodland birds, differences in leaves and tree bark, and about how much effort it takes to maintain a lake.

When I conduct walks I generally take far fewer photos. I have posted the photos on my FB album

here

Please share this link with the others.

Looking forward to future association with all of you...the children were truly delightful!

Cheers, Deepa

Meeting with the head of the hospital, Fortis, Bannerghatta Road, 071217
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I had a long meeting (made longer by the delay in getting his visiting cards!) with Dr Manish Mattoo, the head of Fortis Hospitals, Bannerghatta Road. I had a few major points to convey:
1. In spite of being an educated, articulate person, I did not find any process in place, to route my grievance through, when I found a lack of service in the hospital. I want other patients, too, or their representatives, whatever their level of literacy or awareness, to be given a concrete channel of grievance which is made clear to them at the time of their admission to the hospital.

2. I want billing practices to be improved in the following ways: Operation Theatre (OT) consumables and charges itemized separately, with the patient having the ability to cross-check the items with the doctor/surgeon, in case of a dispute. Other consumables to be itemized on the bill, with the patitent (or the family or friends) being able to query them. Not every patient will need, or want, this facility, but it should be in place for those who need it.

3.I took along a friend of mine, Tara Ollapally, who is a legal mediator, to ask the hospital to build a system whereby, in the event of a grievance or of lack of service by the hospital (whether administration, billing, or medical/nursing care) , the patient or the representative can have the option to have a legal mediator (a neutral third party) present in the meeting between the hospital and the patient, guiding both to a practical and pragmatic solution, rather than a path to our time- and money-consuming courts.

Dr Manish and Nayna Pai both agreed to the points of view presented, and did mention that they would also want such practices embedded. Dr Manish mentioned how,often patients and their representatives threaten and do actually take physical action against doctors and hospitals. The idea is to reduce this culture of confrontation, where one party is aways jockeying for superiority with the bottom line being money, not the issues at hand.

If I am given clear documentation in the near future, that Fortis Hospitals, Bannerghatta Road, has changed the billing system, with more clarity and transparency, and is working, long-term, towards making patients more aware of their rights in querying hospital practices, I will certainly change my present opinion of them, and be willing to agree that there is hope for positive change.

As of now...my perception is that I don't want to ever enter a hospital... or a court of law....if I can help it! I feel both may take years of my life, and/or chunks of my money, with nothing to show for it.

From Nallu (Shiv Shankar Sastry, a gastro-enterlogist)
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DOCTORS AND ETHICS

Medicine must be the only profession where the service provider, (the doctor) must do his best to ensure that his client, (the patient) goes off happy and never comes back to him and remains happy for not having to come back.

My internet service provider keeps promising me great offers and gifts if I can refer new customers to them and get them more business. Getting more business, attracting more people and ensuring that they keep coming back is a fundamental requirement for any business or commercial service. But not medicine. For doctors this is unethical.

Ethics is a strange beast. It is an ancient code of honour, a covenant to build trust and the understanding that the service provider will do everything possible for the good of the client and will not allow profit or greed to get in the way of selfless service. You will note that I am using the words "service provider" instead of doctor, and "client" instead of patient. I do this deliberately, because legally medicine is a service and patients are consumers. Medical treatment in India comes under the consumer protection act. This ruling came about because private medical practice is a "fee for service" entity - that is, the doctor provides a service and is entitled to charge a fee for that service.

The fact that doctors must charge a fee for their service was recognized in the west long ago. George Bernard Shaw actually wrote a play about the dilemmas that doctors face relating to service and fees. But western nations also realized that doctors must be compensated fairly for their service - and this has made a medical career in the west a magnet for young Indian medical graduates.

The story in India is different. Indian attitudes towards doctors are often based on an imaginary ideal - of a person who has dedicated his life to the service of mankind. He (or she) is the epitome of compassion and sacrifice. Pecuniary considerations are not for the doctor. When a patient, fearing for his life goes to a doctor, the last thing on the patient's mind is that the doctor too may need to lead a life. The compassionate saviour mindset is drummed into young children as their parents desire them to become doctors. Television and other media stories regularly feature interviews of children of adverse circumstances, or of a specially gifted child who is asked about the future. "I want to serve society" blurts the child. "I want to be a doctor". Funnily enough no one seems to realise that becoming a teacher is also service to society - but doctors are thought to be "serving society". And of course we all know that social service must be done gratis. Free. Phukat. Or at least the doctor must at every instant of time be conscious of the fact that the patient is almost invariably poor, or, if not poor, has a daughter's wedding coming up, or has already spent a lot of money on other doctors and other treatments and is now coming to this doctor as a desperate last resort because he has finally heard of this doctor's great skill and compassion.

This is all very well but it is simply unrealistic. Ill health is only a problem for people who suffer from it. For the "health care industry" Ill health is supposed to be a profit making business. Like food and clothing, medicines are sure fire sellers - with huge and unceasing demand. Wealthy multinational Insurance companies are reported in the finance pages of newspapers as wanting to enter the "emerging market" of India's health care industry. To them it is a market where their product is sold, and making a loss or being charitable are not part of the business plan. Doctors are a small cog in this huge business. They have to slot themselves into a position where everyone around them is intent on making a profit while they show the empathy and compassion.

If a patient needs an operation, the first person he must ask about the cost and the person he must depend on is the doctor. The doctor has to make a rough estimate of how much the hospital charges will be, how much the tests and medicines will cost and how much his own charges will be along with the fees of other essential doctors whose skills will be needed. The pharmacy is in it for profit and cannot give a concession on medicines. The hospital is a business - it could be a company with public shareholders. It must show a profit. Ultimately it is the doctor who is required to make a sacrifice and adjust his fees to suit the patient's pocket. The doctor is a "third party" who neither sells medicine nor has control over what the hospital charges.

The three primary "health care delivery parties" are the medical shop, the hospital and the the doctor. The medical shop is a business that sells products at a suitably marked up price to make a profit. The hospital is like a hotel where charges depend on the facilities offered. A general ward, more crowded, less privacy is less expensive. A private room with more space, a bedside telephone and a TV attracts a higher charge. If the patient can afford more, he has the choice of paying more and getting more.

Doctors give exactly the same treatment to every patient, whether the patient is in the general ward or the private room. Therefore doctor's charges must remain exactly the same no matter where the patient happens to be. This is an area where doctors have allowed themselves to be trapped by what I think is an unethical policy. Many corporate hospitals allow only lower doctor's charges for patients in general wards and higher doctor's charges for patients in private rooms. This is an anomaly. Should a doctor charge more for the same treatment just because a patient can afford a more expensive private hospital room? Or should a doctor accept a lower charge for his skills if the patient chooses a general ward? It is almost impossible for a doctor to give lower quality treatment to a patient in a general ward but he is forced to accept lower fees for the same skills compared to a patient in a private room. Doctors actually sign contracts to accept these terms and I think it is only a matter of time before some legal eagle points out the anomaly in different charges for the same treatment.

As far as I am concerned, I charge the same fees whether a patient goes to a general ward or a private room and I state my fees up front, telling the patient that he can himself make his treatment less or more expensive by choosing a general ward or private room. I feel that by doing this I am being transparent and not encouraging the dubious practice of different charges for the same service. Hospitals that have built in anomalous charges for the same service will, in the course of time, have to take note.

Trying to include accountability in hospital practices
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Long and detailed post about my follow up on the bad billing practices at Fortis. Read only if you feel like it.

I spoke to an advocate friend of mine yesterday about the possibility of taking Fortis to consumer court. We agreed that it would take a lot of my time, effort and money. But mentioning consumer court to Nayna Pai (Customer Care exec) at Fortis has resulted in Dr Manish, the head of the hospital, agreeing to meet me after my appt with Dr Priyadarshan (that is another story...my wrist and elbow are extremely painful after a month, and the scar is absolutely ORIBUL, so I am going to ask if the scar can be reduced and made more aesthetic.)

Today my advocate friend called me back. She feels that I can make the case that the contract that the patient signs with the hospital must include a clause whereby, if there is cause for a complaint by the patient (could be medical negligence, bad billing practices, or whatever), the patient can meet the hospital representative with a legal mediator ( the cost of the mediator being shared by the patient and the hospital, or by the hospital) and the complaint thoroughly looked into and settled.

As this kind of accountability is what I am looking, for, I asked if someone she knew could come along with me on Thursday. She has suggested someone who is an advocate and a mediator, who can come along with me on Thursday. I don't know if we will make any headway on the accountability thing...but I am going to try.

Crows using vehicles to crack seed pods! Ragihalli, 211017
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I had read about how crows put nuts and seed pods in the way of approaching vehicles on roads and then eat the cracked nut.

here

is a very erudite study which does not rule out the possibility of crows using vehicles in this way, but suggests that they only drop the nuts on the road to crack them.

However, at the Ragihalli sheet rock area in the Bannerghatta National Park, on 21 Oct. '17, we observed a Jungle Crow which definitely seemed to use the oncoming vehicles to crack the tamarind seeds that it was bringing, and then going to the road to eat the exposed soft tamarind.

Here's the crow, which deliberately (and fearlessly) the crow leaves the seed pod and flies off only when the vehicle is almost upon it.



Here, the crow flies in after the vehicle has passed. You can clearly hear the excellent description of the crow's behaviour by my friend Aishwary Mandal in the video.



Birding is not "ticking off" birds that we've seen...it's also watching and learning more about the feathered creatures around us...sometimes they surprise us with what they do.

A blank wall
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When I think of Death, I face a blank wall.
I realize that I do not know Death at all.
Will I just stop? Will I cease to be?
Or is there, just further, what I cannot see?
Will I be born again?
As a human, or a worm?
Would I move in someone's bloodstream...
A single-celled germ?
Would my spirit float free?
Would my sins be wiped out?
Would I live on, just not me,
Only when I got talked about?
Would I really exist, apart from this shell?
Would I ascend to Heaven, or just go to hell?
For the answers to these...
Upon whom can I call?
I can ask as much as I please...
No one knows Death, at all!

?

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