Old is NOT always Gold


So for those of you who don’t know me, I am a freshly graduated Doctor from Mumbai. For those of you who do, well; skip the first line. I recently returned from a Neurosurgical Conference in Gurgaon, a city in the northern part of India. During the discussion, which was largely based on the use of intraoperative imaging in neurosurgery, I observed one thing. Man is, and has always been resistant to change. Now, Darwin might beg to differ, after all we survive because we adapt to change quite well, but you get my point. I see this especially in India where the attitude is that “itne salo se chal raha hai, badal ne ki koi jarurat nahi hai” which translates to ” it’s been going on for so many years, why bother changing”. Technology is not embraced as willingly as it should. What does this have to do with my conference? See this argument came up at one point, where someone said, the introduction of better imaging capabilities has led to the downfall in clinical diagnosis. In the past, neurosurgery was done purely on clinical diagnosis. This meant you had to be very good at picking up subtle hints from patients. But today the role of clinical medicine is rapidly declining. That’s not to say it’s a vital step. I can’t imagine a Doctor asking for investigations without getting a rough clinical impressions. But, let’s say I am equal to the medical legends of the past, would you still let me operate on you simply based on a weakness in a muscle without imaging you. I hope not. When a surgeon is operating using, what is today’s trend of minimally invasive surgery, wouldn’t you rather have him see in real time with the help of images or a navigation system (which is widely used in neurosurgery, similar to the technology used by drones to self navigate themselves) where he is at in the patients brain and how he should proceed. People in the past were excellent at distinguishing normal tissue from abnormal but they weren’t perfect. There was still a high level of error and morbidity. Let’s face it, the human eye is only capable of telling you so much.

Then comes the argument that when for whatever reason this technology is not available today’s doctors struggle. I don’t see where this argument is going. The debate should be on why this technology is not available rather then what the doctors shortfalls are. So yes, at the cost of being rubbish without gizmos, i’d rather be the best with some. In the 1920’s when William Bovie invented the electric cautery to help with bleeding during surgery, procedures were routinely performed without it. It would be unthinkable today to do a procedure without one. Does that mean residents should be trained to operate without one in case it’s not “available”. I can’t see that happening unless the apocalypse hits. Then again, if it does,I doubt much of surgery will take place.

This got me thinking. There is this notion that in the old times there was less disease, people were much more healthier, so we should do what they did. That is incomplete logic. It’s like the logical fallacy post hoc ergo prost hoc ( after this therefore because of this). Firstly, people had disease. Probably more than today’s world. They lived shorter. There’s an argument that heart disease and the dreaded C weren’t as prevalent in the older times as they are today. Who said it wasn’t? How many blood samples were collected for testing 200 years back? How many deaths were attributed to the Gods rather than simple heart failure? So modern technology has it’s own problems like bringing obesity and back pains and cancer due to radiation exposure. But the age old times people died of stomach infections, pneumonia and wound infections far more than people die today. Yes, maybe diet and lifestyle was better back then and there is certainly value to ancient Indian medicine, but unless we can prove how it works and more importantly IF it really works, i’d rather bet my life on a doctor saving me then a potion promising to cure me of cancer. Again, I’m not of the belief today’s medicine is flawless. It certainly is far from it. It’s a continuous learning branch of science. We haven’t figured out everything. Ancient medicine has a lot of answers which we don’t have and it certainly has given a lot of answers to modern medicine, but blindly saying that in our times we used to take a mixture of this to cure malaria so I’ll skip the drugs, seems ridiculous to me.

Let’s take another aspect of my life. Running. In the past, if you want to be a good runner, you run fast and run hard and work your ass off. It still certainly holds true today, but now it’s about adjusting your training. There’s fartlek, interval runs, tempo runs, hill repeats and so on. You do core strength exercises and stretches. It’s a fact people are getting faster and running longer today. Science has helped with that. If I say, all this is rubbish. To be a good runner, I have to just run, i’ll never beat the world record for a marathon( haha not to say that if I train properly I will). There’s a global movement for barefoot running. Now i’m not saying it’s bad. But it also has it’s own variety of problems. Cushioned shoes in the market today might not be the answer, but simply dismissing it and moving to barefoot running because that’s how our ancestors ran is certainly not. Unless you can prove scientifically that it’s better, i remain a skeptic. The day that’s done, I’m all game for it.

Yes. The things from our past were certainly good. Look at the benefits Yoga has brought to the world. But change is good and embracing improvements shouldn’t be this hard. We learn from the past and try to improve on it. Iphone 3 was better than the 2. Iphone 7 may not be better than the 6. But to continue using an iphone 6 for your whole life because it worked for you at one point and to say, “that’s what everybody used at that time” is hindering progress. My argument isn’t against ancient methods, it’s about trying to understand what was better then and what is better today?

What do you think?


What I thought about while I was running.

Alas, what I'd do without you Sunnto!
Alas, what I’d do without you Sunnto!

Now before you say anything; yes, the titles been inspired from the book What I talk about when I talk about running by Haruki Murakami, which by the way is a fabulous read. So on this very pleasant Sunday morning at 4:15 a.m. I set out to attempt my longest run till date. For the avid runner it was a modest 29.7 km distance. I’ll confess I’d aimed to do 35 but a combination of fatigue, lack of a will power after km 28 and my new Asiscs hyperspeed 6 which I was not yet fully used to( having lesser cushioning then the shoes I’ve used in the past and being flat footed, my arches decided to go on a strike). Very well maybe next time.

So, at approximately 4;15 a.m. I left my house. Just 600 meters into the run I land up bumping into this group of people who were probably returning from a party somewhere. I’m quite certain they looked at me with curiosity! What creature runs the streets this early, that to on a Sunday morning? Given my running routine in the last few months I was equally amazed to see them. So I ran on, thinking how unthinkable this would have been for me a year back attempting to run at 4:15 on a Sunday morning. How life changes!

As I was running along, seeing a number of stray dogs fast asleep my mind drifted to the comfort of my own bed. “When will this insanity stop? Normal people sleep in on Sunday mornings!”. Another part of my brain promptly replied, ” I’m really hoping never!”. See once you’ve tasted a better life, one where your fitter, you don’t really want to go back. I’ve been moving forward in my short life as a runner with this amazing momentum. I reminded myself of a line I heard on a Nike commercial that momentum is a cruel mistress who could turn on a dime with the smallest mistake, ever searching for that weak place in your Armour. I knew if I give in to comfort now, It’s only gonna get tougher the next time.

So I’m nearing Sion now, roughly 9 km into my run. See I planned a route, so that I’d pass by the one place I visited nearly everyday for the past 6 years, Medical school! Now I knew running to medical school was no big thing for me now. It’s 14 kms away and that’s a distance I’m quite comfortable with. But in the past, with the Mumbai traffic and my sheer lack of running ability, the notion of running there seemed absolutely ridiculous. Ha, I was so wrong. I’ve graduated from med school 6 months ago and it felt nice to pass by a place I was so familiar with yet it seemed so alien today. All the times, taking a good 45 mins to get there, rushing through the traffic, honking my way, struggling to reach the wards before my unit head got there. Who knew this was all a run away.

Quite comfortable at this stage, I thought I’d be able to do a full marathon distance. Experience has taught me, how quickly comfort turns to sheer agony, running with amazing speed can turn to laboring on nothing more than will power very quickly. Baby steps I told myself. Lets get to 21 km first. My last half marathon taught me the ill effects of overhydration and the relative hyponatremia(low sodium) it can cause. I had a 500 ml bottle of water in my hand, which was starting to run out and I was determined to make it last till 21 km.

Somewhere in the depths of chembur, I reached that golden 21( see I’d decided midway through my run that I’d keep moving forward till I reached 21 km so that turning back I’d be able to complete a 42.2 km run just as i reached home. Pffft dreamer!!) . Turning back, with it being around 6:15 in the morning I looked out for a store to refill my bottle of water. I briefly entered a stray dogs so called “territory” and he kept following me albeit at a distance(haha chicken), emphasizing with his loud barks that I was trespassing. I reminded myself, “a barking dog seldom bites”. Not aware of the origins of that line I wasn’t prepared to test that theory. I ran ahead, certain that in this drained out state of mine I’m wouldn’t be capable of outrunning a dog (maybe the scent of my canine buddy back home, smeared all over me, angered this particular dog, I don’t know.)

So nearing 25 km, pretty exhausted and my feet cursing me. I dropped to 7 min/km pace. All that mattered today was putting one foot forward after another. Speed was the last thing I cared about. At 26 km my dreams of a 42.2 km distance were drifting far away. The last 3 km I ran were by far the toughest I’ve run. I used every trick I had to keep moving. Motivational books( I remembered the chapter “pain only hurts” from Eat and Run by Scott Jurek). Even the Rocky Balboa scene popped in my head. I imagined Rocky screaming at me “It aint about hard you can hit, It’s about how hard you can get hit and keep moving forward, how much you can take and keep moving forward!”. Even a wonderful blog by Amit Sheth titled “men in boat” came up. But at 29.7 km, my mind gave up. I rarely say my body gave up. It’s usually always the mind that caves in long before your body does.

Don’t get me wrong I’m super proud of my run. It’s the longest distance I’ve covered. 8 months back when I started running I had mustered a huge 100 meters. Today I’ve run 29.7 km. Not to mention how much thinner and fitter I am. But as the saying goes “yeah dil mange more”(the heart wants more). Sitting here writing this, the feeling of my aching muscles gives a weird sense of pleasure only long distance runners would understand. I fear the day I’ve reached my maximum. But then again that’s a myth. There always no pace too fast and no distance too long to conquer, right? With people out there doing a full marathon in just over 2 hours, I can always get better.

I leave with a quote from arguably one of the greatest marathon runners, Emil Zatopek ” To boast of a performance which I cannot beat is merely stupid vanity. And if I can beat it, that means there is nothing special about it. What has passed is already finished with. What I find more interesting is what is still to come.” Happy Sunday to you!