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The New York Times recently had an interesting article “Does Your Doctor’s Age Matter?” It was authored by Dr. Haider Javed Warraich, a 29 year old Fellow in Cardiovascular medicine at Duke University Medical Center. In the article, Dr. Warraich states that, when it comes to choosing a doctor, patients place a premium on age because they equate age with experience. Dr. Warraich argues that “In medicine, a lack of experience may actually not be a bad thing” and to support his opinion he cites a Harvard research study which says that patients treated by younger doctors are less likely to die. The study concluded that younger doctors are less likely to 1) order unnecessary tests 2) to face disciplinary action and 3) be cited for improper prescription of opoid painkillers and controlled substances. It also found a positive correlation between lack of experience and better quality of medical care. Younger doctors were found to be more likely to use innovative practices, learn new procedures and be free of relics of the past.

Now, I have the highest respect for Harvard University but I find it difficult to accept these findings. For one thing, I have no idea how pronounced the results were in favor of younger doctors. How strong was the correlation between lack of experience and better medical care? Furthermore, some of the conclusions seem contrary to what common sense tells me. It seems to me that younger doctors, because of their inexperience, would be less confident and thus likely to order more tests rather than less.

I prefer to trust my own experience with doctors even though it is anecdotal.

To begin with, let’s agree that age and competence are not mutually exclusive. There are some good young doctors, some bad ones and many in-between. There are also some good old doctors, some bad ones and many in-between. I would not choose a doctor solely based on age. If a good friend strongly recommended a doctor (and if that doctor accepted my medical insurance), I would want to be his patient regardless of his age. I will admit that if a doctor was very youthful, I would be a little uneasy about his skills and I would definitely be uncomfortable dealing with him because of the generation gap. Contrary to the Harvard study, which said that younger doctors are “more likely to place the patient on a pedestal than themselves”, I have found younger MDs to be brash and less respectful. Sometimes, I also feel they are less interested in older patients, an unspoken vibe that “You have had your innings already.”

The one thing that I will agree with is that younger doctors are likely to be more innovative and open to new procedures and techniques. I remember that when my wife was considering a knee replacement we were very impressed by a local surgeon who had performed thousands of such operations and received the highest accolades from his patients. Then, a close friend told us of her experience with a surgeon in his forties who used new techniques that resulted in less invasive procedures, smaller incisions and a much reduced rehabilitation period. My wife doesn’t need the surgery anymore but, if she did, I know which one she would prefer.

On the other hand, medicine is not only a science but an art. Med school is only the beginning of a doctor’s education. The greater part of his education occurs later as he hones his skills on real world patients, real life situations. I remember a doctor who used to practice in Rahway. He was not impressive in his appearance or manner but his diagnostic skills were phenomenal. He was able to accurately diagnose what was wrong merely by listening to a patient’s description of symptoms and by asking the right questions. His patients loved him and valued him highly. His office receptionist once said to me, “If I ever fell ill, there is no one I’d rather have as a doctor than Dr. M.”

Insofar as choosing a doctor for myself is concerned, I would opt for the one who was strongly recommended, regardless of his or her age. Wherever possible though, I’d choose one who was in his or her fifties or younger but that is for a practical reason. I want a doctor who is not close to retirement age, one whom I can rely on for the next several years.

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While watching the smash hit  Netflix series The Crown, I was struck by how the Duke of Windsor has gone from being a hero to a shallow,  selfish dilettante and quite likely a Nazi sympathizer. Initially, he was admired by many of my parents’ generation for giving up the throne of England to marry the American divorcee Wallis Simpson. That view has long since been discarded. Historians now feel that it was lucky for his country that he abdicated, paving the way for his younger brother to become King George VI.  By all accounts, the latter was a man of sterling character who overcame his insecurities and worked well with the wartime prime minister Winston Churchill to guide Britain through her darkest days. The Duke meanwhile was an embarrassment who was appointed Commissioner to the Bahamas to keep him out of the way and spent his later years as little more than a pitiful shell of a man who spent his days travelling and attending endless parties.

An even more striking example of changing perceptions is Herbert Hoover, the most derided American president of his time. His image is forever tarnished by his ineffectiveness during the Great Depression  which began in October 1929, just eight months after his inauguration. Hoover’s insistence on balancing the budget even at the cost of raising taxes sent the economy into a tailspin from which it never recovered until FDR succeeded him. And yet, there was much about Hoover that was laudable. His early years read like a Horatio Alger story. Orphaned at age 9, he was sent to live with an uncle who disregarded the young boy’s brightness.   He was sent to work as an office boy even  before he completed high school. At age 17, he passed an entrance exam that enabled him to attend Stanford University, then a free school. After graduating from Stanford with a degree in geology, he was unable to find an engineering job. He took a job loading ore carts at a gold mine in Nevada City  CA, working 10 hours a day, seven days a week for the miserable pittance of ten cents an hour. After several years of this dead end job, he was chosen as trouble shooter for a British mining company where he rose to become chief engineer. When World War I broke out he helped evacuate Americans stranded in Europe by the war and displayed remarkable efficiency in bringing home 120,000 of them home. His finest moments were after the war when he was chosen to head The Committee for Relief in Belgium. At the time, Belgium was in sad shape , its  farms destroyed, its factories shut and its food stocks depleted. The Belgians were in grave danger of starving but Hoover managed to supply them with 20,000 tons of food, every week for a period of 2-1/2 years – a feat which made him an international hero and earned him the title of the Great Humanitarian. However, a  recent book by Bill Bryson is not so laudatory. Bryson’s book says that Hoover missed no opportunity to publicize his humanitarian work and that others, such as Myron Herrick, the U.S ambassador to France worked just as tirelessly but never sought the spotlight. So how should Hoover be remembered … for his humanitarian feats or for his ineffective Presidency? There is no easy answer.

In bygone days, celebrities were usually protected from the results of their peccadilloes and their character flaws hidden from the public. JFK , for instance, was  a serial womanizer whose affairs were kept under wraps until long after his assassination. Journalists felt an obligation to do so out of respect for the President, the position not the man. In those days, there was too little information about public figures. Nowadays, there is too much. Every action is dissected, audio and video equipment intrudes on every moment, public or private. News is mostly opinion and it is difficult to know what the truth really is.

The British cricket writer , Peter Roebuck, tells in his autobiography of a chance encounter with a soldier.  At the time, Roebuck had been dealt with rather shabbily by the powers that be. The soldier approached, shook his hand, wished him well and said” The closer you get to men of substance, the more they seem like shadows.”

How true.

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Friends had long ago told us about the Netflix series The Crown and how good it was but we put off watching it. “How interesting could it be?” we thought. I am not a fan of the British royal family and Queen Elizabeth has always struck me as a colorless character, her monarchy boring. Consequently, my wife and I didn’t watch The Crown until two weeks ago. Then, in the space of eight days we raced through both seasons ( 20 episodes) and absolutely loved it.

These first two seasons ( I believe a total of six are planned) cover the early years of Elizabeth’s reign which began in 1953. The first episodes provide a preamble to her ascension to the throne with flashbacks cluing us to the circumstances that led to it , notably: the abdication of Edward VIII ( later The Duke of Windsor) and the short reign and early death of George VI, Elizabeth’s father. We also get vignettes of Elizabeth’s childhood: her father’s affection for her and her sister Margaret, and her marriage to Prince Philip her impoverished second cousin from another branch of the family.

The series is a masterly collage of scenes that give us a sympathetic portrait of a young woman, totally unprepared for the monarchy, who nevertheless grows into it, overcoming government ministers who look down upon her, palace intrigues, a petulant husband who feels emasculated by his role as Prince consort and a train of events that she has no control over but which will reflect upon her as the Queen of England. Among the problems she has to deal with: her sister Margaret’s dalliance with a married man Group Captain Peter Townsend, and her later marriage to Antony Armstrong- Jones; the aging PM Winston Churchill, at 80 a shadow of his former self who still thinks of himself as indispensable; his successors Antony Eden beset by health problems and in over his head  and the weak ineffectual Harold McMillan; the Suez crisis; the breaking away of Britain’s African colonies beginning with Ghana and, in the last episode of the second season, the Christine Keeler scandal which threatened to ensnare Prince Philip if only because of his connection with Stephen Ward the osteopath and procurer who committed suicide before he could be tried.

As she overcomes these problems, Elizabeth is shown as growing from an inexperienced, under-educated unsure young woman into a true monarch even though she has limited powers. Claire Foy is magnificent as Queen Elizabeth, portraying her as one imbued with a strong sense of duty, dignified, hardworking, vulnerable and lonely and yet possessed of a quiet strength that comes through when she needs it most. The scene in which she stands up to her uncle, the Duke of Windsor, and turns down his quest for a meaningful job is a masterpiece. It made me want to stand up and cheer.

She is ably supported by the rest of the cast particularly Vanessa Kirby as Princess Margaret, John Lithgow as Winston Churchill and Alex Jennings as the Duke of Windsor. The one weak link, in my opinion, is Matt Smith who plays Prince Philip and turns in a one-dimensional performance. Other strengths of the series are the excellent writing ( Do people in real life really express themselves so well?), the attention to historical detail, the costumes and the pageantry and the lovingly photographed English countryside.

The Crown does not have violent scenes, nudity or even partial nudity. Neither does it have epic  battle scenes. That it yet is so gripping is a tribute to the acting, the smooth pacing of the unfolding story and the superior acting and writing. There was one episode, about Prince Philip’s  struggles as a young boarder at Gordonstoun which I thought was given more screen time than necessary. I understand how it led to his insistence that Charles follow in his footsteps and attend that school but surely it need not have taken up an entire episode. I would have much preferred to know more about the early attraction of the young Elizabeth to Philip , as also the way in which both Elizabeth and Philip neglected their children, particularly Charles.

Growing up in India in the fifties and early sixties, I was exposed to more coverage of the British royal family than most Americans. Once I came to the U.S in 1968, I ceased to follow news reports about them and read only the major stories about them such as the death of Princess Diana and its aftermath. Consequently, most of what I knew about Queen Elizabeth pertained to the early years of her reign. I certainly didn’t know the extent of the Duke of Windsor’s Nazi sympathies or what a bounder Antony Armstrong Jones was or the suggestions ( in this series) that Philip was a womanizer who played around.  I am sure the writers and producers of the Crown have a solid factual basis for the events described in the Crown but have no way of knowing which of the details are imaginative extensions of the truth. This, after all, is faction ( a blend of fact and fiction) or ” creative non-fiction”.

Whatever be the case, the series has left me impatient for the next season. Until then, I am going to bone up on stories about the British royal family. Already, I have gotten from the library a book on Prince Philip. In The Crown, Philip does not come across as a likeable character. He is always whining, obnoxious and loudmouthed, resentful at his secondary role, harsh with Prince Charles and not there for his wife when she really needs his support. I didn’t like him even before I saw The Crown but was he really that bad? The book I have seems to say that he was a talented man with many accomplishments to his credit. I want to find out if that is really true.

 

 

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Handwriting

I miss writing. Not writing per se, but writing by hand … the act of putting pen to paper which today is obsolescent and fast becoming obsolete.

Don’t get me wrong. I fully appreciate the convenience of typing rather than writing things out longhand with pen or pencil. I am old enough to remember the days before word processors when office memos had to be typed out by secretaries. I marvel that they were able to reach speeds of 35 -40 words per minute with few, if any, mistakes. I also remember how difficult it was to white -out the occasional error .

When computers became common I was initially resistant to using them because I’d never learnt typing. I quickly changed because it was so much easier to compose my memos and articles. With computers, it is so easy to change words here and there, to shift sentences and paragraphs, to edit and revise. It would probably take me four or five times as long to write this piece if I had to write it out in pen or pencil. Not for me, the old way of doing things.

And yet…

I miss the physical act of writing and all the steps it entails.  Sharpening pencils. Getting out the writing paper, the eraser.  Sitting at the table staring at the blank page can sometimes be frightening but, oh, the pleasure of  getting the words down on the pristine unlined paper. Rounding the g’s, crossing the t’s, dotting at the i’s… it’s beautiful, it’s satisfying, it’s personal, it’s sensual. When I look at the completed page, I feel a sense of accomplishment. This is MINE. I don’t feel nearly the same pleasure as when I look at my type written work. Yes, it’s neat, it’s compact, there are no spelling mistakes thanks to Spellcheck but.. it is almost too easy.

Writing is also a link to the past, to others. I still have some few recipes in my mother’s handwriting, some letters that my father wrote. When I look at them, I can see them, my parents that is, as clearly as if I were looking at a photo. They have been gone many years now but I can clearly see their handwriting in my mind’s eye. I can’t say the same about my children’s handwriting. They do most of their writing on the computer and, except for their scrawled signatures, what their handwriting looks like.

Precisely because a word-processor is so easy to use we have seen a decline in writing skills, a carelessness in the way we communicate, a creeping disregard for the beauty of language.  Most people are just concerned with just getting the task of writing over with. They see no reason to be exact, no need to learn correct spelling . After all, that’s what Spellcheck is for, isn’t it? In much the same way that calculators have led to a loss if our mathematical ability, computers have caused a decline in our language skills.

When I started to write this piece, I was thinking primarily of the lost pleasures of writing by hand. I accept that typing on our computers is the way to go but I find opportunities to write in pen or pencil. For instance, at the discourses  we attend on Saturdays, I make copious notes. So do many other attendees but, even here there are some who can be seen tapping away on their I-phones. You’ll never see me doing that. Never.

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The director Judd Apatow once bought a home gym. After using it three or four times, he stopped lifting weights and the gym fell into disuse. He didn’t get rid of it, however. It still sits in a corner of his office where it functions as a storage room cum clothes hanger. Apatow tells himself that it could be used one day. As he puts it “ … anything’s possible. All hoarding is hope. You think ” I can’t die because I have to watch that stack of DVDs! Makes you feel immortal, having too much stuff.”

Really? For a moment I thought that Apatow might have hit upon something. But , upon further consideration, my reaction is ” Nah!”

I have a friend who has 5,000 records and CDs. He is retired now and is busy cataloging his collection and , of course, listening to his favorite songs over and over again. Another friend is at once a bibliophile, a film buff  and a music lover. In his house he has a large loft, three walls of which have shelves containing his collection of books ( many of them autographed by the authors) and CDs and DVDs. He admitted to me that there is no way he could possibly read, listen or view his entire collection. Once in a while ,he may dip into this or that but his chief pleasure is in owning that collection and knowing that he can access it whenever he wants. I myself had a large collection of books ( particularly cookbooks) before I gave half of it away to an acquaintance. What remains is still sizeable and I have no illusions that I will read all those books again or cook one tenth, one-hundredth of those recipes. I like having those things around because of the pleasure of possession.

A good friend of mine put it perfectly. He said” I have boxes and boxes of stuff, most of which means something only to me. These things are not valuable but I will never get rid of them. One day, when I am gone, my son and daughter will go through the things in my garage , then call the junk man and have them hauled away. That’s OK but, as along as I’m around, I want them.”

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Two weeks ago, there were three Test series simultaneously in progress: New Zealand- West Indies, India – Sri Lanka and the Ashes Tests between Australia and England. Three of us – all of Indian origin- were following the cricket on TV and all of us plumped for the Ashes over the other two series. Granted this was the most competitive of the three  series but, had it not been so, we would still have preferred to watch it. Why? What is it that makes the Ashes so compelling even when the teams are not evenly matched ?

Part of the charm can be traced to tradition and the regularity of these contests. England and Australia have been competing in these series for more than a hundred years and the prize for which they vie ( the ashes of bails used in a long ago contest) adds to the mystique. Even though, South Africa, India , Pakistan and New Zealand often have strong sides and play good cricket they do not play each other with any regularity; traditions and rivalries have not developed to the same extent. But there is more to it and, in my opinion, these are the reasons:

The pitches and the conditions make for a more even contest between bat and ball. In Australia,  pitches are hard and fast, a paceman’s delight. Speedsters are able to menace batsmen with sheer pace and high bounce. In England, the heavy atmosphere enables the quicker bowlers to move the ball in the air and confound batters. Spinners play a supporting role to fast bowlers but, when they are really good ( Warne/ Laker), are equally a threat to opposing batsmen. And yet,  when batsmen are up to the challenge, it is a delight to watch them master opposing attacks before cutting loose.  In contrast, pitches on the subcontinent are usually batsman-friendly featherbeds on which bowlers ( particularly pacemen) toil without reward. Whether by accident or by nature, the pitches tend to break up in the latter stages of a match so that winning the toss plays a larger part in determining who wins the match. Sometimes , as happened at Nagpur and Pune the past year, the pitches are prepared to be unplayable  minefields where the best batsmen in the world struggle against even ordinary bowlers. In either case, it is an unfair contest and not as interesting to watch –  unless you are one of those ” fans” who wants your team to win at all costs.

Because of the nature of the pitches in Ashes tests, the result is often in doubt until late in the match. In the test now being played in Perth, at the end of the first day’s play, England were in a great position at 305 for 4.The morning of the second day , Malan and Bairstow carried on where they had left off overnight and took the England total to 368 for 4. A huge total, 500 even 600, seemed likely. Then the unthinkable happened and the last 6 wickets fell for only 35 runs. England were all out for 403, a good total but not formidable. It looked even less daunting at the end of the day’s play with Australia at 203 for 4, and Steve Smith still unbeaten on 92. Suddenly, the Test which had appeared to be in England’s favor was dead even ( perhaps even slightly in Australia’s favor). Considering that Australia have to bat last, it is not possible to say with certainty what will happen next. Either side could win or it could end in a draw. Whatever the outcome, cricket fans will be captivated until the end. In comparison, particularly in matches in the subcontinent, the result is often a foregone conclusion by the second day’s play and, once one side has established an advantage, the result is never in doubt. Most often it is a victory for the side batting first; otherwise, it ends in a tame draw.

In Ashes tests, because the pitches do not deteriorate as fast, it is possible for underdogs to battle for a draw. That too makes for a compelling spectacle. Such tussles which feature dogged resistance and fightbacks against hostile bowling are full of tension. Runs may be slow in coming but that is immaterial. Defending one’s wicket is the order of the day and spectators watch every ball with bated breath. Such draws are different from those mentioned in the earlier paragraph where there was never a chance of a decision.

Finally, the Ashes usually feature good fast bowlers on both sides and, for me, it is a most exciting spectacle. It is thrilling to watch a genuine speed merchant gallop to his mark and hurl a thunderbolt to the crouching batsman. The latter has only a split second to decide whether to play the ball, duck or sway out of its path or leave it to thud into the gloves of the wicketkeeper. Every delivery is an adventure. Spectators feel a frisson of excitement because of the element of danger; a slight misjudgment on the part of the batsman could result in a catch or an lbw shout or , God forbid, injury. Helmets and pads provide some protection but a 145 kph delivery thudding into the ribs can cause severe damage.

And those are the reasons why I like to watch the Ashes.

P.S Some of the reasons I mention are, of course, generalizations. They are not always true. South Africa often has a good pace attack, Indian groundsmen sometimes prepare sporting pitches and Ashes contests sometimes result in 5-0 whitewashes. On the whole, however, my reasons hold good. At least I think so.

 

 

 

 

 

 

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Some years ago, when we were in Siena, Italy our guide told us about pro basketball as it is played in Italy. He described a match between Bologna and Siena played on the latter’s home court before 6,000 frenzied fans. Before spectators could enter the arena, they were searched for concealed weapons. Just before the game started, five busloads of Bolognese fans were escorted into the stadium by policemen in riot gear. They took their places in the visitors section – a virtual cage surrounded by metal bars. This was for their own protection as soon  became apparent. When the home team took the court, the visiting fans played drums and trumpets , then turned around as one, dropped their trousers and mooned the home fans. This resulted in an outpouring of rage as Sienese fans stormed the cage , throwing missiles, cursing and spitting through the bars of the cage. This set the tone for the rest of the proceedings which featured rude chants, constant drumming, taunting and frequent stoppages of play due to court invasions. When the visiting team won the game on a last second three pointer, there was a full scale riot during which the police were overwhelmed and dozens of fans wound up in hospital. I wish I could give you more details of the game but will not do so because I cannot do so without bursting into gales of laughter. It really was too funny though not to the participants. For them , these basketball games are deadly serious: a re-enactment of past struggles when city states were bitter enemies that fought constant wars over territory.

In comparison, American sports fans are well mannered and civilized. But, only in comparison. There are certain rivalries in American sports which generate the worst in people. One of them is that between the New York Yankees and the Boston Red Sox, two baseball teams many of whose fans hate each other with a passion. In the Bronx, there are certain bars which are for Yankee fans, others which cater to Red Sox fans. Woe betide the unwary fan who strays into the wrong bar. I remember reading about a fan wearing a Red Sox  journey who was walking home from a game at Yankee Stadium. As the fan passed a ” Yankee” bar, another fan came out and challenged the former to a fistfight. What blew my mind was that both fans- the Red Sox fan and the Yankee fan- were women ! Yes, women fans can be passionate too.

Too my mind, football and ice hockey attract the most aggressive fans because of the nature of the games and because more drinking goes on during these contests. My acquaintance Steve told me about a game between the Philadelphia Eagles and the Detroit Lions that he attended in Philadelphia. He was not a particular fan of either team but when a Lions receiver made a spectacular catch he applauded . At the time the Eagles were leading 38-9 and the game was not in doubt. However, an Eagles fan took umbrage and started directing obscene comments and threats at Steve. Steve took it quietly for some time but it finally got to be too much. He was there with his young son and did not want to give him the impression that he was a wimp. When the Eagles fan went too far, Steve got up and challenged him to a fight. Luckily, cooler heads prevailed and the other guy backed down. This is not to criticize Eagles fans; Giants fans, Jets fans are just as bad.

There was a time when visiting fans clad in their team’s colors could sit anywhere in the stadium, in the midst of home fans. They would have no fears for their safety. Both sets of fans would watch the game without fear of violence. This is still mostly the case but increasingly I read of altercations between fans of opposing teams. This is a pity because I fear such people are missing out on the real beauty of the contest they are watching. They may call themselves sports fans but what they really are fans of a particular team, not of sport.

My friend Arnie used to support all the New York teams at a time when none of them was doing well. Towards the end of the basketball season, as soon as the Knicks were mathematically eliminated from the playoffs, he would say ” OK. Game over. Time for hockey.” He would stop following basketball and switch to reading about hockey.A month later, the scenario would be repeated . ” Time for baseball”. And so on. It’s OK to root for a team but when you identify so closely with its successes and failures, you open yourself to disappointment.

 

 

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