Hospitals and Train Stations

From guards manning multiple entry points, greedy auto drivers at the entrance, turnstile access on the ground floor, sea of humanity conversing in different languages (Telugu, Tamil, Hindi, Bengali, etc.) to food carts rolling in for purchase, there seemed no difference between Apollo Hospitals and the Central Railway Station. 

The last time I was at Apollo was probably 5 years ago, despite multiple specialty hospitals mushrooming in the city this place continues to be a beehive attracting patients from across India. From consultations, admissions, insurance, to pharmacy there is a method to madness and on every visit I discover something unique in the medical business.

During my last visit to Apollo, I noticed some radiologists working without lead jackets and discovered many worked beyond the stipulated hours thereby exposing themselves to excessive radiation. Is it a supply demand issue or is it the quota or target system that is operational across most corporate hospitals, where everyone on the payroll carries a monthly target? Why would someone in the medical field who understands radiation risk over expose themselves?

The innovation in the medical field continues to surprise me and what was earlier a hospitalization procedure is now a day procedure. Nevertheless, hospitals and insurance companies continue behave like snake and mongoose going after each other’s throat.

I was at the hospital a day prior to get an admission note from the doctor and his secretary suggested that I explore the insurance route and sent me to the insurance desk. At the insurance desk, a hospital staff handed me a bunch of forms to be filled out and explained that the procedure will cost Rs 36,000 with insurance and Rs 25,000 if I opted to pay out of my pocket. This explains to me why the insurance companies and hospital behave like snake and mongoose.

Like a boomerang, I was back at the doctor’s office to get the insurance paper signed off. After an hour, the doctor surfaced and convinced me that the insurance route might be a difficult as the preliminary test results showed nothing irregular establishing the need for further medical investigation. He convinced me that I must opt to pay from my pocket and take it up with the insurance company in case they discovered something unusual.

While I was working on the admission note with his secretary, the doctor suddenly popped out of his room and offered to do the procedure for Rs 14,000 after 6 pm that evening and said I could go back home the same night and rest in my bed. Was this concession given due to my appearance or financial inability to afford the procedure? I was clean shaven, well dressed and didn’t put up a poor face looking for discounts or someone to fund the procedure and was surprised by his proposition.

I realized this may be the new normal in corporate-run hospitals where hospitalization procedures have turned into day/night procedures to reduce their battles with insurance companies and effectively managing patient load and beds. And they have effective bed utilization strategy and dynamic pricing aimed at maximizing revenue.

Life is an economic activity and for hospitals irrespective of whether you are dead or alive, the terms are strictly commercial. Unlike the radiologists, who ignore their health, I wasn’t ready to make a compromise on my health. I settled to pay out my pocket and even offered to stay overnight. While our airlines, railways and cab aggregators like Ola and Uber are on dynamic pricing, our hospitals may soon go that way.

Despite its uncanny resemblance to the Central Station, Apollo Hospitals are being run in a corporate way. And today, I realized Uberization of medical care is not far away!

 

Discrimination is Two-Way

Few weeks ago a section of India was seen reacting to the suicide of a PhD student Rohith Vemula in Hyderabad and an African student racially attacked in Bangalore and this week Jats have taken to violence in Haryana to get them listed under OBC (Other Backward Caste) category. While watching and reading about these news items I was reminded about what happened during my final year of under-graduation 19 years ago.

It was end of April, middle of an unforgiving southern summer and it was officially our last day of college. Our exams were schedule from mid-May and our study holiday was supposed to begin from the next day. 

In excitement to make our last day memorable, we arranged ourselves in file, we held up branches from trees and we walked around the campus cheering our batch mates and teachers. This walk was a celebration to our completion of degree and probably the last time we will all gather together. Some of us bravely walked outside the Dean's office attracting his attention and wrath which abruptly ended our walk and turned our bright future gloomy.

I still don't know how he identified us as students from Chemical, Mechanical and Computer Science discipline. Within an hour the heads of the three departments were summoned to his office where our behavior was condemned and were asked not to issue our hall tickets. We never realized a walk around the campus cheering loudly and celebrating our last days would attract this big a penalty. 

Next day close to 300 of us were suspended, our names were published on the college notice board and our exams postponed indefinitely. Some of us had dreams to pursue higher education abroad, a handful had been placed in reputed organizations, and a few had paid money to get a lecturer post in the same college. We were all in shock and disappointment. 

We went and met our respective HoDs and even spoke to the Dean, but we couldn't convince them to forgive us. By then our suspension and indefinite postponement of our exams became headlines and we were asked to vacate our dorms and had to go home and share the news with our parents.

The gravity of the situation hadn't hit me yet and I was grinning when I broke the news to my father, who instantly admonished my behavior. Is it that big a crime to cheer, walk around the college and celebrate our last day? None of us had vandalized any property or engaged in violent behavior, but that didn't appease my father. When he found out rest of the departments were issuing hall tickets and their exams schedules were carried out as per schedule he was even more annoyed. He was concerned that my plans to go overseas for higher education will now have to be suspended. 

We let a few days pass by and asked our parents to approach our HoDs and the Dean in an attempt to mollify. My college is 250 kms from my hometown; some parents had taken a train, while my father along with a few other parents had sent a letter and a telegram to the Dean tending their apology for our behavior. 

The summer weather didn't help us either. The Dean and HoDs were far from cooling down and were steadfast on their decision: suspension and indefinite postponement of exams. They wanted to teach us a hard a lesson that would be a warning for our juniors and subsequent batches.

Finally, a month later they relented and our exams were held in the middle of June. During my practical exams, a Senior Professor from another caste singled me out and addressed me by my caste to let me know that I was pardoned because of my father and my grades in earlier semesters. I was shocked upon hearing this from my Professor, but sheepishly smiled and let it go as I had a dream to embark. And today when I hear some Dalit students speaking up and sharing stories of their assault, verbal taunt and discrimination, I am reminded of my experience. Sadly, discrimination is two-way.

The Indian society was deeply divided by casteism prior to independence and continues to be divided by reservations post-independence. It isn't that easy to get into good colleges in India, which are only a handful. It is as much as ordeal for a student from a forward caste to get into a college or a job as much as it is for those from other castes. This is probably explains why some parents continue to prefer their children to go overseas and settle down there, while some pay bribes to get them a job. Some parents even engage in paper chasing and recently some in Bihar and UP were caught scaling exams halls to supply answers to their wards. 

At work, when I heard they were looking only for a woman of a particular nationality to fill a role in the headquarters I was irate and jokingly told a colleague that I'm not ready for a sex change to get the role. If India is obsessed with caste, the west is obsessed with race and neither societies have progressed much. 

Sadly, reservations and quotas along the lines of gender and caste haven't done much good in any country. It spreads discrimination, turns people into targets of hate, creates a fountainhead of mediocrity, unleashes an epidemic of corruption and forces many more Rohith's to either end their lives or leave the nation.

Chewing the cud

In this day and age this should not matter, but will it be a male or a female continued to linger on my mother's mind. After having 3 male offsprings added to the family in the last five years, my mother was determined to see a female offspring. Though Maneka Gandhi, Minister of Women and Child Development had recently voiced her opinion about having the law preventing determination of gender of the fetus repealed, but there was no way for my mother to determine the gender of Lakshmi's fetus until birth. Thank god!

Setting aside the unsolved question, she summoned the doctor for periodic home visits to ensure Lakshmi was healthy and she would have a complication free delivery. With three more weeks for the arrival of the new born, she was ready with her home made remedies to nurse and care for Lakshmi on her second delivery. 

My mothers love for Lakshmi and little one was definitely beyond gender of the new born. She pitied every time Lakshmi found it difficult to stand up after she sat down on the floor. She visited as soon as she woke up every morning and kept her bedroom windows overlooking Lakshmi shelter ajar, in case she delivers at night. There were also a few days when she had to travel outside the town and she often called to check on Lakshmi and ensured there was someone care for her. 

For Lakshmi many others in the rural home delivery meant comfort and happiness, though urbanites knew of home delivery from point of view of food joints and e-commerce sites. It was early afternoon, Lakshmi went into labor after lunch. My mother got anxious as soon as Lakshmi went into labor and she texted me as she was getting ready to play the mid wife as she awaited the veterinarian. We all said a little prayer for Lakshmi to have a safe and trouble free delivery.

And within an hour into labor the new born was delivered and the 39 weeks wait to know the gender also came to an end. My mother got busy nursing Lakshmi and the little one, but she quickly sent me a picture of the new born and announced that the hat trick with males continued. She confirmed that the little one was healthy, quickly stood up on four legs and Lakshmi was on her legs happily nursing the calf.

My mothers message made me compare and contrast delivery and associated commotion in the human world versus animal world. Periodic ultrasounds, health check ups, counseling sessions to unsolicited advices from friends and relatives on postpartum and child care often leave women in maternity overwhelmed. While Lakshmi had an easy home delivery under medical supervision and was given home remedies. She didn't have postpartum issues and went back to her routine faster than Marissa Mayer, CEO of Yahoo. 

Lakshmi was happily back on her feet in two hours, chewing the cud and licking the new born. Importantly, Lakshmi didn't have to go through books to find an appealing name for her new born; my mother simply named him "Narayana" as he was born on a Wednesday. 

Lakshmi's sister, Saraswathi was impregranted a few days before Narayan's birth. If everything goes well and as per plan in less than 40 weeks Narayana will have a first cousin and Lakshmi will become an aunt. As always, my mother will get busy with her preparations and will continue to pray for a female calf, which is more valuable in the material world for its milk. I went to bed that night thinking why is gender and child birth and rearing so planned, yet so complicated in the human world. 

Gandikota: Wild and Beautiful

When a western reference is used to market a place, it not only raises eyebrows and curiosity, but also motivates people to explore and compare. When my friend uttered Gandikota, it sounded like an exotic Naxalite area and failed to excite me. But when he referred to it as the Grand Canyon of India, I was half sold and instantly jumped online seeking more information to feed my curiosity and draw my conclusions on the comparison. A French traveler Tavernier has also referred to this place as the second Hampi. Do we really need western references to enjoy the geographical territories with historical significance in the Indian Peninsula? 

14.8134° N, 78.2848° E

Gandikota is a small village on the right bank of the river Pennar, 15 km from Jammalamadugu in Kadapa district, Andhra Pradesh.If you are traveling from Chennai set aside 6-7 hours for a comfortable travel. Get on to Chennai-Tirupathi highway and proceed towards Cudappah. At Cuddapah, take the by-pass road to Jammalamadugu. Though it is just 85 km from Cuddapah it takes roughly 2 hours to travel due to single-track and winding road.

My friend and I left Chennai at 8.00 am and reached Gandikota at around 4.30 pm. We checked in at a Government accommodation run by Andhra Tourism. Racing against the setting sun, we hurriedly dumped our bags in the room and up picked up our camera equipment and swiftly marched towards the fort to only capture its raw beauty and real history unlike our ancestors.

A bit of history (From Wikipedia)

Gandikota was founded in 1123 by Kapa Raja of nearby Bommanapalle village and a subordinate of Ahavamalla Someswara I, the Western Chalukyan king of Kalyana. The town played a significant role during the Kakatiya, Vijayanagara and Qutub Shahi periods. Gandikota was one of the greatest forts of south India in its heydays and so were the kings who ruled the region. 

Geography and terrain

Gandi in Telugu means gorge and the Gandikota is located between the Erramala range of hills and river Pennar that meanders at the foot of the hills. Surrounded by a deep valley (300 feet) and impenetrable hills with massive boulders of red granite and the river Pennar flowing on the west and northern sides, make it a strategic location to build a fort. 

Today, the treacherous terrain and scenic location makes it a photographer’s paradise, but in those days it prompted the Chalukya Kings to build a fort on top of the hill and guard the region. But what surprises me is that the wild forest and abundant natural resources hasn’t attracted the interests of political community.  

Exploration

One has to go through the fort area to enjoy nature at its best. But the structures enroute: temples, mosques, ponds, wells, and granaries definitely reminds you of the ruins of Hampi and make you contemplate on life of royalty and what could have possible led to demolition of the two temples: Madhava Swamy and Ranganatha Swamy and sprouting of a mosque between them.  Was it a peaceful coexistence of religious faiths or did religious intolerance lead to the demolition of the two temples? I leave this battle to the history buffs and saffron brigades.

Two sides of nature

Though every step we took looked dangerous, but it was getting us closer to nature. The locals had drawn white lines to mark the path to the cliff, but even from a distance we heard and spotted other travelers who had come to enjoy the wild beauty of nature. We climbed on the rocks, jumped from one to another like our distant ancestors.  As a precaution, we banned each other from taking selfies while on the cliff. On our way to the peak our cell phones started to tinkle, yes, that was only place we had reception in this small town.

Though it would have been nice to have a chopper ride similar to the one in the Grand Canyon to savor the beauty of the terrain from the sky, but a short trek to the edge of the hill and peek down at the valley made us both speechless and breathless.

The fast descending evening sun was behind us and its soft light illuminated the red granite hills making the setting both surreal and shade of pink in the sky made it poetic. After safely feeding our shutterbugs, we both settled on a rock and enjoyed looking down at the gorge and visually tracing the origins of the Pennar River.

Finally, as the night descended, trace of lingering clouds vanished, shades of pink turned black and the stars studded sky against the background score by crickets brought out the romantic side of nature. 

One last walk

We got up early the following morning and walked back to the same spot where we went last evening. Both nature and photo enthusiasts were already ahead of us, one waiting to get their shots before the rising sun, while the other waiting to enjoy the new dawn. We silently sat on the rock to say our thank you and good bye to Mother Nature, while our minds turned blank and leaving behind silly comparisons and references.

A real traveler discovers his depths, while he explores the world. Though our intention was not to popularize such places and turn them into noisy touristy hubs, but we couldn’t refrain from discovering and sharing the contrasting sides of nature. Hope you will travel your depths.

For accommodation visit: http://www.aptdc.gov.in/accommodations.html

Job Interviews in this day and age...

Though companies and managers (including HR) may perceive to have an upper hand when recruiting candidates, but they fail to understand that they are the first touch point invariably leaving a lasting impression of the organization and the brand in the minds of candidates. While there are hundreds of podcasts, thousands of books and millions of blogs and articles on how to ace a job interview, it is hard to find articles that teach etiquettes and best practices to interviewers. Here is a real-life incident shared by a close friend.

 

Don’t flip-flop: Like many of us, John too had applied for a job announcement on LinkedIn and to his surprise he promptly received an acknowledgement along with the job description from the HR of the organization. John being a meticulous guy, did a lot of research on the organization. He started following them on the social media the same day and he even set up Google alerts to stay up-to-date.  As promised, the HR got back to him in 3 weeks and confirmed that his resume was not shortlisted by the panel. Though John was a little disappointed, he courteously closed the email thread leaving the bridge open for future, but continued following them on various social media channels. And three months later, John received an email from the same HR guy, who used the same old thread confirming John’s candidacy for an interview.

 

Though John was excited, but his excitement evaporated when he poured over the job description. Upon seeing no change in the job description from the earlier one, John’s mind was filled with questions: Why and how did I make the cut this time? What made them go back on their decision on my candidacy? Not sure if this was a faux pas or if someone who accepted the offer backed off or someone in the panel had reconsidered John’s candidacy, shouldn’t HR explain the reason to John? Though John was tempted to write back to the HR asking these logical questions, but he remained non-confrontational and confirmed his interest in the job and availability for an interview. 

 

Respect the time of the candidate: Since John had applied for a senior position, the HR quickly came back to him asking for five interview slots with various stakeholders in the organization. That day John had three back-to-back telephonic interviews. As a part of his interview preparations, he spent time reading the vision, mission, philosophy of the organization, tracking the latest news items and also equipped himself with financial and management information. John even found a few outdated facts on their company’s website, but decided to keep this to himself. While the first two interviews started on time, John spent 20minutes waiting for the third interviewer (HR Head) to call him. At the end of 15 minutes, John courteously shot out an email to his contact in the HR team asking if the interview was delayed or rescheduled. While it would be unacceptable for a candidate to show up late for an interview, is it okay for a HR Head to show up late for an interview? But John confirms that the interviewer was apologetic, well-mannered, and soft spoken that made the interaction pleasant, despite the late start.

 

Say no to question banks: As John’s role will be part of the support function that touches various business units, he had interviews lined up with senior leaders in various streams. Given John’s penchant for preparation and attention to detail, he accessed their LinkedIn profiles to know more about them and to see if there was something in common between them. To John’s surprise the only common thread between them were the questions thrown at him during the interview. During each of the 45minute interview slots, all of the interviewers asked him to share his career highlights, strengths, weaknesses and career aspirations. “Either they must be sharing the same question bank or they must be testing the integrity of my answers,” quipped John.

 

“I had rehearsed in a big way to share my story, but they killed my creativity and enthusiasm with their canned questions. Moreover, back-to-back interview slots were getting too monotonous and none of the interviewers wanted to discover or understand me beyond my 3-page resume," said disappointed John.

 

Handle questions with poise: I was curious to know if John’s interview marathon was a one-way interrogation or if he had opportunity to ask questions that he prepared for each of his interviewers. John confessed that one of his interviewers didn’t have the courtesy to introduce herself. Though he was given a chance to ask questions towards the end of the call, but it seemed customary and some of their answers seemed honest.

 

I grilled John to find out more about the questions he asked them. To prove his honesty and attention to detail, John pulled out the job description and asked me to focus on one of the key performance index (KPI) defined in the role description and how it didn’t make sense and relate to role. When he posted this question to the Head HR, he realized that it was a copy paste error, but turned defensive and went on to convince John that it is a part of the KPI for the role.

 

Before closing my conversation with John, I asked him if there were any other questions that were posed to him that he considers discriminatory in nature or made him feel uncomfortable. “All the India based interviewers wanted to know if I were married and were beating around the bush by indirectly asking about my family. I lost my patience and proudly announced my single status to end this rigmarole,” fretted John.

 

We live in the age of digital where communications and human emotions are conveyed at the flick of a finger and first impressions are made from social and professional networking sites. But that doesn’t take away the responsibility of organizations and individuals in position to represent the brand treat candidates with respect and leave them with a lasting impression. Sadly, most of us are treated like commodities before we get into an organization and once we join we get treated like an numeric digits; there is very little respect for our skills and professional experience. 

 

Though John was very enthusiastic when he first saw the job description and subsequently followed up with his research, the interview experience certainly put him on the back foot. Will John unfollow the organization on social media? While we wait to hear about the direction of John’s wheel of fortune, let’s think about how we must not interview. Hopefully, the interviewers will exchange John’s responses to find out how they’ve used the same question bank to ruin their organization’s brand image and first touch experience for John.