sexypablo’s blog

In the morning, I go to my office.  I step out from home at 6 a.m.  and catch a bus.  As I go through my way in the bus, many girls get up the bus for going to college.  The dresses they wear really eye catching.  I wonder whether they are going to a college or a disco.  They wear tight jeans and short and sometimes very short t-shirts.  The color of the t-shirts are red, blue, pink, etc.  The t-shirts are tight and they make the girl's chest bulge out.  Sometimes I think sleeveless tops are worn to get attraction from the opposite sex. 

 

Once I saw a girl written in t-shirt "Sweet Girl," her boobs are beautiful and her face so sweet!! She is accompanied by other girls who is wearing colorful t-shirts.  The dress is a matter of choice and the way a girl wears gets all the attention of the guys.  They look at her and naughty guys pass filthy comments.

 

In my opinion, why should a woman wear such clothes and listen to such comments, I think a woman should wear decent clothes so that nobody passes comments at her.  A woman should live her life with dignity.  A dress is a symbol of culture and family background.  A formal dress to an educational institution shows the personality of the student and it reflects the strata from where the student comes. 

 

One day I saw a girl in a bus standing in front of me.  She was wearing a sexy blue jeans.  She was wearing a sleeveless top.  Her breasts are small but firm.  I saw that she is deliberately putting her hands up in front of the girls row seat which is in front of the men's.  She is stretching her arms to show her shaved armpits.  A bad guy can touch her and pass a comment!!

 

I think ragging is not only because of dresses a girl wears but also the person who rags is freak in nature and wants to get attention.  I think there should be no provocation in terms of dress and walking style.  The girl should be modest enough to dress properly.  In modern times, martial art training is good to fight against ragging.  A girl should practice and learn it so that he cannot be teased in schools and colleges by the wicked guys.   

Today is my first day in office and the date is 23 May 2007.  This is a company I had worked for 2 years before and there is a gap and now I have to prove that I can work well. 

 

I had to go to office in time and so I woke up at five in the morning.  I took a cup of tea and went to bathe.  I dressed up and took breakfast and went to the bus stand.  In the stand, I saw two dogs are standing close to each other.  Then I found them of opposite sex.  I saw them having sex in front of me and they went in the middle of the road to demonstrate their live show!! Two little boys three stones at them.  They are just having fun.  I thought that I should stop them but could not as they are innocent.  Then I saw the dog's love making.  It was a quite some time as the bus was not coming.  The bus came finally after 10 minutes and I boarded the bus and went to Rashbehari.  Metro rail service is not available in the morning at 6 a.m. 

 

In the bus, I saw an old man with torn clothes.  He said to the conductor that he was unable to pay the ticket.  The conductor in turn abused him and said, "Should I drive the bus free for you?"  The old man said, "I am a poor man, I don't have the capacity to pay!! Take money from other people."  In the bus, I saw a girl dressed in red t-shirt and she is fair complexioned.  She is quite hot and her sleeveless dress makes her shaved arms quite attractive!! I saw that she went to Rabindra Sadan probably she is some college student.  I saw a school boy often with his father in the bus.  The school boy is small child and his father is quite tall and thin with small beards in his face.  Probably he is a poor man and eager to educate his child.  Then I reached my bus stop and took an auto.  I entered my office and started work.  I had to go through the account instructions and started my work.  I had worked till 6:30 p.m. and went home. 

 

I came out of office at 7 p.m.  I took an auto from Gariahat. In the auto, I saw a big beautiful woman wearing white half t-shirt.  I saw her beauty is glaring in the night's light.  I saw her face shining in the lights of the signboards of the shops.  I saw her sitting beside the auto driver.  She went down at the same spot I went and I entered the metro station.  I saw that she is quite tall and she is walking with her hips swaying from side to side.  She has a bulky figure.  I went inside the metro rail.  I had no ticket, so I took the ticket from the counter and entered the platform.  There were many beautiful women and men standing there.  I saw one woman wearing a cream colored sleeveless t-shirt whose beauty is like a model of a fashion show.  I see in the regions like Gariahat fashionable people with new hair style and dress.  Their colorful dress is a charm to the eye of the passerby.  When you dress nicely, you not only feel but you make others happy by the choice of color and the style of clothes you wear on that particular occasion.  Still in a back office, we can wear formal and casuals are also allowed. 

 

The people invited me with smile and I felt happy and that stimulated me to work well in the first day.  I achieved 525 lines and the boss appreciated it.  My manager is a benevolent person.  She allowed me to join the next day and I feel grateful to her.  I opted to work well and give me in the near future to this company.  This is a company which has lots of work and you can reach targets well and easily work for more, something beyond your target!! The Spot Incentive technique is a good way to produce more work from the production team.  It gives you payment as you reach target and achieve 25% above target.  Life will go on as usual.  I will work and try to achieve more in the future for my personal development and if I achieve more, I will get more benefits from the company in the future!!

Today I woke up in the morning at five as usual.  The alarm in the mobile of Tata Indicom woke me up.  It is a gadget which is quite obedient and the only thing is that I need to give it some charge of electricity.  It is the only fuel for the cellphone.  A cell phone is something that accompanies you when you are alone.  Life is so lonely these days.  You are surrounded by friends but when you call for help there is no one.  There is no one to help a person protesting ragging these days.  The protestor's life is in threat.  Anyway, let's come to my life story.  The main news today is ..I am going to my company, a medical transcription company since one week.  It is a moderately big company having fifty people working hard to make both ends meet.  The company unlike any other company has no attendance record.  The online attendance is down, so there is no one to frown for you being late.  Only thing is that the progress is slow, you have to wait.  The managers in this firm are two in number.  One went to a slumber and the other a chubby fellow, sitting in the chair to just say "hello" to young aspirants whether they have experience or without.  The pay packets sounds attractive but only thing you have to do is compromise.  The computers are slow and suddenly it behaves like a haunted computer.  It suddenly shuts down.  The manager himself comes as there is no technician to repair computer.  He tells me to bring a brush and a screw driver and tightens the parts of the machine.  Then the computer starts working.  When the keyboard fails to work, one should wait till it reaches its normal state by itself, till then the work is put into shelf.  One has to wait and wait .  Finally the continuous phone calls made to the company who repairs PCs comes and does their job quickly.  The dinosaur PC gets repaired but only for a short time till it reaches the museum.  The manager has lived in USA for 6 years but none of his PC is new.  It squeaks "Mew!! Mew!!"  When its on, the work goes on but when it causes trouble, the transcriptionist can only produce bubble . 

 

Life is such an irony when you are job, you feel you are overtasked and overburdened with a private firm's job.  You go on searching for a greener pasture.  You find a company where work is less and money as a result becomes less and all your energy goes waste.  Your waist gets reduced, and there is hardly any money left in the bank.  Only there is lot of water in this earth's tank.  Its not small, it is 70% filled and the global warming melts the ice.  The people have become wise and to my surprise, there is disturbance in the ecological balance.

 

Life was moving as usual with the editors quite particular with accuracy of work.  A medical transcriptionist's job is full of stress and there is constant demand of high accuracy and demand of more work.  I was working in the present company but there was some communication gap.  The company wanted work and the most annoying thing is they have less job and wants me to practice some tough files.  Some files are so tough that my ears were burning when I listen to those audios.  The work sent to America in a transcription business is of export quality and to survive one needs to work well and hard.  Time here is not limited and one has to work for long hours leaving all social life behind.  A transcriptionist's job is like the job of a saint who keeps on worshipping God leaving everything else.  He is devoted to his work and so is a transcriptionist.  Life is hard but it is rewarded by incentives at the end of every year and promotion.  A tough job in these days is not something we should hate but we should love and take it as a part of life. 

 

The company gave me 1-1/2 weeks salary on the salary per month the agreement was made.   I was asked not to come the next day.  It gave me the biggest shock ever in my life.  I found the person is such a person that no further argument is valid here.  So I went to my previous company and talked with them regarding joining.  They agreed to take me happily showing their new payment scheme.  I agreed and decided to join the next day.  The company is good and reliable.  I worked there for two years and I think it is good to work with them. 

 

Life is always hard for the inexperienced people but as one gets exposure and experience in a company and enhances skill, he or she continues to get big offers.  But one should not go for small companies, one should only go to those companies whose infrastructure and manpower shows that they have the paying capacity.  My return to my previous company is based on this factor.  It is a quite a reliable company.  It rewards those who work hard. 

 

My life will resume its normal routine.  I will be doing three shifts in a month and working hard to improve my position in this company.  Life is not easy these days.  You have to meet your own expenses.  The lifestyle day by day is becoming costlier and one needs a lot of money to survive. 

 

My training in hospital administration is important but what I forgot is the importance of job.  I left a big company and joined a course to complete it.  I completed the survey and the contact program.  It is a fact that one needs experience everywhere and only experience people is well paid.  I got training in hospital administration and I was given exposure in different functions of the departments of Apollo Gleneagles Hospital.  It is a very big hospital in the Apollo chain of hospitals.  I did my survey in a clinic of Apollo called Apollo Gleneagles Clinic.  It is a wonderful clinic with a clean environment.  There is a wonderful religious song as you enter the clinic.  It is a paradise as you go on visiting each floor.  I went on with my survey from 2 to 8^th June.  I completed the survey.  I had to compromise job for that.  I sent the report to Hyderabad where the head office of Medvarsity Online Ltd. is located.  It is in Jubilee Hills.  I had to conduct the data analysis in my PC.  I had to type the entire report and edit it. I sent an e-mail attachment to Hyderabad and another hard copy with it.  I had the pleasure of meeting Dr. P.S. Reddy who is the head of our Medvarsity Online Ltd.  He took two classes and believe me we are spell bound by his lectures.  He gave extensive lectures on the hospital problems and how a solution is chalked out.  We did get knowledge from the experienced managers of Apollo Gleneagles Hospital.  They took our classes and we are pleased to attend the contact program.  We were happy with the knowledge and on the last day we had to attend a seminar in groups.  We were asked to talk about a topic and talk in front of a microphone.  My compromise for job and study hospital administration gave me lot of knowledge and it also expanded my knowledge how a hospital functions in terms of crisis and in normal times.  I loved the hospital administration and did my survey religiously and found that the patients of Apollo Gleneagles Clinic are more or less satisfied. 

 

One should tackle the problems of life in a cool mind.  As it happened to me today, when the boss told me not to come, I went to my old company thinking of the consequences that they might not allow me or tell me to join from next month as it is already 22^nd August.  I had some hesitation.  Still I went there with a brave heart.  I have talked straight away with the manager.  I found that she allowed me to join and I finally agreed to join the next day.  This 22^nd of August, 2007 is the happiest day of my life.  I found acceptance.  I found their smiling face and felt very tension free.  A good relationship with the management is important when you are in a difficult situation like this.  Job market is such a place that there are many jobs but only the right candidate gets the post and private companies will be particular about the quality and quantity.  In a government office, the promotion is based on the number of years you are staying but a private firm solely relies on quality.  It is the quality that matters and your permanent job is made by your work and the effort you give in it.

 

So I wish best of luck to all those guys and gals working hard for building a bright future and hope that these people will survive the rigor of hard times.  According to Darwin's Survival of the fittest, it is the stronger species who will survive and the weaker will perish. 

 

in this wonderful afternoon as I walk along the road in the drizzling rain……
I wonder how happy I am to be with so many people around the world………..
Still in this materialistic world…
There are people who have values…….
There are people who have a big heart……..
Lets share the happy moments …
in the eve of 60th Independence of India……coming on 15 August 1947….!!
Let be happy on this day…………
Lets be free to think of the betterment of India!

JAI HIND!!!

The country is vast!
But We have become independent at last!
In 1947!
We feel we are in heaven!
Actually we have spoiled the nation!
By corruption !!!

In this world where everyone is chasing careers, we have hardly friends.  Friendship is a give-take  relationship.  If in any way, this give and take balance is lost, friendship is spoiled.  From my childhood, I have seen in the school that my friends used to talk with those who they need and after need it is over!  Unlike boys, girls have a rapport among them.  They mix with other girls for need and beyond.  The fair weather friends are many as I saw in my life.  They come when there is need and forget you when the need gets fulfilled.  In my schools, I have studied at St. Thomas Church School at Howrah Maidan and Cossipore English School at Dumdum Seven Tanks Estate.  In my St. Thomas Church School, there was private tuition and those who used to take private tuition from school teachers were separate group.  They preferred to talk among themselves as they thought that their teachers questions and suggestions might get leaked out.  I have seen this in my Cossipore English School also.  Everyone seems to be chasing from school.  They do not know what but still the parents have unusual behavior.  They tend to avoid parents whose child is not good at studies.  Everyone wants to be selfish!! But I don't know what these parents got finally!!!  A boy in my class named Indrajeet left school and joined some other school as he could not get the first position in class.

 

In my Cossipore English School at Dumdum Seven Tanks Estate, I saw my friends going to our school teachers tuition for good marks.  I do not know actually doing good in school exam will do any good for their future as we all know we have to sit for job exam where your skill will be tested.  They used to be in a group and communicated with them only.  In Anthropology, we studied that man is a social animal but in reality I find that man is a selfish animal who can do anything for meeting his selfish needs.  I studied anthropology in my graduation. 

 

I studied in short courses of French at Alliance Francaise at Kolkata.  I saw that in the French class, our friends are from well-off families.  They loved to talk but all are not equal.  There are still groups but what is notable there is a sophisticated class who wants to communicate and there was communication as the institution has teachers who are trained in France and there we don't need a private tuition.  Everything is done in class.  You don't have a homework or there is no fear of homework.  You are taught nicely by the teachers and exams taken there have the results published after the day or in the same day. 

 

Now I would like to share my days of training for civil service exams.  After completing my graduation, I have joined a training of West Bengal Civil Service Examination.  This exam for civil servants under West Bengal.  I joined Rabindra Bharati University at B.T. Road for training.  Through lectures and notes, we were taught history, geography, psychology, maths, etc.  The lectures were good and the classes were held on time.  I had also a number of friends.  In the course, I had even visited  a friends house but he said he will come but never came to my house.  Everyone seems to behave like a boss.  In this world where everyone has a mobile, you have to phone the person for reason or without some reason but the fact is that the person you are calling will ever call you in return.  This is a need-based world.  Without any need, people will hardly move a step or talk for sometime.  The contact numbers you get after a course but you will hardly find any old friends calling to you. 

 

There is really no "feel-good factor."  This is true for a political campaign but not in real life friendships.  You have friends when you are in a powerful position.  Everybody is there to please you to meet their selfish ends.  Money and power are the two things people crave for.  If someone is happy with money and power, he will hardly want anything.  We find power hungry people have so many social contacts.  They make friends and get their like-minded friends as there are a lot of them getting trained in politics.  Why a politicians son become a politician?  Why do an actor's son prefer to be an actor? Because there is money and power .A politician loves power and that carries in his heredity and his son whoever may be comes to politics for the lust of power, money and opportunities.  He will have friends with other politicians and underworld links.  Even underworld links have been found in Bollywood also where actors make friendships with criminals for their opportunities in Bollywood. 

 

Human being loves power more than anything.  Even in small posts of governing bodies in colleges, teachers fight for a post but they are hardly going to do anything in return for the college.  It is the glamour of the post.  Even if there is no money still people run for the glamour of the power.  They join political party to get their evil suppressed by the backup of the political party.  Friendship is there but in this way!

 

In professional world, we have friends but they are so formal.  I entered medical transcription profession after a short training.  Getting trained in a company and joined the same company, I found that the people who were friendly in the course period turned a different color after the course.  They have their terms and conditions which is different than stated previously.  So it is the inexperienced person who suffers.  The experienced persons can move from one company to another without trouble.  An experienced person has a lot of friends.  The friends I developed in this profession are good and they can talk but all of us getting little time to talk as we all have to meet our targets.  We have targets in terms of line counts.  The number of lines produced is the basis of income of the person working and the accuracy really matters in this field.  So if I ask my friend to come and listen to the audio, hardly there will be anyone who is going to listen to it.  A few friends used to listen and I respected them as "TRUE FRIEND." 

 

In the IT field, our friendship is highly internet based.  We have accounts in different networking sites like Hi5, Orkut, Myspace, etc.  With the help of these sites, we share our thoughts and ideas.  We can all write in blogs and develop friends there also.  Now the question arises whether net friendship is better or not? In my opinion, it is far better than real face-to-face friendship as we get to know each other and we can talk only when we are willing.  I have seen net friendship can be quite intense than real friendship.  There is always love and respect from both sides.   Over the internet the age gap hardly matters.  I have friends who are my father or my mother's age.  It is their message that matters to me! It is not the age!  We used to talk in messengers like Yahoo, Google Talk, MySpace IM, RediffBol, etc.  With the help of these messengers, I got a large number of online friends and felt happy talking with them. 

 

Even when you have no internet connection, it is good to write something in Microsoft Word and post in the internet as blogs.  People visiting you web site will put comments and from their comments you start building what other people think on the topic you wrote.  Blog writing is highly recommended as it is quite an interesting thing.  It can be as simple as writing your daily activities and your impression of life.  It can be a memoir.  It can be your travel story.  Sometimes if you feel bored with online friends, start writing and writing skill develops as you keep on writing in the net.  It is the readers who will teach you what to write and what not to write.  Their valuable comments will be an asset to you throughout your life.

 

 

Human body is made up of a network of connective tissues.  These tissues are highly prone to injury.  It can be through exercise, normal lifting, pulling, and pushing of daily life. 

 

In our life, we have sprain in our ankle several times.  We all know when an ankle is badly sprained, it may be sprained again.  This also happens with other body parts which causes arthritic changes after injury.  The re-injury arises when the ligaments that link bone to bone and bone to muscle fail to heal completely.  Over a period of time, this incomplete healing can result in lax of connective tissue that cannot fully support a joint. 

 

In the University of Kansas Medical Center, Dr. K. Dean Reeves compares the damage to a partly shredded rope that lacks the strength of a normal one.   He specializes in a therapeutic technique called prolotherapy. It is an alternative medicine method that helps tissue repair after many years of its damage.  This technique was endorsed by Mayo Clinic.  In April 2005, the clinic stated in a scientific paper that when physical therapy and exercises prescribed to the patients fail then "prolotherapy may be helpful."

 

Prolotherapy is much less invasive and expensive technique.  It is better than surgery as it is cheap comparatively.  The only thing is that you have to find a skilled and experienced practitioner.

 

Prolotherapy involves a series of injections, which produces inflammation in the injured tissue.  This method reactivates the healing process by injecting a mildly irritating substance like a somewhat concentrated sugar solution along with the painkiller lidocaine.  It is injected into the injured area to produce a temporary inflammation.  Sometimes growth factors are also injected.

 

 

 

 

 

 

 

 

I came to the Apollo Gleneagles Hospital at E.M. Bypass in Kolkata. I went to Swabhumi on August 10, 2007.  I got some spare time in between my classes of Hospital Administration.  I got a lot of time.  I thought it would be better to spend some time at Swabhumi.  It is beside this Apollo Hospital.  Swabhumi has a huge complex with cinema, auditorium, restaurant, shops, conference rooms, information centers, parks. 

 

At the entrance of Swabhumi, there is an ATM of UTI Bank.  It is called the Heritage Plaza as there is a number of handicraft shops in its complex.  There are trees which decorate and make the area green and splendid with fresh air around.  The atmosphere is calm and cool far from the noisy city and smoky vehicles of the roads.

 

There are a number of entrances.  The entrances have slopes so that cars can enter it.  The entrance has trees making it look beautiful.  From the EM bypass, it looks as if a hill surrounded by trees with a big sign board written "Swabhumi."

 

The whole Swabhumi is divided into 4 divisions:

1. Uttara.
2. Paschima.
3. Purba.
4. Dakshina.

 

There are a number of shops at Swabhumi.  There are shops of fashionable sarees, imitation shops, toy shops, handicraft shops, tribal craft shops, saree shops, fashionable clothes shop, cement shop.  The saree shop has a large variety of sarees made by the craftsman from all over India.  The tribal welfare of Central Government has opened a shop exhibiting artworks made by tribes from various parts of India.  The money obtained from selling goes to the tribes who make it.  The fashionable clothes shop has expensive clothes made in Swabhumi itself. 

 

There is a big auditorium where LIC meeting was going on at that time.  There were a number of people seated outside who were employees of LIC (Life Insurance Corporation of India).

 

There is a public auditorium with a big stage where talent exhibition is made.  A large number of music shows are held.   The popular music bands perform here. 

 

There is food canteen where South Indian and snacks are found.  A number of multi-cuisine restaurants are also seen at Swabhumi.

 

There are 2 lions at the entrance of the auditorium.  The buildings are in the cottage pattern.  The trees are beautifully trimmed. 

 

There are benches where people relax and chat.  Girls and boys come here to chat in this wonderful place which is free from air and noise pollution.

 

Aged people come here to sit and chat in the wonderful place where culture and tradition is the hallmark.  The place has wonderful musical programs and cultural program which draw a large number of crowds at particular seasons of the year.  Conference halls draw corporate people for meetings and seminar.

 

The movie theaters are wonderful with the minimum fees of Rs. 50.  Cinema halls have pink colors.  The wonderfully painted cinema halls look great. 

 

If someone visits Kolkata, India, one should visit Swabhumi.  The entry fee is Rs. 10 but what one experiences is something worth remembering!!!  A place where tradition and modernity mixes and one cannot distinguish where tradition ends and modernity begins.

 

 

 

 

 

Contact program Day 1

 

Dr. P.S. Reddy

 

 

 

We spent 3 trillion dollars on healthcare around the world

In US, 1.3 trillion dollars spent on healthcare.

 

In terms of expenditure, US ranks 37^th, 36^th Puerto Rico, Slovenia 38^th.

 

Functions of management:

1. Leadership
2. Delegation
3. How to get along with people.

 

Concept:  Transaction Analysis.

 

Management was there in the building of the Pyramids of Egypt.

 

Transaction Analysis was proposed by Eric Berne.

Eric Berne was a Swedish Psychologist.

He wrote a book called: "Games People Play."

 

 

Penfield did research on temporal lobe epilepsy

 

He stated that human mind is like a small tape recorders.

Human being has multifaceted personality.

 

Transaction is the basic unit of human interaction.

 

Ego

Superego —- Controlling/restricting.

Id—— Intuitive/instinct behavior

 

He found that out of 100, words share 7%, body language 55%, and paralingual the rest.  It shows that human body language has a major role to play in the human communication.  We get to know more about body language:  http://en.wikipedia.org/wiki/Body_language

 

There are 3 types of ego:  http://en.wikipedia.org/wiki/Ego

 

Parent Ego

Adult Ego

Child Ego

 

Ego?behavior thoughts and feelings

 

Parent ego—– nurturing parent

                ———critical parent

 

Child ego— can be divided into happy child and destructive child.

Destructive child can be divided into Rebellious child and compliant child.

 

Parent ego ' Taught concept of life.

                —–Child ego— felt concept of life.

 

Sigmund Freud  was an Austrian Neurologist and Psychiatrist (http://en.wikipedia.org/wiki/Sigmund_Freud)

 

It is always advised to use soft words in hard arguments.  In a hard argument, when the manager talks in a soft tone.  He gets the situation under control otherwise it would be a total chaos. 

 

Building Adult Ego:

 

—-Recognize your child

—–Recognize your parent

—–Recognize others child

—-Be sensitive to child in others

—–Count ten.

—–When in doubt, leave it out.

 

Thomas Harris—-Life Positions

 

I am ok. You are ok. —-natural child

 

Strokes —- gives recognition

A stroke can make you feel good or bad.

People work hard for strokes.

Argument is worst sort of conservation.

 

 

Contact Program Day 2

 

31/7/2007

 

Dr. P.S. Reddy

 

Hospital Administration

 

Beautifying the Mind —- Edward De Bono

 

Functions of Management:

 

PODSCROB (acronym denoting planning, organizing, directing, etc.)

 

Intensive care therapy is very expensive.

 

Hospital Laws and Medical Ethics

 

It is very important as on the basis of this a number of litigations are made for improper service in healthcare.

 

Legislative body makes the law.

 

National Laws:  Indian Penal Code, Welfare Code, and Administrative Code.

 

Implied consent:  A consent that is not told but is implied, say when a patient visits a doctor, the implied consent is the patient wants treatment, so tests are done by injecting syringes and blood taken, etc.

 

IPC sec. 90 —- Consent

IPC sec 88 —– Medicine

IPC sec 80 —- Accident in doing a lawful act

IPC sec 92 —–Act done in good faith for benefit without consent

IPC sec 320 —- grievous hurt

IPC sec 336 —– rash and negligent act endangering life

IPC sec 304 A —–Causing death by negligence

IPC sec 269 and 270 ——Negligent act likely to spread infection of disease.

 

Indian Medical council  act 20 —– confidentiality

 

Break the bad news — it is difficult for a doctor to tell the bad news of the disease to the patient, say if he suffers from blood cancer or any thing like that.

 

The method is called SPIKE:

S—-Setting up

P —- Perception.

I — Information.

K —– Knowledge

E—- Empathy

 

Terry Schiavo Case

 

——She was a model who wanted to be slim.  She wanted to be slim so she vomited food after eating called bulimia (a form of eating disorder).

—–Teenager with bulimia

——Potassium (K+) deficiency —it lead to cardiac arrest.

——Anorexic brain damage in 1990

——Removal of feeding tube.

——She died on March 31, 2005 due to dehydration.

 

Mary and Jodie

 

—-they are conjoined twins

——Mary uses Jodie as life support machine

——Separation might kill Mary as Jodie uses some organs of Mary to survive.

——continuation will kiss both.

 

Euthanasia is Mercy Killing.

 

IVF mix up.

 

It happens accidentally say a white couple has a black child.  They claim this is a mix up with some other donor's sample. 

 

Men ought not to play God before learning to be men.

 

Human cloning

 

Physician assisted suicide

–Case of Dr. Timothy E. Quill

 

Ethics—law, good/bad, moral, principles.

 

"Ethics has to do with my feeling tell me is right or wrong."

 

"Being ethical is doing what the law requires."

"Ethics has to do with my religious beliefs."

 

Why ethics???????

 

Doctors use technical skill and expertise which the patient does not have, possessing this skill gives doctor greater power, in caring for patients, doctors, make a series of judgments, decisions .

 

What is ethics????

 

—-Standard of right and wrong that prescribe what humans ought to do .

Surrogate mother — There is no law which states that surrogate mothers not allowed during child birth in India.

Law is silent (a legal term meaning nothing to say).

 

Law:  Set of rules of conduct enforced by threat of punishment.

 

Ethics is more than law e.g. Harmless negligence.

 

8 slice CT scan, then 64, 128, and finally we have 256 CT scan.  1 CT scan is 400 chest x-rays (according to radiation).

 

Importance of Medical Ethics:

1. Increase in use of technology.
2. Better informed society.
3. Public scrutiny.
4. Trial by media.

 

According to Medical Council of India, a doctor is not supposed to advertise on any healthcare product.  We often see doctors in advertisements.

 

Theories:

—Consequentialism or Teleology (what is the consequence of the action)

—-Deontologism (proposed by Emanuel Kant; end never justifies the means.  The means must be correct.  If the process is good, the output will be acceptable.)

—-Utilitarianism (Proposed by Jeremy Bentham  — positive and negative).

 

Principles ———-

1.  BENEFICENCE:  Goal of medicine, always do good, benefit to the patient, and paternalistic.

2.  NON-MALEFEASANCE:  Do no harm, fundamental commitment, constant duty to minimize or avoid harm.

3.  AUTONOMY:  DNR (do not resuscitate) New York, 1988.  DPAH (Durable Power of Attorney for Healthcare) —Proxy directives.

 

Deliberate self rule, living will, obligation to consult and obtain agreement.

 

"Medical Jewelry"— a wrist band is tied to wrist of the patient.

 

5. JUSTICE: 

1. Distributive justice.
2. Right based justice.

 

Ethical models in medicine:

 

1. Ethical Model —-Disease, not person.
2. Priestly Model —- Benevolence, moral dominance.
3. Collegial Model —- Patient as a colleague or partner.
4. Contractual Model —- Negotiated sale of services.

 

Issues:

 

—-Abortion versus right to life.

—–Assisted reproduction

—–Death and dying

—–Transplantation.

—–Research injury.

—— Confidentiality.

 

Euthanasia

 

1. Active
2. Passive
3. Involuntary
4. Voluntary

 

Indian Journal of Medical Ethics

 

Privileged Information —Whom should you tell in what manner and when.

 

CPA — 1986 —- speedy redressal of repetition—- replaced MRTP Act etc. —-amended in 1991 and 1993.

 

CPA is compensatory —-Simple speedy and inexpensive redressal.

 

Consumer is any person who hires for a consideration which is either paid or to be paid.

 

Deficiency —- Fault, imperfection, shortcoming, inadequacy, nature and manner of performance.

 

District forum —State Forum (20 lakhs to 1 crore) —– National Forum (above 1 crore)—–Supreme Court.

 

Unclean hands—- bribes, corruption.

 

Vicarious responsibility —- select the right person.

 

Consumer is the patient who hires the service for consideration.

 

In government hospital, private ward is charged and general hospital is not charged.

 

User charges are not applicable.

 

We cannot collect indemnity from the hospital as well as consumer forum.

 

Consumer forum does not give money for the claims for the following reasons —-

1. The money charged is inflated.
2. The patient suppressing facts.
3. The negligence is not gross.
4. The losses are imaginary.
5. The complaint is not precise.

 

How do we determine the compensation?

 

1.      Severity of negligence or loss.

2.      Functional loss.

3.      Age of patient.

4.      Number of dependents.

5.      Loss of future earnings.

6.      Effect on career.

7.      Future expenditure.

8.      Anxiety, agony and distress.

9.      Expenditure on travel, stay, and loss of reputation.

 

Duration of medical record maintenance—

Medicolegal record —10 years.

Medical council —- 3 years.

 

Support groups are insurance companies.

 

Technical defence —- Treatment without charge, concurrent jurisdiction, complicated issue like cerebral hemorrhage.

 

Factual defence.

 

BUILDING A HOSPITAL:

 

1.      Beds.

2.      Speciality.

3.      Budget.

4.      Area and land.

5.      Speciality.

6.      Need assessment.

7.      Planning.

8.      Structure and design.

9.      Staff.

10.  Licence

11.  Market.

 

 

 

Bed is the universal indicator of a hospital.

 

Funds for hospitals come from share and bank loan.

 

Funds for hospitals come from your own investment, partners (who gets a share of profit), investors (interest on investment), shares, loans, hire purchase.

 

If a company wants to release IPO (initial public offer), track record should be proved.

 

Gestation period is the amount of time to build to the time to get the profit.

 

 

Waste Management

 

Biomedical Waste

 

Law and regulation in biomedical waste management and handling.

 

Biomedical waste is the waste that is generated during the diagnosis, treatment and immunization of human being or animals or in research activities, pertaining thereto, or in the production or testing of biological.

 

What is the first step in Waste Management?

 

—–Creating systems for segregation of waste in the first step.

—–Segregation of waste into infected or contaminated waste and noninfected waste is mandatory and is a prerequisite for safe and hygienic waste management.

 

1. No biomedical shall be mixed with other waste.
2. Biomedical waste be segregated into containers/bags at the point of segregation.
3. Color coding signifying the different kind of wastes.
4. Segregation is mandatory prior to storage, transportation, treatment and disposal.

 

Government rules:  Biomedical Waste Regulations of the Ministry of Environment and Forests, Government of India.

 

Human Anatomical Waste —Yellow.

Animal waste — Yellow.

Microbiology and Biotechnology Waste —Yellow.

Waste Sharps —Sharp Container.

Discarded medicines and cytotoxic drugs —-Black.

Soiled waste contaminated with blood —-Yellow.

Soiled waste generated from disposable items other than sharps —Blue.

 

Sharp container should be puncture proof.

 

If a substance is kept in sodium hypochlorite solution, no infection occurs.

 

Safety at work àHand Gloves and Face Mask.

 

Don't mix the infectious waste with noninfectious waste.

Don't recap the needle or break the needles by hand.

Don't fill the container more than ¾ capacity.

Don't allow unauthorized person access to waste collection.

Don't use open buckets for infectious waste or sharps.

 

Bins are placed in nurse's counter in all wards.

 

The packed bags are stored in the garbage bin.

 

The trolleys are green in color and are placed in the service lift area.

 

Handling of infected linen — Yellow garbage bag.

 

The infected linen is sent to laundry for chemical treatment and washing.

 

It is advised to inform your head of the department or supervisor if you have any needle stick injury. 

 

Quality in Healthcare

 

Dr. V. R. Ramanan

 

Quality means conformance to the standards both stated and implied, at a given time, over a period of time, and at a price, the customer can afford to pay, or is willing to pay.

 

Quality management is the scientific search for the most effective way to deliver the best care to the patients.

 

Quality is the lifeblood of any organization.  Our aim is to do the right thing, the right way, first time and every time.

 

How would it help us?

 

—Improved patient care.

—-Safe environment.

—-Continuous improvement.

—–Self-development.

—–Strengthen patient confidence.

—–Achieve international recognition.

—–Expand customer base.

 

From where it started—-

 

In December 1919, American College of Surgeons adopted 5 criteria, known as minimum standards, by 1950, it became a national norm.

 

Formation of US joint commission on Accreditation of Hospitals in December 1951.

 

In August 1966, JCI undertook a complete revision of standards to reflect an 'Optimal Achievable' rather than a 'minimal essential' level of care.

 

JCI accreditation manual has 152 pages.

 

Quality is virtually important in the hospital sector for it determines what, when and how much will be the same effort of care.

 

Quality in service establishments has to be ensured by emphasis on the processes rather than on the final output or income.

 

ATTRIBUTES OF QUALITY IN HEALTHCARE:

 

—Effectiveness.

—-Effeciency.

—-Optimality.

—–Acceptability.

—-Legitimacy.

—-Equity.

 

Evolution of the Concept of Quality Management:

 

Statistics and audit –à Quality Assurance -à Total Quality Management à Continuous quality improvement à Quality Circle.

 

How to measure quality?

 

—-Credential and clinical privilege.

—-Risk management  —-incident review.

—-Committee.

—-Patient satisfaction survey.

—–Audit.

—–Quality indicators.

 

Root Cause Analysis —- is a process for identifying the basic or causal factor that underlies the variation in performance, including the occurrence or possible occurrence of a sentinel event.

 

Product of root cause analysis is Action Plan.

 

Evidence based Medicine à  It is clinical practice based on sound evidence.

 

Six sigma —It is a methodology to manage process variations that cause defects defined as unacceptable deviation from the mean or target; and to systematically look towards managing variation to eliminate those defects.

 

Objective of six sigma:  To deliver high performance.

                                         Reliability.

                                       Value to the end customer.

 

 

Six Sigma was pioneered by Bill Smith at Motorola in 1986.

 

Three main areas:

—-Improving customer satisfaction.

—-Reduce cycle time.

—-Reduce delays.

 

DMAIC:

D—-Define.

M—-Measure.

A—-Analyse

I—-Improve.

C—-Control.

 

QUALITY POLICY OF APOLLO HOSPITAL:  "Our mission is to bring healthcare of international standards within the reach of every individual.  We are committed to the achievement and maintenance of excellence in education, research and healthcare for the benefit of humanity."

 

My First Blood Donation

 

I am doing a course at Apollo Gleneagles Hospital in Kolkata under Medvarsity Online Ltd. through distance learning.  I am presently doing a contact program from 30 th July to 12 August in this hospital at Eastern Metropolitan bypass.  It is my fourth day in the contact program.  Today we did our class on Human Resource Management from 11:30 a.m. to 1 p.m.  We were asked to do a department visit on the same day.  We are a batch of 30 students.  We come from various backgrounds of doctor, hospital employee, housewives who are qualified doctors, nurses, paramedical staff.  Students living far away from Kolkata like Durgapur, Tripura have come to this contact program on the above-mentioned dates. 

 

I never gave blood anywhere before in my life.  I thought primarily due to unhygienic condition and the chance of getting infected with disease was my primary fear.  I loved the atmosphere of Apollo Gleneagles Hospital.  The hygienic surrounding of Apollo Gleneagles Hospital will motivate you to give blood.  Giving blood is a social work.  It is a duty to the society.  It is for the patients who need blood and it is the only thing which we cannot get in a shopping mall.  It is produced by man for another human being.  Blood has a limited life span.  Blood is basically composed of red blood cells, white blood cells and platelets.  A person giving blood will be able to get blood from the hospital when he or his relative is admitted to the same hospital.

 

I gave blood along with four students of Medvarsity Online Ltd.  They are my close friends.  Two of them are males and two are female donors.  I am a donor with A+ blood.  The hospital has a systematic approach of blood testing with sophisticated equipment imported from foreign countries.  The costs of the equipment for blood testing goes around Rs. 50,000 to Rs. 75,000.  The Blood Bank has equipments to store blood for a long period of time. 

 

Procedure for Blood Donation:

 

The procedure for blood donation are as follows:

1. I was asked to take to fill up the card at the reception where a technician filled up the card putting my surname first and then my first name.  Then he wrote my age, sex and I was asked whether I had any blood donations before.  I said, "No, this is my first time!" 
2. I was then taken to another room where a nurse was seated in the chair.  She told me to take the weight and then she told me to wait a while my friends data are collected and blood sample taken to determine the type of blood.  Then the same was done for me.
3. The blood sample was taken.  Only one drop was blood was taken in a slide and the blood was thrown in copper sulfate solution to see whether the blood has the right percentage of hemoglobin.  If the hemoglobin is lower than the specific gravity of the solution, it will float.  So it was found that I have the right percentage of hemoglobin.
4. My blood pressure was tested by the doctor who is in charge of the Blood Bank.  He was curious to know about Medvarsity.  I clarified his doubts.
5. I was taken to the blood testing area. 
6. I was asked to relaxed.  The staffs talked with me with smile and told me that there is nothing to be tense about as it is only a small pouch of blood they will take.  I asked them, "How much blood will u take?"  The nurse said, "350 ml."
7. The blood collection had already begun in my 3 friends.
8. I am the fourth donor. 
9. I was asked to lie down in a chair which is quite comfortable.  It is an adjustable chair.  It is a chair whose height and the angle of inclination can be adjusted.  It is a well-cushioned chair which will make you sleep after lying down!!
10. I laid myself in the chair.  I was made to lie and my upper arm was tied. 
11. I was told to fold my full sleeve shirt. 
12. I was given a small wooden piece to hold it tight and then relax. 
13.  I was then told to relax the arm and a thick needle with a tube connected to the pouch was placed.
14.  The pouch had the capacity of holding 350 mL blood. 
15.   The blood was gradually going down and I never felt any pain.
16.   Only when the needle  was inserted, I felt a pain there but after that no pain.
17.   I was told to relax and the tube was removed. 
18.   A cotton was placed at the junction of my fore arm and upper arm. 
19.   I was told to keep the arms folded for 15 minutes.
20.   After this donation, I was told to sit there for some time and given  fruit juice.
21.   At the end of this session, we came out of the blood donation center.

 

 

We are students of Medvarsity and we came here for increasing our knowledge in blood testing.  We had the opportunity to know it as closely as possible being the only four candidates who had the patience to wait for quite some time to know about blood testing from the person who is in charge of the Blood Bank of Apollo Gleneagles Hospital in Kolkata.  After the class, we felt quite fortunate being a part of Apollo and being a blood donor in one of the leading hospitals in India.

 

The knowledge we gathered are as valuable as platinum for being a future administrator in a hospital. 

 

History of Blood Testing:

 

1. In blood testing, the venereal diseases was tested at the initial stages.
2. In the 70s and early 80s, hepatitis B was tested.
3. In 1985-86, HIV (human immunodeficiency virus) was tested.
4. In 1989, government made laws for compulsory testing of blood and the following things were tested:

1. Hepatitis B.
2. HIV.
3. Venereal Disease.
4. Malarial Test.

 

5. Licensed blood bank was started after that under the government laws.
6. Drug control was made and the laws were made stringent.

 

In blood preservation, CPDA1 , an anticoagulation is used so that the bloods do not coagulate or clump after the donation. 

 

As the blood comes out and anticoagulant added to it, it becomes a medicine under Drug and Cosmetics Rules, 1945.

 

7. According to the order of  Supreme Court in 1998, blood cannot be collected from Professional Donor.  It is important to state that a professional donor is a person who gives blood for money.  In the past, it has been found that these professional people have low blood cell count and due to frequent giving blood, the required blood components are not found and they are often found to have narcotics in their bloods which is not all desirable.  Their lifestyle is different from the voluntary blood donors in the sense that their blood often contains something which is not desirable for transfusion to another recipient of his blood.  So it had to be banned under court order and so nowadays a person giving blood is not given money but an opportunity for his family to take blood if the patient or his family gets admitted to the hospital.  But on discharge, some blood should be given as per the specific hospital rules.
8. From June 1, 2000, Hepatitis C testing was also made after blood donation.

 

It is to be noted that the medical laws we follow is from U.K.  The Indian Medicine follows 3 pharmacopeia:  USA, UK and Indian.  Among these three, British is given more emphasis. 

 

A blood bank is run on "no profit —- no loss" basis as per the order of the Central Government.

 

A stand-alone blood bank is made with the blood supply mainly from the relative of the patient and blood donation camps done regularly in a year.

 

  Blood becomes a pharmacy product under the name "solvent detergent treated plasma." 

 

  Red cell is given to Anemia and Thalassaemia patients.  Red cell is called "packed cell" in medical terms.  A red cell is 230 ml in a 1 liter blood of man.  Packed cells are stored at 2 to 6 degree Centigrade.

 

  Platelets are stored at 22 degrees in a shaker.  The shaker is run for 5 days continuously so that the platelets can thrive. 

 

Plasma is yellow in color.  It is 150 mL in 1 liter of blood.  It is given to liver disease patient.  Plasma is stored at -18 degree Centigrade.

 

Platelet is 30 mL per 1 liter blood.  It is given to blood cancer (leukemia) patients.  Platelets are stored at 22 degree Centigrade.

 

It is to be noted that in a 350 mL of blood of the donor, 49 mL is anticoagulant.

 

Every year the machines for storage of blood of the donors are calibrated by an organization run by Central Government called Eastern Regional Testing and Calibration Laboratory.  Calibration is a method in which the temperature of the machines storing the blood of the donors are checked.  It is a special technique done by an organization whose duty is to see the machines are okay for future use.

 

VDRL is Venereal Disease Research Laboratory.

 

At the time of admission, a patient asks for blood to the blood bank.  If he has given blood to that particular hospital before, he gets blood and during his discharge, his relatives are asked to give blood.  The relatives may argue but it is duty of the person in charge of the blood bank to counsel him.

 

Before my blood donation, the nurse asked me whether I had a disease like jaundice, any allergies, recent medicine uptake etc.  If I take an aspirin before my blood donation, I was told by the supervisor of this blood bank that my blood platelets loses functional ability in the last 72 hours.  So it is always advised to give blood after 2 hours of heavy meals. 

 

We were eager to know how a pathologist comes to know whether the donor is a professional donor or not.  It can be known by the low hemoglobin count and the number of punctures in the arms. 

 

After my blood donation and the knowledge we gained from the person in charge of the blood bank in Apollo, we felt that a bottle of blood can save life in crucial moments.  It is something as priceless as gold.  It is something a person whether a rich or poor has to take without any discrimination in race, sex, class, etc.  It is something which will be produced for oneself and for others in his community.  A blood is a priceless gift a man can give to another human being.

 

 

Motivation

 

Three key factors:

1. Direction.
2. Intensity.
3. Persistence.

 

Motivation is the willingness to exert high degree of effort by overcoming any obstacle to reach every goal.

 

Abraham Maslow —-Hierarchy of Needs à

Physiological à Safety à Social à Esteem à Self-Actualization.

 

Frederick Herzberg:

Motivators and Demotivators.

 

Satisfaction — no satisfaction (absence of good salary).

 

Expectancy theory —Victor Broom.

 

Individual Effort à Individual Performance à Organizational Reward à Personal Goals

 

The individual effort to individual performance is called Expectancy.

 

The individual performance to organizational reward is Instrumentality.

 

The organizational reward to personal goals is Valence.

 

MBO 'Management by objective.

 

Management is doing things right and leadership is doing the right things.

 

Important books on Management:

 

Emotional Quotient —Daniel Goldman.

 

Seven Habits of Highly Effective People — Steven Covey.

 

Leaders

'Autocratic Leaders 'High degree of dependency on the leaders.

Democratic Leaders — bottom up approach.

 

Change leadership style.

Consolidation.

 

Change Management:

1. Immobilization.
2. Minimization.
3. Depression.
4. Depression.
5. Acceptance.
6. Search for meaning.
7. Internalization. (Change is understood and adopting it within the length and breadth of the company).

 

Theories of leadership —

1. Trait Theory:  Leaders are born.
2. Behavioral Theory:  Leader can be trained.
3. Contigency Theory:  Leaders need different styles of functioning with different groups.

 

According to Jack Welch, Teaching Organization is better than learning organization.

Leaders are actually developed by honing skills.  Leaders are not always born.

 

 Gaming Policy à Abstract environment, solution out of it.

 

XYZ theory.

Steven Robins: Organizational Behavior.

 

Theory Z is the personality X and Y.

 

The Japanese have a lifelong employment.  The Americans have a hire and fire policy. 

 

Marketing of Services in 21^st Century — Joshua Kahn.

 

Leadership Engine 'Eli Cohen.

 

 

Human Resource Management

 

In 1940s 'industry in West Bengal was mines following Mines Act.  Labor laws were followed.  Consumer protection Act is not a cabinet act, so it cannot order imprisonment.  The fines are made in terms of money. 

 

The labor laws are:

Maternity Benefit Act.

Minimum Wages Act.

Provident fund Act.

Gratuity Act.

 

Recruitment and Selection:

 

Recruitment:  Advertise, short list, etc.

 

Selection:  Written test, group discussion, interviews.

 

Framing advertisement.

Word-of-mouth (cheapest method of recruitment).

Job sites (for high quality worker).

Campus interview.

Internal advertisement.

 

Orientations:  history, profit, goal, mission, vision.

A goal does not have a statement.  A goal is set for the customers.  For the HR, it is the employee; for the doctor, it is the patient.

 

A vision is a generalized statement.

 

A mission is for the community.  It gives better profit to the stakeholder.  There is no motivation. 

 

Companies of different types:  public ltd., trust, society.

 

Pvt. Ltd.:  For 2 persons.

 

Public Ltd.:  Minimum 8 persons and maximum infinity.

 

Departmental orientation.

 

Self-appraisal is made for an employee.

 

360 degree appraisal is made for the CEO of a company.

 

Abraham Maslow:  Hierarchy of needs.

 

Training:  Periodic training can be in-house.  It can be external as well as internal. 

 

Big bowl of soup.  The bowl is 10 feet in diameter.  There are chairs around.  An 8 feet long spoon is given.  Only through team work the soup can be drunk.

 

Spiritual Quotient. 

Emotional Quotient (emotionally how you feel at that moment; emotional quotient is very important in modern management).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Today I woke up at 5 a.m. and brushed my teeth.  The skies were cloudy and as I wanted to move out for a jogging in the morning I could not as the rain was drizzling. I then did my skipping or rope jumping which I do a 1000 times at the roof top.  I do Yoga everyday and did an hour of yoga to keep myself fit.  I ironed my shirt and went to Apollo Gleneagles hospital in Kolkata at E.M. Bypass where my hospital administration contract program is being held.  I attend classes from 10 a.m.  So I take breakfast and move out at 9 to reach at 10 a.m.  I have to change 3 vehicles.  A bus to a stop called Khanna and then an auto takes me to Ballygunge Railway Station and then finally a packed government CSTC bus takes me to Apollo Gleneagles Hospital.  While I was in the bus, the bus was too packed to move and so I moved towards a little far from the gate of the bus.  I standed near the bus and my hand was touching the posterior of a beautiful woman and the pressure generated around her was intolerable!!  I then moved towards the gate and asked the conductor for the fare to be taken.  I cannot take out my money bag.  So I took out the 4 rupees I have instead of Rs. 5 which I was supposed to pay.  I told the conductor that I would give you after the bus stops but he never waited for me.  So it was a 1 rupee saving for me! J   J J J J J J J J J J J J J J J J J

 

I entered Apollo Hospital and the guard as usual checks the identity card.  I produce my Medvarsity card and they allow me to enter.  At the base of the staircase, there is a Goddess temple which I pray everyday before moving up the staircase.  I usually prefer the staircase as it is better to walk and burn calories than move to the floor with the help of lift.  Sometimes we do use lift when our friends are in group. 

 

I sat in the waiting area or lobby for half an hour.  I had to wait for another half an hour after our teacher Abhijit Majumdar who is the Marketing Manager came to our class for the scheduled class.  Mr. Majumdar could not start the projector and so he called the technicians.  The technicians also tried for an hour but could not start the projector.  Finally we wrote down whatever our teacher said and he took class on Principles of Management.  He also referred certain management books and told us to buy certain books at home to study.  He is a young man in his 30s.  He has a moustache and his clothes are neatly iron and his shoes well polished.  He has an impressive look, an ideal manager!!  JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ

 

We sat in the lobby and we planned to distribute our photocopies of study material.  We had to spend Rs. 23 and the students who took this responsibility of photocopying are two women, mother and daughter in relationships.  They are studying hospital management.  The mother wants to build a hospital and the daughter is just a graduate.  I have never seen such a pair before in my life!!!

 

I went to an interview in the Billing department where recruitment is being held.  I went to meet the manager who was flanked by 2 people with him.  They questioned me about my previous companies and job profile.  I answered and they asked me whether I know anything about the cash handling as the billing is about hard cash handling.

 

The class of Management ended at 1 p.m. and there was a 1 hour lunch break.  We usually take our lunch from the local canteen where the charges are quite reasonable with good food.  After lunch we went to our lobby where we chatted for a while and finally we went to our department visits.  Reepa Barai is in charge of Medvarsity in Apollo Gleneagles Hospital in Kolkata.  She told us to go to the housekeeping department of this hospital.  She introduced us to the housekeeping manager and after a session of discussions, we went to another department called the Outpatient Department.  The outpatient department was shown nicely by a lady who toured the outpatient department and we were following her as ants follow the next one in ant queue.  We have all seen ants and one ants follow the other ants in a line and we flocked from one place to another and the patient and their family members were watching as some aliens from another planet!

 

After these two department visits, I went to my Reepa Barai's working area where I saw the slides which my friend prepared.  The slides will be shown on 11^th August.  It will be our last day where a group discussion will be held. 

 

I came out of the Apollo Gleneagles Hospital at 4 p.m.  I went to the bus stop and took a West Bengal Surface Transport Corporation bus which takes only Rs. 4.50 and I reached Ballygunge Station and from there I went to Khanna with an auto and finally I took a bus towards Northern Avenue where I live.  In Khanna bus stop, I was standing in the bus stop.  My eyes were fixed over a lady who is quite healthy looking with large breasts.  She has nice cleavage.  She was sitting over a bench in the footpath.  The cleavage is nicely visible and she was wearing a red blouse.  I was watching her and I am feeling heated up. All the erotic thoughts are crowding my mind!!!  I entered the bus and I saw the bus is filled up with school girls.  I sat in the general seat where three school girls sat.  I pushed aside and I sat.  My legs were touching the soft thighs of these cute ladies.  I  saw the row opposite to me and saw a lady who is quite gorgeous with a girl seemed to be her child.  She is dark complexioned and not at all sexy!  A lady entered our bus.  She was a busty woman with a child.  She has huge boobs with the boobs coming out of bra.  The blouse is red in color and unable to keep her boobs within it.  She was trying to hide her breasts from public but her boobs are coming out and she was trying to adjust.  She then came down near R. G. Kar Hospital.  I thought of passing a night with her in the same bed.  You know she was hot, quite hot lady!!  I came down from the bus and went to my house.  I changed my clothes and took my tiffin.  I slept for a while and read the newspapers.  I studied for a while and started writing my whole story of this day. 

 

This day is special for me as it is the day when I gave my first interview at healthcare sector.  The Apollo Hospital wanted to recruit someone who can handle calls of patients and cash handling expert.  Anyway I am going to enter a company I have decided.  It is a medical transcription company in Kolkata. 

 

Anyway my life goes on as usual.  If anything special happens I love to write it down and share it with my friends.

 

 

Difficult to find change

 

Its difficult to find a change!

In money as well as job!

We search for a better education

We invest capital!

We get little in return!

If we get some job at all!

It is hard work ..

Salary .not enough!

We keep on changing jobs

Till we get a nice one!

 

When we go for a change in money!

We do not get anyone willing to give in small currency!!

They pray us to give the price in small denomination!

As it is their prime limitation!

They are in a lot of tension!

They request the customers!

Quarrel starts but hardly it ends in anything good!!

We have to buy something for giving the price!

We feel money has lost value!

In modern human society, we do feel man has lost values!

They admire the valuable!

Disregard the cheap things!

Still they go to shopping mall

For discounts and more goods!!

In the end, the credit purchase is high!

At the end they have to sigh!!!

Regret of their greed!

Being the seed of all corruption!