New York the big Apple

When I planned my US visit this time it was for a very short two weeks and I would be mostly in Cleveland ,go for a five day trip to the Canyons and Vegas arranged by my daughter and her friends .
It was stark winter and both New York and Cleveland was in a spell of snow and extreme cold .
But I still decided to make a flying trip to the Big Apple as to be so near I could not miss it .


So on a late night Greyhound I travelled to new York and reached there in the morning .
As I came out of the bus station onto 8 th avenue  I knew walking along the streets as I planned wasn't going to be that easy in the chilly wind .
the cold got into my bones knawed it and came out leaving me a huddled wreck
I tried to fill up all exposed skin with the clothing's I had like muffler cap hood of my coat and gloves of course and now only my face was exposed partly but that was enough .
My plan was not to stay in New York as I would have to wait to mid afternoon for a check in and the next day check out early instead I thought I would get into a hop on hop off and see the most important sites in Manhattan and leave the rest to the next time
After all this was my first time and something told me I would be back again to this city
certain cities have that dynamism in them and you feel its your kind of place Mumbai was one I always felt so ,KL,Hong Kong strangely Not Singapore ,Paris too .
Manhattan island is lined by skyscrapers and you feel deep down in a gully street ,the roads are all perpendicular to each other and designated as street and Avenues ,it wasn't difficult to trace a path because f this grid design .
I had a 10 minute walk to Big bus place and I was already exhausted trying to beat the chill
and then in front of me as if a genie ordered it there was the office of life line another famous hop on company
I went inside forgetting my loyalty to Big bus ,such cold one is allowed to be unfaithful after all it wasn't to your wife
I found a bargain ticket of Down town  middle town with an Empire state building ticket thrown in and took it for 64 $
Empire state building has always been a child hood fascination to me .
I walked across to the waiting double decker went up to its cellophane covered roof and sat in a chair ,the camera picture through this cellophane would be horrible but the cold made it stay
for once I agreed with my children who always ask me to look not with camera but with my eyes .

Big Apple is a label that New York city carries amongst many , like city that never sleeps Gotham city , etc. .

The famous journalist Fitz Gerald in 1930 heard this as a slang talk by two African American jockeys in a New York race course when they said
"I wud go to the big apple again "
Fitz used this label whenever he mentioned New York in his posts and thus big apple became its acronym
Aptly labelled
For there's that something that makes New York different
Something very palpable
Very alive
The city is like a being
One can feel its beats
We do have such cities with such magic ,
Mumbai our own has it
Hong Kong
Paris !
Many more as I havent been to so many cities yet .

New York never sleeps
Its a seething mass of concreted forests an example of mans ingenuity in building places of stay .
In the thirties New York was in a mad rush to build higher and higher towering iron and steel staccatos that changed the face of the city .

Those spires would dwarf the streets of Manhattan .

It was nicely represented by the Manhattan cocktail I sloshed in a downtown bar the vermouth blending with the rye whisky on loads of ice .

Sitting on a high stool listening to slang around the men the women the waitresses the bustle I  was reminded of all the Hollywood films I had watched .
Now I was part of one !

A character in a live Hollywood set ,
All around me were the very scenes I  had seen
And as I sipped on the bitter cocktail I felt New york was best seen in the bar.

 It was free
It was unobtrusive
A man is left alone to ruminate to himself sipping his drink lost to his thoughts and no one is bothered as long as he keeps to himself
They are polite but non interfering .

And as I people watched them I felt the ethos of New york was you carry on , life carries on and I liked that ethos a lot .

The only thing I wished  wasnt true on this 12 hour run to the big apple was the weather.

That hampered me

It was not cold alone but bitterly so !!

The wind would sneak its way through any gaps and reach my soul licking it with cold fire and the spirit of my looking feeling was all lost in searching for some warmth !

 .


The downtown point covered all the iconic points like the legendary Times square .
This is actually a city junction with neon lighted brilliance happening crowd and a living example of that magical realism of the city
It was like living in the pages of a Salman Rushdie .

The milling crowds were crowding on the pavements
Selfies were taken in hundreds
A bride and groom had come for their photo session
The tall neon tower blinked its preferences
I heard the tower was otherwise empty and earned its keep by being in the costliest space on earth .
The very cradle of capitalism the likeable decadence of consumerism the Times sqaure had it all .
The place was safe despite all this crowd .

The landmark iron horse skyscrapers were dutifully detailed by our guide in the bus the millionaires row
Trump the present American President hails from New York where he raised its fortunes
The Presbyterian st Pauls church loomed near the 9/11 memorial and as I walked into its vast space of memories I felt that the disaster struck on the soul of Americanism the Trade centre itself symbolic of the hatred of fundamental fanaticism the very opposite of the spirit of the city of freedom and goodness.

I went into the church too for a peep and walked on to the famous Brooklyn bridge from where I got a good view of the island .

But it was from the 86 floor of the Empire state building I really got a glimpse of the miracle Manhattan was ,no is , and will be forever .

Getting into the building itself was tedious with long depressing ques and security but was worth the effort .
I skipped the uptown tour and so missed out central park ,several universities ,etc but for a daytime roaming of such a big city I saw parts of Manhattan that justified it to be the big apple .

Maybe I will be back another day to sip my cocktail sitting in a bar high above its concrete towers
The symbol of man and his making

Cleveland

Cleveland in Ohio state on the side of Lake Erie is one of the three big cities in Ohio the other two being cincinnati and columbus .
I had landed in Chicago after a direct 14 hour flight from Delhi India and was suitably jet lagged ,Ii wasn't brazed for the chill in the air as it was winter .
I did not feel it in the airport or in   the RTA Blue line metro that took me more than 1 hr to Clinton station for my further travel in a Greyhound bus .
But when I wheezed my way up the steep stairs ( strangely no escalator which I hardly expected in USA )and came out of the station and faced the elements the cold hit me as a blast ,I  managed to scurry quickly to the icy pavement and fluffy snow to reach the greyhound station around 300 meters away and managed to get into its warmth .
I traveled in the Greyhound reaching Cleveland by 8pm ,
Cleveland too was covered with snow and its pavements glistened with ice .
My daughters apartment was in downtown and not very far from the Greyhound station another 300 meters ,and i slept like a log with my melatonin all in a mess !
Cleveland was the 51 st largest city in the US with a population of around 400000 founded in 1796 near  the mouth of the Cuyahoga river ,it was known after General Moses cleveland who was the leader of the group of surveyors drafting the city
its also known as the forest city and its residents called Clevelanders .
It started growing after the completion of the Erie canal and thus its connection to the Atlantic
it grew all along till the sixties when there was an exodus of population to the suburbs a general trend in the US
at the advent of 21 st century Cleveland became known in the medical field and health industry and also in Arts
the public square was the major downtown area which included financial district ,theater area called playhouse square ,
Me and my wife plodded through the snow to the public square and went into a memorial of the civil war where I rightly answered the questions of a very conversant and knowledgeable security cum manager who was keen to know how much of American history this Indian knew !!
the Clevelnad clinic was a well known medical center internationally and were running several hospitals in its name in the middle east etc ,other than this there were the university hospital and the Metro health medical center where my daughter was doing her Pediatric residency 
Cleveland is also known for biotech start ups and research
info tech ,industries were all famous in Cleveland
The playhouse area had theaters with Broadway type productions
The most famous museum was the Museum of fine arts ,we would go there the next day in a health line bus ( one of the Bus companies in the city ) and walk through a sludge of snow to reach the museum itself ,we spend a long four hours in its voluminous halls containing art pieces from all over the world ,renowned paintings of the mediaveal periods etc
Later our daughter would pick us up and go to a park in a cemetery ,a huge well kept park with dark foreboding trees ,pinnacles silhouettes of cottages icy roads and not a soul to be seen but tombstones
the stark beauty of the p[lace filled us with delight and we managed to take pictures of a pale peeping sun in the frosty skies as a parting shot to this fairy tale land 
dinner was at an Ethiopian restaurant a homely place with bouncy waitresses and music that played in the background of Ethiopian variety ,we sat in a an alcove nibbling into very Indian Samoaas the only difference being the changed word
Later we would be brought the landmark Ethiopian Injera a type of dosa made of Teff grain powdered into a dough and fermented and baked as thin pancakes eaten with different sauces and a meat curry !
On Christmas day we went to the nearby cathedral enjoying the exhilarating  white day ,
The cathedral was huge with painted windows and glittering altars ,

slowly it filled with well dressed and well behaved polite locals who had come for the special Christmas mass ,we sat through he ceremony lasting more than two hours with a sepulchral organ chiming in the background the baritone of the bishop in his sermon of the day and  the hymns sang with so much devotion that it thrilled our soul
on way back we did see a homeless man huddled in a dirty body bag on the snowy pavement exposed to all the elements the stark reality in the US of A such a rich country with some inequalities on inquiry i came to know that they preferred the street ans elements to a cloistered shelter when taken

Of course I hadn't done justice to the sprawling city this time and hardly visited a very small part of its downtown ,i did not venture into the Lake area or the famed Rock and roll house
Cleveland was part of several entertainment and film ventures and is part of several films too .it had its p[lace in art and literature too
with so many immigrants it had a rich culinary history and variety famed for its Polish and central European contributions and was known for its  corned beef sandwiches
Cleveland is known for tis famous basket ball team the cavaliers

Cleveland marathon was an annual event too

Grey hound buses

Greyhound buses are a well known bus service in the US interconnecting the country
I travelled from Chicago to Clevland and now from Clevland to New york and back .
I also returned to Chicago from Cleveland by greyhound .
The buses are modern huge comfortable .
We do have very good bus services in India too these days like fully sleeper ones etc .
The bus stations of Greyhounds are self contained with rest rooms food areas and waiting places
Though not posh they are neat safe and userfiendly .
Once we check in our tickets we wait till its time to go to gate and alight buses in order surrendering our big luggage to the hold and get in .
Theres free WIFI though not very fast and a tiny toilet in bus .
The driver himself announces to passengers the expected time of arrivals dos and donts stop overs
With a no nonsense lecture telling not to use blaring mobiles but be concerned for others
And not to disturb him while he drives .
The order impressed me
The state transport dept stands in kerala are a mess with passengers running behind buses arrogant announcers rusted chairs leaky smelly toilets and putrid restaurants
Its time they learnt lessons .

Theres a general feeling amongst Indians that greyhound travel isnt very safe with number of Afro Americans hispanics as fellow travellers .
I found this a myth .
Agreed there is a wide variety of people in buses but its very safe and most passengers including whites are well mannered and civilised in behaviour .

Air travel

Air travel has become a neccesity rather than a luxury these days .
Airline companies have multiplied , fares  tumbled , so have services .
The concept of airlines being vessels of five star service have been downgraded to them being  methods of transportation .
The industry is becoming a lean mean one .

Perfectly fine !

We still have Business and first class to cater to those who need the ambience and luxury and extravagance.
Take my word I too enjoy it when it doesnt cost me .
If one takes a survey of thee passengers in B class one finds most have tickets not bought by them .
Many travel as part of thier work consequently these long travels give them enough free miles to never travel in economy again .
Enlightened souls

Free loaders like politicians and  bureacraut baboos  are sponsored trips by thier  benificiaries or the Governments pay for them .

Sponsorships for meetings conferences conventions for many .

Artistes travelling for shows

Real rich may travel first class because they have enough money to spend and dont want to buy a jet themselves .

How many amongst ordinary middle class people put thier hard earned money to travel business class paying two to four times the fare ?
I can be frank I wont !

The occasions i had travelled B Class were all sponsored or upgraded .

Now lets come back to economy

Flying economy is no fun these days .

The smiling hostess wuth burnished hair and a tray of sweets is no more .

Instead we do get a smiling hello and at times extended hand to store your bags .

You throw tantrums they throw you out as seen in recent incidents some blatantly unfair to passenger ..
the answer is discipline is part of air travel you obey rules to fly.
.fair enough .
The worst thing that has happened in air travel is food .
Inspidity is USB  of economy food .

Mass production  from distant places ,plastic cutlery ,cramped seats , jerky holders .
All one needs is a  boory passenger in front of one tilting  his seat so much that he is lying on your food tray and your lap literally .

To eat in this condition or worser to drink hot fluids in this mess needs the skill of an acrobat .

In low cost airlines unless when one orders food one is spared of such tortures but then we do need food also in any travel other than short bursts of hour or so .
I pity all the middle and corner seat passengers as every time they need to use restroom they need to be at mercy of fellow passengers and Aisle is king of low costs .

This time in Air asia from Delhi  I carried a Mc burger and a lays chips packet
All i needed was a soft drink from the airline i was literally  in Mcdnold avoiding the unsavoury offers of the flight .

I should try to take my excellently made Biriyani the next time in an air tight box .

I would be cheeky if i dare to ask the hostess to heat it for me !!

She might just call the air marshalls to turn the heat on me !

Ghazi attack ..film review

I saw the bilingual film  Ghazi attack today in hindi .
Many military feats of contemptory indian history are unknown .
Most of us do not know that the Indo pak war of 1971 was preceded by a quiet sinking of Pakistan naval submarine PNS Ghazi off Vizagapatnam .
The PNS ship had come to Indian waters to target INS Vikrant the only aircraft carrier of the Indian navy to cripple it before war was declared  but Indian defence intelligence recognises this and sends S 21 an Indian submarine which is technically inferior to the Pakistani submarine .
The film is all about what happens deep under the  water for 18 days .
The PNS Ghazni fires on an innocent merchant navy ship initially to divert attention .
The pak submarine when detected is fired at by S21 but missed
This exposes the Indian submarine which are hit by mines planted by PNS Ghazni
S21 sinks to bottom
Its brave captain dies and asst takes over
The submarine loses its power to chase the enemy and can only go up or down and to fire its torpadoe it loses the automatic controls and needs a manual torpadoe firing !

How cleverly S21 avoids the PNS Ghazni torpadoeing barrage by quietly adjusting its depths and later manually fires single torpadoe that sinks the Paki vessel is the film taken brilliantly .

Though Pakistan denied this ever happened and said its submarine had sunk because of an accident from its mines stock .

But it started the indo pak war immediately obviously as a revenge .
We all know how it was defeated too .

Such stories becoming film scripts is brilliant in fact they should become part of school text books .

Cold Calculations

COLD CALCULATIONS

I had always been in warm humid places .
Chennai or Madras was famously known for three seasons hot hotter and hottest

Having born into this seething cauldron of a city where sweating was part of life the only time when it was relatively pleasant was the months of December January the mellow Marghazi when children rushed in darkness of dawn to nearby temples and madams to sing hymns and get the much awaited prasdams .

During those pre dawn adventures when one could collide into dark buffaloes frequenting the roads driven by thier equally bullous keeps with trailing milk cans .

The summer months started by march end and slowly the city literally boiled .
In the evenings of may the populace would meander to the marina or santhome beach for a solace as the cool breeze from the sea would to a small extent relieve thier hot humid misery
The rains came in september and lasted for a month of pleasure
The streets were slushy but the pleasure was unimaginable .
Kerala my native place too was warm humid but totally different for one its green roof cooled it to some extent the summers in April and may were still hot and wet but by the middle of may one could see the pregnant clouds gathering strength from the south .

By end of may mostly on june first the south west monsoon would arrive regally wetting the school children in thier brand new uniforms like a ritual of age .
And then for three months it would be a waterworld as incessant rains would fill the green ponds and wells the richoceting of the roof by the rains would be rhymed by the cackle of the happy frogs .
Other than these two places an occasional foray into a hill station or a Delhi in winter was the only experience of cold to me .
Eight years in UAE showed me how hot deserts could be in summmer and how cool it was in winter with a happy 16 degree climate but in Brunei with eqautorial uniformity it was warm humid and rainy on off throughout the year  .

So the cold of a december winter in snow covered Clevland windy Chicago or bone chilling cold of New york put me off a bit .

Warmth definitelly seems less obtrusive now
Iam almost warm to it

And thus one more xmas

And thus comes another christmas
As it does year after year with no great fuss

2000 years back  one kindred soul
Was born for the human race as a whole

A baby an angel  full of innocence
And who never lost it with sense
 goodness and love and forgivance
A life of tireful and tearful penance

Hounded since birth by those who hated
And those  who wanted him negated
Wandering in the desert and the plains
Was it in harsh sun blowing winds or in rain

None knows his childhood or as a teen
Was he mischievous naughty or serene
What and where was he as an young man
Up in high mountains or under the sun with a tan

And when he did come back
There was wisdom in his eyes black
There was a grave sadness in his face
In his concern for the human race

He was in a hurry with little time
He built his disciples to rhyme
He had his message to spread
To all unread and read .

He knew all along the pain to come
He knew of the hatred of some
He knew his future as a vision
He knew the reason for having risen

So he went ahead with no rancour
He did his duty with no anger
 No happiness no hate no sadness
But love pure and with no badness

His pain had come in time
The agony of the flesh and sublime
The tortue of his body and soul
Was seen by the world as a whole

The cross would become the symbol
Of patience suffering and love
The thorns on his crown nails on his flesh
His head encircled on a mesh

And as he left he was born again
For his life was not in vain
He taught us love and what it meant
And that was just what he was sent

Merry xmas

Harimohan

Tissue is the issue

For non medicos Pathology is the study of cells microscopically in diseases states and histology is the same study in normal states !
Histology is microscopic anatomy of the human body at cellular level and is studied as a basic science in medical curriculum ie during the first or second year while pathology is generally done in third or fourth year after starting medicine surgery and gynecology and knowing about diseased states .
Forensic science is the study of dead tissues and post mortem examinations also are a part of pathology but of a more investigative approach associated with criminology and post mortem examination to find cause of death etc a totally different and vast field by itself as a medical student one went through that in fourth year ,

To us working in oncology or cancer medicine ,pathology is vital and pathologists are one of the most important specialists we work with as a team .
In these days of great advances in the molecular level of differentiation's pathology at many times decides on the treatment and the word of the pathologist is sacrosanct .

Getting a pathology or biopsy report for a patient too is very unnerving as it could be a diagnosis which would strike terror into his or her heart or rarely relieve him of his anxiety !

in oncology we always say tissue is the issue

we have in most centers multidisciplinary meets with pathologists to discuss cases as subtle difference can alter the whole management
in these days of highly specialized stains in immuno histochemistry and molecular tests and even genetic mutations the differentiation is so vast .
in the early days it was suffice to get a diagnosis of say in breast cancer what type of tissue it was either from glandular called adenocarcinoma or from connective tissue a type of sarcoma called malignant phylloides whose treatment were diametrically opposite today the sub classifications like the hormone status the aggressiveness by grade or by KI 67 range or specialized targets amenable to treatment like Her 2 or epidermal receptors ,the microscopical invasions into blood vessles lymph nodes or lymphatics or nerves are all vital

in hematology too the sub classifications of lymphomas or leukemia's deserve separate tomes and are in hundreds and each one is important for prognosis or outcomes ,
second opinions are taken at times when pathologists themselves are foxed over certain modulations in tissue

Transformation of the tissue from one type to another as tumor grows certain mutations that confer resistance to certain types of targeted treatment or monoclonal antibodies have all made pathology a highly specialized and meticulous science in oncology .
over the years i still remember some eminent pathologists i had the opportunity to work with

a reputed madam professor in lakeshore hospital in kochi who was very helpful when requested for an early report for those whom we wanted to waste no time to start treatment like in young patients
i still rememebr getting a bone marrow report on same day something which would never happen abroad !!

in Tawam hospital in Al Ain a John Hopkins hospital managed tertiary care center the pathology hematology had a great team there was an Italian hematologist who only specialized in lymphomas and he was an authority on that

in the center i work here now too we have a highly specialized and capable department of pathologists who are the main support structure in the diagnosis of our patient s

with newer forms of tissue sampling like circulating tumor cells and plasma based DNA detection the paucity of sampling from difficult areas like lung will be met better in future

so the kaleidoscopic world of starry cellular wonderland the home of pathologists is dear to us too .

After all tissue is the issue