Monthly Archives: May 2014

It Should Matter That YOU See

It Matters

At around 3 p.m. one Friday afternoon, about ten years ago, I was sitting in front of a monitor, reviewing a child’s angiogram.  We were operating on her next, and I wanted to refresh my memory.

I was at one of the busiest heart hospitals in the country.  We averaged 12 operations every day.  About a third of them were on children.  As a specialist pediatric cardiac surgeon, I loved and enjoyed the work despite the long hours and high stress.

That day, our team was running behind schedule.  Not by much, but enough for our anesthesiologist to get a bit anxious.  She was a talented and skilled lady, and a good friend of mine.  Walking up to me, she said:

“The patient’s ready.  Are you going to get scrubbed?”

“Just a minute,” I said.  “I haven’t yet seen this angio fully.”

And then, she spoke the words that would change the direction my career took from there onwards.

“It doesn’t matter if you have.  The surgeon has seen it already.”

I got up, and walked slowly over to the wash area.

My heart was heavy as I went through the pre-operation ritual that has remained constant over time.  As I gazed numbly at the foamy bubbles that lathered my forearms, the water sluicing down to wash them away along with all germs and dirt, leaving my hands sterile to assist at the long, complex heart operation to follow, the truth of her blunt statement gnawed at my insides.

She was right.

It didn’t matter if I saw that angiogram.

I wasn’t the lead surgeon.  Someone else was.  And he had seen it.

I don’t recall much of the next 4 hours.  I assisted at the operation mechanically.  All the while, I was pondering the important issue raised by her comment.

Through the long drive back home after we finished, and a restless night that followed, I kept thinking about it.

And by next morning, I had made up my mind.

Barely a fortnight later, I resigned my position to return to another, smaller hospital where I had once trained.  To a unit which was, relatively speaking, poorly equipped and under-staffed.  To an environment where I couldn’t hope to put to use more than a tiny fraction of my hard-earned training and knowledge from years spent at centers of excellence in the U.K. and Australia.

I returned because, here, it matters.

That I see an angiogram.

That I examine a patient.

That I counsel a family.

That I perform an operation.

I left because, there, I was redundant.  Unnecessary.  Replaceable.

A tiny cog in a big machine.  Easily exchanged with any other cog.  Not unique, needed, or significant.

Several things have changed in my professional career since that momentous decision.  Through them all, I have never once regretted leaving.

The center I left has grown to a behemoth, carrying out 150 operations every week.  Where I operate today, I’d be lucky to do that in a year!

The difference is that the few children I treat won’t get operated without me being in this place.  

My presence is necessary, essential, required.

It should matter that YOU see.

That YOU do.

That YOU provide value, support, purpose to the project or group or organization where you are engaged in investing the rest of your life.

It should matter that YOU make meaning.



Stuck In The Past

Dr.Mani at Annandal

Many years ago, as a freshly graduated doctor, I received my first posting order – as medical officer at a primary health center (PHC).

To get there, I was forced to take a five-and-half hour bus ride every weekend to a nearby town. Next morning, I would catch the only train passing by the village – an ancient old steam locomotive that only managed 35 kmph – when it was speeding! (Now I wish I’d been smart enough to grab a photo of it – but I didn’t, though you can see the over-crowded carriages above!)

The trip lasted 40 minutes. Sitting by the window would leave a thin layer of grime on my face, and gusts of black smoke stung my nostrils everytime the wind blew it into the compartment.

Since the train didn’t halt at the village (even through the track passed beside it), I’d alight a kilometer away – and either walk or hitch a ride on someone’s bicycle to reach the ‘hospital’.

There, in a gloomy, damp room I would see 100 to 150 patients every morning… in under 3 hours! A few were seriously ill. Most had chronic ailments needing prescription refills. And a fair number came out of curiosity – to see the ‘city doctor’ who was visiting their remote village!

No, this wasn’t in the dark ages as Angkor Wat Cambodia. The year was 1990.

It was my first exposure to medical practice in the public sector – and was representative of what I’d see and experience over the next 15 years, until I quit to follow my dream and set up my non-profit project in the private sector.

Medical science was not stuck in the past. The practice of it in certain locations, and the distribution of these services to geographically remote places, however, was.

Barely 400 kilometers away, state-of-art medicine was practiced at standards that rival – even exceed – the best available in most developed nations. But Annandal village was stuck in the past.

It doesn’t happen with technology or science alone.

Sometimes, our attitude and mindset gets stuck in the past. When we should be looking ahead, we put our heads in the sand and remain caught up in obsolete paradigms. Where we should be proactive and forward-thinking, we let the past smother and imprison us.

In an era of the bullet train, we should be thinking about tele-portation and speed of light travel, not the horse-and-carriage system.

Cherish the old steam locomotive, by all means. Even feel nostalgic about the tang of burning coal in your nose, if you must.

But stay focused on the future. It’s the only part you can influence… and change.


The End of a Dream

End of a dream

I was at Hotel Saravana Bhavan having breakfast one morning with one of my best friends of over 25 years.

This man is one of the fortunate few in my medical class who got to discover the specialty he loves, chose to work in it, and enjoys his daily routine. But he hasn’t yet received the highest degree in that branch of medicine.

Sipping a hot cup of coffee, he was recounting the early days of his medical career, and mentioned how he first planned to take the qualifying board exam in his specialty.

“When was this?” I asked.


For the next few minutes, the words he spoke barely registered in my mind. I sat in shocked amazement, even horror, as the reality of that date sunk in.

It had been 15 years.

He still hadn’t taken that board exam.

Over this time, I (along with many other friends) had nagged him about it. Always the reply was, “I’m going to do it – soon” or “I’ve applied this year”.

And, just like that, a decade and a half had flown by.



A poignant quote came to mind. “The opposite of love is not hate. It’s indifference.”

I thought about the many things – ideas and plans, projects and activities, ambitions and desires – that I, too, had shelved for a “tomorrow that never comes”.

Some were put off for a few weeks, others for years.

I’d never before taken stock. Now I would.

As soon as I got back home, I pulled out a moleskin diary and started writing in it, furiously. Soon, there were 9 entries. I’ve started working on two of them already.

No more waiting until “tomorrow”.

Because the end of a dream is not its death… it’s learning to live without it.


Who Is A Winner?

Who is a winner?

I take long walks in the evening with my daughter. We talk. A lot.

Looking back over the years, I wish we had recorded (or taken notes on) what we discuss, because these conversations are often insightful and instructive.

Yesterday, we were talking about what makes someone a ‘winner’.

Having a dream, making a plan to achieve it, and taking action on the plan may lead to it coming true. But does that make YOU a winner?

“You can’t possibly call someone who achieves this a ‘loser’!” my daughter exclaimed… until I gave her a scenario.

What if someone trains hard for a competition, dreaming about winning it – and then he does, which makes him delighted… but he also knows that if he had lost, he would have been DEVASTATED?

Is it wrong to call such a person a ‘loser’?

We explored this from various angles, but this is the crux. It is what defines a ‘winner’.

If you can dream, plan and act – and then accept whatever result you receive with aplomb, grace and gratefulness, then you’re a winner… regardless of what the ‘result’ is.

And to the contrary, if your achieving the ‘result’ means everything to you, and not getting what you want will leave you angry, frustrated or unhappy… why, then, you’re NOT a ‘winner’ – even when you win!



Entrepreneurship – What Does It Take?


Entrepreneurship is gaining popularity. People like you are taking the idea of starting your own business more seriously. Maybe you are upset at your job, or want to pursue a dream, or are just excited at how easy it is to set out along the entrepreneurial path today. Whatever your reasons, it is important that you understand the pillars of launching a successful enterprise.

The 4 key elements are to:

  • spot opportunities
  • assess them sensibly
  • select the right choices
  • execute confidently and effectively

How To Spot Opportunity

The first key element of being an entrepreneur is to identify opportunities that exist. Can you identify an unmet need? This involves spotting market inefficiencies, which leave a loophole wide enough for an intelligent competitor to exploit. But nothing is clear or cut-and-dried about this process. It’s kind of messy. And entrepreneurship involves working within this situation to figure out potential solutions that no one else provides for a problem – and thus creating a new opportunity.

How To Assess Opportunities

There are simply too many rabbit-holes down which you can scurry in search of your business model. The secret to entrepreneurship is to focus on the ones that are best aligned with your strengths, talents and capabilities. Analytical skills come in handy in assessing these options. The chance of success must be weighed against the cost of establishing your business and executing your plan.

How To Select Ideal Opportunities

Apart from the effort and money that you will lose by picking the wrong choice, there is an “opportunity cost” which is measured in precious time. The time you spend chasing the wrong opportunity might have been better deployed in another venture with greater possibilities. Entrepreneurship is about assessing opportunities carefully before coming to a decision. Once the decision is made, there is no room for second guessing the choice, or delivering anything less than maximum effort towards making things happen.

How To Execute Confidently

The ability to squeeze the greatest value from any business opportunity requires the capacity to execute your plan masterfully. Becoming an entrepreneur involves having passion, purpose and persistence as you flesh out your plan and build something of value. You must know what tasks take higher priority, and get them done in a timely fashion. Having a well-thought out and detailed business plan written so that you can refer back to it often will make a huge difference to your success.


Understanding these four pillars of entrepreneurship helps budding entrepreneurs like yourself gain better insight into the path you choose for yourself. It can be a dangerous and risky path if you set out along it recklessly and without planning. But if you take the intelligent route, implement principles of time management, focus and goal setting into your entrepreneurial career, this can be one of the most exciting, satisfying and profitable endeavors of your life.

Time Management Tao can help you along this path by teaching the powerful concepts of how to:

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Success Amplifies YOU

Success Amplifies You

I was thinking about those ‘celebrities’ I mentioned in another post.

They have gone on to become household names in the film industry. Along with others.

Barely 2 or 3 of them, however, can really act well. All have large crowds of acolytes who worship their every antic, regardless of merit or quality. They have TRUE FANS.

I thought back to the actors and celebrities of yesteryear.

Even they spanned a similar spectrum. Some were very talented. Some were very popular. In only few exceptions were the two in proportion (anyone else here a fan of Rajnikanth?!)

Even off-stage, the impact these celebrities make on the wider universe runs the gamut.

Some are generous, others stingy. Some are noble; others petty. Some become inspirational icons of a generaton; others are scary role models for our youth.

But here’s the rub…

None of them became this way AFTER they grew famous.

They already were. It just got bigger.

In your impassioned quest for success, remember this.

The time to become your best ‘YOU’ is right now… not afterwards.


Do You Read Enid Blyton?

Read Enid Blyton

As we grow older, we read weightier, more abstract tomes.

Books like…

Then, we try to figure out the deeper meaning and profound insights these authors expound.

But we also forget how much power and impact is there in SIMPLICITY.

In children’s books – like stories by Enid Blyton.

Each experience of their characters is a lesson that’s applicable to us adults in our lives – and what’s more, they are EASY to understand!

Pick up any book your child is reading.

Browse through it.

Watch for the lessons.

Take them to heart.

Because, at heart, we are all still children.


Believe And You’ll See

Believe and you'll see

A few months ago, I was on FB when a chat window popped up. It was someone on my contact network.

“I’d like you to write an article for me. What do you charge?”

I named my price.

(It’s high. It took me years to work up the confidence to ask for it.)

There was a significant pause. Then he replied.

“That’s a bit out of my budget.”

“I’m sorry to hear that,” I responded. “If you like, I can recommend other writers who are just as good.”

“No, no. I want YOU to write for me.”

He waited. I went on browsing my timeline in another window.

After a while, he typed… “Let me try and come up with the money.”

He did. I wrote for him. He loved it.

The secret to this happy result is being able to believe.

On my side, to believe that

  • a. there are people who can afford to pay well for quality work
  • b. that I can deliver value for the money they pay

On his side, to believe that

  • a. what he gets will be worth paying for

People say “seeing is believing”. It’s not. Once you’ve seen, NOT believing is foolish!

That’s why there are many excellent writers willing to ply their trade for a couple of dollars per piece… they refuse to believe UNTIL they see.

Flip the paradigm around.

Believe it – and you WILL see.

Not intuitive. Not easy. But rewarding – in incredible ways.

Go, believe!

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