Exam Countdown has begun! Part II

 

This is in continuation to the previous blog where I wrote about pre-examination manifestation of adrenal cry. Unlike other diseases, this “adrenal cry” pathogenesis passes through distinct stages (We need not to talk about etiology, do we?). In following texts I will be discussing clinical course and pathogenesis of the adrenal cry.

Stage 1: Worried

The moment you get a circular from University, declaring the date of your final exams, you enter into this stage. To be more precise, preceding your entry to this stage, there is a transient phase of happiness (cf. transient vasoconstriction followed by prolonged vasodilatation in acute inflammation) because you have already started to think about your post examination plans.

But as soon as you work out the stuff need to be read, the worry start to play “Garba” around your grey matter on tune of “ my friend you are in stage 1”. The scenario particularly worst for PG students as they haven’t appeared for any exams in last three years (In fact, some of them already forgot to spell “examination” correctly). The thought of sitting and writing for three hours has potential to pass a chill through your skeletal in spite of obvious perspiration from face sweat glands.  This stage is further aggravated when you juniors tell you “Boss! You need not to read, you will do well”:P

Interestingly, during this phase you pass through lots of WTF moments and wonder about where you spent last three years.

The only good news about this stage is, it is short one and let you enter in the next stage of pseudo-euphoria.

Stage 2: Pseudo-euphoria

Pseudo-euphoria is actually our brain’s compensatory mechanism which works on psychology of secondary gain. As I discussed previously that in present time we don’t have option of fleeing in stressful situation, alternatively our brain has developed this adaptation. At the beginning this phase is intense and then it becomes feeble and persists in residual state till a day before exams. Eventually, it ceases itself as soon as you have exam question paper in hand while in examination hall. It is so strong betrayal, leaving you in middle of examination hall. It is akin to withdrawing sympathetic support from patient having compensated congestive cardiac failure.

This adaptive stage start with self explanation e.g, come on, I will pass the exam, it is very easy, and in last three years I have already read all books. Some of them are even little overt e.g, my memory power is very good so it would be problem, I will finish everything in couple of days.

Once you finish this job of getting explained that you will pass this exam, you are in full blown Pseudo-euphoria stage.

Stage 3. Reading

 

At the end of stage to you realize that your cool attitude is not going to work and there is only three options: Read, read and read

This stage is relatively short in duration and the quality of reading is not that good. It is more on psychological support and to maintain that residual pseudo-euphoria. Essentially the reading quality is equivalent to student on amphetamine just day before the exam. The only, goal of the reading is to turn all the pages of all the books at least once regardless of what is written in there.

It has mix picture due to residual presence of stage 1 and 2 so while planning your reading schedule (which you usually work out at the end of stage 2) you should all some days in between for possible predominant periods of aggravated residual worry and pseudo-euphoria.

Stage 4: Unsure

This stage starts couple of days before the exams and lasts till the results are declared. During this stage all of sudden your all emotional supports becomes weak but interestingly you have a hope of passing (of course hopes are all about uncertainty!). The major symptoms are: you start to believe in God and some unexplained natural powers. In spite of the fact that you haven’t walked for 20 km ever in your life, you will bargain with God with offer of walking to his temple, 20 km far away, in exchange with passing marks.

Even after passing exams, you are unsure that how examiners managed to pass you!

Conclusion:

The pathology of “Adrenal Cry” or examination related pre-cushing syndrome, in other words, passes through distinct stages which give us scope to design the intervention accordingly.

The present modality of treatment, prevention and future interventions strategies will be discussed in subsequent blog posts.   

Exam Countdown has begun!

      

You need to worry especially when your all books look New totally!

Just 60 days to Final exams!!!  My heart is pounding, and the adrenals have already started to cry. Yes, there is subtle difference between crying adrenals and adrenals with attitude “yes I can do it”. In later case you call it “Adrenal rush” and its most of time “flight or fight” response to some stressful/fearful situation. Well well well, this true in pre-civilization era where you had choice of fighting or fleeing. But, in this era you don’t have option for fleeing and you are left out with only option of fighting, that’s what known as “adrenal cry”. Interestingly, “adrenal cry” secrets plentiful of glucocorticoids (kind of stress hormone) over adrenalin compared to “adrenal rush”. Adrenal cry has deleterious effect on your physical and emotional health (most of emotional disturbance is secondary to the deteriorating physical health due to excess stress mediators).

 It’s kind of pre-cushing syndrome status, manifested by wasting of skeletal muscle which is further aggravated by forceful sedentary status as a result of 24 x7 Fevicol –ing your butt to chair and table full of books. Paradoxically, your stomach start to build belly and it is on boomerang has you have starved it for long time (its revenge time buddy). Typically, your stomach protrudes from point down to your umbilical though its anatomical location is above the umbilicus (I guess stomach has arms which are known as “greater and lesser omentum and they are extending down the umbilicus). The skin started to lose its glow and the beard purposefully start to grow which helps other people to identify you as “exam going” (it’s kind of do not disturb sign on your face). The large bowel may suffer from alternate constipation and diarrhea owing to frequent change in ratio of glucocorticoids to adrenalins. The brain is represented by slowly developing “khaduch” attitude where it usually ignores/do not appreciate beautiful things happening around.

One of important manifestation is, all of the sudden everything seem to be so important and you want do everything in this 2 months i.e, you want to start blogging, you want to fall again in habit of reading, you want to read more and more non-educational stuff, you want to start intense cycling and.. Especially you want to join gym and get your shape back by exams (I am not sure if there is any positive correlation between the body shape and exams clearance). You haven’t cleared exam yet and you start to think of getting job!!!  But, it is again adding some more key players to the vicious cycle of stress – broken goals - - stress.

The Good News!  

Is that this is self limiting status which pass through some well defined stages and it is very well preventable as well as curable! Though, right now I don’t want to add one more key player to vicious cycle by writing to too much right now. I will talk about pathogenesis, prevention and treatment later in this week. So, happy exam oriented reading now! 

150th Birth anniversary of Swami Vivekanada

         12 January..! today is 150th birth anniversary of a great thinker, philosopher, intelligent person Swami Vivekananda. Today I am going to say few words and my understanding about a famous quote by him.

             " Arise, awake and persist till goal your is achieved "

     This single sentence has power to deliver any of your goal. Its is very essential to understand the first three words of the sentence to make sure that you can achieve your goal.
      Arise - we have immense power within ourselves that can remove all wants and miseries and we can realise this power. Believe yourself and power will be manifested. When you realise this power within you, you will believe in your decisions.
      Awake- is a spiritual awareness here. Once you have believed power within you and started to believe your decisions there wont be space for further questions!
      Persistent-  perseverance- continuous efforts in direction of your goal, that all you need once you believed your power, decision and have no further questions.

Your not just fine, you are fantastic, fabulous!

Some more thought: 

Truth alone

gives strength

...Strength

alone is the medicine for

the world's disease.

How has all the

knowledge in the world

been gained but by the

concentration of the

powers of the mind?

...There is no limit

to the power of the

human mind.The more

concentrated it is, the

more power is brought

to bear on one poing;

that is the secret.

Our mistakes have a place

here.Go on.

Do not look back if you

have done something

that is not right.

Now, do you believe

you could be

what you are today,

had you not made those

mistakes before?

Blessyour mistakes,then

They have been angels

unawares...

Hold onto the ideal

March on!

Anything that makes

you weak physically,

intellectually and spiritually,

reject as poison

Every

duty is holy,

and devotion to

duty is the

highest form of

the worship of

god

May you realise who you are....

Vish
.

Hey Chetan Bhagat.... Start exercising as soon as possible!

       To start with I would like to make disclaimer. I am not chetan bhagat fan and also dont find him totally trash. 

       This 5th novel by chetan bhagat, typically like previous ones but has got good popularity. I am not going to review the novel but going to say something to chetan bhagat... 

Hey Chetan!

               Cant you write something differently? Yes, I do appreciate your efforts in describing the common subject "Unacceptable Love" and so everybody feel that this is their story. Congratulations! Once again you have succeeded in realising peoples that the characters are connected to their real life. I liked your start of story in revolution 2020, all that child lunch box breaking ( I too use to do that, but never caught fortunately), boat rowing, Gopal's family problems. Gopal is lead character in your story. I am not able to understand why are you so obsessed with fatty peoples (you did mentioned Gopal hadn't flat stomach).  What was wrong with Ryan, Varoon, Ishan and this time Raghav? This are the probably potential character to be a lead character. Hmm,  peoples with flat stomach, muscular physique or crack crazy different thoughts are also existing (of course in low quantity). Probably I found the reason....

Naturally, everybody like to believe themselves a Hero. So you are thinking the same. You are trying prove, peoples who are lazy enough to not to exercise can prove themselves a Hero.  Hamm, fair enough. Man.. if  God didnt give you good height, at least try to compensate it with flat stomach and toned physique (see above).  I bet the day you will make it, you lead character will change. But mind it when  your novel get shaped into bollywood movie, your supporting characters become lead character.   For example, Rancho in 3 idiots, all characteristics were of Ryan, isnt it? Then you end up with fighting with producers that they didnt acknowledged you.. huh.... Its partially because they changed heart of story, a lead character.

Well about revolution 2020: Your have choose a right background of sub standard education and corruption  to fill 25% of novel where Gopal and Aarati are not there. Well, mentioned about Money machine Kota as education business. Okay... thats  all fine to add some salt to your novel.
          What I really appreciate is description of confused Aarti. It is realistic. A truly wavering, insecure, confused character that really resemble a girl fell between two boys who always see the grass greener on other side. This is the reason I am not putting you in trash, because I know well, to get such detail knowledge about girl, you must have worked and even suffered very hard :p Aarti tries her best to make Gopal accept the facts and maintain the balance but she hurts both men in process. After all boy brains! Girls could have handled in better way.  I am wondering about Raghv's hurt that's not mentioned.
          Like hollywood movies there will be surely 1-2 sex scenes in your story, in better words love making scenes (પ્રેમાલાપ દ્રશ્ય). Well, to describe Indian scenario, you  must have worked hard to gain knowledge of different types of love ( infidelity in this case). But still you can improve in this particular field. In  my school and college there were better such scene teller and writers (of course in toilets), I can forward their contacts to you if you want :D :D.
         At the end of story, it is always the corrupt and hopelessly in love Gopal that you empathise with and root for. This is what hurt me, why not Raghav ? Man,... you should get flat stomach as soon as possible and start to change over rolls in your next novels.

I am not going to reveal the whole plot and kill your joy of reading revolution 2020. Go and have read, It wont be waste of time.


Vishal

When you start falling, I start getting just amazing....!

I took this picture from University park today morning. As such, I was looking at this tree almost everyday since it caught my eyes  as a solo stander while passing on my bike. I thought of stopping by and catch a picture many time but being always in morning rush didnt stopped until today. I am sure this will be happening to you guys also. After experiencing joy of taking a time to praise the beauty around me, I would like to tell you "don't dance fast, otherwise you will fell before the song is over"  

         Finally, today I gave myself time to catch this beautiful picture. It say me don't afraid to be different from others because when other will start felling, you will start getting just amazing.

Here I would like to remember a poem by terminally ill young girl who had less 8 days to live when she wrote this poem. 

Have you ever watched kids 
On a merry-go-round?

Or listened to the rain
Slapping on the ground?

Ever followed a butterfly's erratic flight?

Or gazed at the sun into the fading night?

You better slow down.
Don't dance so fast.
Time is short.
The music won't last.

Do you run through each day
On the fly?

When you ask How are you?
Do you hear the reply?

When the day is done
Do you lie in your bed
With the next hundred chores 
Running through your head?

You'd better slow down
Don't dance so fast.

Time is short.
The music won't last.

Ever told your child, 
We'll do it tomorrow?
And in your haste,
Not see his sorrow?

Ever lost touch,
Let a good friendship die 
Cause you never had time 
To call and say,'Hi'

You'd better slow down.
Don't dance so fast.
Time is short.
The music won't last..

When you run so fast to get somewhere
You miss half the fun of getting there.

When you worry and hurry through your day,
It is like an unopened gift....
Thrown away.

Life is not a race.
Do take it slower
Hear the music
Before the song is over.

   

Red............................ Creating Godly inspiration..

Yeah!!!........... perfect!! thats it! exactly this is how it was looking!!
                 Without putting you peoples in confusion rounds..... I am gonna  talk about something that very few people use to believe. Its a short story from my 1st MBBS year, a  never understood, funny, crazy and I am trying to explain it now. 

                 My first year in MBBS had both tastes, bad as well as extremely good. This is something about the faith in something which you believe exists and other believes doesnt exists. On those days if somebody have noticed, I use to have a white cardboard paper with me, and there was a single word- 'Red"-  written over that. Many peoples asked me whats this, I told its a God, a real God. Peoples understood its a joke. Another day, a guy snatched it away from me to make counter joke and I beat him hard. Some, smart peoples started to believe that there something interesting with this cardboard and that's why I am very much attached to it. It was with me always, doesn't matter I am in lecture, at canteen, outside the reading room or inside the reading room. 

                 Yes, it was my inspiration. I never knew how it become my inspiration, there is no story behind it to tell. It was simple piece of cardboard paper with a single word "Red" written with red pen. I liked that writing so much that I started to believe its a mirror, a mirror of my wishes. Whatever I show to it, it reflect it back. Isnt it sound something similar? probably with God? We like something without any story behind it, any reason behind it. Or, we start to like something and a stage come where we declare our wish, we dedicate it to something we like and eventually we work hard to achieve it. The thing inspires you need not to be a human, an animal or an object, it could be something that really doesn't exist, isn't it? Well, best inspirational object in the world is you, yourself. You just need to find a mirror to reflect yourself. 

                Sometime, I wonder when people says I lack inspiration, I need something to inspire me. I would say, you can see, hear, run, your heart is working, you can respire, you can think, you can imagine, you can visualize... isn't it amazing, isn't it inspirational?

                Okay, I am leaving now believing you understood my point.

Well I am bit crack so weird thoughts are my inspiration :D :D

Who inspired you in your life? I believe there must be something like "Red" who told you to get to work or get lost :D :D

And you think... its too late?

Picture: Liverpool from Albert Dock. 

                    Liverpool has got world heritage status by UNESCO, want to know why? ... go and visit city :D 

Well, I am today not here to talk about the Liverpool but about something very important that I learned from the Liverpool. Few days back, I was thinking its too late to go for PhD now as it will take away five more years of my life and neither its worth to get enrolled in CCT ( Completion of certificate of training) as it lasts for 7 years and you will labelled as trainee for 7 years. This were the thoughts and I have already abandoned thought of PhD from my mind. 

                     I went to Wigan, a small town near by the Liverpool, having a very famous NHS hospital. Its Orthopaedic department has been given a Centre of excellence status. I met some of the doctors there and talk with them realised me that there are still peoples who believe that there is never too late! They are enrolled in CCT at age of 32 years or more. So its not hard boy! you are still quite young to follow your dreams. My friend Jyotirmay is also 32 years old and I never knew that he completed his MS ENT in 2009 and went for fellowship in skull base surgery in Bombay, later joined as AP in some medical college in Karnataka and presently on Dr P N Berrys fellowship in UK. He is still aiming to pursue Mch in rhinology and skull base surgery from wigan! 

                    I dont know why I always require some examples to keep me motivated but thats it about me :) Later in evening I was sitting near Albert Dock in Liverpool looking at horizon displaying play of beautiful colours. It was telling me it doesnt matter whether you succeed or not, it doesnt matter what your friends are doing, what really matter is are you enjoying your journey towards your dream? If yes, then its never too late to continue your journey to pursue your dreams!

Hmmm,.. now I am in mood to talk something else and why not about Liverpool!

Liverpool is multi cultured city having a magnificent history! You wont believe but it has more foreign trade offices than London! Its a Liverpool which introduced the peoples that world is quite larger than you believe and quite shorter to reach various places that you believe totally unreachable.
Well, it all started like this..
   Liverpool was commercial trade centre of the world, all the ships to USA and from east countries like India and china were going from Liverpool and coming to Liverpool. Africans were being made salvers and exported to USA were they forced to work for cotton production and cotton from USA were imported to England though Liverpool. More than 70% immigrants going to USA or any other part of world including Australia and New Zealand were travelling through Liverpool....
    Its has got two very good museum with historic importance. namely Liverpool Maritime museum and International Slavery museum. If you want to know more about Liverpool history, just Google it out and you will know lot of things that you might not have come across!