Category: general

Discharge procedures

Earlier today, I had gone to help out a relative who had been admitted to hospital, and who was getting discharged today. The procedure was bizarre, to say the least.

A little before noon, a nurse walked into the room announcing that the discharge formalities were being put in place, and asked us if we had insurance cover (we didn’t). She reappeared five minutes later in order to remove the thing through which the intravenous drip and medicines had been administered. We thought it was time for us to leave, and informed people at the relative’s home to get lunch ready. What we didn’t know was that the “release” process would take nearly three more hours.

Every few minutes, I would walk up to the nurse station on the floor, and ask them when the discharge would happen. For the first one hour, they would tell that the bill would be ready “in ten minutes”. Finally I lost patience (my loss of patience doesn’t exactly make me an appropriate choice of personnel to manage discharge, I know) and asked them to direct me to the person who was actually preparing the bill. The bill was ready a minute after I appeared in front of that person, and it had been settled in the next five minutes.

A word here about the billing procedures. The relative’s ward was on the fifth floor, and I went down to the basement (“floor minus two”) to the billing section where I got the bill. I had to then take the bill and walk up to the ground floor to the cash section to make the payment, and once again take the receipt back down to the basement to get a printed bill.

Anyway, I thought most of the ordeal was done and proudly announced to the nurses at the nurse station that the bill had been cleared and they should let us go. But the discharge summary remained, and for the next hour or more, they said it would be ready “in the next ten minutes”. And once it was done, a nurse had to run down to the basement (yet again!) to collect it and get the signature of the doctor on duty. And run back up six floors (in another bizarre policy, hospital staff are forbidden from using the elevators!).

Then there was the set of prescriptions that were delivered to us regarding the medicines we had to buy for the following one week (and I’ll write a separate post on drugstores located within hospital premises). This wasn’t the first time I was helping someone get discharged, and this wasn’t the first time the discharge process took this long. From my own anecdotal experience, and from that of other relatives who I was talking to today, this is more the norm than the exception.

This makes me wonder why most hospitals, without fail, have such screwed up discharge procedures? Is this a matter of such low priority that all hospitals can consistently choose to ignore it? It is not like the amount of work that needs to be done is immense, so I wonder what prevents hospitals from streamlining the procedure? Or, like some hotels do, fix a discharge time so that they can batch process the procedures?

The problem, in general, with people in businesses that makes them feel noble, I tell you, is that they are not willing to heed to advice. And are not willing to question themselves enough. The nobility of their profession, they believe, places them too high to deal with mundane trivialities such as time taken to discharge a patient! And I’ll write a separate post soon on people in noble professions.

The Importance of Discipline

I’ve never been a fan of discipline. I think it is a major constraint and hinders creativity, and puts too many walls within which you need to live your life. Despite constant exhortations by my father, I never wanted to join the army. Hell, I tried my best (successfully) in order to even avoid NCC when I was at IIT. I pride myself on being some sort of a free spirit who isn’t held back by any arbitrary rules that I create for myself to live my life by.

A really nice article that I read today, however, makes me think twice about this stand. So this article is about “decision fatigue” and is not very dissimilar to what I’d read a long time back (again in the NYT) about the Law of Conservation of Willpower. So this article talks about how every time you need to make a decision it consumes some part of your mental energy. Irrespective of the size of the decision that is to be made, there is some willpower that is lost, and that causes you to be suboptimal in your decision making as the day progresses.

The article really struck a chord with me, and I realize I’m also heavily prone to decision fatigue. Sometimes the smallest decisions take away so much energy from me that I simply put NED. And yeah, on a related note, I’ve got the wife upset innumerable times solely because of my indecisiveness, a part of which can be attributed to decision fatigue. I even remember not going to a wedding reception some three years back because I couldn’t decide which shirt to wear! And no, I’m not making this up.

So on that note, here’s where I think discipline has a part to play in life. By putting certain constraints on your life, you are reducing the number of decisions that you have to make. And that implies your willpower and mental energy will be reserved for those things where it’s really important that you decide carefully. By making a schedule for yourself, you are outsourcing to you-the-planner all the trivial decisions of your life. Yes, you might feel constrained at times. But it saves you so much energy by way of saving you from several trivial decisions.

Of course, feeling constrained can also affect your mental energy in a negative way, and prevent you from giving your best. Nevertheless, this decision fatigue thingy implies that discipline may not be all that bad. Or maybe I need to think about it some more.

More on consulting partners

I’d written in an earlier post that consulting firms remain young nd dynamic by periodically promoting new people to partnership, and they in their quest to develop new markets and establish themselves, take on risks which can prove useful to underlings who now have a better chance to make a mark and establish themselves.

However, as I’d once experienced a long time back, there can be a major downside to this. The new partners, in their quest to establish themselves, can sometimes be too eager in the commitments they make to the clients. They are prone to promising way more than their team can logically deliver, and that contributes to putting additional and unnecessary pressure on the people working for them.

Nothing earthshattering, but thought I should mention this here for the sake of completeness, so that I don’t mislead you with my conclusions.

Live Music at Wedding Receptions

The problem with live music at wedding receptions is with the volume. If you keep the volume too low, the musicians find it offensive. If you keep the volume high, on the other hand, people can’t hear each other talk and get irritated. And I’ve never really attended a wedding reception where the live music has had the “right volume”.

Hence, at my wedding reception, we dispensed with live music and instead carefully put together a set of trance numbers which were to be played over a CD-speaker system. And two hours before the reception is to begin, we find that there was no music player in the hall, and no one had bothered arranging for one. Thankfully the photographer, who I’d fought with for the duration of the wedding, agreed to arrange for a music system at quick notice. And then, when the reception was about to begin, it turned out that the uncle who had the CDs had gone home to get dressed.

Ultimately, I think they played the music that we’d carefully put together. I don’t know really because it wasn’t audible on stage, but we’re told by a few people it was quite good (they even asked for and “borrowed” the CDs). If you attended my wedding reception, please to be telling me how the music was.

So before my wedding, when I sent the invite to Mammo, he replied asking who was performing at the reception. When I told him my reasons for not having live music at the reception, he explained that performing at a wedding was a good chance for musicians to experiment, and in some ways it was a “paid rehearsal”. And that it really helps in the development of musicians.

On the other hand, I remember, some fifteen years back, my violin teacher being furious that he’d been called to play at a wedding, and there was no one listening to him, and his volume was turned out to be quite low, and he had a really bad experience.

So I don’t know. I still think the best thing to do would be to put recorded instrumental music that isn’t too intrusive. What do you think?

Charades of obscurity

Having “played” dumb-charades (DC for short) competitively at a school and college level, I don’t particularly enjoy playing it casually. I’m prone to getting annoyed when people around me (either on a picnic, or a party) exclaim with great enthusiasm that we should play DC. Till recently I used to think it was like chess – where my enthusiasm for the game has been killed purely because I played it competitively, but now I realize there are more reasons.

The challenge with “competitive” DC is that it is a timed game. You are judged based on how fast you can act out a certain name/place/animal/thing/. Because of this the clues need not be too hard, and there is a fair degree of challenge in acting out even simple things. Apart from this, the clues are set by a neutral third party which means they can all be trusted to be of approximately similar standard, so there is some sort of a level playing field there. Then, you have teams that have practiced well together, and have clues for all the trivial stuff, and you have a game!

With casual DC, there are several problems. Firstly, the games are not timed. Secondly, the teams haven’t practiced together at all, so it takes ages to communicate even straightforward stuff (which is why the games aren’t timed). And then the clues are usually given to you by your competitor. And for some reason, casual DC always has to be movies. No books, no places, no animals, no personalities, nothing.

The f act that the games are not timed, combined with the fact that the clues are given by the competitor, means that the game usually gets into a downward spiral of obscurity. You don’t want your competitor to guess the movie easily, so you give a vague movie. And they reply with something vaguer. And so forth, until teams have to check IMDB to find out if the movies actually exist. By which time all the enthusiasm for the game is lost.

On a recent trip (with colleagues, as part of our CSR initiative. more on that in another post) we played casual DC, and after some 10 clues it had gotten so obscure that nothing was guessable. I’d lost interest when someone suggested we do Kannada movies! Now, that’s something few people would’ve played – DC with Kannada movies as clues, because of which we could give clues while not keeping them too obscure (but it was hard. I completely bulbed trying to act out “Kalasipalya”).

Still, my hatred for casual DC remains, and I try as much as possible to not play it. Maybe next time I’ll impose conditions (like timing, choice of subjects, etc.), and refuse to play if they want to do English movies with infinite time.

Cab guys’ tales

I travel to and from work in the company-provided cab. It’s a fairly convenient system, offering you flexible timings, and routings that aren’t too bad. The overhead in terms of time of traveling by cab is about 15-20 minutes for a 40-minute journey, so I take it on most days.

Given a choice, I try to sit next to the driver – maybe that’s the most comfortable seat in an Indica, and it definitely is the best seat in a Sumo. On most occasions, I chat with the driver as he drives me, but sometimes I don’t have the opportunity – since the driver is too busy chatting on his mobile phone. Yeah, company rules forbid that, but I guess no one really complains, so these guys get away with being on the phone a lot of the time.

Most of the time, the conversation is about loans, and repayment. Most of it is about informal loans that people have lent each other. The amounts these guys lend each other – seen as a percentage of their income (which I’m guessing based on what one cab guy told me last year) is humongous! They make loans to each other of the order of a few months’ salaries, and it seems like these loans are in perpetual transition – between the cabbies and their friends.

I hear them shout, strategise, pacify, ideate, about these issues. And sometimes after they’ve hung up I talk to them about this. One conversation comes to mind. So there was this cabbie whose family had lost a lot of money by “investing” it in a chit fund. It was an “informal” (i.e. unregistered fund), and in the previous “round”, his family had invested and made a good return. So in this “round”, more members of the family invested in the fund. And the fund manager decamped with the money!

I remember telling him that it was a bad strategy putting all their investments with the same guy, and tried to explain to him the benefits of diversification. He replied saying that he didn’t want to invest in the chit fund (the one he lost money in) but family members forced him to invest along with them, calling him a “traitor” when he tried to diversify!! Strange.

Back then, I didn’t know how exactly chit funds work else I would’ve also told him that it was an especially bad idea for people from the same family to invest in the same chit fund. If you think about how a chit fund works, you are basically betting on the desperation for money among the other “members” of the fund. You are betting that someone else in the pool needs money so badly that they’re willing to forego a higher “discount” which will then come into your kitty. So with members of the family all putting money in the same fund, they were just betting against each other! So even if the fund “manager” hadn’t decamped, it’s unlikely they would’ve got a particularly significant return on their investment.

 

On reliably asking for help

Last evening while I was trying to teach the wife to ride a geared motorcycle, a middle-aged woman accosted us. She told us that she was a teacher from Hiriyur (Chitradurga district) and had lost all her money and needed help for her bus charge to go back to town. This sounded suspiciously similar to the couple from Nagpur with a similar story that I’ve encountered a few times, and so I told her off, rather rudely I must say.

She seemed to be taken aback, and hurled some curses on me as she walked away, and then my wife pointed out that there were some things about this woman’s story that made it sound genuine. So now I wonder (given that it is a finite possibility that I might be stuck in an unknown city without money) what one needs to do in order to reliably ask for monetary help – given that fraudsters abound (if I had been convinced that this woman wasn’t a fraud I would’ve helped her out, so let’s take that as a given).

Here are some points that I can quickly think of:

  • Location – would you think someone who would come to you in a residential area (Jayanagar) where not too many people were walking around, and ask for help if they really wanted money? Wouldn’t they rather try at bus stops, or even get on to buses and try get the ticket off a conductor or a fellow-passenger? Or considering that this lady had to make an inter-city journey, wouldn’t it be more reliable for her to have somehow got to the bus stand and asked someone there?
  • Persistence – after I’d told this woman off, she just kept hanging around, and refused to go after I told her in no uncertain terms that I’m not helping her out. Wouldn’t you expect people who are really in need to be more rational and try and look for other sources rather than hanging on to the one person she sees on the street?
  • What you ask for – again ties back to the first point that it might be easier to convince people to buy you a ticket than give you money. Or if you were to walk up to a shop and ask to use their landline phone? (mobile doesn’t work, since that’s a well-known method of swindling mobiles; was once tried on me in Bombay)
  • Abuses – when you are really in need, and someone doesn’t help you out, you don’t loudly abuse them when you go. You’d rather quietly slink away and try your luck elsewhere .

I must say that the woman was rather “respectably dressed”, and before she started abusing she spoke “good Kannada”. It’s just that I wasn’t convinced she wasn’t a fraud so didn’t give her any money.

In any case, what signals would you look for when someone were to come and ask you for monetary help? And what signals would you try to give out if you were to ask for monetary help?

 

Coffee Cultures

I realize each place has its own coffee culture. And coffee culture varies remarkably across short geographical distances.

America likes it large and watery. Even our office coffee machine here describes “americano” as “espresso with hot water”.  And the less I say about the “traditional brewed American coffee” the better. Few people make coffee worse than these guys.

Oh and they like it large. The smallest size on the Starbucks menu is “tall”, though there is a “short” option available if you ask for it. I don’t know how often Americans like their coffee.

Turks like it really thick and strong, and in small quantities. It seems like they don’t like to filter their coffee. But whattan awesome coffee it is! Full in flavour, and the thickness means the taste lingers for a really long time.

Probably the best coffee I’ve had on this trip was at an Ethiopian restaurant (I’m thinking of going back there tonight) and it is not surprising since the coffee plant was first tamed there. Again it is strong and hot, and I was given the option of having it with a little milk and sugar. It is filtered I think, for there was little residue in the cup after I’d emptied it.

Madras likes it strong, with sugar and rich creamy milk (hence the “degree”). And Madras likes it large. I’m told most Madrasis have coffee just twice a day, once in the morning and once in the evening. The quality of milk, though, means that the Madrasi coffee looks light, though it’s quite strong.

I don’t remember too much about coffee in London, but I do remember that Costa’s there served fairly awesome coffee. Again it was all espresso based, which probably implied the quality. Though I do remember cribbing (maybe on this blog) about it. I remember drinking tea in my office there because I found the coffee not strong enough.

Bangalore likes it hot, strong, small and frequent. If I go to any of my father’s relatives’ houses, I usually have at least three coffees before I leave. All small shots. With a little milk and sugar.

At home, nowadays, I’ve been using a percolator I’d bought in Cafe Coffee Day to make my coffee (talking in singular since the wife thinks I make fairly horrible coffee). The problem with the thing though is that it keeps toppling over and I’ve to stand there holding it on the stove while the coffee brews. Any pointers as to where I can get better and more stable percolators will be appreciated.

I don’t know why but today as I was returning to my desk with half a glass of espresso and steamed milk (I’ve figurd out how to structure coffee in this office machine) I was thinking of Baba Budan. About how his efforts have made it possible for us in South India to enjoy this wonderful drink.

Jai Dattatreya.