Tag: last friday

The Jayanagar Problem

I don’t know why there are no good mid-to-high end restaurants in the Jayanagar-Basavanagudi area. Ok I must admit there are a few that are quite good – Chung Wah Opus (run by the Kamats of Yatri Nivas fame) and Banjara come to mind, but there aren’t too many. What bothers me more is the profusion of positively bad mid-to-high end restaurants – Presto (Yediyur circle), Cable Car (inner ring road, near Raghavendra Swami temple), Baron’s Inn (9th Main 40th Cross) come to mind.

There are several other reasons as to why I won’t move out of this part of town (except maybe to Kathriguppe, where I own a house – and that area I must say is now quite well served in terms of restaurants) , but it is a big problem for us when we want to go out to a decent place for dinner and are in no mood to drive. One such occasion was last Friday and we ended up walking to Hotel La Marvella at South End Circle, which had an extremely awful lounge and fairly decent north indian food at the not-too-bad rooftop restaurant. Still, there was something missing (which I can’t describe here) which meant the experience wasn’t particularly fulfilling.

One thing to note is that this part of town is home to a lower proportion of upper middle class immigrants compared to other parts of town. Also, the fact that the growth in the mid-to-high-end restaurant industry in Bangalore is largely correlated with the growth in upper middle class immigrant population (read: the IT boom) lends credence to this line of thought.

Then, there might be people who argue that these are “traditionally traditional areas” so people won’t eat out much, and won’t spend much when eating out, and don’t look for diversity in cuisine and all that. But the fact that in recent times KFC has opened a few branches in this part of town (“few” is important – because it’s clearly been successful) refutes this argument.

I don’t have too many other ideas about why this is the case. If you do, plis to be enlightening me.

Collateralized Death Obligations

When my mother died last Friday, the doctors at the hospital where she had been for three weeks didn’t have a diagnosis. When my father died two and a half years back, the hospital where he’d spent three months didn’t have a diagnosis. In both cases, there were several hypotheses, but none of them were even remotely confirmed. In both cases, there have been a large number of relatives who have brought up the topic of medical negligence. In my father’s case, some people wanted me to go to consumer court. This time round, I had signed several agreements with the hospital absolving them of all possible complications, etc.

The relationship between the doctor and the patient is extremely asymmetric. It is to do with the number of counterparties, and with the diversification. If you take a “medical case”, it represents only a small proportion of the doctor’s total responsibility – it is likely that at any given point of time he is seeing about a hundred patients, and each case takes only a small part of his mind space. On the other hand, the same case represents 100% for the patient, and his/her family. So say 1% on one side and 100% on the other, and you know where the problem is.

The medical profession works on averages. They usually give a treatment with “95% confidence”. I don’t know how they come up with such confidence limits, and whether they explicitly state it out, but it is a fact that no disease has a 100% sure shot cure. From the doctor’s point of view, if he is administering a 95% confidence treatment, he will be happy as long as his success rate is over that. The people for whom the treatment was unsuccessful are just “statistics”. After all, given the large number of patients a doctor sees, there is nothing better he can do.

The problem on the patient’s side is that it’s like Schrodinger’s measurement. Once a case has been handled, from the patient’s perspective it collapses to either 1 or 0. There is no concept of probabilistic success in his case. The process has either succeeded or it has failed. If it is the latter, it is simply due to his own bad luck. Of ending up on the wrong side of the doctor’s coin. On the other hand, given the laws of aggregation and large numbers, doctors can come up with a “success rate” (ok now I don’t kn0w why this suddenly reminds me of CDOs (collateralized debt obligations)).

There is a fair bit of randomness in the medical profession. Every visit to the doctor, every process, every course of treatment is like a toin coss. Probabilities vary from one process to another but nothing is risk-free. Some people might define high-confidence procedures as “risk-free” but they are essentially making the same mistakes as the people in investment banks who relied too much on VaR (value at risk). And when things go wrong, the doctor is the easiest to blame.

It is unfortunate that a number of coins have fallen wrong side up when I’ve tossed them. The consequences of this have been huge, and it is chilling to try and understand what a few toin cosses can do to you. The non-linearity of the whole situation is overwhelming, and depressing. But then this random aspect of the medical profession won’t go away too easily, and all you can hope for when someone close to you goes to the doctor is that the coin falls the right way.