Posts tagged Dr. Aparna Govil Bhasker

When failure is not an option

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My husband and I recently binge-watched “Made in India- A Titan Story”. The eloquently told six-episode series chronicles the journey of Titan and its visionary leader, Xerxes Desai. It takes you through the highs and lows of building one of India’s most iconic watch brands and keeps you gripped till the very end.

It is a story of innovation, risk-taking and institutional patience.

But most of all, it is a story about having the “freedom to fail”.

Every time Xerxes Desai failed, he celebrated that freedom. Failure wasn’t an embarrassment; it was a stepping stone to the next breakthrough.

Since then, I have been thinking about- the freedom to fail.

Almost every profession is given the luxury of failure.

Entrepreneurs are encouraged to “fail fast.”

Scientists spend years failing before they finally discover something.

ISRO learnt invaluable lessons from the failures of Chandrayaan-2 before Chandrayaan-3 scripted history.

Historically, politicians have failed with astonishing regularity. I mean look at the world around us today. Do we need anymore evidence for their failures?

And then there is medicine…
It is probably the only profession in the world where failure is not an option.

Not because doctors are superhuman.
Not because we never make mistakes.
But because the consequences of failure are measured on a very different scale.

In business, failure may cost money.

In politics, it may cost votes.

In sport, it may cost a trophy.

But in medicine, it can leave behind unbearable pain, a permanent disability, a grieving family and sometimes, a tombstone.

That is a burden every doctor carries from day one.

People often ask me whether surgery becomes easier after nearly two decades.

Technically, yes.

Emotionally, never.

I still pause before every operation. I still prepare obsessively. I still replay difficult cases in my mind. I still pray every time before a surgery.

Because when someone lies unconscious on an operating table, they have surrendered complete control with absolute trust. They have placed their life in our hands.

That privilege can never become routine.

We are never given the freedom to fail. And yet, as doctors we obsessively devote our lives to studying failure.

We learn from our own mistakes, and from those of others. We continuously question, refine, teach and learn—because everything we do in medicine is ultimately aimed at reducing failure.

We spend our entire careers trying to prevent something we can never completely eliminate.

Perhaps that is the paradox of medicine.

And perhaps that relentless pursuit is both the privilege and burden of being a doctor!

Happy Doctors Day!

A PAGE FROM A DOCTOR’S DIARY

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Blessings alone are not enough to keep the lights on

She entered my cabin with a bright smile, reminding me of our acquaintance from years ago.

She thanked me profusely for changing her daughter’s life—this time, it was her son she had brought along.

Between every sentence came a blessing, every pause filled with praise—you are so kind, you are so nice—it was truly overwhelming.

And then they walked out—without paying the consultation fee, despite being politely reminded.

As doctors, kindness is stitched into our DNA.
We don’t treat people for money—but kindness alone doesn’t pay the bills or the rent or the staff salaries.

My colleagues say, “Write it off—there’s not much you can do.”
Because the moment you ask for your dues, the society will turn you into a greedy and money-minded villain.

That’s the paradox—doctors are villainized in headlines and shortchanged so often in reality.
Where empty words of gratitude flow easily, but people’s hands hesitate to shell out a simple consultation fee.

Ironically, it’s not the truly poor who ask for discounts.
It’s the well-to-do, even the ones stepping out of luxury cars, dressed in designer labels, who do.
While those with little often pay in full—with dignity and grace.

It’s never about the money. It’s about attitude and respect.

Blessings are divine and always appreciated—but blessings alone are not enough to keep the lights on, my friends.

©️Dr. Aparna Govil Bhasker

WHEN A CHILD IS PUNISHED FOR HER WEIGHT

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She is just 13 years old.
Six months ago, she weighed 153 kilos. Today, after 6 months of bariatric surgery, she weighs 112 kg.

She has lost 25% of her total body weight—a remarkable achievement by any medical standard. Physically, she’s doing better than ever. Emotionally, she’s struggling.

Because no school wants to take her in.

She hasn’t been to school since Grade 3. Her weight—and the judgement that came with it—forced her into homeschooling. Now, even after making such incredible progress, she finds herself rejected again. Every admission form, every interview, every polite refusal chips away at her self-worth.

She is a bright, curious, and articulate girl. But instead of celebrating her courage and recovery, the system is punishing her for a disease she never chose to have.

Obesity is not a failure of willpower. It’s a complex medical condition—one that affects the body, mind, and social identity. Yet, even when a child fights back with everything she has, stigma continues to stand in her way.

Schools need to do better.
Education is not just about marks—it’s about inclusion, empathy, and growth. A young girl’s potential must not be limited solely by her weight.

It breaks my heart that even after winning the battle against her body, she still has to fight one against society.

The Ladies’ Doctor

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As a lady doctor/surgeon, I end up having amusing experiences on some days.

Today, a lady came in with a rectal prolapse.

She’d already seen a male doctor but now wanted to consult a “lady doctor.”

We spoke, I examined her, explained the condition, and gave her my advice.

Then I said, “You should also see a gynecologist.”

She paused. “What’s a gynecologist? Is that a ladies’ doctor?”

“Yes,” I said, “the ladies’ doctor. That’s who you need to see next.”

She looked a bit confused.

“Oh… but we thought you were the lady doctor.”

I smiled. “Well, yes—I am a lady, and I am a doctor…
But I’m not the ladies’ doctor. I’m just a lady who’s a doctor.”

She wasn’t convinced. “So… you’re not the ladies’ doctor?”
“I mean, I am a lady doctor,” I said, “but not a ladies’only doctor.

“Ohh…” she said, “we came because we wanted to see the ladies’ doctor.”

By this point, I was in splits! ????
“Well, you saw the gentleman doctor. Now you’ve seen the lady doctor.
Just not the one you expected.”

THE SILENT STRUGGLES

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Yesterday, a 44-year-old man living with a weight of 182 kg broke down in tears during the consultation.

He did not cry because he was in any kind of physical pain. He cried because he felt utterly helpless—and scared. He cried because he could no longer breathe easily or walk without difficulty. Breathing and walking are basic, right? He cried because he felt he was failing as a father and as a husband, unable to support his wife and children the way he wanted to.

Every attempt to lose weight had ended in defeat. He felt like he was a burden on everyone. He felt that his life was over.

This is the hidden weight of obesity. It’s the part no one sees.

People living with obesity carry years of silent suffering. They are constantly mocked, judged, and dismissed. They are labelled as lazy, irresponsible, or lacking willpower. They live an entire lifetime with smirks, unsolicited advice, or silent disdain.

And yet what we see in our clinic is that most of them have tried—tried harder than we can imagine.

Here lies the paradox: society expects them to “do something” about their weight but offers little understanding of the disease or support. Instead, it adds layers of #shame, making an already difficult journey even more difficult.

It expects them to fight a complex battle alone and also pins the blame on them at every step of the way.

Obesity is more than a physical condition—it’s a complex and deeply emotional experience. What people with obesity often need is not more advice, but more #empathy.

Sometimes, just being treated with kindness and understanding can lift more weight than any scale ever could.

©️Dr. Aparna Govil Bhasker

PS- Image is AI generated

Calm Under Pressure- Becoming A Surgical GOAT

Bariatric Surgery

©Dr. Aparna Govil Basker

It’s my regular bed time routine to scroll through some Insta reels before I crash for the night. I usually love watching commencement speeches and sometimes some other stuff like stand-up comedy etc. It is good to end the day on a funny note or an inspiring one!

One of the recent commencement speeches I watched was that of Roger Federer. Federer is not only a personal favourite but is also undisputedly one of the greatest tennis players of all times (a GOAT!). He has been admired and celebrated all over the world not only for his impeccable tennis skills but his calm and cool demeanour. I am yet to come across a more graceful personality on the court. Every time I’ve watched him play; I’ve been hugely impressed by his composed demeanour.

Whether he wins or loses, he remains unruffled and tranquil, never showing a trace of excitement or agitation. It has never mattered whether the crowd is cheering him on or being hostile, whether he is being trolled or adored. Federer’s mental strength and fitness shines through. He has maintained the same calm composure in hundreds of matches over two decades. It’s actually quite funny; as bystanders in history, we not only take his greatness for granted but also his remarkable calmness.

What struck me in Federer’s commencement speech was his confession that he wasn’t always this composed. Before his golden era of Grand Slams, Federer was a completely different person— a hyperemotional racquet-breaking brat who couldn’t handle a bad game. This calm and composed demeanour was consciously acquired and cultivated after a deeper self-realization and work with a sports psychologist. It took continuous effort over many years to develop the persona we witnessed on our television screens for so long, both on and off the court. There is no doubt that technical skills and physical prowess played a big part in his success but ultimately what led him to being a GOAT was his ability to create a serene and a resilient mind.

Federer’s journey to mental tranquility and his insights about the importance of mental fitness are highly relevant to a surgeon’s life. Similar to professional sports, the field of surgery demands not only exceptional technical skills but also extraordinary mental resilience and composure. Surgeons operate in high-pressure environments where the stakes are extremely high; a single mistake can have a significant impact on a patient’s health. This responsibility necessitates maintaining a high level of calm, focus, and precision.

In our profession, we confront numerous critical situations at various points. Surgeries can be challenging and intricate, emergencies can arise unexpectedly, equipment malfunctions can occur at critical moments, human errors can happen when least anticipated, and complications are an inherent part of every surgeon’s experience. While it is very easy to express frustration or tension, it is crucial for us to develop our mental resilience to remain composed under pressure.

Many a times surgeons express tension and frustration, especially by directing it towards surgical assistants or operating theatre staff. This creates a stressful environment that affects their performance. This can ultimately impact the overall surgical outcomes negatively. Moreover, such behaviour increases the general stress levels in the operating theatre, which increases the likelihood of mistakes occurring. Surgeons who create a tense and intimidating atmosphere in the operating room disrupt the conducive working environment needed for long-term success. It’s evident that this approach doesn’t lead to achieving any kind of greatness in the field of surgery even if the surgeon is highly skilled technically. I personally feel that they may be successful in creating fear in the short term but fail to get any respect in the long term.

On the other hand, even though it may be difficult, maintaining a professional and calm demeanour not only fosters a more supportive atmosphere for the entire surgical team but also enhances communication and collaboration. This contributes to a smoother operation and better patient care. Surgeons who are conscious about this and prioritize creating a positive and respectful working environment help mitigate stress and optimize the team’s performance, ultimately leading to improved surgical outcomes. Its difficult, but doable!

Federer’s journey has several lessons that are also relevant for surgeons and can be adapted. Just as Federer learned to manage his emotions to avoid being a hyperemotional player, surgeons must learn to regulate their emotions to maintain clarity and focus during surgeries. Emotional outbursts or distractions can impair judgement and affect performance.

Actively working on emotional regulation can help surgeons to remain steady and effective, even under stressful circumstances. Surgeons can benefit from mental preparation strategies, such as visualization of procedures, mindfulness, and stress-relief techniques. These practices can enhance concentration and reduce anxiety, leading to better surgical outcomes. Resilience and the capacity to remain unruffled in the face of complications or unexpected challenges are crucial for successful surgical practice. Ultimately staying calm and composed in the face of adversity can be acquired and cultivated. The first step towards change is to be aware. At the end of the day we all are a work in progress in different stages.

Developing mental toughness and inner calmness is crucial not only in the operating room but also in any high-stakes profession. Surgeons who cultivate these qualities in addition to clinical and technical skills can navigate their responsibilities more effectively, resulting in improved patient care and personal fulfillment. This approach also paves the way for achieving excellence. So if you ask me who is the greatest surgeon I think you already know the answer by now. GOAT in the field of surgery would be someone who would not only be technically skilled but have the highest level of mental fitness and tranquility.

Happy Doctor’s Day!! 🙂

Hope and healing

Bariatric Surgery

©️Dr. Aparna Govil Bhasker

One of the most powerful stories that Homo Sapiens have passed on from generation to generation over thousands of years, is the story of “hope”. “Hope” is our true super-power. Hope can work miracles. Without “hope”… well… everything will be … “hopeless”…(no prize for guessing that)!

Hope is unique to our species. No other animal can boast of being able to feel this magical emotion. Human children are born brimming with hope. One just needs to look into those innocent eyes to feel it. However, with time, this reservoir of hope starts diminishing. As we grow up, few of us become childishly optimistic, some lean towards realism and many turn a tad pessimistic.

Like in everything else, “hope” is a very important ingredient in the potion of healing too. It is a lifesaving elixir for the patient and serves as a vital anchor for the anxious family members. It is no secret that patients who lose hope have poorer outcomes as compared to those who do not. A lot has been written about the role of “hope” in ailing patients and their families, however not much has been said about the significance of “hope” in doctors. It is simply assumed the doctors are the most “hopeful” of all adult humans. Can you imagine a doctor who is “not hopeful”?

As doctors, we start our professional careers by training on dead people (That’s not very high on hope score!). By the time we complete our medical training, we have already seen more sickness and death than any normal human would in their entire lifetime. We frequently witness the fragility of life and very often have to bow down to the forces of nature. Yet, as paradoxical as it seems, we have to dispense “hope” in every prescription that we write.

Does the reservoir of “hope” diminish in doctors as they age or does it increase? This is a million-dollar question. Doctors are like old wine. They are said to get better with age and experience. As years pass by, we see that many more people live through their sicknesses and regain their health, as compared to those who enter the doors of a mortuary. We come across many patients who defy all odds and overcome the worst of diseases. And though we spend a lot of time studying complications, we all know that complications are rare and rare things happen rarely. Thanks to advances in medical science, today most people are living twice as long as they were living a hundred years ago. Not only are they living longer, they are living healthier and looking better too. There is every reason to be hopeful.

However, the true measure of hope for a doctor lies in how they navigate challenging situations. Every healthcare professional encounters difficult cases at some point in their career. These could encompass complex medical scenarios, cases with uncertain prognosis, difficult decision making, ethical dilemmas, emotionally charged relatives, legal threats etc.

We can never have all the answers when it comes to complex case scenarios, but years of experience engrave subtle patterns in our minds, aiding us in anticipating the clinical trajectory of a specific patient. Our minds weave together a tapestry of various stories and clinical situations, forming a powerful network of interconnected experiences and insights that significantly enhance our clinical ability. Many times, we are not able to pinpoint the exact pathology, but these interwoven stories serve as valuable reference points, enabling us to recognize patterns, identify key indicators, and make informed decisions in patient care. So, when an experienced doctor exudes hope, it signifies a profound understanding and confidence rooted in years of experience and learning. Hope is not just an abstract emotion in medicine, hope is entrenched in a blend of evidence and experience.

Sometimes the inability to achieve desired results despite best efforts can lead to feelings of frustration and failure. At times, coping with their own emotions can be quite overwhelming for doctors and the idea of “hope” can feel very elusive. Well, doctors are human too and can be as emotional and vulnerable as everyone else. Also, though the doctor patient relationship is often gratifying, the weight of responsibility always lies on the doctor’s shoulders and it can become a tad burdensome at times. At such times, just like we write prescriptions of “hope” for our patients, we need to understand the value of rejuvenating ourselves also from time to time. We also need to understand that battles are never won by lone warriors, it usually takes an army to defeat the enemy. On days when our “hope” reservoir is running low it makes perfect sense to take a break and let someone else take charge.

In the realm of medicine, hope emerges as a vital thread. Despite the challenges doctors continue to dispense hope, navigating through complexities with resilience and compassion. Empowered by knowledge and years of experience, hope transcends being merely a destination; and becomes a continual journey shared by patients and healers alike.

EMPATHY AND OBJECTIVITY- A DELICATE BALANCE

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EMPATHY AND OBJECTIVITY- A DELICATE BALANCE

©️Dr. Aparna Govil Bhasker

As doctors, we love evidence-based medicine! Most of us believe in the old adage- “In God we trust. All others must bring data.” We are deeply impacted by impact factors and the graph of our pride rises in direct proportion to the number of times our research papers are cited in the literature. Today, we have journals sprouting by the dozens and thousands of research papers being published every year. We go around the world, brainstorming with colleagues and trying to make sense of these infinite numbers in an attempt to solve the mystery of human health and disease. Though we are always trying to apply the evidence to generate best practices, many times during heated discussions in conferences it all boils down to- “What would you do (WWYD) if this was your wife? WWYD if this was your mother? And saving the best for the last…… drumroll please!!….. WWYD if this was your (you guessed it right!) ….. mother-in-law?”

The biggest irony faced by medical practitioners is that while data guides clinical practice, statistics get severely skewed when viewed from the perspective of the patient and their family. The universally acceptable 0.1% adverse event rate is a one hundred percent catastrophe when the life of a loved one is on the line. Randomized controlled trials (RCT) fall terribly short when we have to break bad news to a patient’s family. Unfortunately, RCTs can’t feel the pain or the disappointment. In real life, numbers are just numbers and they have no feelings. At such times, emotions overrule evidence leading us back to the timeless question- “Doctor, what would you have done if this was your own family member?”

Medicine is probably the only profession with a direct impact on a person’s life and death. An average person would probably make life and death decisions once or twice in their entire life. Some may never have to do it at all. Doctors are professionals who have to make these difficult choices on a daily basis. We have to remain objective while everyone is panicking and remain calm in the midst of chaos. We have to keep our head on our shoulders and our heart tucked a little away. We are bound by oath to take risks on behalf of others. Well, we all know that taking a risk is a risky affair and things can go either way. We have the impolite job of being realistic and setting the expectations right. Sometimes we have to say things that people may not wish to hear. And sometimes when we say things, people may choose not to hear. At the end of the day, we have the challenging task of keeping hope alive too, for hope can be a stronger potion than any medicine in the world.

Striking a balance between objectivity and empathy is like navigating a ship through turbulent seas. If either side is lost or if there’s an excess of one, it could tip the balance and sink the ship. Published literature, studies, trials, data and numbers can at best guide clinical practice to some extent. However, rattling off numbers can never provide solace to a suffering family. The practice of medicine is beyond that and the healing potion must contain the right dose of empathy to be effective.

Some of us can overdose on empathy too. Excessive emotional involvement in every patient’s case can lead to burnout and compassion fatigue. Overwhelming empathy can be quite exhausting and we need some degree of professional detachment and objectivity to navigate the medical maze effectively. This brings me back to the WWYD question. Throughout my career, I’ve been taught to treat patients as I would my own family. While we hold our loved ones dear, treating every patient as kin would lead to an emotional roller coaster. Trust me, it’s not good for any of the stake holders.

The journey of a doctor is a delicate balance between objectivity and empathy. We begin our careers armed with a solid foundation in evidence-based medicine and data-driven practices. With experience, we come to appreciate the necessity of complimenting these with empathy and a profound understanding of the humane aspect of healthcare.

When science marries compassion, the journey of healing begins. Those who find this equilibrium our blessed and experience immense gratification and fulfilment in their professional lives. For others, it remains a work in progress. It’s challenging, yet attainable. It’s not easy, yet possible. It is a continuous journey of growth and learning, shaping us into better healers every day.

Quality versus Quantity Nutrition

Bariatric Surgery Blog Diet Obesity Surgery Weight loss surgery
weightloss diet in mumbai, india

Author- Mariam Lakdawala (Registered Dietician)

Common questions I generally get from my patients suffering from obesity,

“I don’t eat much, still why am I gaining weight?”

“I eat less than one of my friend, but why is she so thin and I am not?”

My answer to such questions is simple, “Don’t only see how much is on your plate, but also see ‘what’ is on your plate”.

The basic rule of weight loss is to restrict the overall quantity of food and increase the calorie burning capacity of the body. However, this rule has been outdated as only quantity restriction in the absence of food quality management, will not result in positive weight loss outcomes. Also a good quality diet which consists of good quantities of proteins and fiber keeps you full for longer and delays the intake of subsequent meal.

Though factors like genetics and heredity play a major role in adding those kilograms, ‘food’ can also be a major factor for tipping the scales towards obesity. If the quality of the diet is poor, food becomes the major cause of obesity. Your food plate determines the quality of your meals. An ideal food plate must have all the major (macro) nutrients i.e. carbohydrates (also includes fiber), proteins and fats in correct proportions.

weight loss diet in mumbai, india

In India, our diet is rich in carbohydrates with very less quantities of vegetables and proteins. This has an adverse impact on our metabolism and exposes us to various metabolic diseases, including obesity. In metropolitan cities the dependence on ready to eat processed foods like biscuits, breads, noodles, sausages/ nuggets etc is much higher in order to save time. These processed foods are generally high in sugars, salt and fat which makes them less nutritious and dense with empty calories. Poor quality diet coupled with lack of physical activity just makes it worse and has played a big role in increasing obesity levels.

The quality and quantity of food are two sides of the same coin. Both the aspects are equally important not only for weight loss but also for maintaining good health and must not be ignored.

How to manage Reactive Hypoglycemia?

Bariatric Surgery Blog Gastric Bypass Gastric Sleeve Obesity Surgery Weight loss surgery
Hypoglycemia

Author- Mariam Lakdawala, Registered Dietician

The most common observation made among diabetic patients is that they generally grab on sugar or sugary beverages when they get hypoglycaemic (a drop in the blood sugar levels). But are these sugar shots really helpful?

Temporarily – yes, but after 2-3 hours there are higher chances of experiencing another episode of Hypoglycemia. This kind of meal or rather simple sugar induced Hypoglycemia is known as Reactive Hypoglycemia. After the ingestion of sugar/ sugary beverages there is a rapid increase in the insulin secretion. Insulin causes a rapid digestion and absorption of sugars and still remains in the blood eventually causing low blood sugar levels.

The symptoms include dizziness, fatigue, light headedness, sweating, irritability, confusion, blurred vision, heart palpitations, etc.

Here are some dietary tips to prevent and manage reactive hypoglycaemia,

  1. Avoid consumption of sugar, honey, jaggery, processed foods, bakery products (bread/ biscuits/ cookies/ toast/ khaari/ butter, etc).
  2. Add fiber rich foods like vegetables, pulses, sprouts, fruits to every meal in order to improve the quality of carbohydrates.
  3. Do not keep long gap between the meals. Eat a small snack in between the main meals.
  4. Ensure every meal is balanced with good quality proteins from milk, curds, paneer, soy and its products, egg, fish, poultry, meat, etc.

Reactive hypoglycaemia could be because of multiple other reasons (Eg. Post gastric bypass surgery) and can be managed with the same dietary modifications. In case it doesn’t resolve with the diet, you can check with your doctor for further medical management.