30 November 2019

Came across an interesting chart…

This apparently is the population of the earth (in 2000) by latitude. I knew that most of the earth’s population lived in the northern hemisphere – but what I did not realize is that more than half the population live north of 27 deg North! That is even beyond the Tropic of Cancer!!! That would imply that more than half the population in the world do not experience the sun directly above their head ever!!

(Source: Radical Cartography)

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18 October 2019

From the quill of Purnam Allahabadi

(sung by Nusrat Fateh Ali Khan)

“Agar’che kisi baat par woh khafa hain

To achha yehi hai tum apni si kar lo

Woh maaney ya na manaey yeh marzi hai unki

Magar un ko purnam manaa kar to dekho”

Roughly translated (improvements welcome)

She seems to be upset about something
Perhaps it is best to just move on
It is up to her whether to accept me or not
But please try to convince her with all your passion

There is a clever play on the word “purnam” in the end. The last line can mean – try with your “full” force to convince OR try to convince her about “Purnam” – which was the name of the poet. In the old days in that part of the subcontinent, poets often embedded their names in their poems – in a form of copyright protection!

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14 October 2019

The toll that systole and diastole takes

A few weeks back, I had gone for my annual physicals. For some reason, I look forward to this trip. A great chance to meet all the nurses and doctors there that I get to see once a year, go thru all the tests to look at the progress over the years (I have been going to the Emory Executive Physicals for 12 years now – so there are a lot of graphs for me 🙂 ) but the best part is sitting down with the doctor and understand in details how our body works.

This year it was about blood pressure. Before I go any further, I want to add that I am no doctor and a lot of my knowledge is from reading up on the internet (mostly documents from Mayo clinic). So, take this as a neophyte’s journey into understanding how our body works.

That said, one of the challenges I have been facing is sudden change of blood pressure. I have had pre-hypertension for a few years and take a daily dose of the minimum amount Losartan (25mg) allowed. I have kept meticulous records of my blood pressure throughout the day. And you can see clear patterns. The swings are predictable and pretty wide. Initially, I had difficulty convincing the doctor that I had no issue with my machine or taking readings. Till he took the pressure himself this time. Within a matter of three hours, my pressure came down by over 40 points.

That is what got us to figure out a strategy to understand what is happening with the body. Given that I had readings that came down to well within normal limits, he could not prescribe a higher dose. We are trying out some strategies to understand what might be causing this but that discussion led to my inevitable question…

“All this time you told me that controlling sodium is the best way to keep blood pressure under control. I get that. I remember in eighth grade learning that sodium chloride is hygroscopic and every molecule attracts and hangs on to many molecules or water. That would increase the blood volume and put pressure on the vessels.”

“That is accurate”

“But, how is that volume varying so much so quickly for me?”

That is when he knew that we are going to have one more of the “sessions”. He stepped out (my guess is he cleared out his schedule for some time) and then came back and sat down on the computer taking me thru pictures and some literature.

So, what I gathered about blood pressure is fascinating!!

My starting question was “Are there known long term effects of any blood pressure medicine?” (I wanted to focus on that aspect and see if I could take steps to counter that).

“Yes,” he said.

“What?” I asked somewhat concerned.

“You live longer,” he deadpanned! Yes, this is why I look forward to my annual visits.

After about thirty minutes, this is what I understood. If you are an engineer, it will be very easy to understand. Think about the blood vessels as pipes. They are built to carry liquid at certain pressure. Of course, if you suddenly send fluid at an astronomical pressure – it will burst. But if it is slightly higher pressure than what it is built for, it will not burst immediately. Over a longer period of time, the smallest part of the pipes will burst though. And they tend to be in our kidneys, eyes and brain.

But how does medical science control blood pressure?

The easiest – and the first medicine I was prescribed – are of the category ACE inhibitors. To understand this, you have to go back to evolution. When we were hunter gatherers, the brain often had to control blood supply to different parts of the body to focus on immediate preys or a lurking danger. To do this, it would send signals to constrict certain part of the blood vessels. To achieve that, the kidney would release a hormone (called angiotensin) in the blood. The hormones would be the signals for the muscle layer covering the vessel (called white muscle) to constrict itself.

The ACE inhibitor simply inhibits the kidney from producing that hormone. This prevents blood vessel to be constricted and raise blood pressure.

When I started taking Lisinospril (the ACE inhibitor), I started coughing. It took some time to realize that they were connected. But moment that happened, we switched to the next category of medicine – ARBs. Which is short form of Angiotensin Receptor Blocker. Instead of telling the kidney anything, this medicine works by blocking the white muscles from acting on the hormones. As the name suggests, it blocks the receptor signals. That is what I have now (Losartan is the specific one I take).

“My friend Anusuya takes another medicine – which is a beta blocker. How does that work?”, I asked.

To understand that, we have to realize that the blood pressure is not just about the volume of blood or the width of the pipe. How fast the motor is sending the fluid thru is the third factor. If the motor is furiously pumping the fluid thru, it will obviously creating more pressure. And that is what the beta blockers do. They get the heart to slow down a trifle bit. Of course, if you overdo it, there will be other disastrous effects.

There was a fourth strategy medical science takes to deal with specific blood pressure case. I cannot remember that now.

But the fifth case he described was fascinating. This is used mostly by gynecologists. I did not understand the method very well, but the problem is easy to understand. Basically, you are dealing with two human bodies now – the baby and the mother. They have different systems but any medication you put in one is going to reach the other. So, there is a more intricate approach to dealing with high blood pressure expecting mothers. (e.g. you do not want to slow the heart down – it might have verynegative effects on the fetus, as an example).

Later I came back home and was thinking if the body had any natural ability to get rid of extra sodium. Of course, for a person like me who travels five days a week, I must be consuming a lot of sodium – just from the preservatives of food eaten outside. Turns out you can help your body. Caffeine is a diuretic. And that prompts the kidney to dump sodium and water from the body. Tea, ginger and other plants help too. For that matter so does coke. (Coke has other terrible effects).

Which is an irony. I gave up on coffee just six months back. Completely a tea-totaller now (not teetotaller though 🙂 ).

“You know doc, what I am going to do when I take the next year off?”

“Study medicine?”

“Yes”

“Let me know if you need a reco letter. I have had a student who started at the age of 50. She is practicing medicine now.” (My doc is also a prof in Emory).

“Well, I do not want to practice. I just want to learn.”

I came back home – somewhat excited and told Sharmila –

“I want to study medicine after I am done with this job. My doc thought it would be a great idea. I think I should have become a doctor.”

“Yeah! Right!! You would have gone around telling people how to build self driving cars then”.

I was this close to calling my doctor to increase my Losartan to 50 mg!

12 October 2019

Talking to strangers

Just finished up this book after seeing that Somshekhar recently did the same. Overall, like every other Malcolm Gladwell book, there are a few key points. Some very interesting side facts. And lots of real life stories told in a very gripping way. Devoid of those stories, the net net of his message is about 4 pages strong. If that.

The stories, while initially very absorbing (again, he has a great way of narrating them) eventually became fairly repetitive and a tad too drawn out for me.

The core messages that he wants to deliver are not as insightful as his other books. His basic points are that we are terrible in judging strangers – we let a person’s demeanor color our judgment of their truthfulness, we are too quick to judge others (but never ourselves) and so on. The fundamental issues we suffer from when we judge strangers according to him are:
(*) we default to truth – we believe not because we do not have doubts but because we do not have enough doubts
(*) the illusion of transparency – we overindex on behavior and information gathered from personal interaction
(*) we fail to take context into account (from the stranger’s point of view)

Then again, without these we will not have a functional society either. If we did not default to truth, for example, we will never get anything done. So, in some ways, you are left wondering what to do with what the author is saying.

Now for some interesting side facts:
a. There are tribes in many parts of the world that drink alcohol that is as high as 180 proof. That is near-pure alcohol. They suffer from no social pathology. Now, we understand that alcohol is not a disinhibitor. It merely creates myopia. Meaning we can’t see the long term effect of words or actions. Just the short term ones.

b. When London switched from town gas (other than giving energy at homes, this was also the most commonly used mode of suicide – inhaling the carbon monoxide) to natural gas, the suicide rates plummeted. And did not come back. Implying that suicidal people are NOT determined to commit suicide one way or the other. The tendency needs to be matched with a particular context.

c. Poets have the highest suicide rate (5 times) as much as the general population. They also have far lower life expectancy and much higher emotional disorders than others – even playwrights, novelists and nonfiction writers by a wide margin

Not a big thumbs up from me but you will not regret reading it, for sure.

18 September 2019

Atomic Habits

[This just in… found out that the author was a student of my senior from high school days – Prabasaj-da – who incidentally is absolutely one of the smartest persons I ever had a chance to spend some time with]

About a month back, I was talking to Roger and he mentioned this book. Downloaded it and read it. It is a fairly easy and quick read. There are some good nuggets of wisdom from James Clear.

The underlying thesis of the book is to not focus on outcomes (“want to run a marathon”) and instead focus on the “identity” (“I want to be a runner”). It takes you thru the author’s framework of Cues-Craving-Response-Reward with respect to how to build new habits or break down old ones.

Some interesting observations that caught my eye:
(*) We want to first fit in a group and then we are accepted, we try to stand out
(*) Agriculture spread much faster in Europe and Asia than the Americas and Africa because Europe and Asia is spread left to right rather than top to bottom (think of the homogeneity of climate)
(*) The reason we stick to bad habits? Human brains have not evolved from the immediate-return environment (foraging leads to hunger satisfied now) to delayed-return environment (we invest now so we will be wealthy twenty years from now). Thus we smoke for immediate pleasure but we underestimate the danger in the future.
(*) We can be rational and logical only AFTER we have been emotional

You can read the book to pick up other nuggets yourself.

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13 September 2019

Friday evening relaxation with Nusrat Fateh Ali Khan and Rahat Fateh Ali Khan songs

“Tu mileya te mil gayi khudayi ve
Hath jod akhaan payee na judaayi ve
Mar javangi je akh mein tho pheri
Dua na koi hor mangdi”

Somebody with a better grip on Punjabi needs to help me with the translation but I believe what the words mean are

I found my God when I found you
I now pray with folded hands that we be never separated
I will die if you ever take your eyes off me
I have no other prayer (than you)

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13 September 2019

The Algebra of Happiness

That was a quick read. Did not land up being a great fan of it. If you are a young person in twenties or thirties, you might like this – kind of a Ready Reckoner for Happiness. But, if you are somebody in my age group or at least have any reasonable level of reflections on life, you are probably going to find this book not having much depth. Perhaps, my disappointment is because I could not learn anything new.

Scott – who is a professor at NYU – where I have a daughter – starts by tying to be funny and some of the doodles will make you crack a smile. But the narration goes all over the place and I, at least, could not find a coherent path. Plus, it came across as more of a “mea culpa” on his life.

That said, there are a couple of things that caught my attention. First is his reference to the app 1 Second Everyday. Seems like an interesting idea (you take a second of video everyday and then look at the collection – often mashed up – much later to go thru reflections and recollections). I have downloaded it but not tried it yet!

Couple of the more memorable statements include:

“When times are bad, people look for gray hair for leadership. When times are good, people look for youth”. and

“Entrepreneurship is a sales job with negative commissions until you raise capital; they are profitable or go out of business – whichever comes first.”

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8 September 2019

Range: Why Generalists Triumph in a Specialized World

I got to know about this book written by the investigative journalist David Epstein, while reading another book.

First, I have to start by saying that I became a believer of “breadth over depth” long time back in my career (which explains why I have never worked in the same industry twice and have thus never been accused of being an expert in anything). Therefore, my recommendations for this book might be a form of self-rationalization.

But if you want to understand why variety of knowledge and experience leads you to understand the deeper structures of a problem and their relationships much better – which is impossible to do if you are looking thru the tunnel vision of one discipline only – this is a good book to read.

The author does a good job of separating those domains where deep knowledge actually helps (he calls it “kind domain”). These are also the domains that are likely to be taken over by computers. e.g. Watson will beat humans in chess. But when it gets to “wicked domains” – requiring a lot more of strategic thinking – that is when interdisciplinary knowledge becomes interesting. (Till date, all progress of Watson solving cancer has been nothing to write home about)

On the flip side, the author makes most of his points in the first quarter of the book. The rest of the book is filled with a lot of very interesting stories and examples from all over the world. However, at times, it becomes difficult to understand what the core message in those stories are or how it directly relates to the original point. To be fair, there are connections – it is just that he does not draw the line for you.

All in all, a very enjoyable read. Highly recommended.

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