Pashchimavaahini – Part Deux

I’ve twice written here about Pashchimavaahini – that part of the river Kaveri near Seringapatnam where it flows west. I had once written about it immediately following my first visit there. And I had written about it once again last year when I had disccussed the economics of the place. So over the weekeend I had to go there again, for the second time in two and a half years. In order to do the ritual that is associated with the place – which is to immerse ashes of the dead.

A few pertinent observations from the trip:

  • The place has lost the economics of the food. They probably didn’t want “casual travelers” to come and eat there, or maybe they overestimated their own monopoly power, but the lunch is priced at Rs 70 now. Quality has also dropped – sambar was watery and vada not fried properly. (I’d recommend you to read the death markets post I’ve linked to above before reading on).
  • To put this pricing in perspective, I must mention Kamat Upachar, a restaurant between Channapatna and Maddur. They have a breakfast buffet for the same price! And the buffet includes a choice of juices, bread, idli, vada and dosa, and you can eat as much as you want.
  • This time the shastri we engaged was peaceful. We included an “all-inclusive” price and told him we’ll give only small change as daana
  • I told the shastri to do the minimum possible rituals and told him that I’m doing these things becasue they “need to be done” and not due to some special religious intent. He agreed and kept his word, as he quickly took me through the most basic rituals.
  • When I was away and in the river taking bath, the shastri told one of my uncles that I’m the types that would’ve dunked ashes online if that were an option.
  • I had made it clear to my relatives that I find most of the post-death rituals extremely depressing and so I didn’t wnat to engage in anything beyond the most basic stuff. This meant that at the end of yesterday’s rituals I’d to discard my procedural “tools”. The “paatrams” were given as a gift to the shaastri. The sacred stone was thrown backward in the river. And when I was bathing after the rituals, I let the river wash away the highly starched procedural dhoti

    Once that was done, I uttered a silent apology to the river for polluting it

  • Having been through all this once before, I knew what to expect and so was completely in control of the situation. This helped me manage my relatives better and have my way.
  • Having my way meant occupying the relatively comfortable front seat in the sumo while my senior citizen uncles struggled in the back due to lack of leg space. “This is even worse than an aircraft”, a former-HAL-employed granduncle told the driver
  • To help ease the situation for myself and distract myself, I live-tweeted the journey. And to further distract myself, I tried to tweet like Tharoor.
  • There was a fair bit of pollution involved in the ceremonies. A fair bit of plastic was used, and all got dunked into the river. Extremely sad stuff but I couldn’t really do anything.
  • I wonder why the urn of ashes is thrown backwards into the river. You stand on some rocks facing away and then chuck the thing backwards. I wonder what the significance of this is.
  • Looking at the general crowd there, I was wondering if death is a profitable business.

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.