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Wednesday, October 23, 2013

medical moments 7---the two sides of pain

                                                             He didnt protest . He didnt even  wince . But he gave me a sad look which i still remember .  Though 99 percent of the sadness was at the world and himself as he was just out of a failed suicidal attempt the remaining 1 percent was because of me .  A well built youngster of around 18-20 years that didnt help because i was trying to take his blood sample for the third time . And being my first  attempt in the procedure i failed . But that day i decided i will not contribute to pain of a patient to the best of my ability .

Though never interested in invasive procedures blood sample taking including that made me keenly interested in taking a deep interest in skill development just to avoid paining the patient . And maybe that failed first attempt helped me to do the procedures assigned to me including lumbar puncture and suturing with as much patient comfort as possible . My skill improved tremendously at these minor procedures by the end of housesurgeoncy .

Fast backward many decades . I was a small boy eating as much chocolates as any other . And soon the time came to get a tooth pulled out . I still remember the day because i saw heaven on that day . It took me years later to realise that the anaesthetic hadnt fully taken effect on that day and the dentist was a little early in pulling the tooth . He was a nice man but didnt check whether the anaesthetic had fully taken effect . And like many i too developed a dentist phobia after that . But years later i realised that some doctors are more tuned to patients pain than others .   And like i wrote yesterday on choosing a doctor its important that you should choose a doctor/dentist who is as interested in curing you as in doing the procedure with minimal pain .
"Please lift your finger if you have pain " shows the ability to empathise with you in addition to the medical knowledge .

Though these days the public often quote Hippocratic oath without even reading about it when questioning doctors ethics,  in one aspect i think Hippocrates can be quoted

One of his sayings : "Cure sometimes, treat often, comfort always.".   And though as discussed in medical moments 6 , this comforting by words depends on patients expectations also which can vary , the comfort by minimising pain to the least is a realistic expectation in these days of good anaesthesia . And yes , if your doctor or dentist is insensitive to your pain , dont complain that ALL doctors are bad but look for another good doctor .  (there are many out there these days ... )  

Comments welcome and share it if you like ...



Tuesday, October 22, 2013

medical moments 6---choosing a doctor

Decades ago when i was a medical student i used to accompany one of my elder relatives to her doctor . He was a nice doctor but i didnt like him . The reason being he wont talk . Buzzling with curiosity i wanted him to discuss how he arrived at his diagnosis , why he treated the way he did etc . I was not to blame because inspite of the private visit (he was a retired senior physician ) i wanted him to discuss my relatives case in detail . I would have told my elder relative not to go to him but there was a big problem . She liked him so much and also his treatment was working very much . And jokingly we used to tell that she was in love with him .... One day i asked her why she liked him (as a doctor of course ) so much  ... And the answer shocked me ....,HE DOESNT TALK MUCH . I like it that way .

Medical practice has changed so much in recent years and following it very closely i find theres so much change in the doctor patient relationship . Actually its inevitable because of many reasons a few prominent ones ....
1. Inspite of tremendous advancement in all fields of science including healthcare it still hasnt progressed as much as the "demand " . As a brief example most of the tests have an accuracy less than  100 percent while even educated people  expect 100 percent accuracy in diagnosis .

2 . cost of healthcare has gone up at least in part due to costly healthcare equipment . And while the average person wants to enjoy all the benefits of these fascinating technologies few are ready to pay for it . I have personally seen people who spent 10000 rs for a dress who cry spending 40 rs for medicine .  The same goes for lifesaving surgeries which are often available even now in india cheaper than many home appliances ..
3. I have also witnessed the same people who wants doctors to be ethical and humane but sitting around a table and discussing multicrore project of hospital and discussing ONLY the business aspect of it . ( And none of them where doctors  )  ..Most healthcare is owned by businessmen who have the same ideals as soceity .

                                                                  I mentioned these points because the "trust " in the doctor patient relationship has definitely lessened ( I will not say its gone as im optimistically pessimistic in most things )  and the "fault " is on both sides of the equation . Now all this lack of trust and the loud voiced discussions about the "bad doctors "  gives way to confusion when the time to find a doctor for any of your illness comes near .Because here discussions turn into panic .
Some suggestions :
1. Get a referral from a family friend doctor . In that way he/she will have your best interests in mind when choosing a specialist . Also he will have a good idea about specialists expertise and experience .

2. Trust your instincts when assessing a new doctor . In medicine call it the "placebo effect(refer wiki )  " the doctor patient relationship is also important for cure . But instead of complaining that all or most doctors are bad its important that you choose one depending on your personality  . Just like i told in first para i have seen many patients who want a brief explanation not all the possible complications and others who want to hear everything .

3. If you are not comfortable and for life changing therapies get a second opinion . This doesnt mean keep on shopping around for doctors too much (i mean going around more than 2-3 doctors ) .

4. In healthcare a doctor is expected to have ultimate knowledge , the ultimate communication skills  and the ultimate ethical behaviour . But practically this ideal can never be reached because doctors are representatives of the soceity they represent . So when choosing a doctor also have reasonable expectations .
5 . Read up on the internet from good sites about your health and illnesses . And use it as an aid in your understanding of the illness to make informed choices . All too often i have seen on one extreme educated people who have zero knowledge on their illness and on the other extreme so much partial knowledge only to question  the doctor (not question about the illness )  . Yes , why i mention this is if you are in current generation choose a doctor who talks logically and friendly to you about the illness and answer your questions (not questioning ..). But always remember the time limitations of a consultation which the poor doctor is helpless about . So ask the most important questions and forgive him/her for not being too talkative because of the big queue outside

                                                  So in this era  the onus is on the patients to make informed choices , take more active part in their illness including taking some  responsibility for the bad outcomes . And exercise your choice wisely so that you yourself can collectively weed out the unethical ones from the real good ones ( there are many )  . And above all have realistic expectations especially since even today diseases dont respect neither the doctors nor their patients and doctors should be blamed only for their mistakes and not blame when the real culprit (the disease ) does its job .  


"Reflecting on his career in medicine years later, Dr  Michael Crichton  concluded that patients too often shunned responsibility for their own health, relying on doctors as miracle workers rather than advisors . "...... And luckily we got the Jurassic Park novel and lots of others because of this decision . But we want a few of the good ones in the field to fight the deadly diseases . 

Comments welcome 

Monday, October 21, 2013

Kite runner movie review

                                     Always in the best seller list and in the bookstands this heading always fascinated me . Recently though a little lazy to read a book (im always lazy :) )  i saw the movie of the same name . I always wanted to know who this kite runner was .

Its a movie illustrating the friendship between two boys in Afghanistan . One of them is the masters son and another is the servants son. But that doesnt stop them from being kids indulging in games including flying kites in rural  afghanistan . The servants son likes his masters son more than himself and that is illustrated  in the movie . But the masters son basically a coward gradually feels insecure and plots against his friend . The child actors have acted well . While this friendship and its trials are being played there are other relationships like father-son , master -servant etc well played out by the other characters in the movie . The movie is slow paced (dont say i didnt warn you )  but that helps in imbibing the subtle relationships being played around .

In the later part of the movie the sons grow up and one becomes a famous writer and seeks refuge in the USA . Meanwhile the son of his friend is caught by religious  fundamentalists . What he does further is shown in remaining part of the movie ..

As you know the book is written by doctor turned writer Khaled Hosseini and the book is a best seller . As it happens with movie adaptions some changes will be there but the authors idea , theme and demonstration of human relationships is very good . And the background setup in rural afghanistan , the soviet invasion etc is neatly interwoven in the movie . But i think the screenplay and direction could have been better to make this a great movie because the latter part of the movie is not believably picturised .

To make a long story short this movie if you are a real action fan is not for you , else you may like it ..  But definitely read the book ..  Comments and feedback please and share it if you like ..

Saturday, October 19, 2013

Marriage and emotional abuse

                                                                     Do you know why movies like titanic and casablanca are so famous . Its not because of their photography or their acting (though that all is too good ) or not even about Kate Winslett .   Its because its about true love the ideal we all aim for in our relationships .  Now lets be real ... Movies are movies and reality is different . But being an ardent reader of autobiographies and with a keen interest in psychology as well as having a wide range of friends who are married , single and some divorced its but natural that i think about this occassionally about the male -female relationships around me be it the puppy love , the not-so-puppy love and the holy grail the marriage .

                                                                          India is one of the countries which has the least divorce rates . But recently the trend is changing rapidly with kerala becoming the divorce capital of india multifold  growth in divorce rates .  And though we prefer to shut a blind eye to the negative things including divorces these days many of the divorces happen soon also . There are cases of divorces happening in weeks to months after marriage . And divorces are not rare at all even around yourself and has become part of conversations these days .  I often used to think why for flimsy reasons these youngsters divorce and why cant they face reality and take the good along with the bad  . Yes even in the most ideal marriage lots of flexibility , understanding etc is required to make the marriage work .  And there are many happy marriages around .

But why this pro-marriage person is worried is not because of all this . Its because these days some of my married friends who are "happily married " are telling their not so happy stories .  Those who know me knows that i never prod anyone for their personal lives unless they share it . And some of the stories are shocking . One of my younger good friend is telling about after her recent marriage she was hospitalised after domestic abuse and the daily verbal abuse by her partner which is unprintable . Another friend of mine getting emotionally abused on a daily basis and putting up with it for the "sake of children and parents " .
Yet another friend putting up with the extramarital dalliances of her partner .

Having written earlier blogs on this topic why i write this one is for a specific cause . Marriage still is a great institution provided it is entered into for the right reasons by the right people . But marriage is not an excuse for getting abused be it physical or emotional . Though fights etc are part and parcel of marriage a persistent abuse from one partner warrants family counselling from a good therapist . This is all the more important because sometimes one of the partner could have narcissistic or any of the other personality disorders . And surprisingly the "victim " of abuse may also be part of the problem with severe self esteem issues which allow their partner to abuse them . With so much information available on the internet and books these days ( check out  http://drharoonhmarikar.blogspot.in/2013/03/book-review-fifty-50-marriage-by-vijay_4506.html             ) its high time in this twentyfirst century be happily married for the right reasons or at least evaluate yourself and the situation realistically with the help of a good therapist . Since india still prides on its low divorce rate  compared to western cultures we should still try to uphold our tradition ( Am i sarcastic here , maybe )  . But " abuse " in marriage in whatever form is a wake up  call to think about not only your situation but also yourself as  a person and make informed decisions .(be it 1 day or 10 years )

And lastly i am pro-marriage and also against divorces for flimsy reasons and where flexibility can solve many but not all problems . And i also realise that our great soceity looks down upon single moms and divorcees . But i think there are ways to be assertive in any interpersonal relationship and the concept of free will . Is my thinking because i dont like abuse in any form as its a violation of anothers independence or taking things too personally because my friends are getting affected .  Could be both .Would love your feedback in the feedback form on the right side . Thanks for reading ..



Thursday, October 17, 2013

Alleppey beach ---Venice of the East in Gods own country

                                                                  Though i am a mountain man (i meant i like mountains like munnar and wyanad not that i resemble a mountain gorilla :) )  beaches are beautiful in their own way . And alleppey beach is one of the beaches i love not only because its a  nice beach and easily accessible (just 200 metres from alleppey railway station ) but because it oozes history . There was  a famous port here and was very important in erstwhile foreign trade .

Ok as the merchant of East venice (alleppey was called like that ) you land at the railway station by early evening . You can take an auto or better still take a long walk to the nearby lighthouse one of the few lighthouses constructed by royal family of travancore . The place was a weapons arsenal and later converted to a lighthouse . You can have a beautiful view of the beach and the quaint town of alleppey from the top .  Entry fee is peanuts (Rs 10 )  ...Yes price of a packet of peanuts  . In very few places in the world you can get entry into a nice lighhouse at this cost . And in the same well maintained compound you get a museum where hundreds of year old equipments are kept as museum including telescopes , communication equipment and even the older lighthouse "coconut oil " powered light of more than a century back . Amazing . Again entry cost Rs 10

Stay on top of lighthouse for sometime enjoy the breeze do some beachwatching and people watching (Nice to see people getting excited when on top of a lighthouse coming from different lands)  .  Take some photographs especially of the old bridge over the sea .

Its time to climb down now and go to the beach proper . Dont ask me whether this is Rajasthan but there are 3 camels for camel rides . Unless you are a puritan who will only camel ride in a desert , hop onto a camel and do a camel ride seeing the nice beach . Take photographs of the pier , take photographs of the signal house and walk along the beach road and if u like parks there is a small park nearby .

You should not swim in this beach due to currents . Watch the sunset and then have some peanuts (that too costs around 10 Rs ) and go back with memories of visiting a historic beach in the spice route ...

Btw i forgot the story : was the merchant of venice the good or the bad guy :) doesnt matter ...


Monday, October 14, 2013

the cyclone and some little thoughts

                                                          The cyclone which hit the south eastern part of india recently luckily didnt cause much casualties . But considering the fury of nature these days be it the tsunami which hit southeast asia or the hurricanes in the USA each of this makes us think about how powerless we are in spite of all progress in science against nature .

For a moment think about yourself . Having been told to evacuate in a few hours your house and on returning back you realise that you have lost everything which you have earned for many decades . Just because we are not in that state doesnt mean that anyone of us is immune to it . Isnt it a humbling thought when we realise that all our material gains and our vanity amounts to nothing even in this 21st century where we think we own the world . And its all the more relevant because many of us these days have pride proportional to the material things we amass .

And some more little thoughts ... I heard in one of the radio FM channels the anchor asking the audience what they would take if they are in the same situation and could take only one or two things only  and reply by sms . Many were telling money ,passport etc and some were telling letters from close people , things to remember etc ... It would be an interesting thought to think what you would take if you are in the same situation . Is a letter from a close person more precious than passport ?  Of course its a question of practicality versus emotionality and depends on personality but i was randomly thinking a lost passport can be replaced but a lost letter or something given by close persons can it be replaced ?

And lastly having lived off a suitcase (rather a bag ) many times in travel and also having read numerous accounts of travellers who have travelled extensively around the globe though we think we need so many things actually we can survive and even be happy with very few things . And these can be packed in a few hours too ... Because though its unfashionable "philosophy " we came into this world with nothing and will leave with nothing . And these calamities should make us realise our real place in this world .  Need not agree but i think about this whenever pride rears its head in myself or anyone i encounter in my day to day interaction .




Saturday, October 12, 2013

Fox crime tv channel

                                         I am still searching for the person who called television the idiot box .  In moderation television viewing is nice  . Especially channels like discovery , national geographic and depending on your taste Fox crime . Hey a channel on crime ?  Yes there is its called Fox crime on satellite television .

Those not familiar with it let me explain . It contains a series of programs some of which is fiction , some real and some fiction based on real events . There is CSI miami which in each episode shows a crime scene and  how the police detectives track down the criminal using intelligent police work . Though fictional it shows the complexity of tracking down a criminal and the modern tools of crime detection . But who steals the show is Horatio Caine the chief detective who has a personality as good as James bond minus the women . His one liners , his sensitivity to the victims of crime as well as excellent detective skills makes this program too good . The plots of each episode till now (i have watched around 10) is very good too and in some episodes the motives of the "criminals " also makes you think.

Then there is the practice a program on fictional court drama on lawyers . Having a keen interest in law it is nice to see the arguments for and against a case often sensational being played out in court . What makes each episode even more interesting is the ethical element in many of the cases where the lawyers (as well as the viewers ) are called upon their value system . To make things more complicated each of the lawyer has their own personal stories and it is very interesting how they have to delicately deal with that aspect when arguing the case .

And lastly the police women of some US cities .. This is not fiction but based on actual 911 calls to police ans how they deal with it . This is also interesting as a viewer seeing how the personality of the police officer influences how they deal with a crime situation . As has been supported by crime statistics the black minorities is disproportionately involved in crime and this is also seen in the program . And as a viewer i couldnt help but observe how when an attractive white policewoman with an attitude (one particular policewoman) wherever she goes to defuse the situation ends up calling the entire police force around ultimately . While another policewoman in most of the situations is able to defuse the situations just by talking empathetically yet firmly .

At least for me (dont know about others ) this channel helped to understand the challenges felt by frontline professions like police and lawyers who work ethically . And even some criminals motives and their solutions . And btw where is the person who told television is idiot box ?  I want to shoot him :) :)  

Saturday, October 5, 2013

medical moments 5 .... little knowledge is a dangerous thing

                                                                   I miss those phone calls . It starts off as an inquisitive call asking about some serious medical illness , its treatment options etc and which requires me not only to use my knowledge which i studied as well as some websearching at reputed medical sites .I like intellectual challenges but as soon as that information is given soon the discussion turns to the inaccuracy of medicine , how such and such patient died due to doctors mistake and all the negative talk on the medical profession .

Having seen the profession from three sides ... as a doctor , as a patient and also as a teacher working along with doctors ...( i teach radiologists and technicians )  i do see very well both sides of the coin . As i have blogged earlier the human body is the most amazing piece of machinery much more complex than any engineering marvel ( i work with both unlike most doctors )  .  And still inspite of tremendous advances in medical science each day we are discovering new things not only about treatment but even about the body .
Its really amazing if you spend time learning about it even by spending some time on the internet (as there are lots of patient-knowledge sites by reputed medical centres ) goes a long way in getting a good picture of the subject .

But there is one problem . Even at this moment some diseases have 100 percent cure (if detected early ) and some have 100 percent mortality and most diseases come in between . And also its a fact that most of the tests done have their on risks and benefits  .  Here is the issue .

We have a life where there is no guarantee of the next moment (even when travelling as a pedestrian on road ) or even sleeping in our bed at night (earthquakes etc .. ) but whenever people undergo a treatment or a test they expect 100 percent results (its foolish but thats how it is ) . The really wise accept the risks and go ahead seeing the bigger picture of life but many dont . The really wise also read a lot and also realises the limitations of humans when doing treatment on another human and also makes informed decisions

But mostly i am apalled at the levels of knowledge of highly vocal people who are excellent in their careers (often in the scientific domain ) but have rudimentary knowledge of medical science which these days even a kid can get from google .And other than a cursory search they dont read about this subject which is a manual of the only "machine " they really own --- their body  .   Doctors know from day one that they are not dealing with a subject where all the possibilities are known (because the body is not designed by them )  . And even after spending millions of dollars on drug research all sideeffects are not known because thats the way of science . (even basic laws of physics have changed in many cases over the years )  .

                                                                          Since i am not giving away any shortcuts to knowledge when all have access to the internet a brief discussion on CT scans is relevant as an example . In olden times many lives were lost after accidents as doctors could only diagnose a head injury by external symptoms and often by the time patient starts getting worse it was often late for surgery . The CT scan test in a few seconds could diagnose the brain bleed and help to diagnose this early and saves lot of lives . But its a procedure involving radiation . And before anyone gets hyper on radiation we should realise that radiation is a thing we are all exposed to even when we are in our house or outside  ( from radioactive gases in air , cosmic rays etc ). But CT scans do deliver a  radiation dose . So now what is the choice .... Should we do the test to save the life or dont do it because of radiation risk . This is where risk versus benefit comes in .  Just like walking on the road the possibility of reaching safely is much greater than dying in an accident . Similarly the benefits of Ct scans outweigh the risks depending on the patients condition . This risk -benefit ratio is a complicated subject but the general recommendations are clear in medical sites for patients (by reputed instituitions )  .

Why it is or not followed in a given case depends on many factors especially in our society especially since these days at least a part of medical care is determined by patient demand in a consumerist culture .There are patients who demand a CT scan , there are patients who cannot wait till morning for observation of head injury and a host of other reasons . Further complicating things is the kickback or corruption indulged by some doctors (coming from the same consumerist culture these days )  in ordering CT scans.

Medical profession is one built on trust and knowledge(with all the limitations ) . And in the best interests of the patient and the doctors it would be best that patients start learning about medical science in the same way as the good doctors (there still are many )  realising that humility and knowledge goes hand in hand .. Not arguments which till this date i have seen only from people with the least knowledge ...

PS : I will definitely comeback with the kickbacks which complicate medicine practice in another blog but this blog is directed at patients who should make informed decisions especially in this internet era and shouldnt say " I didnt know " and try to blame the person who is between God and U . Even as a doctor i respect the good doctors and find its the noblest profession and WE as a soceity has commercialised the profession  ..(thats also a blog this week )  ...

Comments please ......

Disclaimer : this is not medical advice .. 

Friday, October 4, 2013

utility value ...on bicycles and choices

                                                    In my tenth standard my dad presented me with a BSA SLR bicycle . It was in my favourite colour black , sporty in its looks and very comfortable to ride . But even at that time of limited choices ( this was the prehistoric 20 th century )  there were three main choices . One was the large bicycle hercules  extremely sturdy and strong and could easily carry two people or heavy luggage . Then there was BSA Mach 1 the bicycle with racing handle where you have to be in  racing position to ride it always and with thin racing tyres to give that extra speed . Then there was the BSA SLR which had sporty looks , above average speed (why these guys always are into this speed and acceleration thing :) )  .
Not only because it was a gift by my dad i was also extremely happy with my bicycle . But being human i "occassionally " envied the few classmates who came in a Mach 1 BSA the racing bicycle .

Fast forward many many years . Recently i rode a racing cycle on the road(not my own ) . Actually i went shopping on it . It was not a Mach 1 (i think BSA has stopped Mach 1s long back ) but one with 20 + gears and imported . It was fine as soon as i went in the road people stared at it as it was extremely sporty and the looks itself showed it was built for speed . After checking the acceleration soon it was time to pedal in a relaxed way and do away with the racing position ( not very comfortable for a long ride ) . And then it hit me . The brakes are available only in the racing position else its a juggle each time you have to brake . Then the second thing .. No bell . The third thing .. No sidestand for parking ..List was endless the thin tyres costing almost as  a motorcycle tyre will not tolerate the unexpected gutters .  And the last thing was no mudguard . Imagine in the rain on a muddy road .

To tell the truth the acceleration on the open road was great . But the rest of the journey was quite difficult .
And this racing cycle was a "road variant " of a racing cycle like our good old Mach 1 of yesteryear .

                                                                  For a long time i choose my gadgets looking into their utility value and my personality . Of course they have to be sporty , reasonable value for money , high in specifications which i can fully utilise in my day to day life . Like in everything the middle path of choices may be the best choice .. at least it has been for me ...

PS :  Dont cancel your Rolls Royce or Jaguar order in kerala especially .. I love those cars but look where you are going to drive it too ... Or maybe i am jealous :)  

Thursday, October 3, 2013

enjoying the moment --music

                                                               

                                                           Long ago during my school days we looked forward to the friday last period . During that time the talented ones used to present mimicry , monoact or even quiz programs for the entertainment of the class .There was no prize for any of these events . For a million dollar i cannot do mimicry ,neither could i conduct a quiz program . Being an audience was ok but every friday i felt like i should also do something .  I had done speeches for competitions with shaking knees but in an all boys school in the entertainment hour no one is in mood for a speech that too a shaky speech ..( threshold for howling is rather low too )  .

And then one day it happened . I gave my name for singing . Not that i was a great singer but having sang along my favourite malayalam songs at home (not in the bathroom :) )  i thought why not sing it in front of the whole class . No accompaniment is a challenge without any guitar or drums . But i went for it . I faced the class and started humming and soon the words started flowing in the tune of the song i had heard and sang along n number of times . I still remember the moment when i was immersed in my song oblivious of the surroundings . There was no target prize , not even the recognition of my classmates . Those 5 minutes only the music mattered and i could realise that expression was evident to my classmates .  What i was not expecting was the applause from my classmates and many of them told me they enjoyed it so much especially they felt so much into the music . I also got paper written with words of appreciation from some .
Over the years though not a "singer " i have sang on stages with accompaniment and also in family gatherings . And before that incident i had took part in umpteen number of stage competitions of light music , poem recital etc  .. But i think that particular friday i realised that its not the prize or not even the applause that was the most important but immersing yourself in the moment and enjoying it yourself.... the moment

And i think on that day my trembling knees disappeared on stage .  The song btw was Mizhiyoram from  movie Manjil virinja pookkal ( flowers which blossomed in the snow ) a beautiful piece of music .. Check youtube ..


Tuesday, October 1, 2013

kerala tourism some more places

                                                        I sometimes feel i should be banned from travelling outside my beautiful state . Because inspite of being a keralite i have still not finished seeing all the nice places in kerala . Each time i am in my homestate i realise that ...

Just a few months back on a lazy afternoon my cousin suggested we make a bike trip in a royal enfield to an elephant sanctuary . This was at trivandrum and i was surprised that such a place even existed near trivandrum having gone to places like kovalam beach and ponmudi hills n number of times . In a red thunderbird we went out and there it was quite close to trivandrum there was an elephant sanctuary surrounded by forest and a lake near kattakkada .  We saw baby elephants rescued from a mountain stream , wild elephant training place where it is converted into "non-wild "elephant . We had elephant back rides and there was even facility to feed elephant for a small fee .  The point is kerala has at least two elephant sanctauries one at kodanad and another near trivandrum .

Then there is Ravi Karunakaran Museum the worlds largest private collection of Swaroski crystals .  To tell the truth i am not a big art connoisseur ,But i was spellbound by the magnificient collection of swarowski crystals in beautiful colours and they told me some are costing more than 3 lakh a piece . The museum has hundreds of these some of them rare and exclusive to them . In addition the museum has an ivory collection and kerala antique collection . All this worth more than 20 crores + belongs to one family . The museum is at alleppey .

Kerala is full of beautiful beaches but i like especially the thalassery beach , the poovar beach and alleppey beach and kovalam beach . Of these the poovar beach is a little secluded and has rocks which gives it a scenic beauty . Maybe because i am a mountain person i like this combination but im sure you will like it too especially since its far from the maddening crowd unlike the busy beach of shankumukhom in trivandrum .

And yes i forgot ... travel north and go with the history textbook in your mind and you will step into the place where the first European set foot on india . Yes , Vasco da gama landed at Kappad beach north of calicut . If you are a history fan its a must visit but dont expect to see anything spectacular there other than a small monument marking the event . And of course have a coffee at the nearby hotel . I liked the place maybe because i am a history fan ..

There are countless other places in kerala i am yet to explore .....I am not paid a penny to market kerala tourism ( i swear :) )  but i think for 1/10 th of the cost of a european tour you can take back enough memories visiting kerala ... Or for people like me 1 litre of petrol on a enfield bike ... Welcome to Gods own country  ...