Vinay Kumaran

I've done a fair bit of driving since I've come to the US. I drove from Pittsburgh to Ann Arbor to Brooklyn (in Michigan) to Cleveland and back again to Pittsburgh and more recently, to New Jersey and back to Pittsburgh. It did not take long to get used to driving on the wrong side of the road or using units of measurements which make no sense (miles). In most cases, I found that the speed limits posted on the roads were sensible limits and more or less the speed I considered to be reasonably safe. Unfortunately, nearly everyone else on the road wanted to drive considerably faster than the posted speed limit. There were periods of time when I found a truck driving at the speed limit (for cars) in the slow lane and I was able to spend long periods of time behind the truck without having to worry about being overtaken or changing lanes. At other times, I found myself on State Highways with only a single lane. Here I determinedly drove at the speed limit (typically 35 or 45 miles...

What this country (USA) needs is a bit of improvisation from time to time instead of a programmed formulaic response to situations. Driving back from Michigan, we stopped at my friend Praveer's house in Cleveland. As we were about to leave, we noticed that there was a puncture in one of the tires. Fortunately, there was a shop nearby for tire repair and we went there. The guy at the shop looked at the tire and said "yes, that'll have to be replaced" and began looking at the other tires (which were fine) and measuring their tread marks. I asked him what he was looking for and he said "if the treads on the other tires are worn to less than (some strange fraction of inches) then we'll have to replace all the tires." I pointed out that the car had done less than 10,000 miles (why do these people insist on not using the perfectly logical metric system?) and that it was unlikely that all the tires were worn out and needed to be replaced. Now if this was...

As I drove from Pittsburgh to Ann Arbor yesterday, I was ruminating on the differences between road traffic in India and that in the US. The highways are generally good although it seems to me that they are not in as good condition as they were 10 years ago. Maybe Trump has a point when he talks about decaying infrastructure. The speed I felt was safe was about 90 to 100 kmph. However it was impossible to drive at that speed even in the slow lane on the right. Trucks (which are supposed to have a speed limit of about 85) would come right up behind me, then swing over to the faster lane (which they are not supposed to do in most stretches of the highway) and swing back into the slow lane sufficiently close to my car to emphasize that they were not happy about having to perform the maneuver. Those trucks are huge. We passed one truck which was carrying five more trucks. It was like a rigid train. I changed tactics and increased my speed to just under the speed limit. The speed limit i...

An earlier version of this article had some unsubstantiated information taken taken from newspaper articles as well as a statement based on rumour which was inappropriate to post on a public forum. This version has been edited to remove the contentious content. A recent article in the Journal of the American Medical Association reminded me of an article I had written for 'Borborygmi' and later posted (with permission) on my Quora blog. The article in JAMA points out that the 'pay for service' model of compensation for doctors creates a 'perverse incentive' to perform unnecessary investigations or procedures. A fixed salary seems like the best model with a degree of accountability built in. http://jamanetwork.com/journals/jama/fullarticle/2623619 My article is reproduced below. The Great Depression, Perverse Incentives and Liver Transplantation  I spent five years in the US from 2002 to 2007 at a time when the country was preparing to descend into one ...

Organ Allocation in America: An Outsider’s View Vinay Kumaran, MBBS, MS, M Ch Liver Transplant Surgeon, Mumbai, India I did my fellowship in Transplant Surgery at the Thomas Starzl Transplantation Institute of the University of Pittsburgh Medical Center at a time when liver transplantation was in its infancy in India. I returned to India after my fellowship to become part of the first generation of liver transplant surgeons in India. Unlike the US, most liver transplants in India are living donor liver transplants, similar to the situation in Japan and Korea. The ethical issues are different and perhaps lets us look at the organ allocation system in the US with a fresh perspective. I was in Chicago, attending the American Transplant Congress. I have in interest in liver transplantation for liver cancer. I wrote the Indian guidelines for liver transplantation for cancer a few years ago  (1)  (2) . I was listening to Dr Ryutaro Hirose from UCSF describe the evolution o...

Another Quora answer worth sharing I think. Will I regret becoming a docto r? I am a bright student with a high IQ(tested) and I am really interested in biology and excel in it too, my maths is good but I don't have interest in it. I have decided to become a doctor but reading about the profession and reviews about it, I have started doubting my decision. What should I do? Vinay Kumaran , Liver Transplant Surgeon Updated Mar 13  ·  Upvoted by  David Chan ,  MD from UCLA, Stanford Oncology Fellowship You probably will. However, please read the whole thing. You will regret it in medical school when you realize that everyone else is also bright with a high IQ and unlike school where you were aceing all the exams, now you’re struggling to pass them. You will regret it when you are looking for a residency while your non-medical friends (if you have any left) are looking for jobs. You will regret it during your res...

Many years ago, when I was in school, someone gave me a small FM radio. There was very little FM programming at that time. Randomly tuning into different stations, I found a program called 'Classically Yours'. They played three pieces of music which hooked me instantly. I defy anyone to listen to these three compositions and not fall in love with the music. The first movement from 'Spring' from Vivaldi's 'Four Seasons'. https://youtu.be/e3nSvIiBNFo The first movement from Mozart's Symphony No. 40. https://youtu.be/mG0Fx-JtANs Ravel's Bolero https://youtu.be/dZDiaRZy0Ak I faithfully tuned into the program every day but there was no other way of getting to hear classical music. My Uncle had a collection of LPs and a non-functional record player. I managed to repair the record player and play the LPs. It was only after I was in college that a friend of mine there introduced me to a shop in Connaught Place called Bluebird which used to k...

It seems to me that I can reproduce my blog posts from Quora here without any risk of being banned. Therefore: The Defenders of AYUSH Vinay Kumaran I recently answered a question about my opposition to AYUSH. Vinay Kumaran's answer to Why is Dr. Vinay kumaran skeptical about other forms of medicine except allopathy? I merely pointed out that I did not care about the name of a medicine or treatment but that any treatment administered to patients should be supported by evidence of its efficacy in the form of well conducted clinical trials. Some might recall an earlier discussion in which a banker and avid Ayurveda enthusiast insisted that since his pet dog’s ‘back problem’ was resolved by an Ayurvedic massage, the general efficacy of all Ayurvedic medicine was therefore demonstrated, including for the treatment of liver cancer. My admittedly sarcastic response to that gentleman led to my answer being collapsed and no-doubt contributed to my recent one week ban ...

I've often been told by my wife that I should take more care of my appearance. I'm notorious for turning up for conferences wearing sandals and bush shirts. Of course, I like to dress for comfort rather than to impress people but there is some long term thinking behind the attitude. My Uncle, Prabhakar Menon, took the Civil Services exams twice in the late 1960s. The first time, his rank was 13 or thereabouts, apparently missing the IFS (foreign services) by one rank. Instead of taking an IAS (adminstrative services) seat, he decided to decline and try again the next year. In an account of the exam by someone else, I read 'I was surprised to see Prabhakar Menon turn up for the interview in a bush shirt. I knew he had qualified for the IAS last year.' Formal attire was nearly a requirement for these interviews. Why did he turn up in informal clothes? I can think of some reasons. He may have done well enough in the exam that he was confident that he would do well regard...

I'm in Chicago attending the American Transplant Congress. Some thoughts: People finish their talks on time. The sessions finish on time. They must be rehearsing and timing their talks. This is something Dr Nundy always used to emphasise at Sir Ganga Ram Hospital. We used to have several rounds of rehearsals of all the presentations the members of the department used to make at various national and international conferences. However, most Indian doctors do not follow these basic norms at national or regional conferences. I wonder why? Is it laziness? Do they not feel the need to rehearse and time themselves? Is it disrespect for the other speakers? I know of people who are arrogantly convinced that what they have to say is more important than what the next speaker may have to say and the audience should be grateful to them for deigning to speak for longer than the allotted time. The transplant community in the US seems very large in proportion to the volume of work they do. Ev...

After the Quora ban, I received several enquiries from people who were following me there asking whether I would write somewhere else hence this format. I was invited to speak at the unofficial Quora meetup in Mumbai last week. There I met people who said that reading my answers made them give up alcohol or think more critically about their religion. I realised that if I was actually making people think by telling them what I think then I must continue to do so. Interestingly, despite the ban, all the content is still accessible. The blogs particularly illustrate how inevitable though irrational the ban was. https://www.quora.com/profile/Vinay-Kumaran/all_posts