Vinay Kumaran

A recent debate on using transplant center outcomes to decide accreditation with insurance and reimbursement reminded me of this article I had written on Quora some time ago. Copied and pasted. Upvote 20 Downvote Comments 2 Why Bill Clinton is alive and Steve Jobs is not Vinay Kumaran , Liver Transplant Surgeon Posted Dec 28, 2015  ·  Vinay Kumaran's Posts Transparency, the intention to treat and analysing data. or Why Bill Clinton is alive and Steve Jobs is not . How do you select a surgeon or a Hospital? How, assuming you are sufficiently rich and powerful that you want the "best in the world", do you find the best (or hire the best finder to find the best)? If you need a liver transplant, you can go to a website called  SRTR -- Scientific Registry of Transplant Recipients . At this website, you can look up the mortality, one-year survival, five-year survival, waiting list mortality and other such statis...

This answer on Quora was collapsed within 18 hours but it still became one of the most popular ones on the topic. Not only is the answer collapsed but the author is also banned from Quora but this is a perfect illustration of why he was banned. Tissues (paper products) Toilets Culture of India +2 Will Indian toilets ever switch to toilet papers? Westerners believe that tissues are hygienic, and Indians think otherwise. Will it eventually change? Vinay Kumaran , Liver Transplant Surgeon Answered Mar 7 Doctors have a unique opportunity to test the efficacy of the two methods. Having worked in India as well as the US and having performed rectal examinations of patients from both places, I can tell you that there is no contest. All American arseholes (and presumably British ones), on close examination, have an appreciable residue of dried faecal matter on the perianal skin. Presumably, this eventually finds its way into the bath water when they ...

I moved from New York to Pittsburgh in 2004 to start my fellowship in Transplant Surgery. While I was looking for an apartment to stay in, I received advice from friends and colleagues: "buy a house instead of renting. Instead of paying rent, you can pay EMIs on the house and when you move, you can sell the house for more than you bought it for. The price of property always goes up." Fortunately I did not heed the advice and we know what happened in 2007-2008. It has long been thought that the reason for the financial crisis was banks giving loans to people who could not afford the properties they were buying with the loans. Bank employees received incentives according to the number of loans they could negotiate. It was in their interest to negotiate loans for more and more people and when they ran out of people with good credit histories who could afford to pay back the loans, they turned to people with poor credit histories who could not. Incomes were falsely stated and ...

What I believe: I believe our planet has the resources for us to live comfortably and sustainably if we control our population and share our resources. I believe we should try and provide everyone with the basic necessities of life. These include shelter, food, clothing, healthcare and education. I believe morality and ethics vary from society to society but there are some basic foundations which should be common to all. These can be arrived at by the use of the 'Categorical Imperative'. As Kant said: "Act only according to that maxim whereby you can at the same time will that it should become a universal law." In other words, when considering a course of actions think about what would happen if everyone were to follow the same course. I believe both Capitalism and Communism have failed. Capitalism concentrates wealth into the hands of a few and leaves many in poverty and suffering with no means of emerging from their circumstances. Communism failed because it ...

He looked quite striking, sitting on a chair in the corridor outside my room. He was wearing robes in the manner popularised by Vivekananda and more recently Adityanath. He had 3-4 rudrakhsha necklaces. I wondered what had made him visit a modern hospital instead of trusting in the ineffable wisdom of Ancient India. I was somewhat surprised later when he was brought into my room and introduced to me as a VIP. He walked in regally and posed in the manner of the Shiva statue near the Delhi Airport. I suspect I was supposed to make a dive for his feet but I'm a bit dense about these matter of etiquette. I only figured out the protocol later. He handed me a small box of Prasad, which, on later investigation turned out to be somewhat stale Barfi. He then handed me some reports and told me the sad story. The patient was a relative/ friend/ devotee (I didn't quite pay attention to what he said since I was reading the reports). In any case, someone close to him. He broke into te...

We seem to do too many things at the same time. We're having dinner, watching TV, reading the newspaper and having a conversation with someone on the phone all at much the same time. We do not focus on the food, do not realise when we have had enough and get into the habit of eating far too much. To gain our attention, albeit briefly, the food is strongly flavoured, the TV is trying to make us listen to the ranting maniac shouting at 6 different people, all trying to say what they came to say, none listening to the other and the newspaper creates flaring headlines trying to catch our attention. This excess of 'input' means we do not focus on any one thing for long. The TV, of course, has its own version of ADHD interrupting the programming for advertising so frequently that there is little continuity of narrative in the program. Shifting focus from one thing to the other, never following a train of thought to its logical conclusion, we have become a distracted people, d...

As I watched the news today, looking at footage of 44 ill-educated people who had been sequestered at a resort to prevent them from being bought and persuaded to support another party, as I noted that an emotionally labile, narcissistic bigot with an ill-informed disrespect for science wants to promote coal mining on protected lands, it seems clear that democracy is not working. In theory, democracy seems like the best form of government we have tried so far. Certainly it is better than being subject to the despotic notions of a dictator or a monarch. However, the only aspect of democracy which seems to be working is the ability to remove from power a particularly disastrous government. Ideally, we would elect competent people who are honest and have a good working knowledge of economics, politics and history. Unfortunately, it is clear that what wins elections is not the ability to lead but the ability to fool people. It seems increasingly incidental that leaders like Nehru, Ob...