Blog

<span style="font-family: var(--head-fontFamily); font-size: calc(24px * var(--head-fontSize, 1)); font-style: var(--head-fontStyle, normal); font-weight: var(--head-fontWeight, 500); background-color: rgba(249,250,251,var(--tw-bg-opacity));" data-mce-style="font-family: var(--head-fontFamily); font-size: calc(24px * var(--head-fontSize, 1)); font-style: var(--head-fontStyle, normal); font-weight: var(--head-fontWeight, 500); background-color: rgba(249,250,251,var(--tw-bg-opacity));">About 6 months ago, my colleague ran an FB campaign to test if it would be the right channel for us to reach patients who may be terminally or critically ill.Out of the 8, we ended up speaking to 2 who spoke about suicide.One of them was so suicidal that I immediately tried putting him across to a plethora of suicide helplines in his location and later his state.Most did not take the calls. For some the lines didn't work.I got flashbacks of a good friend in Singapore who's brother used to be extremely suicidal.We couldn't find a way to work together in time and he ended up killing himself in the most gruesome way.We never got a fair shot at helping him.<blockquote>The regret still haunts me.</blockquote>I tried to find an NGO or someone who can help at his location to no avail.I figured I might as well speak to him to figure out what's going on.A simple man working in a bakery earning the equivalent of $180 per month and supporting a family of 5 as the sole breadwinner.<blockquote><h3>He was extremely suicidal over the previous 2 months.</h3></blockquote>The causes are often complex and multifactorial while there could potentially be some direct triggers.I did what I would do for a paying client as much as possible.And I did it remotely. It took me 3+ weeks to gather the necessary insights for his case.<blockquote>The insights came from someone who taught a nobel laureate.</blockquote>But I had lost precious 3+ weeks.By which time he had gotten worse in his ideation even more.Acting on the insights was tedious and expensive but had to be done.My CFO/advisor was not happy with me spending my own money and time, especially when we were in early stages of our startup.These things do take a lot of out of you.But here's the good news:<blockquote>From the 3rd day of his starting on the suggestions- No suicidal ideation- No insomnia- Good sense of well being</blockquote>It's been more than 4 months since and I'm in touch with him regularly.There are certainly other issues he needs help with. They relate to smoking, stress, weight, diet etc.<blockquote>But suicidal ideation is not one of them.</blockquote>I hope to meet him when I am in his town soon.July 2025 update: One-year on and he's still free of suicidal ideation/thoughts<figure id="figure-2q4ttlc8semdvpcfnm"><img id="2q4ttlc8semdvpcfnm" alt="" title="" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-fullwidth="false" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure>PS: My advisor is a busy executive in healthcare but took the time to witness what unfolded from the start to the end, is so happy I did not listen, and is now a more vocal advocate of our work.---We offer something very interesting in healthcare an<span style="background-color: rgba(249,250,251,var(--tw-bg-opacity)); font-family: inherit; font-size: calc(16px * var(--body-fontSize, 1)); font-style: var(--body-fontStyle, normal); font-weight: inherit;" data-mce-style="background-color: rgba(249,250,251,var(--tw-bg-opacity)); font-family: inherit; font-size: calc(16px * var(--body-fontSize, 1)); font-style: var(--body-fontStyle, normal); font-weight: inherit;">d it does not constitute medical, legal or financial advice.<blockquote>It is private intel.</blockquote>A report that is not standardised for mass replication.A private and confidential report commissioned by patients or their families for educational and information purposes.<figure id="figure-70mb9uxb5qm3qsog7e" data-full-width=""><img id="70mb9uxb5qm3qsog7e" src="https://media.gettyimages.com/id/484069897/photo/portrait-of-man-sherlock-holmes-like-character.jpg?b=1&amp;s=2048x2048&amp;w=0&amp;k=20&amp;c=LYPxeNmLiHZqtOmf9ogeWgBVOS8pd-0sOGFTevf-uh0=" alt="Portrait of man, Sherlock Holmes like character" title="Portrait of man, Sherlock Holmes like character" class="object-cover bg-gray-100 rounded-2xl md:rounded-3xl lg:rounded-4xl" style="aspect-ratio: 16/9; object-position: 50% 65%;" data-corners="large" data-aspect="16:9" data-caption="Private investigator in healthcare" data-positionx="50%" data-positiony="65%" data-fullwidth="true" data-mce-src="https://media.gettyimages.com/id/484069897/photo/portrait-of-man-sherlock-holmes-like-character.jpg?b=1&amp;s=2048x2048&amp;w=0&amp;k=20&amp;c=LYPxeNmLiHZqtOmf9ogeWgBVOS8pd-0sOGFTevf-uh0=" data-mce-style="aspect-ratio: 16/9; object-position: 50% 65%;"><figcaption class="body-normal text-gray-500 mt-2">Private investigator in healthcare</figcaption></figure>The report may have a series of questions extremely relevant for patients to have addressed as they navigate their healthcare journey.<blockquote>If you know of anyone who's likely to end up in a hospital or an ICU, we are good people to talk to.</blockquote>

Intel for Mental Health

<blockquote>“A man with a conviction is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point.” ― Leon Festinger, A Theory of Cognitive Dissonance</blockquote><figure id="figure-hdmsko1rsolx7kehn4"><img id="hdmsko1rsolx7kehn4" src="https://cdn.durable.co/blocks/1epm1zjCXkzHRKwG4BQ5fMfw2XVrPwml1cAIMpPFj7n15UXWSEgldFx2zlJXTNTN.jpg" alt="VAC, PAC and SIMV/PSV" title="VAC, PAC and SIMV/PSV" class="object-cover bg-gray-100 rounded-lg md:rounded-xl lg:rounded-2xl" style="aspect-ratio: 16/9; object-position: center center;" data-corners="medium" data-aspect="16:9" data-caption="3 common types of mechanical ventilation" data-positionx="undefined" data-positiony="undefined" data-fullwidth="false" data-mce-src="https://cdn.durable.co/blocks/1epm1zjCXkzHRKwG4BQ5fMfw2XVrPwml1cAIMpPFj7n15UXWSEgldFx2zlJXTNTN.jpg" data-mce-style="aspect-ratio: 16/9; object-position: center center;"><figcaption class="body-normal text-gray-500 mt-2">3 common types of mechanical ventilation</figcaption></figure>One of the things we admire about medical doctors is their dedication and hardwork. This combined with experience brings about a deep appreciation for the adage "Change is the only constant".In one of my early conversations with my advisor who is a leader in critical care, he stopped me in the middle of a sentence and said this:<blockquote>Ramm, there are not SOME improvements that can be made. There are 100s of things we can do WAY better!</blockquote>An always learning mindset among the fraternity is important in saving lives.But once in a while, you come across those who certainly need to do better.The below is an interaction with one of them---March 20245 weeks in the ICU on mechanical ventilation, what would be the signs that there is some improvement in the patient, doctor?Duh! There's no hope of such recovery!Be that as it may, if there indeed is a possibility, what would those improvements look like?...silence...Have you considered x?There is no role for x in the human body!Really? Didn't someone get a nobel prize for discovering the very same thing in the 1990s?I don't think your google knowledge is relevant here.How about all the publications in your medical literature proving their extraordinary relevance in critical care settings?...silence...---Probably less than 1% of ICUs today use this intervention to improve outcomes for mechanically ventilated patients in their critical care.<blockquote>If you are a leader in critical care in any major city, we would like to hear from you- SafestDoctors</blockquote>All of us experience cognitive dissonance at some time in our professional careers.It's never too late to set aside our ego and consider possibilities from a first principles appraoch.<blockquote>“The existence of dissonance, being psychologically uncomfortable, will motivate the person to try to reduce the dissonance and achieve consonance. When dissonance is present, in addition to trying to reduce it, the person will actively avoid situations and information which would likely increase the dissonance.” ― Leon Festinger, A Theory of Cognitive Dissonance</blockquote>

Mechanical Ventilation and the Art of Helping Patients Recover in the ICU

A dear friend: My menopause started when I was 43 or so. My hormones have all been out of whack and I have felt only better I got on Hormone Replacement Therapy. See! Out of the blue I am getting these hot flashes now.Ramm: Your body is trying to protect you. You've been poisoned!The dear friend: What? How?Ramm: You didn't have it when you walked in. It's something you just ate or drank nowThe dear friend: No! What could it possibly be?Ramm: It could be the beer... or the fish or lamb... they both were very tasty... must have had MSG (Mono-Sodium Glutamate, also called Umami or China Salt in some parts of the world).The dear friend: That's it! Let's call the chef and find out!The Chef: Ma'm, we don't put any MSG. The dear friend: My friend was wondering why is the meat tasting so good!The Chef: Oh! We only use the "Chef's Art" powder in our dishes, ma'm. We don't use MSG at all! The dear friend: Okay, thank you so much!Ramm: Now all we need to do is check online for the ingredients of 'Chef's Art'.The dear friend: Right away!<figure id="figure-vci56zuibln3k3j8q"><img id="vci56zuibln3k3j8q" src="https://cdn.durable.co/blocks/33KOEN7NacCz21KlGIKTy0C7JsyJfDu1546ESMxKfUgrTTQqrQOAS3UJ1XQoDtjm.jpg" alt="Ingredients in Chef's Art chicken broth powder mix" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: undefined 75%;" data-corners="default" data-aspect="16:9" data-caption="Holy Moly!" data-positionx="undefined" data-positiony="75%" data-mce-src="https://cdn.durable.co/blocks/33KOEN7NacCz21KlGIKTy0C7JsyJfDu1546ESMxKfUgrTTQqrQOAS3UJ1XQoDtjm.jpg" data-mce-style="aspect-ratio: 16/9; object-position: undefined 75%;"><figcaption class="body-normal text-gray-500 mt-2">Holy Moly!</figcaption></figure>Ramm: There's more to it.<figure id="figure-l1q5go463xlqhlyzuu"><img id="l1q5go463xlqhlyzuu" src="https://cdn.durable.co/blocks/10v7mxYNYtxGgh2iImtEiniqUeEBKpoUUgXRhCf8prSG9kc6UZZJ3mgHYphLef7H.jpg" alt="" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: undefined undefined;" data-corners="default" data-aspect="16:9" data-caption="A reference from the medical literature on the toxicity of MSG or Umami or China Salt" data-positionx="undefined" data-positiony="undefined" data-mce-src="https://cdn.durable.co/blocks/10v7mxYNYtxGgh2iImtEiniqUeEBKpoUUgXRhCf8prSG9kc6UZZJ3mgHYphLef7H.jpg" data-mce-style="aspect-ratio: 16/9; object-position: undefined undefined;"><figcaption class="body-normal text-gray-500 mt-2">A reference from the medical literature on the toxicity of MSG or Umami or China Salt</figcaption></figure>Ramm: There's more to it.<figure id="figure-l1q5go463xlqhlyzuu"> </figure><blockquote>"Can you pay your way out of a condition you eat your way into?"- Ramm </blockquote>

Blog

Intel for Mental Health

Mechanical Ventilation and the Art of Helping Patients Re...

Can you pay your way out of a condition you eat your way ...