Morning everyone, welcome to theCUBE's day one coverage of UiPath Forward 6 from MGM in lovely Las Vegas. Lisa Martin with Dave Vellante. We're going to be talking about some great industry use cases for AI and automation healthcare at first. We're going to be talking about relieving doctor and nurses workloads, reducing processing time and saving lives. Two guests join us, Jared Stahl, Senior Director Advanced Analytics and AI at Mayo Clinic and Jason Whirlman, VP Global Health Care at UiPath. Gentlemen, it's great to have you on theCUBE. Happy to be here. Let's dig in, Jared. Give, everyone knows the Mayo Clinic, so many amazing advances in healthcare have come from Mayo Clinic over the decades. Give us a sneak peek into its automation program. Yes, it's been a remarkable transformative journey over the years, evolving from experimental to really building out a centralized model for care in the lens of using automation with efforts to reduce administrative burden, to give specialized tasks back to humans, really helpfully optimize the areas that we can focus in on. Again, to give that time back to our patients, which is, of course, what's most important for us. Talk a little bit about how at Mayo Clinic you've successfully built an operating rhythm that's really producing results for the clinicians, the patients, everybody involved. Yeah, so the model itself is essentially a robust series of vetting to be able to ensure that we maximize our abilities with our investments, with our strategic partners, creating the space for innovation to be able to make the right choice in terms of where we're going for directional purpose as it relates to, are we using the systems that we invest into the best of our abilities? If not, when we see those gaps, where can we fill those gaps with augmented workflows, with AI layered in to help that decision-making process or serve up some of those tasks that can then be given over to an individual for decision-making? Jason, we were talking in our open about one of the early RPA days. You had big long tail where customers maybe had just a couple of bots kicking the tires and so forth, but then there were some real successful examples of scale. What are you seeing in healthcare? It's a two-part question. What are you seeing in healthcare in terms of greater adoption in that scale? And are you seeing a shift broadly from back office, any indication from back office to front office? Yeah, absolutely. And we have seen that shift and it's taken a while. I think, to Jared's point, a lot of the programs were very tactical, plugging in gaps, optimizing costs. I mean, there's a lot of interoperability in healthcare today. There's still a lot of interoperability in healthcare today. But what we're seeing is automation becoming a part of the mission of care. And when you put a mission behind anything, you become visionary and when you drive vision, then you see things at scale. And now we're seeing automation becoming a part of enterprise programs, not just the technical program, but also the way they deliver business, the way they transform. I don't think it's a secret of the impact the world has had on our clinical staff, the shortages we've had. And now they're rethinking the way that clinical workers come to work. You know, the work that they do, the administrative work that they do, how can we alleviate that type of outcome? So where it used to be, I have a process, I want to optimize that process. Now it's, I want to optimize the whole staff so I can give more time back to my clinician. And to that, automation has become key to that strategy. And Rob actually alluded to that in his keynote this morning. Jared, I want to kind of double click on the use case here. Revenue Cycle Management, or RCM. Why did Mayo Clinic start there? Why was the focus from automation there optimizing the financial optimization of the healthcare of the health system? Give us that kind of strategic vision. Great question. You know, when you look at the healthcare landscape and the opportunity to bring this technology in, in arguably the most regulated industry on the planet, you know, where's a good place to start, you know, to prove the concept to the clinicians? That's Revenue Cycle. When you make a change in that domain, you almost instantly always see an ROI, right? Where maybe people are checking claims manually to a federal site to see if there's updates, statuses for overturn. We have APIs, we have bots that are putting those things together, automatically serving up details and data in the system so that people don't have to go out and check. The value add work comes to them instead of the other way around. And again, that creates capacity. You know, to Jason's point, we have a shortage in various domains across clinical and non-clinical enterprise. The answer is not filling it with more warm bodies. The answer is creating capacity in different ways and more innovative ways. And this is a very key strategic way to do that. So regulation compliance, was it a catalyst? Was it meaningful use, for example, that drove that? Or was it really more sort of just get better productivity instead of have to hunting and pecking for regulation changes? Yeah, I think it's really about, again, going back to that element of creating capacity, there are individuals who have varying levels of specialization. They weren't working at the top of their license. And so they had to do all of this other work to get to that value add work. And our innovations through the course of automation brings them closer to that value add work. And so, again, some of this work, we didn't even have the capacity to get to before implementing solutions, especially in that claims status domain or denials processing. That was only possible by implementing tools like this. To create new work, to augment existing work, and to reimagine what the future of work looks like after that, really taking them out of the element to see, it's kind of hard to look at your kitchen while it's on fire and say, gee, we really need to remodel, right? You have to pull them out of that and give them the ability to create and think about that future outlook after you augment and change and innovate the area that they live in currently. How is that, I'm curious, Jared, continuing on that, how is that from a cultural perspective to change the behaviors of the clinicians? Obviously, it sounds like what you're aiming to do is give them the capacity that they haven't had, but that's a cultural shift, I imagine. It's a huge cultural shift, and there's a lot of thoughts and ideas, both with the clinicians, our workforce, with our strategic partners, thinking about, is this all right? Is this something that we should be doing? And we have had a lot of experience with this anonymously with other solutions that we've worked with in the past, so sometimes it's creating the understanding of the similarities between the two, but also creating a clear, transparent understanding of what this is and what it can do, and that's really what we've done on our journey in the revenue cycle domain, as sort of an example for the rest of the organization to say, this is what this is, this is the art of the possible. When you think about automation, when you think about AI, this is truly what it can do, and we've seen people's minds open up to that over time as they mature in their understanding of that, come to the table more and more with those ideas, with those thought processes about how to transform and how to innovate and bring those things forward, but it's a journey. Well, Jason Jarrett kind of alluded to it earlier in his remarks, I mean, we saw it in COVID, I mean, just a nurse burnout. I have a personal experience, my daughter was studying nursing, and then through the whole COVID experience, changed her mind, and now she's doing global health, and I know many nurses that are just, were so spent, are you seeing automation having, it sounds like it is, but you could double click on that, having an impact on that sort of clinician burnout factor. Is there light at the end of the tunnel? Absolutely, as Jarrett said, capacity is really the key word here. You know, when we talk about revenue cycle, a lot of organizations start there because it's all about risk, being the largest regulated industry in the world, and also the largest employer in the world, you want to introduce risk into areas that are going to impact patient care. So you normally start in revenue cycle on your work way up, but through COVID, we did see that dynamic shift because the capacity wasn't there, nor did we have the clinicians, it wasn't even about capacity, it was about not having enough clinicians, and it still continues on that way. I mean, there was just a statistic out saying that medical colleges are rejecting nursing applications, not because they're not qualified, they don't have enough educators to educate the clinicians that bring them into the marketplace. So it's not just the clinicians, just not the shared service centers, it's also the educators who are even educating our next round of clinicians. So every little bit definitely makes a change, but from a clinical perspective, we have this principle of pajama time, which is the time when clinicians are doing work at home. A lot of times it's data entry-based work, they're scheduling appointments, they're looking at pre-appointments before you actually go in the next day and talk to your physician, because if you've ever had this experience in going and talking to the physician, and they're typing on the computer at the same time, clicking boxes, there's a number of reasons why they might do that during the appointment, but a lot of times it's because they're closing these gaps that are essential to your care, especially if you have a disease state that they're tracking. So what happens is these nurses in the evening, they'll close that so the clinician doesn't have to, so they can have a meaningful, value-based conversation with you. Those are two to three hours worth of work for administrative nurses for most hospital systems, because they can't do it during their daytime. So these types of processes could be highly automated. They're not clinically impacting, they're not making clinical decisions. What they're doing is they're accelerating the work and turning a researcher into a validator, and a validator into a clinician at the end of the day. So those two to three hours really save a lot of time and effort for these clinicians. A good night's sleep, spending time with family, doing extracurricular activities, these are the burnout principles, I think for anyone, let alone clinicians, but the stress that they feel during the day, of course they need that relief time and when they're still working to the moment they go to bed, that has a significant impact on just the clinical culture at hand.  And then the other, I mean, something else that you said that AI has the potential to effect is education. I mean, MOOCs and massive online education systems can definitely pick up some of that slack, right? Yeah, absolutely, there's a concept out there that says that with a lot of the emerging technologies, there's going to be a difference between a knowledge worker and an intuitive worker. I think clinicians are absolutely an intuitive worker, right? But I think we all got started as a knowledge worker, right? So as we really bring more of these technologies into play and we start to move these knowledge workers to an intuitive worker, I think there's a lot of change management to Jared's point that's going to be required because there is a comfort in clicking boxes sometimes. There is a comfort in doing data entry. We say we don't like it, but at the end of the day, we all got started that way. We all filled our career that way and now we're being asked to move it off our plate and we don't kind of want to give that up. But we also do want to be creative. We do want to be intuitive. We want to be skilled. We want to come into a job and within a few months be just as good as somebody that today took five to 10 years to get there. And those are sort of the gaps we need to close in care. And I think the technology is starting to close that gap quickly. You mentioned the word comfort. And it's from a change management perspective, that's a hard force you're fighting against. I always say to people, whether it's something personal or professional, get comfortably uncomfortable because change is obviously the one constant. Jared, I'd love to, on that front for you to kind of share some of the best practices if there are folks out in the audience who might be where you were a year or two ago, what is your, some of the best practices that you've learned to help drive a culture of automation within Mayo Clinic and really get those folks comfortably uncomfortable? Absolutely. I think it's about being transparent. It's about education. Again, this is something that we would view exists for everyone at Mayo Clinic, right? And so we offer that ability for individuals to explore, to surface ideas, to be part of the process. We have liaisons on the business side that we start to grow up and establish our citizen program. Again, exposing people to what is possible, familiarize them with these tools so they have a certain comfort level and understanding of what would be applicable in this domain. And that really, I think, allows us to continue to accelerate as we mature that population and get them comfortable with the change. To have them understand that this is not something that replaces anything. This is something that enhances your work, right? And that's a very key distinction is to not think about that mindset. Get out of the universe of AI will replace this and it will replace you versus enhancing the work that you do, augmenting it in meaningful ways so that you can be the best version of yourself in your respective domain. Well, it's certainly been our early experience with AI, right? We've all played around with it. So this is good. This has given me ideas and it's definitely not replacing. At this point, it's hard to predict the future, but I wanted to ask you, Jared, you said you went from experimental to I thought I heard a centralized model and that's how you began to scale. As you start to enable citizen creators, does the pendulum swing and does that become more decentralized? How do you manage adherence to those standards and compliance, but yet let 1,000 flowers bloom? Great question. That is a particular unique challenge in the healthcare domain because we can't let everyone go forth and conquer without some level of enablement. And we look at the areas where people can work freely, create pre-approved levels of activities that you could explore in the automation and AI domains where maybe you don't have to go to a committee for approval because we've already cleared that pathway and then have other triggers and safeguards for those areas that might have risk associated with them. So there's the ability to allow those flowers to bloom, as you're saying, within certain pathways, but also have that guidance and oversight when it comes to some of those more sensitive areas in healthcare that we all know about. So. Can you give us a peek, Jared, in our final minutes here into the future of AI and automation at Mayo Clinic? What are some of the things that are on the horizon for you? Oh, so much. You know, Mayo has just a magnificent innovative culture. We have the ability to work in a platform mentality that gives us this ecosystem to allow multiple different groups to thrive and go in different ways by utilizing that same platform mentality, right? We have our strategic partners, but we don't look at it from a pipeline standpoint. We look at it as an ecosystem to be able to create and leverage and the communities that partner with us also allow that to happen. So I think there's a lot coming down the pike, you know, as it relates to generative AI, large language models, ambient listening, process automation. We're really looking at what the next step will be in Mayo and all of those domains, and there's a lot coming up down the road. Jason, last question for you. Give the audience kind of an understanding, RPA plus AI together, how does it reduce the barrier to automation? Why should folks be thinking about this combination? It's really the barrier to complex automation. And Jared, I've been in a lot of these conversations recently. I mean, a lot of the technologies he just mentioned were really difficult to implement for the health, let alone healthcare, any organization. I think anytime you make multiple investments and you're trying to bring it together and orchestrate it, you're upside down typically on the business case to actually do it, or it extends so many months or years that you actually lose the momentum or the interest. And what we're seeing is RPA plus AI, it really becomes a practical way of delivering these complex use cases. Things that used to be nine to 12 months with a large army of experts trying to deliver. Now it's a few months with some creative thinking because that barrier to energy is lower, there's pure play integration. And like I said, my favorite word is practicalness. There's a lot of practicalness still needed in healthcare. Art of the possible is absolutely needed. But I'd say let's move to the science of practical and RPA plus AI I think actually enables that now for the first time in a long time. Whereas that's not a great thought on paper, it's something we can actually put in our hands and deploy. Yeah. Guys, thank you so much for joining Dave and me on the program talking about really what Mayo Clinic and UiPath are doing together to really enable clinicians to treat patients. This is truly impacting lives and lives saved. We appreciate your insights and your time and best of luck on the project in the future. Pleasure. Thank you so much. Our guests and for Dave Vellante, I'm Lisa Martin. You're watching theCUBE, the leader in live tech coverage covering day one of UiPath Forward Six. Stick around, our next guest joins us in just a minute.


Just sitting in the sun because he's always on the spotlight. So I thought that you would like always to be in the spotlight, despite the fact that he's into the ad. See that as it may, it's now five o'clock. And exact by the clock, I, on behalf of Beyond Law CLC, and US Punjabi University Chandigarh, welcome you all to another engaging session. As we have been doing sessions every day and sometimes we have also done two sessions on different perspectives, which invariably are stimulating to the mind for the purposes of knowledge and insights what's happening in the society. We have also done motivational talks. So the topic, which is quite, I may say, hot amongst the discussions, not only among the students, professionals, lawyers, and today I can also say a person who has directed movies. So they say that a person who can make the advertisement click within the market is the best person because he knows what, what is the sentiment of the market. When we all four discussed, we thought that the issue regarding live in relationship and contemporary law, we should have the best of the legal teams, legal brains. We amongst us we have Dr. Sujoy Kanta Wala. I'm most specifically laying stress on Dr. Sujoy because doctor says I'm a doctor and doctor not not a doctor who actually and neither he doctors the thing. But I was seeing on the screen it is only written Sujoy Kanta Wala. So the doctor was only left for me that I should write that he's a doctor. He's a lawyer, immensely popular pan India. He's practicing primarily in Mumbai High Court, Supreme Court and his name is to the set effect. Then he once he came to Chandigarh High Court at that point of time, the issue was regarding the Uttar Pradesh. We would also have that experience shared by him. He was appointed as an amicus. Then the second speaker is the need. The part, the participants who have been participating in on our platform know that the need has already come on this platform. His session was widely received. Somehow or the other, whenever any Talwar is, there are three types of Talwar. One Talwar is Talwar hanging on the, any accused, then people engage him. And when it is Ayushy Talwar's case, then the Talwar case and any other person. So as and when the Talwar name issues, then we it has to be a lawyer. He has done a lot of cases. Then we have Raj Kaushal. He needs no further introduction as such. He has created his niche while directing the movies. Advertisements in our flyer. We have already written that he has done good advertisements.  First I thought that I will ask Dr. Sugoi Kanta Wala. There's a trigger of the issue, but then I thought we should have a director cut. Yes, take it on. Then it will be in only Raj Kaushal and Raj means to rule. So I thought that once he's there, I shouldn't rule the entire rules. He should be given the chance and his player of introduction would be a treat for everyone who's participating. Not only here, but all those who will watch us live on the Facebook and ultimately over to you, Dr. Raj Kaushal. Thank you very much. Thank you very much.  It's not about any real Katna incident or anything. And it's purely put together for today to have an entertainment and a nice chat between all our friends. So please, I am the last person to speak something legal, but I am the fun element in this entire conversation. And thank you very much for having me on board because thank you really. And what a beautiful set of people we have here. So Joy, thank you so much for this opportunity.  That's what they always say, be careful of lawyers. You just do not know, you got to read between the lines. But seriously, thank you very much for me having me on this platform and I will be here through it. I would now like to invite Mr. Pranveer to please come forward and take this entire proceedings ahead. Wonderful. So Joy, you can take the leads then we will have Convius pitching in. Anyway, good evening friends. Live in relationship. It's a common law definition of relationship. And it means adults which are interdependent partners. I was doing research on this topic. I came across a fantastic saying by Swami Vivekananda that the best thermometer or barometer to judge a country's progress or success is how the women are treated. And that kind of stuck to my mind. So, when a couple has lived together for maybe couple of years, different countries recognize it differently. Our country under the Domestic Violence Act recognizes the concept of a shared household. And here we are looking at a situation where a man and a woman adults out of free will and consent are living together. Well, the circumstances under which they came together will come later. But the law deems and treats them as married couples. Now, India has definitely evolved and I'm sure all of us will agree. The last decade has been path breaking. We are now openly discussing and we have all come out as they say from the closet. And we're all discussing same sex marriages, premarital sex and now living relationships on an open platform. Fantastic. But what if after a few years and that is what might take and my contribution is going to be is that this perpetual life plan goes bust. Now, just opposed with the concept of marriage after marriage we saw in India. A provision 498A which was grossly misused and that judicial notice has been taken by the highest court of the land. And then the court had to deliver a judgment, the celebrated judgment in the case of Arnaesh Kumar. And the Supreme Court said and has laid down guidelines but I'm not going to take our audience to the gritties of it. But Supreme Court was so conscious of how men, their relatives, or chacha kao, wo bhi bati jaan and everyone kind of living in Jamshedpur or maybe Assam also was drawn in. The Supreme Court laid down guidelines that said that this should be sent to every police station in the country. So 498A, then after certain judgments came, now is at a back burner. But here now, we are looking at a living relationship with Bonsar. And suddenly when something wrong happens, a lot of these advisors and self-styled kind of lawyers, they crop up and they start advising. And the first provision which is like a hellfire missile on the man which is shot with a specific target is section 375 of the Indian Penal Code. In fact, there was a movie made recently, which was a success 375. So we are not discussing here the domestic violence which deals with shared household because that could also form some of the ingredients of the FIR. If the woman is covered under the SCSE act, more the problem for the man. But I'm not going to all that. We all remember the nation was shocked when Salman Khan said, I feel like a rape woman. It is a very, very serious charge. And my take on this is that in a living relationship when this kind of charge is levied primarily to base the FIR. It all boils down to the concept and definition of consent. Because if there was mutual consent and you are living together and enjoying physical relations, etc, etc. Under the same roof, can a woman, after a few years down the line, allege rape? So I'm not dealing with a situation here where it's like a friends with benefits concept. Or a man is in position of power, superior power over a woman or the woman is underage. But I'm dealing with section 375 as it stands. Now, as I was saying earlier when I was doing research, so many judgments we came across. I'm sure even Tanveer has discovered many judgments. But there were two judgments of the Supreme Court, and there's a time limit over here, so I have to stick to that. Two judgments of the Supreme Court, which kind of immediately and they are quite recent. One is in the case of Pramod Pawar. Pramod Pawar is a very, very interesting case where there were educated, two of them were educated, holding posts. And the relationship lasted for over six years. Wherever Pawar was posted, she would spend a few days. She says in her FIR that Pawar assured her that he would get married to her. Whatever they belong to different castes, there will be some problem. Okay, I'll get over it and ultimately. So she alleges that Pawar promised me that he would get married to me. He cheated me. He was dishonest from the inception because he wanted to satisfy his lust. And I also belong to the SCST community. She lodges the FIR. Pawar loses, Pawar wins ultimately in the Supreme Court. And Supreme Court deals with 375 of the IPC and section 19 of the IPC. And I'll read it for the convenience of all of us. So 375 interestingly deals with several kinds of situations. But here we are concerned with situation two that is without her consent. Rape, 375.  If he under the circumstances falling under any of the following seven descriptions. One tooth, you can avoid second one without her consent and there's an explanation. Consent means an unequivocal voluntary agreement. When the woman by words gestures or any form of verbal or non-verbal communication communites willingness to participate to the specific sexual act. Provided that a woman who does not physically resist to the act of penetration shall not by the reason only of that fact be regarded as consenting to the sexual activity. Then Supreme Court reproduces section 19 which is consent which we are concerned with over here. Consent known to be given under fear or misconception that's the heading. The section goes short provision. A consent is not such a consent as is intended by any section of this court. If the consent is given by a person under fear or injury or under a misconception of fact even if the person doing the act knows or has reason to believe that the consent was given in consequence of such fear or misconception. Supreme Court further observes that with respect to the consent to section 375 involves an active understanding of the circumstances actions and consequences of the proposed act. And makes a recent choice to act after evaluating various alternative actions or in action as well as the various possible consequences flowing from such action. Consents to such action. Supreme Court thereafter goes into the history. Many other precedents are relied upon most of the times the man has lost. But here was a case where Supreme Court took judicial notice that they are having a living kind of relationship for the last seven years, six, seven years. How can you say from the circumstances that the woman can allege rape? She may succeed as far as other provisions are concerned but where is the question of rape and therefore relying on another judgment of Kaini Raja. On the concept of consent, Supreme Court says consent for the purpose of 375 requires voluntary participation, not only after the exercise of intelligence based on knowledge of the significance of the moral quality of the act, but after having fully exercised the choice between resistance and ascent, whether there was consent or not is to be ascertain only on a careful study of all the relevant circumstances. There was another case which came up. Where they accused forcibly established sexual relations with the complainant. When she asked the accused why he had spoiled her life, he promised to marry her.  When the complainant became pregnant, the accused refused to marry her. When the matter was brought to the panchayat, the accused admitted to having had sexual intercourse with the complainant but subsequently he absconded from the village. Supreme Court dismissed his petition. So we have case after case where the Supreme Court has gone into the concept of living relationships and thereafter Supreme Court has held. It is more than clear that accused made a false promise that he would marry her. Therefore the intention of the accused right from the beginning was not bona fide and the poor girl submitted to the lust of the accused completely being misled by the accused who held out the promise of marriage. This kind of consent taken by the accused with clear intention not to fulfill the promise and persuading the girl to believe that he was going to marry her and obtain her consent for the sexual intercourse under total misconception cannot be treated as consent. Now thereafter, in Deepak Gulati's case, the Supreme Court has observed that there may be a case. So therefore every case depends on the facts and circumstances. You cannot have a prenup for a living relationship. I mean, where are we heading? There may be a case where the prosecutor agrees to have sexual intercourse on account of a love and passion for the accused and not solely on account of misrepresentation made to her by the accused or where an accused on account of circumstances which he could not have foreseen or which were beyond his control was unable to marry her. Despite having every intention to do so, such cases must be treated differently. Here the man succeeded. So these are certain situations. I personally was involved in a heavily contested litigation which this earlier case was from the state of Maharashtra. This case which I am referring to is from the state of Gujarat. Recently, it is reported, I'll give the citations because can circulate all these citations where Supreme Court, apart from the section 375 and section 19 came relied on a amended provision. It was amended sometime back of section 114A of the Evidence Act and how Supreme Court has held and therefore it is extremely dangerous in today's times. And because the woman is always considered to be the weaker person, therefore all these provisions are geared in a particular fashion. Can you see how section 114A is reproduced by the Supreme Court? Section 114A of the Evidence Act deals with a presumption and now this is the reverse burden of proof. Normally what happens as Tanbir will bear me out. The burden of proof is on the prosecution, but there are now some acts by which there is a reverse burden of proof cost like example PMLA. But if you read section 114A of the Evidence Act, it deals with the presumption as to absence of consent in certain prosecutions for rape. A reading of the aforesaid section makes it clear that where sexual intercourse by the accused is proved and the question is whether it was without the consent of the woman alleged to have been raped and such woman states in her evidence before the court that she did not consent. The court shall presume that she did not consent. This is heavily loaded. I'll tell you the case what it was. There was a man and a woman. The woman was working in the office of the man. The man bought a flat for her. She changed residences 3-4 times. They had a torrid relationship. The man was married. The woman was not. Later on when the woman said that she wants to get married, I will not give the name because for other reasons. The woman said she wants to get married and she said I want to move on. So the man paid her a heavy amount of money, signed an MOU which is registered as an agreement. After that, maybe the woman gets certain other ideas and 3-7 fire again as a Hellfire missile is shot. And some kind of ingredients is made out in the FIR and the man goes for a toss. So he wins in the Gujarat High Court. The woman who is the complainant approaches Supreme Court. Three judges of the Supreme Court throw us out, lock, stock and barrel back to the Gujarat High Court. So this is what happens. Even despite an MOU, even despite money, the living relationship which went sour goes this way, down the drain. Very recently, and I will end in two minutes, very recently the Orissa High Court dealt with a very particular situation in the case of Achyut Kumar. And that was widely reported. In fact, thanks to social media platforms, today we have so much availability of material. But this single judge of the Orissa High Court has very beautifully drafted one paragraph in his judgment which I would fail in my attempt if I don't read it out. It says, and here he reads all the previous judgments and then he comes to this beautiful conclusion. Like how 498 was, 8A was misused as far as anti-dowry is concerned. Here he holds that it is not possible to convict a person who did not hold out the promise and not present in the false scenario which had the consequence of the other party inducing commission to enact. In such cases, the accused cannot be held culpable. In fact, such cases are on the rise where both the persons out of their own sweet will and choice develop consensual physical relationship. But when the relationship gets sour, for some or the other reasons, the women use the law as a lethal weapon for vengeance and personal vendetta. They, out of anger or frustration, try to convert such consensual acts as incidents of rape. This misuse defeats the very purpose of the provision of law. Now leave the law for a side. What happens when an FIR is lodged and what costs to the men? And today we have media trials which are conducted on the parallel side where the media is the judge, the prosecutor, the defense advocate and they also hand out the conviction also. Before anything and ultimately if he was down the line, when a trial is held and the man is acquitted, nobody even gives him a bouquet of flowers for that. So this is the problem and having completed my part of the topic, I hand over the case file to my good friend Tanvir to take it forward. Thank you very much. They should like one nice masala movie. I'm loving it. Well, in your next movie, before Tanvir starts, you can ask Tanvir and me to co-write your script. No, I'm done. At least I know it'll be legally binding. Thank you so much. Thank you, Sujoy, for that absolutely wonderful discourse. Am I audible? Yeah. Okay, great. So thank you Raj for that introductory message. So a very serious issue that confronts our day-to-day society today. Is the concept of living relationship. So I would like to address this issue that the contemporaneous Indian society is definitely on a mode of transition. And on many platforms, we have seen that there is nothing what a man can do, which a woman can't do. So, while as you know, we understand, and historically in Indian society, in all parameters, there is no denial of the proposition that women have been at the receiving end of the society always. Post independence. There has been a number of legislations. There has been a constant attempt to force equality.  And, you know, sometimes I have no hesitation in saying that there is far more that women can bring on to the table that we men can, that we have to give, and we must always be ready to do so. Be that as it may, the living relationship, you know, is something which has had a huge, you know, progress in the West. And strangely in West, you know, in the Western countries, they are on a different kind of transition now. And they see that family values ultimately are of great need, they are of great desire, and they are of great results. While is this progress and society in transition is always to be reckoned with, the question is whether contemporary Indian laws have also, you know, kept the pace with the society in transition.  So, consenting adults wanting to be in a living relationship will very find it extremely difficult to rent out an apartment. So, I feel that even in a place like Bombay, Delhi, Bangalore, you know, many a times the property brokers will say, Sir, this is only for a married couple.  So why is, you know, we be the lawmakers, the courts who interpret law or sometimes in an empty horizon, even, you know, try to bring in some, some law by the time or by the, you know, methodologies of writing judgments on debatable issues. So one judgment, the contentious issue, you know, in a living relationship was that which was recognized in a Supreme Court judgment called as Chan Munia in 2011, that if a man and a woman are in a living relationship and the living relationship breaks down, can a woman be entitled to maintain this? So Supreme Court, you know, recognizing the International Convention on Women's Rights, Basic Civil Liberties, right of equality, clearly stated that the woman in such a relationship would be definitely entitled to maintain this. So on one hand, we have to be caught mechanisms through lawyering, through lawyers, through enforcement mechanisms. We have certainly progressed, but we are still, you know, we take a step back in giving due recognition to, you know, the concept of living relationships in our society. And that's up, you know, because of our own stringent societal beliefs. I guess it's a matter of time. And in due course of time, I believe that far more recognition will be given because ultimately, the relationship is always based on consent. Everybody is born free. Everybody is to live free with honor and dignity in a manner which is suitable to them, and as described and wanted by them. So we have, through the mechanism of courts, no doubt kept on with the pace to a little bit, I guess, much more is to be done and respect is to be given to women in all quarters, including in living relationships. So there are two constant debates that emanate out of India. And that is because of the legislation in the PNU Court, that is, you know, the crime court in India is something, you know, which was enacted by the British reenacted by the Mint of India in 1973, some changes were made in the procedure. But basically the court remains sane. So we have, the legislature has some done some amendments, just like Sujoy said that 114A reverse burden was brought in that is pursuant to the famous judgment of Nervea, that this 114 came into play. But be that as it may. Now, the constant challenge of living relationships, promises to marriage, or let's talk about failed living relationships. What happens when a living relationship fails? Ostensibly, we see, you know, lock stock and barrel. In many cases, out of a failed relationship, the lady lands in a police station, and the gentleman lands in the jail. That's the reality. So that's, you know, a slightly misfortune out of it. And I have no doubt in stating this proposition that to a very large extent, it's we the lawyers community who advise the contesting parties on both the side. So they will be lawyers advising the ladies. Of course, they'll be lawyers advising the gentlemen as well. But are we in a situation today where a failed relationship, you know, then goes into a spare and domain or exploitation? So is there exploitation before or is there exploitation later? And that's what happens, you know, what Sujoy said in express contested cases. So two persons may be very well to do. They may be very well educated. They may be earning a good amount of money. They may be working with multinational corporations. Why is it that that on the break of a living relationship, or otherwise, we have these kinds of situations?  So as we go into criminal courts all over India, we see that cases which are, you know, launched for a criminal offense of 376, where the core of the case is a failed relationship, the conviction rate after the trial is less than 2%. But by the time the cases reach to their conclusion, sometimes it's over a year or almost two years and somebody would be lucky enough to get, you know, a bail at an early stage. Now, in Delhi High Court, where, you know, I practice on a daily basis, there are many judges who have some kind of a room that I will grant a bail or I will consider a bail only after the woman testifies, which means a custody period of more than a year is as good as a guarantee. And that's a situation which perplexes all of us as lawyers, as social thinkers, as people in the society, that does the consequences in terms of there being no changes in penal law and the penal law remaining same, therefore do good to the concept of living relationship, or does it do back to the concept of living relationship when it comes to India. Now, my friends, let me give an example. In United States of America, there is no concept of any kind of rate charge being fined or being entered by any police or law enforcement agency, where the woman would say that Sir, I was in a living relationship. The living relationship was meant to be for an eventual marriage. And now the gentleman says that look at this thing. I don't think that this is going on. So we should part ways. So I have been deceived. And since there is no marriage, so I was sexually exploited in consequence of which for my male partner should be booked for it. Similarly, in England, there is no such law. Though in some of these states in the United States of America, they have a broader concept than that is a concept of consent. So sometimes states also recognize marital rape as a criminal offense. But these states and these countries do not recognize a failed relationship getting itself consequented into a rape charge. And that's exactly where I take it forward from Sujoy. While Sujoy talked about a criminal offense which was brought by the legislature for the benefit of the women. That is section 498. That is, you know, when you maltreat your wife for demand of dowry, cruelty, etc. And Supreme Court once in a judgment called Sushil Sharma came down to such an extent that they said that the misuse of this provision is now nothing less than legal terrorism. Very strong words were used. So today we are not very far, you know, if we see the logistics that failed relationships end up in unjustified criminal prosecutions under 376. And in consequence of that, the misuse of this provision is not very far from what Supreme Court said in Sushil Sharma's case. But there is a huge problem. The problem is in our statutory context.  In India, the law makers, when the penal law was made, it essentially incorporated two things. If we see the legal provision as Sujoy read it, so it says firstly, against her will, secondly, against her consent. So in the Indian context, since the British in pre-independent era always saw that the women's society, the woman in other society is always at the receiving end. It's very difficult for her to get educated. Mostly she will be doing the household courts. She'll be, you know, teaching the kids as well. So therefore they incorporated this provision of against her will. And again, this against her will is not to be seen at any other place in the world when we see these, these statutory regulations on these kinds of concepts. The conflict which comes, my friends, now into picture is that when we started with against her will, also against her consent, it could not have been encompassed by the law makers that we also have a society which is on a big time transitory board. So as we see today, I'm reminded of Justice Prateba Rani of the Honorable High Court of Delhi, not very long ago, observing in a judgment that the provisions of 375, 376, 377 are being used to unleash personal benefit. While his eye as a lawyer. This is. Highest regard. Every equal has totally or where failed relationships coming out of living relationships. Otherwise, do not land up in charges of off rate, but where it the legislature brings that look if somebody was deceived and somebody was cheated. Let there be compensation. Let there be a charge of cheating. Let there be charge of criminal breach of trust. But whether you are going to escalate it to a charge of rape is something that is very debated.   When any defense lawyer is asked to defend a person, he may come from any straight off society on a charge of failed relationship leading to a charge of rape. We always go to three basic governments. One is a full bench Calcutta High Court called Jayanti Rani Panda. One of the most beautiful treatise is written about almost about 20 years ago. There is another famous judgment called Uday versus state. And there is another judgment called Billip. And now where is the Supreme Court on one hand taking the case into consideration and the factual narrative says that look here enough is enough. As late as on 9th of April, 90, a double bench judge from Supreme Court of justice Nageshwar Rao and justice M. R. Shah. In a case called Anurag Soni where the gentleman is a doctor and he comes from Chhattisgarh. Convicted the person saying that look here when he entered into this relationship, although the girl is an adult, she is well educated and the relationship seemed to be consensual and still handed out a conviction. The man, the doctor was convicted for 10 years. In the Supreme Court, the conviction was upheld, sentence was reduced to seven. So Supreme Court, the High Courts on one hand we have been saying something, on the other hand we have been having something, something other. The dilemma always is on a factual narrative and the judges and the lawyers try to find out whether the person who is accused in failure of this living relationship or other relationships had an intention to be seen right from the beginning. And there is where the convictions lie or equitable lie. So equitables will come in those kinds of cases where the courts find that the party is consented, the man wanted to marry, but later the parents disagreed. So courts eventually will equate. Where the courts come to a conclusion that from the evidence leg we feel that the person right from the beginning had no intention at all. They may go on a conviction spree. But where the case when they look at it is from the concept of a failed relationship. The entire law makers, the Supreme Court judges, the lawyers will remain in this dilemma. So what is the call and need of the other is in order to encourage the choice of adults to live together and to live together under one roof to understand each other. So usually then go for an option of marriage or not. We have to close doors for a pretension.  In many of the cases we see that after about six months money exchanges hands. And then you know the prosecutor it's comes into court goes hostile on an earlier statement. I've seen three cases recently from some sessions judge out of Delhi where the girl was convicted for perjury because she first gave a magisterial statement supporting the charge of rape. After a failed relationship and then turned hostile on the statement. So society in general, people in general are getting confused. We are not being able to get clarity on this issue. And the only way forward for us is to have open ended debates on platforms like these for which I'm thankful to so joy and Raj and the gas as well that when we talk about these issues. Will certainly come to some very good and sound resolutions. So that's my limited submission at this point. So let me give it back to Vikas. Thank you. The insights given by you were very enlightening for everyone, especially it's a point of the day. As I said, we have kept Raj today to just chip in the right words. I'll read the questions. Raj will do the honors today. Swathi Kabadia. Agreement entered in the beginning of the relationship. Would it be binding on our parties on its failure of the relationship subsequently? Because are you asking me this? No, I'm not asking you. You will only have to do the moderation part. I can read the questions. Okay, just hold it because I want to say a few things before we can go into Q&A. I'm going to make this very brief. First of all, I don't understand the laws. I cannot be giving you any kind of terms which could be in terms of what the law is. In fact, a lot of my friends asked me saying, what are you doing on the panel like this? You've been married for 21 years. What is the experience about living relationships? And I said, I'm actually a student. I'm going to be sitting down here and actually hearing everything that's happening. Such interesting things have come from Sujay and from Tanvisa. In both of them, I feel that the skew is a little towards how women are manipulating or using the law to their advantage or because of whatever. I see that living relationships have always been there. Okay, we've never acknowledged it. They've been there. Media has shown living relationships in a lot of ways and just done it very softly, subtly. It's there. No one questions it. In fact, 2013 should do those Desi romance was a film that was made about living relationships and no one even batted an eyelid about it. 2017, okay, Janu was made. So media has been the forefront about like suggested that legitimizing a lot of issues which are real, but people in society are not actually acknowledging.  I have a few important things that I'd like to say. One is are our laws keeping up with what is happening in society? Because in the Western world, a lot of these things have happened much earlier. They've come around back to joint family values and everything. Our country has just kind of slightly opened up. It's like, you know, with all these new apps and new digital platforms and everything, people started finding a voice. And in this entire scenario, what's happened is the relationships have gone into a completely different space. Women in the country are empowered. And yes, today they are not just, you know, growing up to get married. They want to have a successful career. The we concept has gone into the me concept. Everyone's trying to find their space in all of that also trying to find their spouse. And it's completely justified in science. But what happens when a woman comes out of a living relationship? In that scenario, what happens to the man? Does the man do something by law where he is actually accusing her because he feels that he would have married her, but she's moved on. So there are lots and lots of questions that will come from here and go into a lot of other parameters and problems. This is fun. Let's have some fun here. And now let's go for the questions guys. Yeah, Aman Khan. A friend and his girlfriend were in a living relationship for six years during which he took up a membership of a club. At which point he stated his girlfriend has a spouse. The club did not ask for the marriage certificate. Then they actually ended their relationship. He got married and his girlfriend submitted an affidavit that she's okay to withdraw her name as a co-member while he submitted his marriage certificate. The club refused. This is a change the same. In other cases, the club has taken that was certificate and you met the certificate and affected the change. What would happen? Yeah, I know Aman. I know about this case. So I will just say Tamiz sir, you guys are better to answer this. I think we need to take this as a contribution. So do I take a answer to that question? Well it will depend on the rules of the club. The member of the association of the club. But let me answer this particular query by reading out one particular paragraph of justice. But she then was in Lombay High Court dealing with a case for bail in a 376 in a 376 where they had enjoyed a relationship for quite some time and this is how the High Court has held. I'll take a minute on that. There were also other case laws that were there that eight years after living with a person the women alleges rape. There is another case where they subsequently got married so they went for quashing and the court said that there will be no useful purpose which should be served in keeping this man behind bars because if he is married the victim let them lead a happy life. There is a case in which the Supreme Court pushed the case. In the case of Sajju, I have it over here because the victim who was the complainant tended and every day we didn't say we have to make up this sentence. So you know we have all sorts of things coming as Tanveer said. The High Court will say something in the Supreme Court. There has to be a uniform kind of a kind of a procedure which we need over here but let me read Justice Bhadkar. She says she argues all the sides including the complainant and the prosecutor. Peruse all the documents presented here. After going through the affair it is apparent that the petitioner and the victim were in love with each other nearly for four years and thereafter they decided to marry. During this period they had sexual intercourse on a number of occasions at various places and lodges. It is a fact that there was a promise by the petitioner to marry the complainant. However it cannot be said in any manner that the promise to marry was a condition precedent for giving a free consent for sex before marriage. The prosecutor at the time of filing the complaint was 30 years old and was nearly 25 to 26 years old when the first incident of sexual intercourse took place. Thus she was aware of the consequences of keeping sexual relations with a man and she was also aware that there may be differences between two persons and they may find each other not compatible. The girl was highly educated and also 25 years old therefore consent cannot be said to have been obtained by fraud. I rely on a previous decision on a similar issue and it was held that under such circumstances it is a conscious decision to keep sexual relations with a man and thus to have a physical relationship is a matter of choice of both adult persons. It can hardly be said that the consent was obtained fraudulently therefore there is no material to charge him under 376 and the accused was discharged. Now therefore we see a gamut of case law over here what Tanvir also referred what Iman Raj was referring to so this particular particular incident that you're talking about as for the club is concerned and misleading the club would be in its factual matrix and the club would be free to take whatever action they want. Viral Banshali when boy and girls are in relationship and one of them ditches this what rights do they have as such both the sides. Tanvir can take this. All right so you know when you are in a relationship and you are a consenting adult and somebody ditches or walks out of a relationship practically you know you do not have any kind of great legal rights accrued to yourself for the purposes to seek any compensation because you know we always have two kinds of remedies for any person who had a grounds and agreements. Somebody has a grounds that I have been wronged so any lawyer can say that all right you can always you know sue for damages and somebody says that the wrong which has been done to me is far more than that then you try to you know fit it into any parameters that whether any kind of criminal prosecution or you know criminal law can come into play. So practically there are limited things you see one of the way I look at it is one of the most primary reasons why failed relationships you know end up in a charge of rape in India is because the law does not provide you see for example if you say that you are in a living relationship then you have to say it. Now the law generally does not provide any recourse to the wound to claim damages or to claim maintenance except you know to file a rape charge and to have a settlement subsequently as we see sometimes with all the respect to people who lord such claims. So if the legislature the government of India our parliament parliamentarians at some point of time think it wise enough after incorporating parliamentary debates select committees taking into context that we are our courts are flooded with rape charges that's why we have high court judges or Supreme Court judges making you know very strong remarks that the provisions are being misused for scoring personal points or personal benefit. One of the best things is to incorporate an amendment in the rape law where you say that where the claim is on a failed relationship or you know somebody ditching relationship like deep person who asked this question then you can be prosecuted for deception and you can be only charged and crying as it was a charge for cheating under 415. So a purely a cheating charge as it is covenanted in the PDC broken ditching relationship you may go to a lawyer you may talk it out there are limited options that is why sometimes the options are twisted and that's why we have the situation. Thank you. May I just add something that Tanveer said that there is a case I have in front of me am I audible yeah perfect coming out of Kerala can we see the facts of the case I just for the purpose of all the participants just the facts of the case hearing me if any of the participants was a judge what would that what would the verdict just the facts the first respondent a lady age that is the original complainant age about 32 years is the de facto complainant in her statement she states that she is a married woman and the mother of two children she belongs to the schedule caste community according to her she used to go for studying Vedas at the Kashyap ashram on Kozhikode where she met the first petitioner they became closely acquainted and the first petitioner started visiting her residential home they started having a physical relationship persuaded by the words of the first petitioner she eloped with him and stayed together for a brief five later couple of years down the line differences cropped up between them 375 fm I leave it to the audience. Mr. Kaushal wanted to pitch in something and once you were saying am I audible I could see Raj raising the hand it showed that in fact you had muted him indirectly even though the mic was not muted yeah right yeah I want to say that as Sujai said in the earlier part that you know that when that living relationship went wrong they actually signed even an MOU and went off to the court and everything so if pre-nuptials is for marriages is there some kind of a law or something that people can define because living relationships essentially are based on commitments and promises is there something that they can do legally before a live in the relationship that kind of ties them down on the marriages and promises that have been made is there any provision like that the leader just joined Mr. Raj could you repeat the last I got the question okay then it's fine Sujai you want to take a hit on that just I just say one thing then you can see when there is a marriage as far as Hindus are concerned it is around the sacred fire and it's a commitment whatever in Islam it's a contract there is a sanctity to marriage yeah there are people who are present who are witnesses from the olden time that was the whole idea we are all witness to the holy union now we are talking about a living relationship where two people have met and they have decided to shack up together what kind of an agreement can you have in such a case and even if you exchange males with each other I think that should suffice because acceptance of a male and saying no that is not refusing and not negating the whole thing and accepting itself would be a contract so I think in future till the legislature has done we said decides pressing activities to see the man has to go to can you and we are not siding to come together and shack up what kind of a contract can you have as far as that is concerned if there is no trust which is the basis of the structure how long is it going to last sir I was just keeping the session a little more fun I have one more question just while we're talking about this two and a half months three months now people have been locked in at home okay a lot of married people are locked in at home which is fine a lot of living relationship people are locked in at home so do you think after the lockdown open there's going to be a lot of divorce cases coming out or living relationship falling apart what do you feel is happening around I'll take a I'll take a shot at that if people have been locked up during this period only two consequences will follow if you've been together and you have seen each other I think at the first given opportunity the parties will exchange the vows and get married or never see each other in life so only these two consequences can follow but the earlier questions are very good you see in the west the pre-nupital contract system you know comes again from western practice and ours in India you know in you know under Hindu rights and customs you know the reason why in a congenital divorce the supreme court sometimes resolates between giving a mandatory gap of six months between one motion and the second motion and sometimes you know writing another judgment by the virtue of which you can pre-pwn the second motion is because we can say you know considered marriage you know as a sacrament as something as an institution which is created by Almighty God in which we have to have a firm belief and therefore we have to protect the institution at any cost in contra-distinction to other you know spiritual beliefs where you consider marriage you know as a contractual bond between two consenting adults so it may work it may not work in the Indian scenario if you have tomorrow a pre-nupital contract it also will have to be condensed with the personal laws which a you know as far as the the majority community is taken into consideration is codified and somewhere else where it is not codified so courts the social thinkers and society will find it very difficult at the end of the day what can be best you know done in a court of law and you know in India there are not in in America people want to go to a court of law at the drop of the hat that doesn't happen in India so if you can have tomorrow an agreement which can be enforced in a court of law then a pre-nupital agreement may be enforced and the party promising certain things in a pre-nupital contract may have to certainly you know honor those commitments but it's not an easy proposition till you have all these things you know considered properly legislated thought out you know put it in public platforms for commence of everybody inputs of everybody and then you know ultimately the need according to me is that as the society moves on for example you know we the the age of internet was not was not even thinkable in early 80s or even late 80s so there is no concept of internet based law you see now after after nirbaya's case one person you know both either of the sexes can be prosecuted for stalking another person on internet yep so that's where the dilemma lies the next question yeah it was another question which said that like alimony it arises out of the matrimonial relationship one has posted the information for all of us that just like we have an alimony there's a pelimony like in us what is your take that we should have a pelimony incorporated in india or not i can just read it says how to get a pelimony there are two cinearrows and such a partner gets in pelimony involves what is known as a living spouse the second involves the contractual relationship then they can have an understanding how to go about it i have an nk if he agrees upon i can i ask his insights to be given and nk be unmuted meanwhile nk and then sujoy probably you would be able to answer in such a situation if an fr is lost what are the safeguards what is the scope that is asked by siddharth narula and so do you want you want me to answer the fire part yeah yeah because uh you know that judgment of echo miss x was it i will leave the exact question it says what remedy does a man have if the relationship fails and the female alleges rape yeah in fact uh there is a whole gamut of case law uh and seeing the plight of the victims who have suffered uh jail for year for months and years and not got bail in cases where the ingredients of those criminal acts were mentioned in the fire the difficulty is this that when the fire is filed or lodged whatever you say or taken on record by the police uh there are we know how the police functions in our country and uh if the appropriate ingredients are mentioned to create such a draconian cause of action and spirited by section 375 then uh my advice to our friend over here is this that to immediately apply to the court for anticipatory bail and go to the nearest temple or mosque or church and pray just that there is no other option available for you let me tell you because 600 years back shakespeare wrote that uh hell had no fury than the scorn of a woman so uh just try to be on the safe side that's it i i would like to uh you know uh with all the respect you know because at some point i just unmuted nk oh who has pinpointed the preliminary part i thought that let's have the insight of a participant also mr nk you have been unmuted you can give your insights thank you very much vikas and i so i'm what we know your whole name because nk looks it's just like what we were reading in a judgment x y z i'm i'm i'm nikki kadia i'm nikki kadia and i'm from princeton new jersey and i have been following sujebi for a long time and i so i'm an indian very you know conservative coming from you know the roots and all that good stuff but the the whole purpose of this conversation is going towards criminalization of this relationship which is fair because that's what the law is in india but is the society ready for that and if it is then the law has to be progressive what about a child's rights which comes out of this relationship how does the society accept him how does the law accept him is there money for him which is in us so i think that portion of this entire relationship is equally important as criminalization is especially if there is a status to be given to a relationship like this nk what are you doing otherwise just for the insights because i said that you are giving a different flip we are all being enlightened i'm i'm a full-time investor okay right now you're investing in the right time and as jay told that certain views expressed by the participants etc are not invariably they are from the judgments but invariably they there are expressions to the fact that what the law how the law should have been developed with the advent of time because what happened 10 years ago was not acceptable in certain judgments but as they say law is never static it keeps on changing with the flux of time what is your take on that then we then should join then we'll ask Raj to pitch in his words not on law i think what the gentleman said that the laws have to be progressive so they have to be progressive on all fronts whereas you know in a living relationship you have to have laws where you have to protect the parties equally and you also have to then simultaneously ensure that if the relationship goes soft it does not land in a situation which you know sort of you know becomes regressive to the concept of the relationship itself so rightly so that's why in united states or in england there is no concept you know no law enforcement agency or a police station will entertain a complaint where somebody says that sir i was promised the marriage and it is on count of that that i co-habited or entered into a relationship of poitis and now it's not coming through so i want the other person to be tried for a rate charge but at the end of the day if you have certain negative events you always have rights to go to a court of law and seek damages from any kind but ultimately he who has he who goes to a court of law seeking damages has to prove that a case of damages is made up just like you know a person you know if a person is sexually harassed you know you can go for criminal prosecution but as in united states of america or even in india and anyway all common law you know countries you can also sue for damages and sometimes you know if you are you know in the case with big mnc's you can also close the suits on bailing off huge settlement monies that's what will happen so what is your take no i agree and i think that the kind of participation and the kind of questions that are coming and this topic which has so many different dimensions and so many different queries are coming in different aspects i think we need one more session and educate and assist our friends over here who are raising the questions what what because i suggest is that they can send in the queries and then maybe after sometime we can have another session i think this is the field that is developing and let us put our minds together on this yes we will ask them to pitch in the whatsapp the messages what they want we can always go for a second session but again as we said again i will ask mr paushal to give his insights and his own style that is just put the ball rolling in the right way yeah okay i'm sorry actually my internet went off in between i lost half this conversation so i'm back right now but firstly let's take another question forward i will take because i have a question for raj you know because raj comes from the film fraternity so joey is a lawyer in bombay i'm a lawyer in delhi raj so many times you know in this world of glamour i come across you know people wanting to be actors actresses want to excel as models and you know at some point of time unfortunately some of who thought some of those persons also land up in police station somebody lands as a complainant and somebody lands in the jail so could you give us an insight of you know how we how exactly plays in the world of glamour so first of all i think you know poor media industry it's always it's always under everyone's eye because living relationship these kinds of things happen in every industry but it gets spicy when it's uh you know with the media and that is where the gossip mongers come in and everything becomes and then suja just said that you know a full digital trial happens and the conviction happens and the audience has given the entire thing is expected whether it's right or wrong so in the industry there are lots of instances of things like this that happen all the time and after all that's been happening the last couple of years with you know the me too and everything it's made people very very and we you know everyone has to be keeping certain kind of norms and distances because autographs are replaced by selfies today people take cell you know selfies with with media people and they show proximity saying we've been friends and everything uh this industry is driven by glamour yes and a lot of people come into the city and especially to the industry uh with you know stardust in the eyes and they are prepared they've left their homes spot with their parents and come here living this one dream and they start reaching a point where where they want to do or die at any kind of at any price at any kind of thing that's been a lot of bulls I'd say in the industry also kind of take advantage of situations like this but that's the norm of the world but at this moment people from the media need to ensure that they're not getting allocated about something or being sucked in something that so there are lots of changes that are happening in the industry for example if a model irrespective of the gender comes to your office you do not meet them alone you're using casting directors casting directors handle the entire casting process and people are taken on merit not on individual things meeting any no proximity to a producer director actor or someone a lot of a lot of caution has gone in right now and at any point of time for meeting is happening it's happening in a in an office with enough people around including if there's a woman maybe model coming in like I'd say out of my experience I have two assistant directors who are you know ladies who'd be there at any point of time because there is enough instances of people alleging that things have happened all over the industry and no one is there to you know hear the other side okay the point well taken that how the autographs are changed to selfies and yeah we are muting Sujoy the interesting part is that sometimes even a good speaker we always speak on this platform that we have that power to mute that person like they say that the power of the journalism same way sometimes once you are the moderator you can mute somebody and have the control to see that you can also take the cue from that yeah Sujoy. So what has happened is that when we have a second session we can also discuss the complete moral degeneration and spiritual degeneration which has taken place in our society according to me the holiest and the purest of a relationship is between a father and a daughter let me tell you much more than a mother and a son a father and a daughter and Bombay High Court has allowed a 13 year old girl to terminate her pregnancy and the rascal was the father now therefore if this is on one side the social degeneration and the instances that we are seeing in here live in relationship care can't even compare and what kind of legislation the parliament is going to think therefore we as right-thinking people let us devise and let us advise our participants on these aspects which are also in our grasp uh Sujoy we will also ask them to give suggestions for the simple reason that sometimes a word of thought just triggers of the point i am reminded like uh that there are certain movies in saaf kath rasu which changed the entire gamut of uh rape law then there have been that uh movie wise mr sunil that on dorri case i'm just forgetting where the leka which said it also that changed the entire gamut as to how you have to like look at the 4064 98 a so sometimes this trigger point we would not say that the the entire society has degenerated i was just reading an article like you did some research i was also saying that yes living relationship is considered to be an acceptable norm within the society as such but the entire percentage if we compare with others the marriage and living relationship it doesn't even turn into one percent of that because we are all like we all forward say or other platform how many people we are seeing actually in a living relationship invariably we talk yes it is an acceptable norm but be that as a yes uh raj would always have a point because he's from the film industry is uh they always say that the glamour world carries glamour and it is always the thought process is also slightly here we will have the rods we because i don't know you're being nice to me or you're actually taking me the other way but no uh sujay i say yes when you said that you know the the society is degenerating i will also like to imagine that the society is also liberated you can't hold one or two instances to show that the entire model structure and everything is falling apart law in itself also is empowering a lot of people look around you 49% of the country's population is women in the last 10 years they are doing better in every field and the law is actually siding them to a few instances yes do make it tough but i would still say let's see it as degeneration and liberation oh i don't think uh raj has taken the point well forward but yes sometimes because on the media when it says we are given that page let's assume even in the corona we can say not let's talk of living relationship if you read so much of media then you feel it's only corona i was reading one joke it says that once you are reading the newspaper it says it's only corona and you cannot live maybe even for tomorrow but if you're living family you feel that the family has got so much connected further that the family which used to say that you are not giving time you have given so much time in certain families the bonding has increased to much better level the understanding has improved you have been able to appreciate the family the child who was saying that you have just got and lost too much in the profession that's another flip side of the lockdown it's certain relationships have locked for the betterment also what is your take on that raj no no absolutely i mean uh you know it's i i think what's actually happened is uh it's made people realize this lockdowns made people realize that we were running for all the wrong reasons i think one thing that has come very clearly forward my wife also keeps reminding me that saying we've actually stopped running after things we did not need we're actually working towards building that family the values that movement shared together you know in being in each other's spaces all the time it was never happening before children are actually getting that that time and of course it also reaches a point that everyone wants to suffocate and kill each other but at the end of the day we're sitting back and all those handbags that were bought and the BMW cars and everything that was taken that second holiday home all of those things have become immaterial you've come down to the basics and you've realized that as long as you're easy as long as you're down there the family bonding is stronger because all you need is that much time and those many things together so this lockdown actually has had amazing effects i would just say because i wasn't telling about this thing because i thought that the entire show is upon all of us speaking then once you said the wife i said that because we all know that Mandir Abhidhi is quite busy in her schedules of the sports commentary and blah blah blah i will ask raj how that equation during all these two two months have changed where you have given so much time towards each other and professionally also thinking alike and moving around together on this particular topic it's a very a insight which will give another flip to the thought process of the all the indians how professionals who are actually busy you coming out with so many advertisement uh she doing so many shows how this lockdown period actually developed in way i am quite sure that the relationship would have been on a much much better way oh thank you well this uh you know this lockdown's been amazing but it's it's it's been normal for us because uh we we come from a tradition where it was always me more than me you know it was never about what she's done or what she represents or what i have done or what i represents about we being together like a yin and yang in a marriage two contrasting people two distinctly different people with joining together tangentially on what we need to make this work we've always been in a in a point of view where you know if you're 60 pro 40 con let's go for it sorry is not a problem there is no ego there is no such thing as you are the better partner or i am the better partner and this kind of balance is really what makes a marriage work according to me i've done 21 years and i think somewhere it's working this is the problem that's also happening with living relationships because they're still setting up the parameters of the marriage and then not it if it's unequal it is bound to fail it has to come to the point that it's not transactional but it's actually about two people who want to be together and they need to find that together in a way i see a lot of i know a lot of people who've been in living relationships and then taking that into a marriage because they've given it the entire time before legalizing the entire thing knowing we don't want to head into a divorce two years from now let us just give this time and get to know each other and if it works it strengthens let's take this forward and actually legalize the entire thing my marriage a lot of marriages around me have worked only on that parameter and i think that is the most important thing let's work towards being a we rather than being a me i'm just reminded that what you say that the words are same it's only the other side of the mirror image it becomes we if it stops the survey it's we i'm just reminded that on mother's day if we all go on the social media we always see that if we see the reverse mirror side image then it's always the mom if we see on the reverse it becomes wow so same way me and we and wow and mom are coordinated and i think the session will continue and for that we had as we discussed we will have a second session not only on this living relationship but other perspectives of life which have gone and how to develop but uh tomorrow we have a session with justice naga matu on confessions and conspiracy that should be another engaging session but before we part and before we thank all the participants i've just asked uh raj koshel to just give a peep in of the tuesday webinar where raj koshel speaks on communications real or real along with his a friend uh some uh just like a teaser of any movie ad otherwise we don't go for a teaser like that but once we have an ad ad person coming around just a teaser on that what on tuesday okay here comes the trailer all right uh we on tuesday we're discussing life how it's changing from real to real and essentially how kovid has actually changed the entire world and the way people are doing business the way people are communicating the the social distancing norms how the world will be taking it forward communication across all medias in terms of lower budgets tighter economy frustration people need to be finding the entire places the changes that are going to be coming in and in a way the wonderful changes that's going to that's sorry in a way the wonderful changes that are going to happen from now and that's essentially what we're discussing and trying to devise ways forward raj i just wanted because people have seen you the teaser about the second person i'm deliberately not naming that person yeah what what Mr Aman Khan is a is a is a friend of mine and uh he is one of the most senior advertising writers has been in the industry for a long time and also uh he's a great author writer he speaks and writes in Hindi in English and Urdu and it's very very important to get the creative side of all of this because what is becoming very very important today is that content is going to be king every kind of communication that goes out whether it's on a mobile phone a documentary a film a web series anything it eventually doesn't matter what quality you come with what matters is the content you're coming with and essentially content has to be written by very very efficient writers and thinkers they are the future so Aman brings that entire thing on the table i bring in the digital expertise and it just might be an interesting conversation just what you said we all know as a lawyer or anything the communication would always be brevity is dire soul to all this same because as we see in the youtube instagram the immediate reaction time to what we were looking for a greater time that's why from five day match it became 50 50 to 20 hours because all of us even though we are free let's assume in the lockdown but everybody feels no he doesn't have the time so brevity and the communication skill what is the real aspect uh how to go about it let's assume we sometimes do not like a person but on facebook you will give him so much comments and at the very moment after posting a good comment while sitting across with the other friend we will say that what type of photographs he's posting so that's the real and real and when we park way on this on this issue uh as we say since raj was there we thought that why not have a sequel we have been having sequels on other issues why not have a sequel on a webinar which will become interesting and why that's living relationship i would i'm just winding up on the content part it should be brief and crisp and why we are having on Tuesday on the communication skills i'm just reminded there couldn't be a more short risk worth family family would always stand for f for father and a for a and m is for mother and i love you that sums up the entire family so stay blessed during this lockdown stay connected with the family family actually means father and mother i love you but i will go further steps even the children we we love them are extended family the friends during this lockdown i am uh at least beneficiary of that we have got closer to sujoy and me raj what otherwise in the normal course we couldn't have connected so social media in its own way brings relationship let's not see the sad part we should also see the happy part good parts because as they say all coins have two sides except when in chole we had only a coin of one side so that's part way stay blessed stay connected raj is quite laughing i thought that once once you are having a person to speak on communication you will now actually have to improve your communication otherwise they will say the moderator just fizzled out just like a fish whereas the coke was lashed up upon by everybody stay connected stay blessed we will catch up tomorrow tomorrow and sujoy and me and all participants because tomorrow before you finish let me give a small parting remark and you know benefit we are faced with these situations that's why we do an open debate so that everybody can you know put in as given a suggestion so i am reminded of a very famous you know a template which sometimes you know i use in courts or judges write it in judgment you know and then we have these paid relationships and it goes like jala hai jisim agar please head it out jala hai jisim agar to dil bhi jal gaya hoega jala hai jisim agar to dil bhi jal gaya hoega ab kurete ho raah kyun ye justu juu kya? kya baada sir kya baada really amazing really well let's let's part on that point so but one from sujoy sujoy is a very good singer a couplet from sujoy also no no no i just be sensitive to you know the recognition of rights you know in every movement of the society that it states itself the path has to be corrected and our laws have to be protected at the end of the day and they have to encourage what are good for the society at the end of the day no i'll just say one couplet from yore because i know that you are very good singer as such i'll just say one thing that when you use the word confessions there was a smile on tanvir and my face let's end it at that thank you guys thank you so much for this wonderful round thank you stay blessed thank you very much stay healthy bye bye cheers


The Good Doctor. I really am not familiar with this show. I know a little bit about it, but I feel like today's show is going to be a little interesting. Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Chalini, and I'm a board-certified, diagnostic and interventional radiologist. And that last part is going to come into play in this video. So just this week, one of my coworkers that does all of my outpatient scheduling, shout out Lisa, told me that they mentioned interventional radiology on the show Good Doctor. And when I heard that, I went back to Google, typed in Good Doctor New Season, season six, episode one, the first episode this past week, and I opened it up. But before I did that, I decided to turn on the camera, record it because if they're mentioning interventional radiology, I want to watch it for the first time with you all and critique it, because that's my favorite thing to do. And before I get into this part, by the way, this is like an hour-long video, and I'm not going to make this an hour long, so I'm going to fast-forward to the part where it looks like there's going to be interventional radiology based on what I'm seeing on the little scroll caption. So let's fast-forward to, like, a quarter of the way through this first episode. Dr. Glassman says Dr. Lemoners Villanueva may be hurt on the fifth floor. So I don't know who Dr. Lil Nova. I'm not even saying that right, but I don't know who this person is, because I don't watch the show, but hopefully something will come together here. Is anyone here? I'm really sick.  There's a shooter in here? I must have fast-forwarded. I'm only like a couple of minutes into the episode here. Let's throw it on. We can 3D-coded pulse.  Let's throw it on some. So I actually don't know who they're operating on here, but I think maybe I don't know what's going to happen. Lessor races for the pulmonary hyalum. Left ventricles nicked. This will cause the tamponade. So basically when he stuck the needle in the peritardium, there was blood around the heart or cardiac tamponade. Stuck the needle around the heart into the peritardium, sucked out all the blood. Then when they went into the OR, I think this is the same patient. Well, that's what I'm gathering here. There was a laceration of the pulmonary hyalum or the main kind of branch point of the pulmonary vessels and also a laceration to the actual peritardium or the heart. I don't know which one yet, but that's what caused the blood to accumulate around the heart. And when the blood accumulates around the heart, the heart isn't able to expand and pump like it should. And therefore, the blood does not pump to the rest of your body, which is why it is an emergency to relieve that pressure or relieve the blood around the heart. As a grade four liver laceration with active bleeding into the peritardium. So grade four liver laceration, it's a high-grade liver laceration, usually caused by trauma. We see it a lot in patients who are in a bad car accident, usually from blunt force trauma, but I think this person was stabbed maybe, can also obviously be from that. I've seen it be caused by many different things, like a couch falling on someone and causing a very bad liver laceration. So maybe that's what they're going to repair because that's not really an easy repair in the operating room, but it's a lot easier sometimes to get from an interventional approach or a vascular approach, which is what I would do. We can do an NGO embolization instead. And if that goes south, you need a major transfusion That can't happen, we're in a lockdown. A hematectomy would decrease her life expectancy by 10 years. Life expectancy, Sean? She has 20 minutes, maybe, unless we can stop this hemorrhage. So basically they're going through the options of what you can do if someone has a bad liver laceration. He says a hemohepatectomy or resecting a piece of the liver, which he's saying gives her a low probability at a long life, but in the setting of an emergency, if you can give someone five, 10, whatever, many years, it's better than nothing. You are being short-sighted. He's very short-sighted. I wanna keep her alive. Dr. Glassman, Dr. Andrews needs your help with Villanueva. Dr. Gull is showing up.  So I don't know if Sean is a resident or not, but it sounds like that older guy is the attending and he's like making him do the hepatectomy even though he doesn't want to. Which, you know, he, all he's gotta do is go down to IR, which I hope is what they're going to do. She's unconscious. There's no way to test the collateral circulation to see if there's enough to perfuse her right. She's young. I'm willing to take that bet. You're willing to risk a massive stroke as opposed to letting her bleed to death? Yeah. These are actually all good scenarios here. These are the things that a lot of surgeons, physicians, interventional radiologists, we're thinking about all these scenarios in our head very quickly about what we can do, especially in an emergency situation, to save someone's life and what's the best option for that patient, given all the circumstances. And this is a lot to think about, but a lot of people don't realize is we do it very, very quickly and you have to come up with a plan fast or else we know what can happen. Do not need to take half a lever. We can do the angioembolization safely. What you told Dr. Glassman you were going to do the hemipatectomy. For others have changed. The angioembolization is the proper choice. Should someone let Dr. Gossman know? Inform him if you like. It is the proper choice in this case. I will say I agree with him here, even though I don't really like know the case. And basically what I'm trying to say is you would at least try to do the angioedram and embolization first. And if that fails, then you may go through with the hemipatectomy, but you should always start with the conservative minimally evasive approach, especially if the patient is stable like they are now. Now, one thing I will say though, is this guy is a surgeon. He is not an interventional radiologist. So a surgeon or a general surgeon or a hepatobiliary surgeon or a trauma surgeon don't know how to do interventional radiology procedures. So they would need a board certified interventional radiologist to do this. So I'm hoping that he's not the one that's doing this and they call on someone like me. Shawn, did you change the surgical plan? The parameters, it was based on changed. I adjusted accordingly. Well, now he's getting the flak. This is what happens. I mean, if he is a resident, which I don't know if he is or not, and he changed the attending's plan without telling him, woo, not only is that dangerous, but he may not finish residency if you do something like that. Also, I guess he's now an interventional radiologist, but that's neither he or nor there. And ignored my instructions in favor of what you wanted to do? Yes. How far into this are we? I located the site of contrast extravasation and the catheter is in position. Okay. When we're talking about extravasation, that means when we inject contrast within the artery and we see it going outside of the vessel, it's extravasating into the belly. So that's the site of bleeding. So when we say there's contrast extravasation, that means there's an area of acute hemorrhage because the contrast is just doing what the blood usually does because we're injecting it in the vessel. That's a scream. We're locked in. Give me a coil. So the interesting thing is on that angiogram, there actually are coils. So somebody, either him or whoever, already embolized something, but they just didn't show us. And what he just said right there was, give me a coil. That's a little platinum coil. It's literally a coil, very tiny, that we insert into the vessel and block off the vessel that's bleeding. And that's known as an embolization. One area of extravasation remaining. Deploying my coil. Let's go back to that picture. Let's study that for a second. So a couple of things going on here. One, that screen is so far away from where they're working. So I don't know how they see that. But nonetheless, basically they have a catheter up into some artery.  And then there's one random coil that's up north, which maybe that just like flew out of there. Who knows? But that's basically what they're doing.  Herry 168, big drop in BP. Coils are flying, we're still bleeding. I don't know if he said the coils are flying, which means they're not going where they're supposed to or there's another side of bleeding. Large collateral vessel must be damaged. We can inject gel foam particles for distal embolization. Okay, that's partly true. Gel foam particles aren't really a thing. There are a couple kinds of embolic or embolic agents that use temporary and permanent. Gel foam is a temporary agent, which is more of like a styrofoam type material that when you mix with saline turns into like a slushy or what we call a gel foam slurry. It's a temporary embolic. It usually stops the bleeding for one week, two weeks, four weeks. Different studies show different lengths of time that it stops for but that's considered a temporary agent. Permanent agents are something like a coil which stays in your body forever. It blocks off the vessel and it'll always be blocked off forever. Particles are separate from gel foam.  You don't inject particles and gel foam at the same time. That's not really a thing. Don't touch her. I'm injecting contrast. I am removing the packing, Sean. I see how to stop the bleed injecting particles. And you wouldn't use particles in this case for someone who is actively hemorrhaging.  Complete embolization with the residual bleeding. So basically he blocked off the blood flow to the second site of bleeding with the particles even though you and I both know that's not how you do it. I would have probably used glue. Yeah, glue, like super glue, or I would use more coils or you could also use gel foam in there, but particles are the last and only embolic that I wouldn't use here. Nonetheless though, you will see a dramatic drop in heart rate or increase in pressure in someone who's bleeding after you embolize them. It's actually a pretty rapid response. Okay, let's close her up. So it looks like he did the right thing after all. Once again, interventional radiology saves the day. At least he's humble about it, huh? So I don't think there's any more interventional radiology in this specific episode, but hopefully you got a little taste there. I don't wanna drag this out too long, so we'll end it there. Hopefully you all enjoyed this video. If you have any questions about interventional radiology or this procedure or anything like that, leave them in the comments below. As always, make sure you smash like, subscribe button, follow me on Instagram and TikTok if you don't already and check out Chilini Rounds podcast. I'll put a link up here and in the description below. You need to watch our podcast that I do with my two brothers. I promise you, you'll laugh, you'll love it. If you like medicine, if you like laughing, you'll like this podcast. So go check that out and I guess as always, I'll see you on the next one. Bye.