A Helen in the Ortho OPD.

It was the outdoor orthopaedic consulting room of a busy government general hospital - for short, the Ortho OPD. Ask any clinician, and s/he will, without a moment's hesitation, say that the driest (read that again!) branch of clinical practice is Orthopaedics : the doctors there have no heart, no mind, just carpentry!

The Corona epidemic was showing its fangs again and the patient numbers were dwindling. On one such morning, a 58-year-old man brought along his adult daughter for consultation. The daughter looked about 25 years.

Before I could begin interviewing the patient, the father told me that his daughter was deaf and mute, and that all the others in his family- his wife, and two other adult children - were similarly affected, that he was the only one able to speak and hear.

Immediately in my mind, the aphorism, " I cried that I had no shoes until down in the street I found a man who had no feet", came to my mind. (This aphorism - in its various forms- is attributed to different authors, and it is difficult to say with authenticity as to who wrote it - Helen Keller, Leo Tolstoy or Saadi Shirazi (1210 to 1291, Persia- Iran. The link to an interesting article as to the origins of this aphorisms is here)

I decided to use whatever common sense sign language gestures I could muster to try and communicate with the patient. The girl was wearing a mask, and hence her facial expressions were not of much use, except when she would nod her head in agreement or otherwise.

Then, I thought, maybe she reads some words, and started writing the questions I wanted to ask her in the Gujarati script. She answered in one-word responses, in English. Surprised, I looked at her father. He told me that she had passed her 12th standard in the English medium, and that she was the most educated amongst them all in their family! Indeed, it was my time to look the part of a carpenter now! Sorry, I don’t mean to insult the professional Carpenters, but then for the want of a better word to tease us Orthos, that is how we are addressed.

The interview with the patient went off fluently thereafter. All the questions were posed and responded to on paper, in English. She was examined duly.

As she got up to go out of the door, she gestured a friendly elbow-elbow nudge (remember the Covid protocols!).

I was happy the girl felt understood about what ailed her. While exiting the door, she turned around and gestured a thumbs up. I knew she was smiling from the widening of her eyes and bulge of the cheeks from behind the mask!

I had earned my days’ worth -every carpenter has his day!

---------

(C) Dr Tushar Mankad 2021

Hyper Accountability and YOLO

26th April 2020, Sunday

Is this feeling familiar to you? The feeling of Hyper Accountability that leads to an unease that afflicts oneself, like a malady that will not leave you alone, come thick or thin, day or night, good times or bad.

That malady is holding yourself up to being constantly accountable on how well you are performing: as an individual, a partner, a professional, a father, a student, a seeker, a member of the society, as a devotee, as an employer, as a colleague, as a son, a brother, a cousin, a relative, a friend, as...oh goodness, as 'anything' or in any role whatsoever. And in all this, you are the only one doing the performance appraisals on how well or otherwise you are faring ( hopefully!). 

Ain't that a heavy burden to bear? To say that the the load is heavy is an understatement.

Take a leisurely walk, or, sit silently - and undisturbed - with oneself, and ponder over this situation. You may be blessed with an insight, similar to the one that came upon me. It was accompanied with a wave of relief. One realizes that one just has to let go. That's all. You have to let go of holding yourself so cruelly and so horribly accountable to your own self for all your blessed seconds, in all these domains.  

A particularly nasty weight is about the use of available time : am I not missing out on something more important, more productive, more ...  All this while I am engaged in something that is actually quite 'useful'!

In this context, a canard doing the rounds these days is, life is too short! Well, so, how much do you want to pack into it? 

The other version of this one is, YOLO - you only live once. Hence, the reasoning goes, go ahead and make the most of every moment, do this, do that; live here, and also, there. This is fine as far as it encourages you to do well in a given activity, but there is more to it.

The underlying ( and damaging) message seems to be this: like Alexander the Great, conquer all domains of inner and outer experience possible in your life, and also, by wanting to experience first-hand what the others are doing, import these experiences of others into your consciousness, things others have done and you have not, lives others have lived and you have not.  This YOLO attitude and its resultant freneticism of life, frittering from one flower of experience to another one, before the nectar of one flower is even tasted leaves you with a sense of persistent discontent. ( As an aside, the word fritter comes from a related German word, Fetzen, meaning, a rag or a scrap; amusing, isnt it?)

Rather than living life fully in the moment, which remains the eternal message, YOLO makes life an addiction to an adrenaline rush: more  excitement in more domains, without much meaning. YOLO based life is the exact opposite of a life of Wisdom, of Depth, of Contentment and Peace. 

Sometimes I am very curious to find out about the winners and runners-up of Iron Man and Iron Women competitions, the Triathalons, the Marathons and so on. How do these people fare after it is all over, the race? What do they do? How do they live? Are they  contended, are they happy with how they live after the win, once their energies wane. Sure, they would be up to something that engages them, provides a livelihood, but , do they hanker after even more of achievements that are, clearly, beyond them now? How many of them have found their way into a life of Depth? The more such, the merrier!

What if there were a race, a contest, which does not get over after the finish line is reached? You do not have the pleasure of crossing over the pink or white ribbon, whether first or later?  

More pointedly, what if you were in a race in which there IS no finish line? Would you participate in such a race? Or would you rather spend your time in better, more satisfying pursuits?  Is your life such a race?

The Easier Alternative Is Not Necessarily The Better One.

It is easier in life to choose the path of lesser resistance, the ‘natural’ (natural to the temperament) alternative. Let’s see what this means. There will be repetitive phrases in this writing- I hope that this does not divert the reader from the main objective of the writing, for it is important.

It is easy to accept the first available alternative than it is to look for the not so obvious ones and to think them through, and to make the mental and emotional effort to look for other alternatives.
It is easy to hit back whereas it might be better to hold back and wait and make an active effort to reframe it all- but it (that reframing) needs effort and patience- and these two don’t come naturally, they come by training in forbearance.

It is easy to ‘just do it’, - whatever that ‘it’ is, without waiting to think it through. (Even as important a matter as investment in stocks- people ‘just do it’, and repent!)

And, now, it is easiest to only think about something and not do it – not do anything at all- and feel okay about it while in reality one is just being complacent.

It is so easy (and is so very evident everywhere) to let ourselves be fossilized in our thoughts and behaviours – than it is to make the effort to remain mentally, physically and emotionally supple and agile. In other words, it is so easy to degenerate – let the degeneration creep in speedily- than it is to be able to marshal one’s energies to remain fresh. Aging is okay, degenerating with the passage of time is not. It is important to think this through and act upon it than to just pay lip service to it, write about it and then let it pass by silently.

It is easy and effortlessly inevident ( though it is there out in the open for all to sense it) to let the mind take the path of least difficulty and be unaware about it- not only so-  but to be insolent and arrogant about the appropriateness of what one is doing and bringing about in the following of the easiest and the first available path of thinking and action. This causes considerable damage and loss of opportunity – in growth- in all senses. It is easy to let the guard off and yet to continue feeling secure about being watchful and on guard! It is the natural thing to be blind to it but not quite acceptable to be so once one knows what is happening.

It is easy to write a diary of scattered thoughts and feel satisfied about one’s contribution (to the field of writing) than it is to gather one’s energies, apply them and come out with a focused piece of writing! (I don’t denigrate the importance of diary writing for giving oneself the space to one’s thoughts, and its therapeutic potential in personal growth)

It is easy to be something, or even, be nothing, than it is to just be. The first two are appearances- studied ones- and the latter is the reality of how it all is. ‘Just be’ hides within it a state of intense application which when persisted with leads to deliverance – the ultimately worthwhile effort.

It is easy to let the habits and habitual ways of thinking hold sway over our days and to let life pass by, enslaved to these habitual ways- than it is to be aware, and then to act upon and against the flow of the force of the habits. It is easy to accept the inevitability of the force of the habit than it is to even catch oneself being captivated and enslaved by the snare of the habit. It is very easy to accept the hypnotability of the habits than it is to be aware of them and act in better ways.

It is easy to live on auto-pilot, and paradoxically surprising to see that one’s flight lands some place else just because a set of habits (auto-pilot) took over while the pilot slumbered away.
Remember, this piece is not about achievement in the outer world, it is about inner mastery and deliverance. The outer world most likely will benefit, though it might just not, but the inner world will certainly be free of the snare of ‘Maya’. That is no small a thing! A non-thing, actually.

Arre Kuch Nahi Hota Hai!

That one extra mouthful, the one extra swig, the one lazy evening spent not exercising- all these, in one or the other individual, when pointed out, they retort back, Oh come on, nothing can happen! Meaning, dont chastise me, no harm can come to me by just this one infraction
of behaviour. Is it ever just one- does it ever stop after one act of ommission or commission? Experience confirms that it - the infraction- goes on and on, under the assumption that just a little infraction cannot harm!

Honestly, yours truly also has reacted and behaved like that: the unneeded piece of sweet, or cup of tea, or the avoided but needed spell of exercise, the one more(and completely unnecessary) video clip on the net all of these, and more.

It is the more ominous acts of ommissions or commisions that go to make a chain of harmful actions and habits that undo an individual: the one time tax evasion leading upto a large and sustained one, the one time unethical act forming into a habit of thievery, the one more indulgence in an unhealthy habit leading upto an irreversible and complex health condition.

All these are the result of the above mentioned attitude- arre kuch nahi hota hai, just let me do it. There is even a technical name to this attitude: short term hedonism. And its counterpoint is here: https://albertellis.org/yolo/

And then there are people who lead a straightforward -if boring- life, and they feel smug that they have none of the harmful habits, and expectedly, they look forward to a peaceful long life. They are convinced that they have done no wrong and thus have absolved themselves of all blame with regard to not ever having done the wrong thing.

And then one day the world comes crashing on the straightforward one. And they wonder what wrong they did. It needs no special ability to know that the world does come crashing on the people that did the wrong things as well, and it comes crashing sooner rather than
later.

So what happened? Why did the virtuous ones get a whole lot of trouble when they did not do anything wrong? Where did they miss out? What did they miss out? We are not even talking of the karma-theory here, though that may operate. The focus of our topic here is different.

The focus here is this: even the most virtuous ones amongst us have -will have- at least one area of behaviour where he or she absolves himself or herself of any wrong doing- and this is a blind spot. One does not know that he or she is harming oneself. The background attitude-
arre kuch nahi hota hai-, hidden from awareness , is at work. The straightforward one may not steal- never ever- but he may also not ever exercise, to give an example. And the exalted
one may fall into an irreversible and disabling health condition. What wrong did I do, the vitruous may ask, and really he could have done no harm and yet the world comes crashing in on him. The only mistake he may have made would be this: arre (by not doing -----, ) kuch
nahi hota hai! That mistake of assuming that by a small infraction of not doing the right thing on a sustained basis, he could still escape the accumulated effects of not having acted when he should have- that- is the undoing.

What is my area of nondoing, the non performance of something that would one day lead to my undoing?

Anxieties on Replacing The Car's Battery With Some Help from the YouTube !

When a car’s battery dies, you get it replaced. At least that is what I had experienced over the years.

Like mobile phones, cars have gotten more sophisticated and, again like mobile phones, in some cars it is difficult to get the battery out in the first place. This, I did not know!

So when you dont know, you go to someone who does. For me, it was a man, just down the road,  who ran and owned  the agency  dealing with car batteries. I requested him to come and have a look and if necessary, to replace the battery of my car. He looked a sophisticated gent, a coat, a p-cap, a French beard and an accent to his language to sound authentic. I was confident he would get the job done fast and nice.

He asked me to snap open the spring lock to the car's hood from near the steering wheel, which I did obediently. The hood budged just a little but thereafter would not open ajar.So far, I had not needed to open the hood of this car since its purchase. Turn by turn the two of us struggled to get the hood to open widely but to no avail. Then, I thought of the brilliant idea of looking it up on YouTube, and sure enough there was a  video clip showing how to open the hood of this particular model. The gent approved of this idea and smiled benignly. I was not amused.

Now, I remember that in the previous cars I had used, the  battery housing unit  inside the hood was  placed such that removing it and replacing another in its place used to  be a very simple exercise. To my surprise, this car’s battery was placed in an extremely complicated manner with a lot of paraphernalia attached to it in so compact a manner that even a small spanner  could not be easily maneuvered into place to get the battery out of its holding unit. I looked at the gent, this time, asking for assurance that he was up to the task. Imagine my shock when  he  smiled and asked me if I would once again look up on the YouTube for the method of removing the battery of this particular model of the car!

Now my heart raced. What if, I thought, while attempting to remove the battery, this expert damaged the vital parts so snugly placed in close vicinity of the battery. I would then be in more trouble than what I had started out with. The battery man read my concerns and did not tinker any further.

He sought out his friend, a mechanic, to help him out. The two of them wriggled the battery out and replaced it with a new one . The moment they had done it, my troubles began again. For this time these two were lost on how to reconnect  the complex electronic sockets they had disconnected  from  the battery terminals before dismantling the entire configuration!

The chap who was called for second opinion was experienced, however, and with some cajoling of parts, was able to refit the assemblage.  

I heaved a sigh of relief as the car responded immediately to the mechanic’s command to me to apply the “self” – which is quite a Buddhist exhortation! (he meant for me to apply the ignition ). 

As the duo rode off after taking their dues, I wondered what some patients may feel as they entrust their own selves to the doctors! At the very least their anxieties must be addressed by proper communication. On the doctors’ parts, they should only take up what is within their forte!

And, I know for sure that doctors do look up the YouTube, but they do it before  they take up complex issues!

A Cell Phone - Where there is No Mind!

The morning time between being asleep and fully awake is a time of wonderful insights. These insights can come anytime, however. They are more a Grace and Blessing, than being arrived at by an effortful striving. 

One such:

These days one comes to interact and interface with the world through the cell phone for extended periods of time. It is as if one gets one’s bearings from and because of the cell phone. One makes a sense of the world through the social media apps, the internet sites, the news apps or sites by browsing these on the cell phone. Even when not interacting on the net through the phone, one is often found doing something (out of force of habit) in the phone so that the attention is inside the phone- scattered there- rather than it engaging with the world around, the issues around. One is simply absent, for want of attention, to the world around, though that world- people, situations, Nature- all of this- is present.

Is it not likely that the mind too is acting like this cell phone, a filter, which is restrictive like the applications of the cell phone, allowing only a limited, tunnel vision of what it wants one to see, or, by the force of habit -again- doesn’t let you see except through its own filtering mechanisms? What could it be that the mind is filtering out? Just as we are only peripherally aware when using the cell phone, that there is a reality outside the phone that we are subtracting from our interactions – thus reducing the possibility of a richer lived experience- just like that, aren’t we, when using only the mind, subtracting a reality, and, thus, its offer of a richer lived and felt experience? It is even difficult to conceive with the mind what that could be- for indeed that is how it is described in all Wisdom traditions- that reality that cannot be perceived by the mind!

There is certainly a confirmed state of existence where there are no thoughts, and yet where, at the same time, one is very much there, alive. Since there are no thoughts there to process that state, there are also no words possible to describe that state, only similes can be employed, and that too with no satisfaction that the simile will do its job well. The experience cannot be ever satisfactorily distilled into words for the experience to be repeated in the reader. That is why it is necessary for each one to experience it -the thoughtless state- oneself. How?

There are indeed many hows! Know-hows.

Meditation, Music, Inquiry, Being with Nature, Prayer, Service, and, Direct Knowledge ( transmitted or bestowed upon), even Playing ( sports), and, Love.

Yes?

Mam, What's Your Age, Again?

Mrs Sharma ( name & identifying details changed) was an English Teacher par excellence and the mother of a classmate from school days. Though she taught at another school, she gracefully accepted directing a couple of boys and girls from our class for George Bernard Shaw's classic play, Pygmalion. This was somewhere in the time of my tenth standard.

As we practiced regularly, I got very impressed with Mrs Sharma's repertoire of English accents, inflections and general grasp of the language.

One day during practice - and I cant remember what lead me to do this- I asked Mrs Sharma her age in the presence of all the boys and girls - my classmates- who had come to practice and watch the practice. Suddenly everyone became silent and waited for Mrs Sharma to answer.

In those few silent moments before she spoke, I felt her gaze piercing me. As I waited with a sense of tightness in my chest, every pore in my body was telling me that I was now in big trouble.

Then followed the rebuke of a lifetime. How ill-mannered of me, she said, that I dared to ask a lady her age. We were dismissed for that day.

The rest of the practice sessions thereafter were somber gatherings and the final performance of the play was appreciated at the school. In all fairness to Mrs Sharma, she was gracious in personally appreciating my performance as Professor Higgins. I could not bring myself to look into her eyes and shied away at the earliest.

Later on, in retrospect, I would often criticize myself that I was old enough in the tenth standard to know not to ask this sensitive question of a lady. Just how did I commit this faux pas!

As a few decades rolled by, this embarrassment was forgotten and I happened to get busy professionally.

One evening I received a message from my receptionist that my classmate had come at the appointed time for consultation for her mother. It was Mrs Sharma; and I knew before they walked in that this was the moment of my reckoning!

The consultation session proceeded to its logical end and I had the satisfaction of assuaging Mrs Sharma's anxieties about her orthopaedic condition.

As my classmate and her mother rose to leave my office, I smiled and asked Mrs Sharma,
"Madam, would you mind telling me your age now, especially now that I need to know this as a doctor!"
Indicating with a smile that she recollected that incident well, she extended her hand for a friendly handshake, and, in a soft voice, told me her age.

Obviously, I won't reveal her age for the fear of another rebuke!

Just so that you know, I found her to be as graceful as ever, and, ever young at heart!

A Joker Comes Calling.

                 

One day, when I was in the second standard, the Principal’s office suddenly announced that the school timings were being shortened by two periods. The students were ecstatic and started shouting in joy, while the announcement continued as to why the school was being released early. But from the fragments of announcement that I could manage to hear, I understood that a joker had come to the township and would be there for all to see at the pavilion-grounds. En route to the grounds, I left my school bag at home and told my mother that along with my school friends. I was headed to the pavillion to see a joker perform.
  

We school folks huddled and sat down on the ground just a few feet away from a long table laid down, for what I assumed was a walking platform for the joker’s performance. There were others too, our uncles and aunties from the township. These adults were talking about a film and I could not make any sense of it- I could not reason as to why these adults would talk about a film when we were here to see a joker’s antics. I knew that our outdoor theatre was just next to the pavilion where we were seated and may be these people were talking about some film there. Anyway, who cared when we were expecting to have lots of fun watching a joker come out anytime .

Soon enough, a group of elderly people came out walking from the pavilion accompanied with two or three ladies. There was no joker anywhere. I was quite disappointed. But our uncles and aunties were overwhelmed and behaved as if they were in the presence of some great personalities.

Of the people seated behind the long table, the smartest clad person was a pink-skinned gentleman, wearing a royal blue colored coat and dark goggles. From where I was seated, diagonally across from him, I could see he was sporting a pencil thin moustache and a very cherubic smile. I was interested.

Without any ado, someone handed him the mike and he started speaking in Hindi in a warm friendly voice. At the far end of the long table was seated a bald gentleman, also in a suit. The two, this goggled uncle and this bald man, kept on exchanging friendly smiles even as this Hindi speaking uncle continued addressing the audience.  I could not understand much till I heard him speak that all of them on his side of table were just like the rest of us in the audience and that they too had children like us attending school, saying this pointed in our direction where we school boys and girls were seated.  Now I started listening to him intently.

He further continued, saying that when he sang in the film people generally thought that it was he himself singing when in reality it was his friend at the other end of the table who lent his voice.

Saying so, he asked his friend to sing a few lines from a film so that the audience would believe that what he had just said was true.

The mike was passed on to the uncle seated at the end of the table; he got up, smiled and thanked the pink skinned uncle, and, sang in a mellifluous voice with a slightly nasal twang:

“Kehta Hai Joker, Sara Zamana, Aadhi Hakikat, Aadha Fasana…”

As the song ended, the audience was rapturous and the pink skinned uncle was all smiles. The ladies seated along with them were smiling too.

The audience was shouting, “once more, once more”…

It was later in the day that I realized that the pink skinned uncle whom I had come to adore was the legendary Mr. Raj Kapoor, and that he had come visiting along with the cast and crew of his latest film, ‘Mera Naam Joker’.

While my hopes of seeing a joker were certainly dashed, the memory of that day brightens up my face everytime this scene flashes past in my mind!

Tyranny of Numbers

There is a world of experience and living that is not amenable -will always be that way- to ennumeration. That is where living, the exhilaration and the passion of it all, is available, first hand, without, beyond, and transcending any description it.
The tendency of digitize, to put a number to attributes where it was wisest not to, to count a non-thing that was never meant to be accounted into books but which could always be counted upon, that tendency has now morphed into a large scale epidemic that has robbed us all of peace, sanity and wisdom.
In the name of slicing and splicing to get to the method in a madness that was never mad in the first place  (only we did not understand it en masse, as a gestalt)- that stubborn, assiduous attempt at en-clothing of mathematics over things, experiences and traits beyond the pale of numbers is a perversion of life by people who thought that life could be deciphered through decoding a code that is anything but one. There are things that are best left alone, to be felt, to be lived and experienced as such, without corrupting these with formulae and methods. It is only then, without the corruption with numbers, that these things bestow the gift of their full presence and their 'it-ness' on individuals. After all, why do we go about trying ourselves again and again in travelling, meeting, eating; all the time experiencing rather than counting and putting things in matrices? On the other hand who has not come across the rustic who travels to get destinations done?

There is never any doubt that numbers, statistics, trends and application of mathematics are helpful. After all where would we all be without these?
What is to be entertained is the notion of living at least a portion of daily life and a portion of life as a whole outside the grip of numbers even as we know that life cannot be wholly free

Imagine for a moment, if you can, a day lived without having to deal with numbers of any sort: what all will be left out will depend on your own life situation, but for some of us it could be a day without these:

• getting up at about sunrise without a numbers of an alarm clock shocking one up.
• a bath without the guilt of some indicative kilogram-digits not budging a bit: that would be a real good bath.
• a breakfast without the burden of calories but full of in-the-moment experience of the aroma and taste of it, needless to say the company that comes with the breakfast, 
• a meaningful exchange of ideas and information without the sense of a looming time-deadline
• a car ride - a real ride- without the anxiety of the average of kilometres per litre of petrol
• a peep into the mind of one's child's grasp without the burden of any digits that mark their performance when it is a process really.

For people of my ilk, it would mean:

• seeing into the satisfaction of making a difference to a person rather than to their parametres or one's purse.
• being free of the competitive madness of where one is with reference to one's peers and feel the common ground of healing and caring rather than just the one upmanship of papers published or number of cases treated or amount of 'oh-so-hefty' tax.

Just Let It Be.

A few years back an elderly gentleman was under my care in the hospital on a rather long term basis. The man was in his nineties and his wife of seventy years was just touching her 90th year then. The patient, we will name Hairhar, and his wife, Mangla. This couple had three children and several grand children. When Harihar got injured, all three children took time off to take care of their father. Mangla was a rock of a support for Harihar, and if she was away even for half a day, his mood would dive. The patient could not have asked for a better care from his family- and he did appreciate that fact.

In this circumstance, it was usual for me to find a pleasant emotional ambiance whenever I went for rounds to their room. Over the course of the long hospitalization, I became familiar with the natures of all the family members. Without exception, all of them were positive people and there was no artificiality to that. Yes, there were anxieties about Harihar's condition, but all of that was faced rather earnestly. The anxiety didn't linger on and on.

So, one day it came as a bit of a shock to me to find Mangla in an extremely low mood and silent. It was apparent that she had cried, and Harihar's face looked haggard as well. I feared that something must have happened to the operated part in the night and I must have come in a little late- but that couldn't be for the nurse would surely have informed me if there was indeed something amiss. Try as I might, none of the two would come out with what was wrong. I broached questions aimed at ferreting out medical issues but that drew a blank.

Finally, in exasperation and in the fear that I had missed something important that had a bearing on Harihar's treatment,  I asked, "Mangla ji, what is wrong with you? Why don't you tell me, please? You know, I might just be able to do something, even if it is just a bit. Are you upset with me for any reason? Why are you both so low today?"

Now Mangla looked up, locked her eyes on to mine- as I feared the worst, and said slowly, " Doctor, it can just be as it is, sometimes- can it not be? Just let it be. And don't worry, its not about you." Saying so, she smiled a bit and shifted her gaze away toward her husband nearby. He had heard it, and I suspect he tried hiding a wry smile.

Oops, I thought to myself, this  can happen even after the golden jubilee of a marriage is long gone by.

And then, something even more insightful came across; she had said, "Just let it be" - the wisest prescription down the ages so far as feelings and afflictive states are concerned.

That was a lesson for me, from my patient and his wife. Even when all is not as well as you would like it to be, it can still just be, and, that, is alright too. Teachers and teaching can come from anywhere and anybody, I thought.

There is a happy ending to this: that evening when I went for the rounds, all was as it had always been: back to more pleasant states of mind. 

Clean Curse

Some embarrassments last a life time.
This 4 year old boy was obviously toilet trained but it was his first week in the lower kindergarten and he was told he was getting late while he was taking it easy in the toilet accomplishing the only important mission of his day. The boy had no idea of what being late meant so he continued with his fantasies disregarding his father's shouts from the other side of the slightly ajar toilet door. At one point the shouts got pretty threatening for the boy and he decided to make a long affair short by simply sliding his pants up. The father was astonished that the boy could come out so quickly and suspecting that the last part of the job was left undone, questioned the boy about it. The boy lied. The father asked for the son to be inspected- full monty. And there it was in all its pristine glory- the job left undone. The rebuke that the boy got that day still reverberates in his ears, now in his fifties.

That boy, now the adult man that he is, reports that cleanliness has been a death and life matter for him and it rules his life beyond all known concepts of Godliness. He is petrified by any thing whatsoever that faintly suggests his being low on his self calculated cleanliness index - and this index keeps on scaling new heights every day. Obviously he is hard to live with and live upto for his family members now. The curse of cleanliness.

                                                                 ***

A sophisticated lady, then a prematurely retired consular staff, underwent a surgery that precluded getting up for toilets atleast within the first 12 hours after being out of general anaesthesia. The risk of  a fall while one is groggy from the persistent  after effects of anaesthetic drugs are significant and patients are routinely advised to be careful and ask for assistance for any toilet related calls.  This was completely unacceptable to this lady and against all odds and with significant aggravation of pain in her operated part, she got up and finished her ablutions, minimally assisted by the attendants. Not only this, she had her bath, wetting her operative site dressing, much to my consternation.
Shyness and dogged insistence on personal but superhuman cleanliness was the drive behind this rather completely bypass-able situation. We will never know if she was embarrassed in her childhood; but chances are she came from a family of cleanliness freaks. The curse again.

                                                               ***

Now about a freak himself. This man consulted me after having consulted  a few doctors for a shoulder condition. He said he understood that his condition had only one solution- surgery. However, he said he could not tolerate personal stink that he feared would arise if he did not clean himself on the operated side. I reassured him that even that was possible- the cleaning. But then he said his standards of cleaning were such that he had to raise his arm to clean himself; and that - atleast in the first few weeks postoperatively- was forbidden in his case or else the surgery would come undone. He said he would rather live  with a dysfunctional shoulder than tolerate personal body odor.
Seeing that things would not work out in a manner of his liking, he got up to leave; as he was stepping out of the room, he declared, "doc, the day I stink, I will jump off from a train and finish my life."
He worked by liaising with the railway ministry, facilitating contractors- an unclean job done by an ultra-clean man. The Clean Curse.

                                                             ***

Are you this  clean? I hope not- be blessed!

Though an unhygienic life style takes it toll, people with obsession about cleanliness suffer no less.
_________________________
Note:
India is bang on in its mission of 'Swachh Bharat'. The purpose of this post is different. The writer hopes that this comes through.

Unburdened at last.

Samta is 64 years old and the mother of a marketing executive working with a bank. Little on the heavier side for her height of just above five feet, she consulted me for an ankle injury she sustained just as she was to alight the bus that was bringing her from the aircraft to the airport terminal here in our city as she was looking forward to rejoining with her family of three:  her son Chirag, Jasmin- Chirag’s wife  and their son Kahaan- after a gap of six months. This was the first time in her life that she had ventured out of her house for so long. She was returning after this stay with her daughter as well as with other family members spread across the United Kingdom.

I have known this family for over a decade now. Chirag would often consult me for his father’s orthopaedic issues. This elder gentleman was housebound for the past several years from the residua of stroke suffered at the height of his own career. Chirag had to take up a job rather early in life to augment his family’s finances. His father’s indispensation and frequent medical consultations posed significant challenges to Chirag on his career path.  

Once in a while Samta would also seek appointment along with her husband, for her arthritic knees. Samta’s demeanor was always reserved, and her face bore the marks of the strain put on her by having to look after her husband at home. ‘Gravitas’ was the word I associated with Samta’s facial expression. I had noted that none of them- including Chirag, a marketing executive- ever smiled; not even the invariable smile that accompanies the “bye bye” at the end of a consulting session.  However it was not out of lack of manners; they had, between the three of them, quite a lot to bear so that it perhaps rendered them that much inattentive to other aspects of interpersonal behavior. Caring for a person rendered paralysed by stroke is not only physically demanding but also emotionally draining because the stroke affected person has, often, an altered sense of reality and is quite insecure.  

 About seven years back, Chirag had invited  our family for his wedding to his beloved, a girl from a well educated family of a minority community. The parents on both sides had given in to their wards’ demands after some struggle with their choices, going against the community guidelines on both sides. The last few years had gone by without any major marital discord, apparently, and the couple’s son Kahaan was now in pre nursery.  All this and more had transpired between the last time Samta came along with her husband, and today, when she had come with her daughter-in-law, Jasmin.  Samta had lost her husband about a year back.

This time, unlike the other times, Chirag had refrained from taking a few hours  off from his new and better job, not because he did not like to or that he did not get permission to, but because Samta was quite comfortable with just Jasmin in coming to consult me.

Thankfully the injury Samta had sustained in her right ankle was nothing very serious and it was expected that she would do well in course of time. As I was conveying this to Samta, I had to make a determined effort not to be agog with wonder as I saw a lightness of expression on Samta’s face, adorned with a pleasant smile. I wondered whether it was a smile only because of knowing that it was just a minor injury, or whether it was majorly from the relief of being unburdened of a lifetime of some heavy responsibility that she could not have turned her face away from. As she walked out from my office, I noted that her previous limp was now hardly noticeable-certainly a sign of improvement, or, atleast a sign of being less weighed down than before.

Long lasting emotional states can alter your sense of wellbeing-either way. A sense of felt helplessness in altering one’s situation, as in Samta’s case, can add to one’s woes. There is a third way here, if one makes space for it. That way is of developing a Mindfulness practice even as one is in the throes of the woes! 

The prescription is to die to the 'I' in contrast to being weighed down by that alphabet- like all prescriptions, this one too is easier read and said than practiced and done.

At Odds with Parents' choice.

Trisha-a 17 year old, thin, high school kid- a girl, alright- walked in alone to consult me for her neck and scapular pain. When I asked her to be seated on the examination table, she let her very classically designed ethnic purse slide off her shoulder to the floor.

She said her pain started when her two and a half year old kid brother jumped on her neck from behind her when she was reading prone in her bed, while her mom was busy talking on the cell phone- as she usually is- she added.

Always Online- is it worth?

What was missing was a certain clarity about my unease with the various online social networks and instant messaging apps. I knew something was not okay, but could not put my finger on it. Till the clarity came in, I was going along with the trend- almost like bowing in to the latest fashion trends much against personal tastes, affordability and comfort.

There is a crisis of meaningful,  direct, soulful communication in the midst of information overload and chat, more aptly, chatter. 

There is absence of one's presence in a perverse abundance of information exchange. One is left alone in a saturated soup of electronic connectivity. There is a contact without there being any connection.

Not only this, there is a constant anxiety associated with online activity. You are worried about what could be possibly going on on some group of which you are a member- this when you are in the presence of a significant person in physical proximity; you are anxious that you could miss something important online, or, that you may offend the person with whom you are present physically. That's a double edged stress. Even when online in a relatively uninterrupted state, there is still a background anxiety that you are 'eating up' time that could be spent with a person in physical reality- a family member, a colleague, a student, a friend- any one of whom could just be around and would certainly welcome a live, realtime, physically here and now meeting with you, perhaps with a hug or a handshake.

Constant preoccupation with online activity and interaction precludes deep work: be it thinking, planning, execution of important tasks or implementing important projects. Certainly, online activity comes at the expense of important tasks that can only be got done offline, in real life. Some of the most important of life's such tasks are parenting, being a spouse or a child, and most importantly, the exquisitely delicate and important activity of living a life. Is there anything that can equal the last activity in terms of depth of involvement required?

Also once you miss the time with a person, in person, the chance to connect deeply, meaningfully is lost in all this busy-ness and its attendant anxiety. You are physically present but not available- a lamp post could do a better job.

For peace of mind, for better productivity, for sanity, for balance, for richer & real interpersonal connections and relationships, for the calmness and stability that comes with being present, for being a better human, I am advocating a self-imposed and considerably restricted- rationed- online presence and activity. If your job is online, then this applies even more so. And it most applies if your job is off line, because the most meaningfully rich life certainly is offline. Just a few years back this used to be called being here, being available, being present. In its most subtle and yet most exalted expression, it is also called being Mindful.

Lastly this being compulsively online on various fora is the electronic equivalent of a chemical or substance addiction. Addictions, as recovering addicts, and relatives of active addicts will testify, ruin lives- that is more than one there!

Just How Lost?

A few unconnected events coalesced to create a feeling of a deafening sound of a bell tolling. It was a wake-up call without there being any sound- quite eerily it was because there was no alarming sound at all that it was a matter of such urgency. Was it was too late already?  Let’s see what actually happened.

***

Some months back a cousin of mine emailed me a family photograph that he had dug up from his archives. It was a black and white group photograph taken in the back drop of the trellis of our now razed ancestral home. My cousin, a few years my junior, had queried me if I knew anyone from the group, he being my father’s younger brother’s son. Yes, I replied back, I knew only two people from the group of perhaps thirty, all faces being clearly visible. Two children sitting in the front row at one end were identifiable- one, a boy, was my grandfather’s younger brother, and the little girl next to him, was his younger sister, now in her late eighties, and the only living link between that group of thirty and us. Replying to my cousin was not a matter of a resounding “yes” for me, since apart from these two close family members whom I identified, I could not place anyone else from the group, though I knew that each one of them was somehow related to me, most of them by blood.

***

A fortnight back an acquaintance of mine, a man settled in the US for the last thirty years, came in with his mother to consult me for the lady’s knee pain. After the clinical formalities were done, we got chatting since our families were connected back in the past.  He mentioned that prior to his coming into our city he had visited his unlce in Mumbai, the third and the only living brother of his late father. There he had asked his uncle to speak about his family’s history, their ancestral home, and their ancestral vocations and so on, while he recorded all of it in his device. This acquaintance told me that ever since he had lost his father, he was looking forward to somehow connect with his past- his family- that he knew nothing about, and to him it felt deeply satisfying to be able to know first-hand what his family was like in days gone by, prior to his birth.

***

Few months back the Times of India carried a story of a man who had died recently on one of the islands of the Andamans- the far flung group of islands of India in the Bay of Bengal. This man happened to be the last individual who spoke his native language. At that point, I remembered the book, The Way Finders, by the Canadian Ethnobiologist, Wade Davis. He affirms that at present,  once in every two weeks one entire language becomes extinct in the manner depicted above, and with that extinction is erased a sizeable record of human civilization in that part of the world where the language was once spoken. He poignantly exhorts the reader to imagine a situation where he or she is the last living human being who can speak a language which will be no more available in a few days when he is gone forever. What would be your feelings in such a situation? Though he does not ask this, I feel he might as well: would you still want to converse with others exclusively in English, even when the other person can still speak another language of common inheritance?

***

A lot was transmitted through the oral communication, it still is, and it is possible to save that method of communication and transmission, if we just wake up to this looming crisis of rendering everything to a universal uniformity.

Our civilization, our histories, our scriptures, our cultures, our values, our customs, our national and regional identities have come down to us from the oral traditions, from practices that were as diverse, as they were rich and meaningful. In today’s parlance these oral transmissions would be archaic- but is something so profound, something that has birthed the various civilizations really ever archaic?

If your mother tongue is not English, and you work and live where English is the main language outside the house, what would you do for the preservation of the language in your branch of the family? What would you do to preserve your larger cultural heritage?

A young person, not yet married,  when being told about these events just mentioned above, questioned me: what if it was just herself who did not coach her children to speak in her mother tongue? I asked her, what if all the young people do the same?  She sensed the answer and nodded with a smile. After a while, she confessed that of course she would teach her mother tongue to her children, when they came into the world.

***

Let me leave you with a story that happened in my consulting room sometime back.

A man I will name as Hardik, had immigrated to the US after always having lived and conducted business in my city till the age of 40. At age 55 years, he comes in to consult me for his shoulder problem, with a MRI scan in his hand. As I started explaining to him his problem, as reflected in the scan, in the Gujarati language, which I thought was the mother tongue for both of us, he interrupted me, and with a smirk, he asked me to explain what I thought was his problem in English.

I told him English was his problem for he had forsaken Gujarati which would have been the easiest for him to make sense of what was being told to him, while if I communicated in English, he would still be left in the lurch, for English was still a foreign language for him. In all fairness to him, he apologized: not to me, but to his mother tongue, for the huge loss that he perceived was his alone.

Illiterate or Uneducated?

Illiterate human beings have always been a subject of fascination for me; I cannot but wonder as to how they make their ends meet. This curiosity once almost led me to commission a study that would find out jobs that people at various levels of illiteracy do to sustain themselves...more on that some other time; this time it’s about a rough diamond that has come up from the river bed of illiteracy.

Everyday Joys and a spiritual life.

The biggest surprising insight of the week was the sudden flash that made it so clear that being spiritual in no way takes away the possibility of living a joyful life or a life of fun or even of commitment to one's goals and responsibilities. There was even the smirk within that questioned this possibility of  anything else being nursed in the name of spirituality in the first place.

One of the mistaken perceptions of a spiritual life is that of austere renunciation and dourness, a life removed from allowance of a feeling of joy and mirth in everyday life.The joy of a smile exchanged, a hand shake, simple things like this that are neither permissive nor restrictive are not at all out of bounds for a spiritual person. The innocent, pleasant, clean, uncorrupted joy of simple everyday transactions and the commonplace hope that has come to see the light of the day through one's efforts and Grace- these are certainly within the definition of a lived spiritual life.

This is what I wrote in my e-diary:
Being spiritual does NOT devolve you from being committed to your everyday duties and responsibilities. Behaving as if everything will take care of itself, on its own, without any effort from your side, just because you are spiritual is a costly delusion (and something that is not spiritual in the first place- because spirituality teaches us to look at things as they really are). You still have to do your job and you have to do it well, for that too is spiritual.

Included in this duty is the one toward servicing the upkeep of your own self: making sure you are healthy in body, mind and emotions. That is the full compass of spirituality. Spirituality does not ask you to be a pauper on purpose when you are not one to start with; it asks you to see what you really are and then act in the wisest way and in a way that is for the highest common good. The same is true for depressive spells that are passed by almost unawares and even helplessly in the name of spirituality or spiritual practices being done in the background.

A truly spiritual person is healthy, is happy within, and if not, he actually works to make it better with means available to him, and yet is in touch with reality. He does not welcome unwholesome states of mind or body but when in the throes of such a state, he faces it with as much equanimity as possible and makes amends. He does not deliberately sabotage his own career or profession just because he is committed to some spiritual practice or teaching. Anyone doing this or asking you to do this is not practicing or teaching spirituality. Beware. 

The First Cremation of Childhood.

The Colony that we stayed in was the residential facility for the employees of the company my father worked in. If there was ever a place better than Heaven on Earth, at least in that decade or so of my childhood that we lived there, it was there in that colony.  We, the children of those days, were indeed blessed with the best of all that the rest of Indian parents would have wanted for their children.

At various times, we had neighbours from different nationalities- the Japanese, Italians, Spanish, Swiss, the Americans and the British. Those that had brought along their children, they studied with us in our school. Once the various plants of the company were commissioned, these other nationals went away and we had a new neighbour,  a family that had – not at all surprising at that time- known ours for perhaps five generations in the past.

The patriarch of this family, a retired  teacher and a dignified old man in his late eighties was a sight to behold: short statured but ramrod straight posture, bushy white moustache, circle rimmed glasses, black Gandhi Cap, a walking stick in hand, wearing starched white dhoti under a white kurta on top and balck leather mojaris. He was quite amiable and I warmed upto him over the next few weeks. He told me he was personally familiar with my grandfather’s father since he and my great grandfather were neighbours back in our home town! For some reason I was awe struck by this man and fancied a liking for him. The sight of him stirred deep feelings of shared intergenerational bonds.

After a few months, the old gentleman fell ill and died. I must have been about ten years of age then and I recollect being very sad on hearing of this. My father took leave of absence to assist in the preparations for the funeral.  And then out of the blue he asked me to accompany the funeral procession to the crematorium located outside the colony in an inaccessible and forlorn location. My mother protested against this decision, but father insisted. While I do not recollect the exact words of the exchange that my parents had about it, I remembering overhearing something to the effect that it would help in my training.

“Goddammit” was not a part of my vocabulary then but the sense of it certainly was. What kind of training was he talking about?

In any case I did accompany the funeral procession. I asked my father a lot of questions and some of them were answered, like why the logs were being arranged on the pyre as if in a geometric design.  And then a severe concern came upon me: what if the grandpa’s body still had some life left hidden in him somewhere- wouldn’t he feel the burning pain of the fire of the funeral? Was it sure he had really died- for he looked so fresh- as if he was just sleeping quietly.

After a while of questioning I – being the only pre-teen in a crowd of men of my father’s age-fell silent and passed the remaining time at the crematorium lost in thoughts. As I look back now I wonder what thoughts I must have thought at that tender age. On the way back home there were even more questions and fewer answers. I passed the next couple of days in a demure mood.

While questions about death lingered on in my mind for quite a few days the most persistent of all was the question, what, if any, was the training that my father referred to, in attending a funeral? It was not the question per se that was disturbing but the concept of death as an aid to training that continued to ruffle me.

In a twist of serendipity, over the next few days, our history teacher took up a chapter on Siddhartha Gautam. In our text book was mentioned the young  Siddhartha’s first exposure to the fact of suffering in life-sickness and then old age leading to death.  I distinctly recollect the feeling I had as I read that chapter- it felt that seeing a death was a familiar experience but I could not decide what to make of it, except that it had made me very sad for some time.

Only much later did I realize that on that day at the crematorium, I had had my first emphatic experience of what the Buddha called the first of the Four Noble Truths.

Suffice it to say, the training continues!

The Biscuit- Should I Eat It?

That day, at last the main competitive exams for children in the 12th standard was over and all of us could then breathe easy.

From that night to right till about an hour or so into the mid morning the next day, I was under the sway of a powerful mental-emotional spell which urged me to be competitive, brash, uncaring of anything other than personal ambitions. On the whole, it was a fist-clenching, forging-ahead attitude full of grit and devil-may-care slant of mind, while mentally nurturing the rekindling of the goals perceived as hibernating.

The triggering events were two: the first has already been mentioned above, whereby I felt- not quite appropriately, for no one had stopped me- as if I was now free to pursue my own ends; the second was the movie we saw that night; it was based on a book written by one of India's famous whiz kids. The fact that this man's book could be made into a successful big banner movie, conflagrated my desires for some substantially more worldly success. A thousand of my pet projects came tumbling out of my mind's recesses, clamoring for fruition.

At just that moment the thought of the Ashta Sila  came to mind; one of those eight precepts enjoins oneself to abstain from watching entertainment shows. The reason for undertaking the precept became apparent as I went over my mental frame of that day. So powerfully disturbing was the effect of the movie that the meditation session of the morning -after had hardly a moment of Mindfulness in it. Not only these entertainment shows leave your mind distracted, sometimes agitated as well, as in my case, but, and importantly, it takes away scarce time that could be used in Practice.

As if to shame myself further, I had already committed to one more 'sufi music' concert the following evening....prayers for myself and my well being!

The spell of a towering ambition for worldly success has the potential of clouding one's sense of discernment to the same degree as a period of rage; only the spell of ambition lasts longer and is hard to be aware of, where as, at least to some infinitesimal degree, one is aware that one is angry when one is so. This is an insight I was not aware of so clearly right till then.

The question that reared its head then was how to conduct one's life in a balanced manner? I mean how much of ambition to stoke and how much to douse? Perhaps the answer lies in doing the best under the situation, doing it with the intention of highest good for all concerned, all the while being crystal clear about the motives deep within- aligning these with the highest good, and then to let the results take care of themselves. No, it doesn't end there- one has to learn to accept  the result, as it is, and then move on. To do this again and again with every presenting opportunity to exert one's ability, and to do it while being aware as it is being done, if that can be done, would be a big success in itself!

On top of this disturbing frame of mind that day, there was also the news of a dear friend having undergone a coronary angioplasty over the previous weekend. These events in one's circle of friends also influences oneself; this time the effect was a sobering one. In a funny sense, such news can act as a measure of helping one's cholesterol- I let the very enticing biscuit fall back in its container on hearing of the news. This time, however, I knew that I was dropping the biscuit as I was doing it!

The Patient, My Coach.

Chitra, a 61 year old bespectacled, sari-clad lady came to consult me for pain in both her knee joints that she had been having for about three weeks. It had resulted from her tripping over a watering hose in her compound while she tried reaching over to her neighbor over their common wall in an attempt to pass on a delicacy she had just made.  This neighbor, a lady of about the same age, had accompanied Chitra.  While I was not particularly looking forward to this depth of detailed description of her injury, it seemed to flow quite naturally from her. I noticed that she was actually quite casual in reporting it to me and had sought my opinion perhaps as a last resort now that the pain was causing a limp even after three weeks of, what was in her assessment, a trivial trip over a hose pipe. Usually, patients are reticent in giving their details, and I could not but help noticing the absence of that trait in Chitra.

The injury seemed to be bothersome to her in other aspects of her activities of daily living, and the knees were minimally swollen. As a part of getting more information about her medical history, I asked her if she had diabetes; declining that she had it, she volunteered that she did have hypertension, and that it was well controlled with just a tablet twice a day.  Saying so, she paused and then looked at her neighbor. Now, this lady urged Chitra to tell me “everything”. 

The Crying Professor.

It was the professor's weekly round day and his residents were awaiting his arrival in the large and crowded children's ward of the government general hospital. The professor was also doubling up as the head of department of paediatrics.

All the residents, juniors and seniors, looked forward to the professor's grand round for they all agreed that the prof's round was like no other anywhere else, not only in the hospital's other departments but perhaps anywhere else in the country.

Profiting from Idleness

That title will need the following eight paragraphs to unravel its potency on you, and hopefully you will profit from your having read that far.

I deleted my accounts on two major and rival social network platforms, this time, I hope for good, and, out of sound faith in my reasons for doing so.

In some fleeting moments of clarity one is  aware of a sort of cognitive discomfort  where, when you know you have got nothing to do with your time, you desperately seek to plug the discomfort by doing something, just any damn thing, in the misplaced hope that the given activity brings some relief from the pain of boredom; only in retrospect does it dawn that the activity was meaningless and distracting. An example from a previous era hits the point home: elderly gentlemen would read the day's newspaper over and over again, all the while muttering,
"there is nothing new in the newspaper today."
Their hope of being relieved of their boredom was repeatedly belied. That same trait is at work- with some significant differences - when one connects to the social network: seeking relief from the desperation of boredom. The rest of this post is about those differences.

Santa Cross

Most people want to think through, rightly so, about their situation and the treatment options available to them if there is time- if the condition is not desperate. In a non-urgent situation, multiple factors come into play and the least examined (by the patient) is the influence on their decision of the appearance and demeanor of the doctor. Has it occurred to you?

A Different Dubious Distinction

The farm laborer, hailing from the interiors of my district, had come through the recommendation of his local grocery shop keeper- a person I had no remembrance of. He was told that if he found that nothing works elsewhere, at least here he would get a diagnosis. I was mortified by that impression of myself. It is easy to live upto a plain human being's impression but to impersonate a person with powers you don't have is very taxing from the very first moment of interaction.

To cut the story short (so that another story can be appended)

From Ink to an Inkling

Recently I resurrected a fountain pen that came as a gift long back. Under the onslaught of speed and convenience fountain pens came close to getting extinct. Resuming some writing with the ink-pen (as the fountain pen is called), I noticed that legible writing with one is much more arduous than doing so with a ball point pen. This led my thoughts astray for a while and a hitherto unthought-of landscape unfolded in my mind-space. 

Just Missed - A Pregnancy

A dear friend of long standing presently works for a corporate- the same one he joined as a graduate engineer many a summer  back. At one time this entity was the place to work in, and the employees' residential facility was the address to live in India. A fellow graduate engineer joined the company at about the same time as my friend did and as fate would have it they soon got married to girls with the same name. Lets give them both another name for the sake of anonymity; say, Prema.

The two families got close because of proximity and the wives, both Premas, would visit most places in the township together, so much so that they would sometimes need medical attention for minor issues at the same time.

On one such visit, each Prema having her own agenda, one lady's sample tested positive for pregnancy, while the other one was not tested. To confound the matters,

Stress Changes You; Will You?

When was the last time you put Stress at the focal point of your attention? If not in a while, perhaps a few moments to ponder over it may save a life in more ways than one. Here is why:

Stress morphs you into another person, a person you are a stranger to in your calmer moments. But over time, persistent stress also brings in irreversible and undesirable changes within. While stress has been the subject of study since decades, an overall view of it is perhaps not very commonly put across. This write up proposes to do that for you.

A Wake up Call on a Holiday !

Diwali brings in the Hindu New Year and also ushers in holidays for a large portion of people living in India. Like countless others, we also decided to holiday away from home with the family. This time it was Saputara, a hill station in the south of Gujarat, in the Dangs district.

Thanks to a contact in the Tourism Corporation of Gujarat Limited, we could book enough rooms for all of us at a distance of three weeks prior to our scheduled departure, in the Toran Hill Resort at Saputara. It is located at the entrance as it were, into Saputara. The town or whatever little of it is there, unfolds from the traffic circle at the entrance of the winding road as it reaches the plateau atop the hills.

Partly out of human tendency to do so and partly out of the staggering contrast, I could not but help compare my experience of this place 14 years back and now.

The Old Photograph

Cleaning my drawer sometime back I chanced upon a colored photograph of my departmental colleagues from the time I had just cleared my post-graduation in orthopedics.  Below the photograph was a type written note gummed to the cardboard mount of the photograph, bearing the names of the people in the photograph in all the rows, left to right, sitting and standing. What a neat method, I had thought to myself, for making sure whoever sees the photograph knows who is who.

That was face tagging as we know it now, and it was before digital photography came to help us mark people for posterity. Well I was happy for this photograph and the memories of the experiences it conjured for me.

By coincidence, the next day, a cousin sent me by email a scanned copy of an old group photograph, a black and white, with the identifying note below the photograph missing.

In a Manner of Speaking.

If you get the inflection of an "alright" right then you can tell whether the NRI speaking to you is a product of a Gujarati family from Idi Amin's Kenya or she is an immigrant with roots in Saurashtra. What one speaks shows where one comes from. However some chirps are more ominous as can be seen from the following -harmless-in-after-thought- communication. But at the time it transpired, it shocked me.

Doc Get Me Some Sleep!

One of the principal reasons a person goes to a doctor is that the ailment he is suffering from does not permit good sleep. Such a patient asked me one day, " Doc what is that I can do during the day so that I can sleep well at night?" I appreciated the fact that he hadn't asked for a sleeping pill. Also, the question struck me as being at once practical as well as profound.

Coincidentally, the next day I received an email from WebMD with a link to a slide show on how to sleep well. It is here.

However the question kept on reverberating in my mind and I thought that there has to be something even more to getting good sleep. I started with some hands on research and found that some measures indeed helped getting better sleep.

A unique and yet paradoxical finding was that there is some evidence that altruism (helping someone without expecting anything in return) helps in getting good sleep. On one hand the understanding is that you help without expecting anything and yet here you are expecting peace of mind and good sleep! Putting it another way, I thought wouldn't an altruistic act a day be a good thing irrespective of its benefit to the doer?

Another interesting finding was reading the scriptures in the original script (alright, with the translation thrown in as well) as the last thing during the day. Try it and you may find that there is no better sedative.

It is said that Dr S. Radhakrishnan, the second president of India, during his tenure as India's ambassador to the erstwhile USSR, walked out politely from a state function citing his routine of retiring to bed at 10 pm daily.
Maintaining a regular schedule turns out to be important- yes that important!

Then there are foods that can help or harm your sleep just as there are jobs that can wreck your sleep.These links are worth a look.

Perhaps, just as important as these factors happen to be for a good sleep there is also the even more important factor of what you happen to have done during the day that affects your conscience. If your heart is heavy as you hit the bed, it is unlikely that you would sleep well. This does not require any double blind studies, only blind practice.

The Fat Farce.

Jealousy, I had always been confident, was other peoples' domain. It would have remained that way but for a chance meeting between a friend and myself.

To our care givers- Doctors' real colleagues

As a wannabe doctor, a junior medical student dreams of operating upon a patient or ordering a test or writing a prescription for his future patients. It is with great aspirations that one fantasizes about these things, including but not limited to passing orders to those reporting to oneself when one thinks of being in the doctor's position. At that stage there is a vicarious pride in visualizing such a situation. For such a medical student, the sense of anticipating great personal power is there but the same is not true of the irrefutable accompanying responsibility at that nascent stage in one's career.

Well, most doctors-in-training ultimately do mature and there are very few conceited doctors that are still evident beyond a certain age. Yet, even at this mature stage, doctors are rarely, if ever, involved in administering continuous care to patients under their supervision. Doctors hardly have to administer injections or nurse their patients. Rightfully there is a support staff to do these duties. Even if once in a while doctors have to take up the role of their support staff, it is momentary and perhaps gratifying. It is considered as a feather of virtuous humility in the doctor's virtual cap.

Any parent who has nursed a sick child through the night will testify that such care giving is extremely draining. Now try to visualize that situation happening over and over again during every day you report for duty. Just how awfully exhausting could it be for the minds and bodies of the support staff. If you have ever had such a demanding situation at home, you will gladly exchange any other professional role in the hierarchy of health care for that of an immediate care giver. It is amazing to see nurses, assistants and attendants smile and greet doctors on rounds, often in quick succession, through the day.

Two groups of people should spare a kind thought for the support staff involved in any long term care facility: the doctors and the relations of the infirm. For the patient, meaningful life is restored as a result of the daily caring and loving ministrations of the support staff and not just the doctor's wise orders. Next time a nurse smiles at you, smile back to her for this reason alone. It will be a different smile, both, yours and hers!

Choosing a Residency program

Recently a senior medical student requested me to help with the decision making about the specialty to choose for post graduate training (residency). There are some people who are lucky enough to face this dilemma while quite a few are forced to make do with whatever is available after others have left with the meat.

Because there are many people in this predicament, I thought it appropriate to post this email, suitably modified for public reading, without in any way diluting the contents.This is what I had to say:

Why Do I remember Eid at Every Diwali?

The trip was progressing better than our expectations. We felt that our travel agent had planned for and arranged a nice itinerary. Though there was a last minute change in our dates, he had gone to the extent of offering us a customized tour without any extra charge at all. We felt grateful to him at every step of the trip. We felt that our trip was worth the full advance we had paid him.

The second leg of the trip was Singapore. We had to reach there by a train from Kuala Lumpur. All of us felt that Indian trains, third AC coaches onward, were better than the thing we were booked on. There was a major difference, however; smartly dressed lady ticket checking officers were doing their job professionally; it was a night train.

We arrived on Singapore railway station at about 9 am and seeing that other tourists were being escorted out by their travel agents'  local representatives, we were expecting someone to approach us with our names written on a placard. Indeed before the others were out of sight, a man in his late thirties approached us with my name on a sheet of paper in his hand.

i-fast

After the company whose name rhymes with maple came up with a series of products beginning with the first person singular pronoun things have gotten complicated: when last heard of, a contraceptive pill manufacturing company was considering a name-change for one of its hot selling troubleshooters because the small little i in their product’s name rendered itself to being perceived as an offering from the gadget behemoth. So readers are forewarned that this piece has nothing to do with gadgets or speed or abstinence from food. And, it has nothing to do with the first person singular either, though it has a lot to do with the Self.

Ten Seconds Flat

Can anything that's fun and interesting happen in ten seconds?
Well I am referring to quirky everyday events that add some flavour to a day in just about ten seconds.

The best place that I know of to get your fill of events of this import imprinted on your mind is the road in a busy city. Here's a small selection of  what has amused me.

Quick Bite:
A portly gentleman whom I have known for sometime now has recently upgraded from a two wheeler to a car with shaded windows. He has consulted me in the past for painful knees and I have a distinct remembrance of advising him to shed some weight. Well, it seems he leaves for work at (presumably) the same time that I go (occassionally) for my morning walk. The purpose of shaded windows is to prevent peering eyes to see what is going on inside. But that still leaves the front glass- the wind screen- for curious eyes to have their share of peeks. The other day I chanced upon this man deftly handling the steering wheel with one hand while helping himself to a generous portion of what seemed like a pizza from something in the seat next to him. At that very instant our eyes met for a fraction of a second and then he whizzed past. Heaven only knows whether he swallowed the pizza or whether he choked on it! Needless to say, I enjoyed it- the scene!
Total time: much less than 10 seconds.


Pleasure with Duty:
In my city there is a squad of traffic assistants, boys and girls just past their teens, who assist the police in directing the traffic at important junctions. They have no legal authority but most times their signals to stop and proceed are respected by the populace. On this particular day, as I approached a turn-around I noticed two of these boys manning the circle, one each on two successive exits of the circle. There was no noticeable traffic to monitor then.
At about the same time as my car approached the turn-around another vehicle, driven by a very beautiful young lady, approached the circle from my right. I had expected to be stopped for the girl had reached the circle a split second earlier than I had. To my surprise, the traffic assistants waved her to a stop, and bade me to proceed, with a naughty smile. My curiosity was piqued. In the rear view mirror I saw that the two boys were taking their time to wave the beauty to proceed further along the exit. It must have been a good five seconds before they signaled her to go. I was too further away on the road to see the lady's reaction in my mirror, but from what little I know of these, it must have been a vigorous shaking of her head from side to side.
Total time: A generous 10 seconds.


How's he doing?
There are some small but busy and yet unmanned traffic spots where nature- mother and human- slug it out for the best way forward.
At such intersections vehicles jumble up at the junction from all sides leaving no room for anyone to go anywhere. In this heady cacophony some kind souls backtrack or shift a little to make room for vehicles nudging in from all other sides and soon the spot is cleared of the madness.
I found myself in the middle of such a mess one fine evening. With the intention of guiding vehicles on both sides of my car, I opened the car's windows. Just as I was done with firm suggestions to my fellow drivers, a familiar face peered in on me. The face smiled and without meaning to, I did the same. The fellow asked, "Hello Doc, how are you? Remember my father?" In that situation, perhaps even the most devout would be forgiven if they could not possibly remember the Father, leave alone someone's big man. I was hard pressed to go further along the junction on one hand and on the other, I had to blurt out, "Oh, Hi, how's he doing?"
"He came out fine from the hospital" the guy responded.
Someone honked a nasty one from behind this fellow and he mumbled, "Excuse me, Doc, See you later."
Excused indeed, I said to myself-of myself.
Any corporate big boss would have been proud of the time-management displayed by my friend.
Total Time I was tried for: ten seconds that seemed like a decade.