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A nightlight in darkness

>> Wednesday, March 23, 2011

We were trying to give a bath to Michael. He was our mischievous boxer dog, and Sheri was too fond of him. He was not much interested in his cosmetics and would jump and thrash when we tried to give him the bath.
“Acha….hold tight!....He will jump”, she said
I was trying to shampoo his head and he boxed me with his head. That was his style. I slipped and fell down.
Sheri burst in to laughter.....  A thousand tinkling bells.

I woke up in the middle of her laughter. It was darkness and took me some time to realize I was alone and in bed. God! Was it a dream!
It is more than a year since my daughter in law died and I have wept silently every day. Not a single day passes without remembering her. Though I know she is gone, I expect her to walk in the door at any moment and say "Acha..." I think she will call me and we will talk about our action plans at home …. None of this will happen, still.
Michael had left us suddenly one day  and all our troubles started. Within few weeks, Sheri was taken ill.While Sheri was at the hospital,my wife had a heart attack... Do misfortunes flock together? We had planned everything for her recovery.... And that is another thing I learned now. To be prepared for unexpected turns in life.

She made people laugh and time flew when she was around. She was a born singer and was never hesitant. You  just have to ask her, and she had a song ready for any occasion. Her laughter filled the room with all the unheard music and a warmth you never felt before. You could talk to her and she'll help you be at ease, she could change your bitterness, just being with her. Her love reflected God to me, even as I wonder if He really cared about her innocent child, our aching hearts and the endless tears of her parents. Her joy in the midst of circumstances, her hospitality in the face of illness and disability, her laughter in the wake of disappointment, offers me hope that eventually  all of us could learn to behave like her.
Anyone who knew Sheri knew that her family was the center of her life. She brought together everyone in our family. She remembered the birthdays of each and everyone in the family and all of her friends, from the youngest to the oldest. And she never forgot to buy them gifts. She enjoyed in giving.
She would look at me with that coy smile of hers and say, “Oh Acha, you just worry way too much! “
“Acha” she would say,” I have sold 5 Kg of old magazines from Amma’s collection “
“Acha, I cleaned all the kitchen cupboards, and got rid of a dozen bottles from the store”
My wife was notoriously possessive about old magazines, empty bottles and tins; there was no space anywhere at home to keep them all. Sheri and I had entered a secret pact to get rid of as much as possible when my wife would come to stay with me. Sheri trusted me and would call me and give me daily reports of what all she could get rid of.
She will always be a part of my heart and soul. I will always miss her love, her smart and occasional funny remarks, her smile, the food she used to cook specially for me when I go home on vacations.

When a child dies, we lose our commonsense faith in life's predictability. The unanticipated early death cuts through what we have formerly assumed is a natural order of things, shaking the very foundations of our living. All we believed comes into question and we feel as if we have no ground to stand on. All our dreams and hopes are shattered. I had wished if I never existed.
How different this is from the sadness we feel when an older person dies. I remember the time when my mother died. I could understand her long struggle with her illness and accept that her departure had saved her from further sufferings. I reconciled with that truth easily. If she had lived a full life and died naturally, we may miss her, reminisce about all she meant to us, and perhaps wish that we had taken more time to appreciate her. We also come to acknowledge that life brings a series of losses, and we may even understand that they are somehow necessary, or at least part of everyone's experience. But the death of a young person attacks our understanding of life's rhythm and purpose, leaving us wandering in unmapped territories.

Nothing in life prepares you for the death of a child. After Sheri died a year ago, I examined and re-examined my existing values, beliefs and priorities. This process was made extremely challenging by the tearing pain of my early grief. I am a different person, and in many ways, a better person as a result of my struggle with her illness and death. I have also learned some important lessons about love, faith, and the enduring power of relationships.

Now I can understand the depth of the sadness and misery of her parents. If I feel about her this way, how could her own parents take it ! I feel ashamed at the ways I had occasionally thought about their reactions. Their pain is much worse than mine and is going to stay, no matter whatever others may say or do. It is the greatest of their losses.

When I look around, I can see others walking the same path.  Even when the night is at its darkest, I can see streaks of light at distance. Our ability to see light in the midst of darkness will help us to survive in a world without the physical presence of the lost one. When we walk in awareness, we can develop our own unique insights that will help us during our journeys.
If we commit to working through the pain of our grief, that pain may transcend to unconditional love for others.
I will continue to weep, sometimes be angry, to mourn, and to draw strength from others who walk this same path.


A caterpillar for ever

>> Sunday, March 20, 2011


Mentally subnormal people are happy. This is what I have seen in my practice .In clinical medicine, there are many conditions where we link this phenomenon to illnesses. Mongols are universally acclaimed to be happy . And that is considered to be part of their clinical spectrum. Whenever I see them in the clinic, they smile at me, even at the extremes of their illness and suffering. They have fewer expressions other than happiness. They smile through their tears.I always used to think that the life of a mentally subnormal is like that of a caterpillar in a cocoon, never having the chance to grow to a butterfly and fly.

The more intelligent always find reasons to be unhappy. There are innumerable reasons in life. We only have to find reasons to be happy. The rest is all for unhappiness.

I had known Marwan (Not his real name) from the time I joined this hospital . He was very short and morbidly obese with very short arms and legs. In his traditional Arabic dress, he used to look like a  penguin flipping around. He would walk very fast, as if he were very busy at something .I had seen him panting when he walked around the corridors, but he would never stop. He had bronchial asthma to start with, and would come to me for treatment, and that is how I became friendly with him .I always used to think that he was mentally subnormal. But the interesting thing was that he could communicate in English language. With his broken English, combined with many unique gestures, he could easily put messages across to me that I could understand.

We had evening clinics those days and he  would come to the clinic to chat when the clinic was free. And slowly he tried to make a friendship with me .He would tell me many stories of his adventures to impress up on me. He must have been around thirty years of age at that time .He had married four times and divorced all of them because “they were not good enough”( Actually they all had  left him, from what I came to know later).So he was on the lookout for a better girl. And that is when he started telling me stories of his Dubai trips. During weekends, he would go to Dubai, where his friends would take him to 'wonderful ' girls.  And I asked him “for what?”

“ Jig Jiga” was the answer

That was something which was not in my dictionary

I asked him again. He said again “Jig Jiga”, this time with some gestures to show me what it was, and I got the message. I had thought when I met him first,that the gods must have been in a very non generous mood when he was created.He had neither the looks or the brains. But then,if he was gifted with something,this must be it! 

He said he would’ Jig Jiga’ five and six times over the week end. I was surprised at his skills and secretly admired him for his capabilities .And then he would go in to the finer details of his activities, to which I was not much interested. Anyway, he convinced me that he was a very capable man, when it came to matters of sexual activity.

During one of his trips looking for a wife, he got married to a girl from Hyderabad and brought her to this place. He would hide her from outsiders .It was a week after he brought her that she fell ill and I was asked to see her .I was really sad when I found that the woman had a serious heart problem needing urgent surgery. She was incapable of even looking after herself. Someone had cheated him, extracting money from him and had got him married to her. Marwan was really angry when he heard the news. With the background stories of his Dubai trips, I could understand his desperation. He promptly divorced her and sent her back home.

Over the following few years Marwan became progressively ill. He was found to have a heart condition which didn’t have much treatment. His heart was enlarged but weak to pump, and he was admitted with serious shortness of breath and had to be placed on ventilator. It was when I was trying to pass a urinary catheter that  I was taken in for surprise. He had a rudimentary genital which was hardly visible. His testicles were atrophic  and I guessed he would be impotent, for sure.

Marwan was always happy. I had never seen him sad or depressed . He fabricated stories out of his fantasies. And he lived in a fantasy world which he had made for himself. Even in conditions of serious illnesses, he never gave me any trouble, instead, entertained me with his fantasy stories when he was comfortable enough to speak.

Feelings and desires can easily mislead us since they have nothing to do with wisdom or logic.Our emotions tug at us to give way to fantacies and longings that were not meant to be.I often wonder about the way people deal with their personal problems for which there are no actual solutions.Being depressed and angry at the world is one way.We can make others feel miserable too. To convert the problems to be reasons for happiness for others,is another way,but nearly impossible.

“The energy of the mind is the essence of life.”- Aristotle


The mind’s eye

>> Friday, March 18, 2011


A widow from a poor village in Bengal did not have enough money to pay for her son’s bus fare, and so, when the boy started going to school, he would have to walk through the forest all on his own. In order to reassure him, she said
“Don’t be afraid of the forest, my son. Ask your God Krishna to go with you. He will hear your prayer.”
The boy followed his mother’s suggestion; Krishna duly appeared; and from then on, accompanied him to school every day.
When it was his teacher’s birthday, the boy asked his mother for some money in order to buy him a present.
“We haven’t any money, son. Ask your brother Krishna to get you a present.”
The following day, the boy explained his problem to Krishna, who gave him a jug of milk.
The boy proudly handed the jug of milk to the teacher, but the other boy’s presents were far superior and the teacher did not even notice the gift.
“Take that jug of milk to the kitchen” said the teacher to an assistant.
The assistant did as he was told. However, when he tried to empty the jug, he found that it immediately filled up again on its own accord. He informed the teacher, who was amazed and asked the boy:
“Where did you get that jug, and how does it manage to stay full all the time?”
“Krishna, the god of the forest, gave it to me.”
The teacher, the students and the assistant all burst out laughing.
“There are no gods in the forest. That is pure superstition” said the teacher.” If he exists, let’s all go and see him.”
The whole group set off. The boy started calling for Krishna, but he did not appear. The boy made one last desperate appeal.
“Brother Krishna, my teacher wants to see you,  Please show yourself”
At that moment, a voice emerged and echoed throughout the forest.
“How can he possibly want to see me, my son? He doesn’t even believe I exist!”

"Like the flowing river"
Paulo Coelho


Come back to shape

>> Saturday, March 12, 2011

The other day I was rushing to go to my hometown. When I got out of the bathroom, I just ran straight, to put on my clothes. That was when I saw myself in the mirror. After so many years, I saw myself naked in the mirror. And I couldn’t believe the shape I was in. Have I become shorter? No, it can’t be! Have I bulges everywhere?. I turned and looked at me from the sides. Worse than before !. My tummy appears to protrude forwards. Is there a bag under the chin? God ! This is not the same me.

I knew I have been putting on some weight recently, but hadn’t guessed it was this bad. I checked my weight. I have put on a good five kilogram during the last year. I am a doctor and haven’t bothered to check my weight for few months! .My exercise program had changed after our duty plans changed. And I had been eating carelessly too.

I used to walk about 6 to 8 kilometers every day, on all days except when I was on call. There were few of us friends who would join the walk in the evening. It is easier and more fun if you have some friends to walk with. I couldn’t convince my wife to go for a walk with me, at any time. Otherwise we could continue our arguments there as well ! Those of you who still keep up the romance, do it.

So, I have decided to go back on exercises. Being a doctor I thought I might as well share this thought with all my friends out there, instead of grumbling about life all the time. I know most of you are in better shape, still.

When was the last time you have seen yourself naked in the mirror? If not, go ahead and have a look today.....as soon as you get home from work, get naked, weigh yourself, look at yourself from different angles.  Then you can see what you really look like right now ! 
How much did you weigh when you were 25 years old?   You were a grown up person by then. Then you began to "fill out", spread out, thicken up, started to forget about your health, become complacent about your body shape?  Got married, started thinking about responsibilities, and the future?  Stopped thinking about your appearance, bought age- appropriate clothing, and bigger sizes every year?   Started exposing less skin, covering up the bulges, dressing to impress others, but not trying to impress yourself?  Most of us in India do not make it a practice to go to the swimming pool or to the beach in swim wear, so don’t have reasons to show ourselves. So, others, as well us, wouldn’t probably notice. 

It is time to find out what the lifestyle changes did to you.  Let's see what everyone but you see! What happened to you, what about your youthful looks, your younger shape?  Gray hair is OK, that's not the problem. Balachandran wouldn't agree. But you can use some hair color once in a while, if it gives you confidence ( Don’t ever mention it was recommended by a doctor ! A relative of mine was found to have bladder cancer and the doctor asked if he had been using hair dyes. They have been linked to cancer of the bladder )

Some people are intimidated by the idea of beginning an exercise lifestyleThey think people will stare at them, see them trying to change their bodies.  They are afraid of being talked about, criticized, and laughed at.  In the beginning they will But eventually all that negative commentary will turn into respect and positive compliments Your physical activity will cause others to examine themselves in the mirror, nakedly, and some of them will reach the same conclusion that you reached, "It's time to do something good for myself, before the sedate lifestyle makes me flabby and lazy and affects my health."

I was trying to get some information on a proper exercise plan, and that is when I came across the term Calisthenics. They are the performance of physical exercises to promote flexibility, strength, and fitness without using machines.  Like squats, stretches, bending, sit-ups, crunches, pushups, leg lifts, movements like that. 

There are numerous methods to beat the weight and stay fit, calisthenics workout being one of them. Bodyweight calisthenics exercises help in improving the overall fitness, physique and strength of a person. Calisthenics originated from the Greek words, 'kalos' meaning beauty and 'thenos' meaning strength. Check out the benefits of a calisthenics workout.

The origin of calisthenics is linked to gymnastics. Calisthenics workouts increase the metabolic rate of the body hence these exercises should continue with a smooth flow from one exercise to another. The calisthenics workout should not be stopped all of a sudden in between exercises. Initially each exercise can be repeated for five times and as you get used to the workout each exercise can be repeated 25 to 30 times. It is recommended that you begin calisthenics workout after a few warm up exercises. This exercise workout can be made more interesting by playing music and following the rhythm.

Combine the usual calisthenic exercises like squats, sit-up/crunches, arm, knee and hip rotation, flutter kicks and jumping jack etc. Drink plenty of water. Combine this with your daily walk or jogging…and there you are!

Ten years younger!  How would your husband react if you looked and acted 10 years younger? How do you think your wife would enjoy being married to a much-younger you?

Why don't you give it a try and find out ?

Now,the picture below is for illustrative purposes only! If it gives you a stimulus to come to shape, start now !


The Evil

>> Monday, March 7, 2011

It takes only few telephone rings to wake me up. After all these years, I still cannot sleep comfortably when I am on call. It was 2.30 in the morning and I guessed it must be something serious. The call was from the on call physician from the ER. A Bengali man had been just brought in with severe shortness of breath. There was no more history. Those who had brought him had left him in the ER and disappeared. He was found to have severe hypertension and was not improving on the usual lines of treatment.
I discussed with the doctor  and decided to shift him to the ICU and also requested to alert the anesthetist, in case we needed to place him on ventilator. By the time I reached the hospital, he was in ICU. He had severe breathing difficulty and was unable to answer any questions. His blood pressure was too high to be recorded, and it stayed so, in spite of receiving medicines through I V line. That was unusual. I guessed it must be no ordinary hypertension, and must have some serious underlying reason. We gave him a large dose of a diuretic    (a medicine to force the kidneys to produce urine) and another medication to reduce blood pressure. The lab results came in by this time. He was in end stage kidney failure. And that was why his lungs got flooded, making him struggle for breath.
It was impossible to get any history from him. Medical practice, without proper history, is almost like veterinary practice. In fact, half the diagnosis is made from what the patients tell us about their illness. When a patient is critically ill, the doctor is under the worst stress, the patient probably would have lost his consciousness. It took us a lot of stress and effort to get the many test results to come to a conclusion. He had severe hypertension and renal failure due to end stage kidney disease. He needed emergency dialysis. By this time the medications had started taking some effect. His BP was coming down and breathing getting easier. We alerted the nephrologist for emergency dialysis. The patient would die without it.
It was when I started to chart his file that I found he was removing his oxygen mask and calling us by gestures.  Morphia had taken its effect and he was drowsy. He couldn’t talk still, but was desperately trying to say something. Through the gasps for breathe I could gather some words
“ Kapda !, mera kapda !” (Clothes! My clothes!)
I couldn’t make out first. But he was frantically looking all around for something and again removed his oxygen mask and repeated
“Mera  kapda”
I understood it then. In the ICU, the nurses had removed his own clothes and put on him the hospital gowns .I told him there was no need to worry and his clothes would be given to him when he leaves the ICU. He was not satisfied and again kept on repeating the same slogan.
I was close to getting irritated. We were desperately trying to keep him alive, and here he was, worrying about his clothes!
 I asked him  “Bhai, why are you afraid ? No one will take your clothes. They are kept in the cupboard”.
This time he added” Hamara Paisa”, (My money!)  and I understood. His purse was in the shirt pocket and his money was in it. The nurse told him” Brother your purse is with us, and we have counted and kept 120 dirham also’

He appeared bit relaxed after that. He kept his oxygen mask back in place.


The Daily Puppy

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