And thanks to Atul Gawande for writing a wonderful book.
Wednesday, June 29, 2016
I recently and quickly finished reading a fascinating book by Atul Gawande, titled, "Being Mortal". In this book, Atul Gawande, who is a surgeon describes his experiences with death in the form of most bizarre, common and debilitating infirmities seen among people, precipitated by old age and made worse by their gravity. Atul Gawande candidly accepts the fact that medical school never trained him in how to handle demise with grace and care, a revelation to readers. He goes on to beautifully explain, that everyone is entitled to die with dignity and grace but most importantly, a death with little suffering and pain or in best case, bereft of both.
He remarks that medics, doctors, usually, will be persisting about the medical interventions till the very end, often overlooking the side-effects in addition to the pain and suffering that treatment will inflict on the mind and body of the patient. Throughout the book, case studies of cancer are used. In one instance, he remarks, "the tumor is bad, surgery is needed but it will lead to more complications for the person". The paradox then becomes, to prevent suffering or to stretch the life with further complications. Chemotherapy is widely promoted but never are its side effects discussed and the complications further give lancing pain if the person is old. All these cases revolve around the subject of "geriatric care". His book is based on his experiences based in USA, where old people usually live alone and their children live somewhere else. The concept of "nursing homes", "assistive facilities" are mushrooming to give old people care and look after them in ways which is not possible in today's modern world when the children are themselves occupied with their fast paced lives. But the experiences are certainly not dependent on cultural differences. Elderly care is becoming a big public health issue and so is the cases of people who have disability which induces debility among people.
Obviously, reading selected and painful accounts of men, women enfeebled by cancers, tumors was not a very good thing to read, but it opened a wide perspective in front of me. It made me understand a number of things and at a certain point it made me question the significance of ageing - "Why such a phenomenon even exists when it inflicts unknown, unimagined and unpredictable atrocities in majority of people both physical and emotional?" I did find myself ruminating on that. I could clearly understand while reading those pages, what "wish to live is". No body wanted to die, every single person whose account is described in such lucid detail wanted to "get back to their lives", "get back to their families" and continue to live without pain and suffering- something which is intrinsic to all of us. I remember, my grandfather's words when he was in bed after being diagnosed with cancer, "Pappu mujhe bacha le" (Pappu, save me) to my father. Unfortunately, it was too late and he died at an age which is no age to die. This has a spiritual seed to which I will return later in the article.
Atul Gawande, through the story of his own father testifies to what he says throughout the book, something which he learnt gradually with time. The gist of which I posit according to my understanding as,
"In the last time of people's lives, when they know that not much time is left, they should be given what they want to have, what is most important to them in this phase of their life and the medical decision should take care of their volition for everyone deserves a peaceful ending to life.
The kind of life someone wants, in accordance to that should the treatment be planned". To explain to my readers I use this example, "Suppose a lady has cancer and her treatment is required and she is in a bad pain. When she is asked what she wants and she replies - 'diminished suffering, time with family, less fatigue and be able to attend best friend's marriage', then a good doctor who pays heed to her emotions would choose the course which will meet most of her wishes if not all". A patient's life is not just flesh and bone to say, its a precious life, it is precious to him/her.
I could understand very well the challenge that elderly care is and also the care of physically challenged people in the same domain. The challenge is big. Mere reading of the accounts sent shivers down my spine when I speculated of my own old age. Old age can be debilitating, a harsh truth. But I have a more important point to convey here, a point which I mentioned before - "the spiritual seed". as
No one, not one wanted to get rid of their life, the people wanted to just stay there, be able to breathe and be able to be with their families without pain. Few understood death as the only end to their suffering and embraced it, but majorly they wanted "TO LIVE and BREATHE". We do not realize what it means, because it is almost like a proxy experience, hearing from some one else say. But there is truth, life is happening in this moment. This very moment, you are breathing and I am breathing we are approaching our ultimate end. As Rumi says, "The day you were born, a ladder was set to take you back to where you came from". Everyday, we are moving closer to our death. Life is happening right now, live it to the fullest in the most healthy way possible. If we are healthy, we will have a better and more fulfilling life. Only who have few days can recognise the wealth and gift life is, we should take cue from them and start living the life we wish. Every one of us will die eventually, but the end will be glorified with a life of love and no regrets.
Life is happening right now, this is the most beautiful day we ever had and will ever have. This day will not come back, live and cherish each moment of this youth and freshness. Life is a gift, every morning we wake up is a gift, something we always fall short of realizing. I love life. Do you?
And thanks to Atul Gawande for writing a wonderful book.
And thanks to Atul Gawande for writing a wonderful book.
Saturday, June 18, 2016
13th till 15th June 2016, I spent in the serene campus of SEARCH situated at Gadchiroli. For those of you who do not know what SEARCH is, allow me to tell you that SEARCH stands for Society for Education, Awareness and Research in Community Health. It is an organization created by Dr. Abhay Bang and Dr. Rani Bang to cater to the health needs of the tribal people. For more detailed information, please visit http://www.searchgadchiroli.org/ .
In this document I will enlist my experience of those three days and the vital takeaways in this very short time. The time I spent was small, but by no means insignificant. I believe I planned this visit at an apt time, when equipped with theory I had formidable knowledge and SEARCH opened a beautiful class analogous to that of a practical chemistry lab.
|Tribal people seated for bed net distribution. Village name: Udaygaon.|
First day, was understanding what SEARCH is - beyond accounts, books, newspapers, magazines and all sources that we can get while sitting in front of our laptops. The moment I entered the campus, I felt baffled at this place in the midst of a place where on both the sides of serpentine roads one can only see bushes, trees and jungle. It gave a glimmer of peace when I entered, I could make out easily that this was indeed friendly to the people who are served in the premises. Right at the entrance is the small temple of danteshwari devi, the chief god of the tribal people. One official accompanied me and explained to the me the working of the hospital which is inside the campus. This hospital equipped with all modern facilities helps tribals and villages alike in their times of ill-health. There are special modern cemented huts where the family of the admitted person can also stay, something which the tribal themselves told the doctor couple. The doctor couple often allude to the Chinese poem:
Go to the people
Live among them
Learn from them
Start with what they know
Build on what they have:
But of the best leadersWhen their task is done
The people will remark“We have done it ourselves.”
|Getting signature while distributing bed nets.|
Village name: Paraswadi
This poem best illustrates the concept of community and the strength that community cooperation can bring to the people who are part of it. The person, named Ganesh, helped me understand and get acquainted with various sections of the campus, and also told me about the programs that are run under the ambit of SEARCH. He told me about their popular program for youth- NIRMAAN, tobacco de-addiction program for the tribals , HBNC (Home-based neonatal care), sex education program for adolescent. He also showed me the evidence of their programs through statistical results which are well displayed in the room dedicated to the exhibition of SEARCH and its activities. The same day I met with NIRMAAN program co-ordinator, who enlightened me on the way the program operates and the objective of the program. I was convinced that NIRMAAN, is one of those programs which very clearly seeks for the commitment in the youth and at the same time allows them the liberty to pursue what they wish to, in ways they wish to with a belief of making the world a better place. Later in the day I met Dr. Yogesh who has been working with SEARCH for the past five years and is intrigued by the cases of stroke and hypertension in the tribal areas. Dr. Yogesh has worked in USA for the past six years but when he ruminated about his long term life, he ended up at SEARCH.
|Home based neonatal care (HBNC) Kit|
Village : Bodli
He lives in SEARCH campus with his family. In fact, most of the instrumental pillars of SEARCH stay in the campus with their families: a fact that almost led me to a state of amazement. I understood very clearly, “Acknowledging that things need to be repaired, mended and tended to is a different thing, taking efforts on the other hand after acknowledgment is altogether a different thing. Many are willing to acknowledge, but extremely few who come forward and make efforts”. One has the power to make effort where he is, with what he has, lack of will can be the only blocker. Later in night, after prayer: a custom observed at SEARCH at 6:30 pm, I met Nikhil. A post graduate from IIT Kanpur, the way he expressed his motivation to have come to search was very beautiful. His statement, “I was living on an island with all facilities, uninformed about the reality of the world and then I decided it was time to work for the reality”, still echo in my mind. This is definitely one of the many profound statements I have heard and choose to keep in mind. Nikhil works on how technology can play a great role in assisting the health care drivers for the tribal and village people, majorly.
First day was a good introductory day, not to forget the delicious food served at the mess of SEARCH. Second day was to be a field day.
|Primary health care centre. Village: Bodli|
The day started with three of us, a girl doing her practical training in summers, an ANM (auxiliary nurse midwife) and me ensconced in the gypsy. Second day was about distribution of bed nets in two of the forty eight villages that SEARCH has taken responsibility of : Udaygaon and Paraswadi. First was Udaygaon. In this village live 62 families. We distributed close to 180 bed nets, one bed net to be shared among two. Not that I have not been in a village before, but being a part of the process made me realize the responsibility we carry, as being the educated and hence the empowered lot. We also had lunch in a tribal house. These people do farming for some three months and then use the harvest to eat throughout the rest of the year. These villages were really deep in the wilderness. Then we did the same at the Paraswadi.
The interesting thing I discovered was that these tribal people often resort to using the bed nets for fishing, thus, there was an agreement that was signed by everyone that these chemical-induced bed nets will not be used for fishing purposes. After the end of the first day, I had a couple of deep thoughts in my mind. I saw someone having the most common symptom of filariasis, elephantiasis. This was the first time I saw someone like that, and I was shocked to see it. I did not even know the name of this condition. I looked at my legs and I looked at heaven above. Its a miracle that I have a well-shaped body without any inherent deformities, something that we take so much for granted. Education, is the biggest asset of any human. When I was in village, I felt nostalgic of my own roots and the humble roots from which father has created an empire for us. I just can never thank him enough for having given me the kind of life I live and cherish today. Education, I am convinced is the greatest asset and blessing a human can ever acquire, and by bestowing that on me, my father has done me a favor beyond limits. An interesting observation was that sanitation was non-existent, if at all. On inquiry, it was learnt that there was not much funding to avail that facility. And I understand why funding is a problem. Funding is a problem, primarily because the health budget is not used fully and hence the government feels compelled to reduce the offerings the next time. Certainly, plans are not being implemented as deftly as they are posited in the papers.
|At the home of traditional birth attendant (TBA)|
It was quite a hot day with scorching heat and high humidity, but lessons which were like a breeze of cool air. This is just one incidence, when I have been at such a distribution, but I could easily make out the paper overhead that is a big problem. Data managing can be quite a task using papers, that’s when my next lesson came up: “Technology need not be complex, but it ought to be useful”. It almost seems vacuous to me that technology is growing in leaps and bounds, making lives of rich people further easier but doing so little to enhance the basic processes in the areas to assist them in living in better way. And I decided to make an effort in this direction.
Third day I visited a relatively near place, an urban village named Bodli. There I, along with two others got the opportunity to meet the health messengers (aarogya doot) which are the principal drivers of home-based neonatal care (HBNC). She gave us a very comprehensive demonstration of the way she carries out the responsibility of taking care of the health of the new borns and their mothers. It was a clear cut message, “equip the villagers with suitable knowledge and skills, they can take care of themselves”. This message is clearly aligned with the gist of the Chinese poem that is shared above. We also happened to visit the PHC (Primary Health Care) centre in the village and the facilities there were quite impressive. It was a very brilliantly built infrastructure. Alas! That time no doctor was present, else it would have been informative to know more about the functioning of this PHC. After that visit, we came back to our campus. And it was time to travel back to Bangalore.
This was certainly a rich experience and something that will remain in my mind. The important takeaways can be formulated as follows:
- Technology need not be complex, but if it is not useful for those who need it, it is not serving its full purpose.
- If village people are equipped to take care of themselves and their community, they need not depend on full-time external assistance.
- There are people who still think of rendering meaning to their lives by service to others rather than being lost in the race of status and money.
- Acknowledging that things need to be repaired, mended and tended to is a different thing, taking efforts on the other hand after acknowledgment is altogether a different thing. Many are willing to acknowledge, but extremely few who come forward and make efforts. But, all of us are capable of creating meaning wherever we are, with whatever we have.
- None of us is as strong, as all of us.
I would like to thank Tushar Khobragade for having given me this opportunity to stay at SEARCH and enlighten myself beyond books.
Saturday, June 4, 2016
Found this article in the magazine : Infinithoughts. Please read.
Life is about three relationships
your relationship with yourself (intra-relationship), your relationship with others (inter-relationship) and your relationship with Existence (transcendental relationship).
The primary relationship is Intra-relationship: Your relationship with yourself.
You can give only what you have. If you have ignorance, you can only share your ignorance. If you have wisdom, then you can share your wisdom. Prosperity or poverty, you can share only what you have. If you don’t love yourself, you cannot love others, and most importantly never cherish others’ love for you. If you cannot stand for yourself, you cannot stand for anyone. If you do not accept yourself as you are, you cannot accept anyone as they are. If you have not forgiven yourself, you cannot forgive others. Whatever you wish to give to the world, it must start with you. Unless you have it, you cannot give it.
If you define yourself by your looks, you will judge the world too by its looks. If you define yourself by your character, you will judge the world to by its character. The world you perceive is just the reflection of how you perceive yourself. This universe is made up of millions of galaxies, and our galaxy, the Milky Way, is just one of them. The Milky Way is made up of millions of solar systems. And our solar system is just one of them. And, in our solar system, our planet earth is just a speck of dust. And in our planet earth, you are just a speck of dust. Now, visualize yourself in the entirety of this Universe. And yet, in the entirety of this Universe, there has never been another you. There is no one like you and there will never be anyone like you. You are the only one of your kind. God does not repeat. Another you will never be repeated. You are unique. You are original. You are a masterpiece. The Master’s piece. You are unique, original, rare masterpiece, specially designed by God. And this is reason enough for you to celebrate yourself and also to keep growing in love with yourself.
Even if no one believes in you, you got to believe in yourself. Even if no one likes you, you have to learn to like yourself. Even if no one loves you, you have to learn to love yourself. In fact, only when you learn to believe in yourself, the world will believe in you. In fact, only when you learn to like yourself, the world will begin to like you. In fact, only when you learn to love yourself, the world will begin to love you. All in all, how the world sees you will make only a small difference to you, but how you see yourself will make all the difference to you. You got to be your best friend.
The secondary relationship is Inter-relationship: Your relationship with others.
These are some of the usual dialogues in a relationship: “if you do this for me, then i will do that for you”. “If you do not do this for me, then i will not do that for you”. “If you love papa, then go for your dance classes”, “If you really love mummy, then you will not speak to that boy anymore”. “I know you love your brother so much, so get me water”. “For all the love you have for your one and only sister won’t you do this for me?"
When love depends on “what you do” and “what you don’t”, it disturbs the flow in the relationships. it turns relationships into transactions. Where conditions succeed, love fails. Where love succeeds, there can be no conditions. When too many conditions and rules are laid in a relationship, it brings too much the end into the relationship. Relationships being a matter of the heart, with too many conditions, the spontaneity of the relationship is lost.
The net result is the insecurity in relationships. The person beings to feel, “hey! he is not relating to me, but to my actions. i am not loved for what i am, but for what i do and what i am expected “not to”. If this relationship has to survive, then i will have to keep doing things that would please him. Now, with such a thought process, there are only two possibilities.
the first possibility: I want to be “me”, and so much I want to be “me” that I will let go of that relationship, which does not allow me to be “me”. Not just once, twice or thrice but when repeatedly my relationships fall apart because I want to be “me”, I become insecure. Helplessly, the question creeps into my mind, “why is that no one is able to accept me for what i am?” After that, as you step into any new relationship, the thought process is, “What should I do to save at least this relationship?"
The second possibility: I want that relationship so much that i am willing to do anything and everything for the sake of keeping that relationship. I don’t care what i lose, but i want to keep that relationship going. My values, my principles, my originality, my priorities, in effect my very life goes for a toss, for the sake of seeing that relationship intact. Eventually, i become manipulative. For the sake of the relationship, i start thinking, what if i do, how if i do, will he be pleased with me? Every time after doing something, i anxiously wait to see his reaction, this “anxious wait” makes me insecure. This everyday struggle to keep the relationship intact makes feel less about myself and that makes me insecure. And an insecure relationship is never a growing relationship. Nothing grows: not me, not him and not the relationship.
In a secure relationship, you are always true in that moment, and in every moment. There are no pretensions in a secure relationship. In a secure relationship, you value the relationship more than the individuals that constitute the relationship.
If you have even one relationship in your life where “what you do and what you do not do” does not alter their love for you, because that on relationship will transcend insecurity. In fact, from the strength of security you derive from that one relationship, you will have everything else in life.
Love is love only when “what you do and what you do not do” does not alter my love for you. That’s unconditional love. If love is not unconditional, then it is not love at all. Be unconditional in your love. be that source of security. Of course, people will have to be corrected when have to be corrected. Tell them they are wrong when they have to be told. Certain responsibilities must be fulfilled in every relationship. Shrinking from your responsibilities, in the name of love is not love; it is called pampering. Love creates; pampering does not. A true lover is like an iron fist with velvet gloves.
Finding an unconditional lover is a consequence. Being an unconditional lover is a choice. Waiting for an unconditional lover makes you dependent. Choosing to be an unconditional lover makes you dependable. The greatest words you can ever utter in a relationship are, “i will love you the same forever”. Relationship being a fluctuating phenomenon, if your love depends on the relationship, then you will not be able to say this. However, if your love emanates from your core being and it is irrespective of what happens in the relationship, then you will be able to say, “i will love you the same forever”. If a rose, just a flower, can emit its fragrance forever, then you and i as humans can flow in love forever.
It is not easy to love the same forever. In fact, it is not even human to love the same forever. But one of our responsibilities as human is “to love the same forever, if not all, at least some; if not some, at least someone.
For time being, these two are good ;)
Being in Bangalore has one of the most sought after advantage: weather. But more than the weather, what i absolutely love here are the rains. Not to say I like rains of bangalore explicitly, but the frequency of them. Frequent rains in Bangalore, in this city of dreams, capture everyone by their sheer beauty. Or may be, I should say, frequent rains have compelled me to embrace the beauty they bring, which I never could focus on inspite of being an ardent lover of rains. So, I think I should rather write about the heavenly rains, which thanks to Bangalore, have made me more grateful to them.
Rains, when they come just fill my heart with so much of freshness, vigor and happiness. Just looking at the drizzles, it is impossible for someone not to smile, unless you are stuck in traffic and have some exigency. I have fond memories of chucking work and getting outside when its raining just to feel those magic drops from the top in firmament. For me rains convey beauty, abundance, sacredness, freshness, innocence and yes, optimism. Nature, is a gift really. Truly beautiful things that nature bestows upon us are invaluable. Rains lighten up the surroundings, they remove every speck of dust on the leaves and embeds that on roads such that it cannot rise above: it contributes to making the earth more beautiful and heavenly. If you doubt, then just feel the difference in the air that ensues after a hearty shower from the sky above.
From the place where I am sitting, I can see nothing else but greenery as far as my eyes can go and trust me, the amount of peace it is imparting on my heart and mind is surreal. I can feel the mitigating effect of being able to watch this greenery around, lush green trees, lush green earth bed and a clear sky. Big buildings and skyscrapers do not give so much of joy as the joy bestowed by series and series of thickets around. I believe words are just not sufficient to express the magnificent beauty that rains bring with themselves. My experience with nature says that being with nature always bestows a kind of equanimity, poise and vision in anyone who spends time with it. Just looking at the sky at a distance, green trees and smiling for no reason with soft instrumental music in the background makes the day spent worthwhile. And this view would have not been possible, nor this post had I not been at my friend's home :) So, I acknowledge her. Nature is beautiful. Some beauty is still left to savor despite large scale mushrooming of buildings, factories and offices.
Rains, if talked philosophically also send a very profound lesson. In fact, if we observe the nature and our surroundings closely, then they have only one message to give, clear and lucid : "BE LOVE ANYWAY". Rains are testimony to the need of nature's love to life. if there are no rains, life cannot exist at all. Selfless, unconditional and always abundant in characteristics, that is how the nature of rains is and that ought to be the nature of love between us and everybody around us. I am happy that I am sitting in nature right now, writing this post and feeling the divinity in its most pure form. I am grateful to nature, small things big smiles.
Here is the view from where I am sitting:
|This is nature's beauty.|
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