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A Life-size Metaphor

You start a new Job. It’s nice. You hear your colleagues talking about ‘The Boss’. No one’s seen him, but they’re all told that if you step out of line or mess up your Job, the consequences would be severe. Now you could do a good Job because you fear The Boss and his anger, or irrespective of whether you think The Boss is watching. You could genuinely be nice to your colleagues, or pretend to be polite so The Boss doesn’t get wind of your true colors.

Now exchange some of the words in the above paragraph. Job= Life. The Boss= God. And your colleagues are everyone you meet in this Life. This is not the same old debate- “Is there a GOD?” This is just a thinking-out-loud-let’s-have-a-conversation kind of thing. I’m not particularly religious in the traditional sense, and I have no beef with overtly religious people, so long as it doesn’t encroach on other beliefs and opinions. I think the basic question should be- “Are we behaving in anticipation of a higher being? Are we behaving the way we are, expecting a reward? Or are we behaving in a way that’s true to ourselves?”

Big question, and equally complex answer- which I won’t attempt to lay out here(thank God?). I feel that if religious people are charitable or kind because they believe God would punish them otherwise are in the same category as people who don’t believe in a God who live without a moral- left to their own devices, they’d turn – well, bad. People who do good and are good, simply because they share a kinship with fellow humans- now that’s the real deal. Because they are intrinsically good. I honestly don’t see it any other way. And no one is perfect, I know that- and by ‘good’ I meant ‘tries to do what is morally right most of the time and as much as possible’.

Still here? What drove me to this particular thinking and area(religion can be a sensitive topic- but it doesn’t have to be) is the violence and hatred I hear everyday that is committed in the name of religion. From all parts of the world, from the past and the present, the stories of the persecuted make me wonder- what God would want this? Which prophet would endorse this? And that’s when I concluded that God and religion were just a ruse, a smoke screen, for people to do what they wanted, to who they wanted. Invoking the name of a higher being gave them a false sense of purpose, of power, of a sense of misplaced righteousness that has only resulted in pain and sorrow. This is my two cents on this, and sure, things are not as simple as that. All I’m hoping is that this makes people stop and think, and in turn help them do what is right. Any thoughts?

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COVID-19 2.0

I am writing this still bleary-eyed from one of the most demanding night shifts I have ever taken. Still bleary-eyed because I want to put this out before the realization of the enormity of the situation washes away with my morning tea. In the media, I see “the second wave”, describing the rising number of COVID cases. But this is not a wave. This is the next level of an updated version of a game whose rules have changed against us. It’s COVID 19 2.0.

Sorry for the dramatic beginning. But that was the only way I could think of to get this message through. No numbers, no percentages, no bar graphs plotting the rising number of cases here. All I want to talk about is what I saw in the last 12-13 hours- which was so anguishing that I felt like I needed to vent. Please don’t read ahead if this is a sensitive topic.

After months of relative(and I use this term very loosely) calm, where people were getting used to shrugging off “I got COVID, no biggie” and vaccines were getting good momentum, the time has come where whatever resources, manpower, medical supplies(including oxygen) we have is quickly running out and simply isn’t enough. I did rounds wearing full PPE for most of the night, and by the end of it, I was a sweaty, tired, dehydrated mess. But nothing compared to the patients.

The patients. Our COVID wards are full, and most patients need oxygen support. While some parts of the country, and even the world, are trying to grapple with oxygen shortage, there are no shortage of problems once you do finally get the amenities you need. We can give mechanical and pharmacological support to help patients breathe, but there is a limit to what we can do. There comes a point where we-the humans, the alphas of the animal kingdom, top of the food chain- watch helplessly as people struggle to take a breath. Their struggle is harrowing, and painful to watch. Yes, people do recover, but even they suffer from various post-COVID syndromes and issues that are still being studied and researched.

What can you do? There are SO MANY sources saying the same thing- socially distance, wear a mask, wash your hands- I won’t sing the same(but true) tune. And yet, COVID is doing a second round all around. It can only be concluded that this is not for a lack of information, but an unwillingness to follow through- blame it on pandemic fatigue or a false sense of security after being vaccinated or plain old stubbornness. The ‘new and improved’ COVID is physically debilitating, and mentally demoralizing. But this is not the time to lag behind. Let’s take small steps, do small things. Take it one day at a time, and I’m sure our perseverance will pay off. Stay safe!

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Bridge Between Healths

Case 1: Ray had lost his mother to cancer 2 months ago. They were very close. For the past few weeks, he’s been having episodic palpitations at totally random moments. They went away after some time. Sometimes, along with the fast heartbeat, he’d also have sweating or a queasy feeling in his tummy. He consulted doctors, had ECGs and scans done- all normal. His worries made him uneasy and nervous, and it reflected in his work.

Case 2: Leya is a single mother working 2 jobs to keep her family of 3 afloat. Last week, she slipped & fell on the curb outside her home; her left leg is now in a cast, and her doctor had advised strict bed rest for 5 weeks. She couldn’t afford to rest, but she didn’t see any other option. Her inability to help her family made a once optimistic Leya an angry, bitter mess.

Both these fictitious characters and stories have a real origin. Ray’s recent mentally traumatic experience of losing his mother has manifested physically in the form of an accelerated heartbeat and upset stomach. Leya’s angry outbursts and sadness stem from the consequences of her broken leg. I wouldn’t be the first to say this, nor will I be the last, but there IS an intangible yet significant connection-a bridge, if you will- between our mental and physical healths. Another good example is the rising numbers of people with depression during the pandemic, when people where socially isolated, be it at home or at the hospital.

My point is, physical and mental health are very delicate scales balancing our health in an environment that is ever-changing and prone to disrupting that balance. So whether you or your fellow human is physically indisposed or not, make it a point to look past the fa├žade of ‘perfect health’- smile, and ask a simple question– “Are you okay?” If ever the answer is not ‘YES’, seek help. If you had a broken bone or chest pain, you would. So why not for a hurting mind?

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The Operation was a success, but the Dosa didn’t survive

Many skills were learnt during lockdown, many barriers overcome. It birthed new singers, dancers, artists and the like. What was my greatest achievement, you ask? The perfectly round dosa-albeit lacking much substance.

During the pandemic, due to certain circumstances, my sister and I had to feed ourselves for a month(shout out to all the parents still selflessly feeding their kids!). And that is when we discovered the advantages of the (common) Dosa, a kind of crepe made from fermented rice and lentils. The key word is FERMENTED. We realized that if we had enough batter, we could keep making Dosas for a very, very(I mean very) long time. The final hurdle was pouring the batter onto the pan and letting science do its job. Sounds easy, right? But actually pouring a ladle of batter onto the pan and spreading into any identifiable shape was the hardest part, at least for me. If the pan is too hot, it cooks fast and becomes too sticky to spread. If it’s not hot enough, the batter becomes runny and you get a floppy Dosa. Needless to say, many a ruined Dosa, and my confidence were thrown into the trash. But practice does make perfect(at least perfect-like). And after a few weeks, we were whipping up Dosas and chutney like pros. So yes, the process was a success, but nothing short of dire need will make me pick up the ladle again.

I Left My Phone at Work…

I left my phone at work the other day, and only realized I didn’t have it in my bag after reaching home. I searched, rather frantically, in my bag, my car, retraced my steps from the car back to my bag, and stupidly checked the car and bag again. Checked the bathroom as a last resort, but to no avail. The moment I confirmed that I did forget my phone, I could feel the withdrawal hitting me like a hundred unread notifications. I’d never forgotten my phone anywhere-I’d forgotten my lunch, my medicines and one time my stethoscope, but never my phone. My hand felt weirdly empty without the familiar weight, my fingers itching to swipe up or down, or in any direction. When I picked up a book, my eyes searched for moving pictures and videos that would grab my attention. I kept hearing phantom caller tunes and notification noises. After my ablution and breakfast, I sat down and wondered what to do. Often, my hand would reach for my absent phone, and I kept realizing that, no, my phone was not with me. Usually by this time, I would be deep in the rabbit hole that is YouTube or Instagram or chatting with a friend. I could physically feel the absence of my phone, like a phantom limb.

Without my phone, I wandered from room to room. I read a newspaper after a long time- I did have some trouble handling those big sheets of paper, but I managed. But I stopped when I realized I was pinching out pictures on the paper to make them larger. That’s when I realized I needed help. I thought I’d take a nap, but with no phone to set my alarm in, and since I didn’t own a prehistoric alarm clock, I had to ask someone else to “wake me up after an hour please”. When I woke up, I had to go through this entire process again, because I forgot that I forgot my phone at work.

Jokes aside, I don’t think I am addicted to my phone. The above experiences were a bit exaggerated for comedic purposes, but it’s true that I experienced a watered down version of all of the above. No, I’m not addicted, but I do heavily rely on my phone, as do most of the world today. It’s not a bad thing(aside from a strain on your eyes, becoming socially distant, and other unknown side effects, if used excessively), but like all things, phone usage (and in a broader sense, the Internet) is something that requires moderation. An excess of anything will always end up, well, not good. And having realized that, I vowed to reduce my screen time. It’s a work in progress. Slowly progressing.

P.S.: I forgot my phone at work once more after the above incident, and because I didn’t want to go through all of it again, I just went back to work 10km away and got it. I’m going to hang it around my neck from now on.

Etiquette in Health-Part 2

So much has been taught to us at medical school about respect and empathy towards patients and their bystanders. It’s one of the most fundamental aspects of medicine that is impressed upon young medicos. There is the Hippocratic Oath, that swears us in to a new life, where the patient’s wellness is above all else- to improve their health, to safeguard their privacy, and above all, to do no harm. And to my knowledge, every single intern, junior doctor and consultant I know has done exactly that. However, this etiquette in health hasn’t completely extended to the other side, i.e., the patient.

From the outset, I want to clarify that this is neither going to be an accusatory post nor a delirious rant about the unfair systems of the world. I have come to terms with the reality of it, sort of like climate change or reality tv, but the saddest part is that violent acts against doctors have become so commonplace that I am now used to it. I first started writing this post around October 2020, when stories of alleged medical misconduct flooded social media and possibly lead to the suicide of an Orthopedic Surgeon in Kerala. Every so often, a new video pops up showing people punching and kicking doctors and medical staff, often in the wake of the passing of a loved one. These stories create hubbub in the medical community for some time- we see Facebook posts, chain messages and very short lived rallies. After a while though, they fizzle out. Doctors go back to their jobs, treat people, all good until the next member of the medical fraternity becomes a punching bag. After every incident, there is outcry from the medical faction- for laws to be enacted, for police support. And eventually, these outcries peter out as we focus on other, bigger issues. The most recent events were attacks on doctors in different parts of the country for oxygen shortage and lack of hospital beds.

It’s true, maybe proper laws and fear of repercussions may stop the next angry mob, but I feel the issue runs much deeper. You see, even with laws, the basic outlook of an enraged bystander will not change. What they too should learn is empathy. They should also practice an etiquette in health, wherein they respect the knowledge and expertise of the doctor. Sure, ask questions, clarify doubts. But do so in a peaceful manner, without prejudice in the mind.

I’m afraid this has ended up sounding like a sermon. The gist of the matter is, we as doctors, should be able to go into our workplace, and be able to do our jobs to the best of our abilities, without the fear of physical or mental abuse. All we want is a reciprocation of the empathy with which we see our patients.

Impact of COVID on Caregivers

The complete effects of COVID and post-COVID phenomena are still being studied and researched. And there’s no doubt that patients who go through it endure a lot of stress, both on their bodies and minds. Another huge chunk of society that goes through a similar, yet different harrowing process are the caregivers. Having seen many such friends and family, and having been one, I feel that whatever support we give to COVID patients should be extended to their caregivers.

Often, caregivers are close family members-parents, children or partners- and this would probably be the first time they’ve seen their child, parent or spouse so weak and in need of this level of care. There is suddenly an ‘action plan’ they must adhere to, drugs to dispense in a timely manner and extra chores to complete; sometimes it’s limited hospital visits and even more limited medical supplies. The emotional trauma of seeing a loved one struggling for air(as a worst case scenario) is enough to trump any strong mind; coupled with the feeling of not being able to do anything about it, beyond a limit, deepens the abyss they find themselves in. In the event of an unfortunate death, this helplessness may morph into survivor’s guilt, delaying the caregiver’s path to recovery.

This group of people were previously farmers, teachers or homemakers who were completely oblivious to the inner workings of the medical community. And yet, now they keep up-to-date with the latest medical journals, studies and drug trials. They might quit their jobs, travel back to their home country or forego their own comforts. They care, and they do all that is in their capacity to make life easier for the patient. And I believe they are a crutch to the COVID patients, a support that helps them fight back and regain as much of a pre-infection status as possible.

It’s important we empathize with these people, that we address their concerns; we should reciprocate their support in whatever ways possible. This is my acknowledgement of such pillars of support, whose numbers we don’t see, whose percentages aren’t counted in any statistic, but are still a huge faction of people whose lives have been affected by the pandemic.

Wi-Fi: The Watering Hole

One thing that’s become very evident during the pandemic and series of lockdowns, is how dependent we are on the internet. Like, the pyramid of basic life necessities have become- air, water, food, internet and then, shelter. It has been so for some time, but ‘the web’ has become more ingrained in our daily lives than ever before. We need it for everything- from checking the weather to ordering groceries and food(and not to forget, rate it 4 stars). And of course, all the health apps that monitor your heart rate, the number of steps you take and how long you sleep(creepy when you really think about it). But I don’t want to rant about how the internet has made everything easier and more accessible while isolating everyone. Surprise, it’s the opposite.

Call me an optimist (actually, don’t), but during these trying times, the internet has actually brought my family closer together. To be more specific, our wi-fi. You see, the modem is in the downstairs living room, and the internet speed gets weaker the further away from the modem we go(pathetic, I know). This means we cannot enjoy the full benefits of our measly 50Mbps data plan unless we stay in the vicinity of the modem, i.e. the living room. The result? Most of the time when we aren’t working, cooking or otherwise engaged in old timey ‘offline’ chores, we sit together in the living room, scrolling through Instagram, watching YouTube videos or working on blog(s). The modem and the promise of uninterrupted net connectivity has become sort of a watering hole*, and all us social animals gather around it, feeding off of it. Doing our own thing, but together. And often when we get together at this “watering hole”, there might be a greeting here, a smile there. Sometimes we speak to each other, using our vocal cords. Sometimes we have the whole gamut of actual conversations about real things, like the good ol’ days. Makes me emotional just thinking about it.

I just realized that my mom has been talking to me for over a minute now. Bye!

*A watering hole is a large source of water, often seen in the wilderness, where different animals come to quench their thirst. It exists in the real world.

Pause

Keep it up. Move on. Keep going. Get up.’ All our lives, we’ve been told that if we don’t reach somewhere, we’re going nowhere. You know, “A rolling stone gathers no moss” blah blah. This invisible weight that’s put on our shoulders brings forth a false conclusion that if we don’t achieve perfection- in our jobs, in our life, in our relationships- then our worth is decreased, that we are less. But I’ve come to realize that that’s not true. Sometimes, taking a Pause does wonders.

All my life, most people around me have asked almost the same question- What’s next? “When is your exam?” “Are you done with your studies?” “Are you working?” “Why aren’t you working?” “What next?” Very few are so invested about the present- “Are you adjusting to college?” “Doing OK?” “Are you enjoying the job?” The former questions are enough to destroy any semblance of peace, and will have us scrambling to map out a blueprint for our future. But things don’t work out like that- one can never plan for the future. Take it from someone who graduated from med school and directly into a raging pandemic.

Even without these questions, it’s been drilled into us that striving relentlessly for something is a sign of strength and that stopping was a sign of weakness. ‘Society’ looks down on college dropouts or failed entrepreneurs for this same reason. It’s ironic because society is made of imperfect people like you and me, who just want to be validated for the work they do, appreciated for the effort. When this is denied, it starts a vicious cycle.

I hope I break this cycle. I hope I don’t put the pressures that have been handed to me on another shoulder. I realized that the Pause is a good thing. Pausing is not equal to stopping or quitting. The pause is so you can collect your thoughts, regroup and get back into the fight with renewed vigor. The Pause doesn’t only mean doing nothing. It can be, but it can also mean taking a walk, calling a loved one or getting back into a forgotten hobby. For me, I find the Pause when I write, watch a good movie or talk to my friends. Sometimes when I read a good book. Find a Pause that works for you- it’ll be like Spa Day for your brain.

This particular train of thought took off when I was rereading Paulo Coelho’s “Manual of the Warrior of Light”, and as always, I decided to spew my brain juice all over this blog. Hope it helps you find a Pause.

Why Mental Health is Important

The concept of health has evolved a lot from the times when leeches were used to cure anything from toothaches to severe infections. Health is now defined as physical, mental and social(emotional) well being. Although definitions have changed, people’s perspective of health remain heavily dependent on physical wellness. It is promising that discussions about mental health are emerging, but like accessible healthcare, these discussions tend to be limited to a particular demographic. The importance of mental health is not pressed upon the common man, and is merely an abstract concept to those who even bother to think about it. Recently, I was part of a team treating a man who had attempted to commit suicide by hanging. He survived(after appropriate resuscitative measures were undertaken) and all seemed well. But it was when his 10 year old son came to visit him that the enormity of the situation dawned on me. Besides counselling of the patient himself, a holistic treatment plan would be to offer the same for his family, who were just as(if not more) traumatized as he was- but without any of the external physical signs or symptoms. This was an example. Every person we meet is fighting his/her fight. And realizing that is the very first step of many, in order to make Mental Health, not only a well-discussed topic, but a realistic goal for all.

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