Death and after

It has been my lot over the years to visit the homes of those who die. Many of them being my patients.There is always an atmosphere of sombre sadness at the place with relatives and friends busy consoling the bereaved family. There is also quite a bit of whimpering and often loud crying. Some times I detect contrived sorrow and avoidable histrionics.

There however was one instance still green in my memory though it occurred more than 30 years ago. Then in my area f practice there were a fair number of Anglo Indians,most of them retired, living and some were my patients.One such family were Smiths.Mr Smith [ I have forgotten his first name] was past75years and suffered from episodes of angina and in those days we practiced what from today's standards primitive cardiology The drug for angina was nitroglycerine tablet placed under the tongue. Mr  Smith had a stock of these and needed to use it only rarely. He was full of life and told me once that a shot of whisky worked better than the pills I gave him. They were a nice couple and when ever I visited  them I was sure of a cup of tea and home made biscuits.

When the call came to see Mr Smtih one day, it was close to my closing time in the clinic and when I went to see him, he was  already feeling better and was sitting with his evening shot f whisky listening to music. Having gone there I took his blood pressure and found his heart ticking well. Reassured them that all is well and promising them a visit next morning, I returned home.
 Next noon when I went to their home, I found a small group of people outside. And when I went in I found Mr Smith's body laid well prepared for the final journey. Speechless and distressed I went inside to see his wife Mary. If she was shocked and sad, she didnot show it, instead when I told her how sorry I was she said,' doc ,he had it coming, and he went well with out nay pain' and got her self busy making a cup of tea for me!

I visited her a week later, except for he cousin there were none in the house. I said what a fine man her husband was and how I was going to miss him and his wit. Her pent up emotions cut loose and she broke down with huge sobs, holding on to me for support.

When, I finally took leave of her, her cousin came up to the gate and told me, 'now she will feel better'.

Musings-2

I said  decluttering one's mind leads to peace. With so much happening in day to day strife ridden lives, how can this be done?

Let me explain what I have attempted with some success. Keep your mind occupied with less number of thoughts. Yoga teachers have different methods of approach to achieve this.One such is concentrate on breathing. Forget about breath being the elixer of life and such other kinds of yogic mumbo jumbo. What it does is that it is relatively easy to observe your own breathing and when you are doing it the brain [mind] has one thought, that is breathing! this single thought can be for few minutes or if you are jobless can be for hours. Sport,physical work outs, listening to music too achieve the same purpose. The opposite happens when you become jealous, angry and sad. Being humans with a huge mostly unoccupied cerebral cortical cells, it is easy to engage them with these negative thoughts often leading  troubled lives.

Therefore the trick is to occupy our minds with few pleasant thoughts.Whether these lead to pleasant actions or not is not really material. It will at leas keep you happily idle!

Try it out,will you?  

Musings

I take long walks in this wooded community, barely disturbed by other walkers and joggers, my thoughts run to what this land had been barely 200 years ago. Mexicans owned this land which was nothing but dry scrub land. What transformed it into what it is today? War, violence,subjugation,hardwork,suffering and above all harnessing the waters of the river Colorado  and the snow which earlier melted down and went waste. In two hundred years this land has become the bread and fruit basket of the country.

Was it all worth it? Decimating whole population of natives,Indians to achieve this? I wonder. Some times it i better to remain backward and poor if it means happiness. I met and interacted with a gentleman who teaches techniques of relaxation. The mind [mostly located in the cortex is essentially made of thoughts leading to either action,both negative and positive. It may also lead to pent up[locked up feelings not resulting in any action]. The need is to delete this clutter of feelings and free the mind and make space for positive inputs

Day to day life is full of these minor and occasionally major strifes. And these involve second and third parties.These may be your relatives,wife,lover,business associate or even random men and women. How we react to them is in essence what our emotional mind is made up of. If the inputs are happy and positive, you remain relaxed, other wise you will be restive ans tense.

Is it making some sense?

I will try and explain how to next time I write

Breaking the silence

June to September is a long time to remain silent.
But then I was in no mood both physical and mental. Mental because of the social, economical and political atmosphere in my country which was so depressing. Our PM on whom the likes of me had so much hope when he assumed power 8 years ago, has proved such a disaster what ever angle you look at him. We have erudite spokespersons of ruling party who speak rubbish and gibberish in impeccable public school English. They irritate me no end.

In my own professional life I see gradual and inexorable taking over of medical care at all levels by private players and venture funds leaving the lower middle class and the poor high and dry at the mercy of the poorly managed and funded public health service. Even here the care[private] is not always ethically correct but is often dictated by profit motive as illustrated by a real life incident I came to know of recently[see below].

Money meant for public works goes waste and often into the pockets of beurocrats and politicians. Example is the road in front of my home. It is pot holed and has not been tarred since ten years. Repeated pleas have fallen on deaf years and written appeals have found their way to the waste paper baskets. May be the next step would be to hold a hunger strike in front of the local MLA

Physically, I had a worrying time after undergoing surgery and fighting a wound infection which took time to clear.

I am now in the U.S, and each time I come here the contrast becomes much more glaring,  especially the civic amenities.

An Ophthalmologist sought a job in one of the well known corporate hospital in west Bangalore. He was received well and looking at his impeccable qualifications and experience, he was offered a post. He did not take it. Reason: he was told at least a third of his patients need to be admitted!

This is an example of corporate medicine where money rules ethics.

Learn from Bhutan

With reference to the recent ghastly tragedy that occurred in Uttarakand we have a few important lessons to learn from the Bhutanese.

Geographically Bhutan is located  to the northeast of Uttarakand and shares same kind of topography and weather pattern. It too has a very high risk of flooding but we don't hear much of this in this small nation. Let us see how they have tackled this. I visited Bhutan 4 years ago and these are the reasons why.

1. Restricted tourism and taking a certified guide is mandatory. By this the Bhutanese have managed to minimize the pressure on their fragile ecosystem. Guides help to streamline the trade and also create employment. There are hardly any haphazard sales kiosks and tourist related trade is strictly controlled.

2. Minimum deforestation. Probably Bhutanese Himalayas are the only remaining part of Himalayas where the original forests still exist. This naturally helps to prevent soil erosion and consequent flooding

3. Graded development. Theirs is a go slow approach.Television had just made its advent when I was there. There area few hydel projects in the making but they are well planned. Buildings are all planned and take into account the need to do.

4. Happiness more important that perceived prosperity. Bhutanese are fortunate in having a king who believes in making the people happy and the development efforts are designed to do this and not towards making them rich. The guide who escorted around was a typical example. Educated, fun loving, urbane, steeped in Buddhism and contented.

4. No litter. Man made litter clogs the environment as we can see everywhere in Uttarakand. This is not so in Bhutan.

Will our politicos wake up before another disaster strikes us?

Let Mukesh Ambani build now

Mukesh Ambani built a 400 crore dwelling for him and family to live in Mumbai few years ago [see the pictures in the net]. He is supposedly not living there because Vastu experts told him it is inauspicious! In the first place to build like that for a single family in a poor country like ours is in itself vulgarly shameful and not living in it after having built it is even worse. Then, so what, when our politicos and bureaucrats are wasting hundreds and thousand of crores of rupees, what is Mukesh's 500 crores.

That the Ambani's are amongst the richest of men gives them an opportunity now to really build. This is take on hand in the reconstruction of the flood damaged infrastructure of the holy land of Uttarakand. Given their undoubted ability to get work done by hook or crook, and their enormous wealth, they can do it, but will they?

That is the question

The Braca Gene
Women who carry this gene are almost certain to get Breast cancer some time in their age often during their reproductive age. This cancer is often is of a severe type and the advice to get the breasts surgically removed makes sense. Many women who are so advised wait till they complete their family.
Angelina Jolie's decision to have this surgery is therefore should come as a major boost to those who are carriers of this gene in making this difficult decision.

Stink spreads
I have never been a fan of the shorter version of cricket which goes by the name of 20/20 and the Indian brand name of IPL[Indian premier league]. My dislike was mainly for cricketing reasons. I hold the view that it is destroying the real cricket that is test cricket. This short form of cricket is vulgar, flashy,base to say the least. I say this despite its huge popularity. Like many such things in our country things of value don't always are popular but something that appeals to coarser instincts gets the nod of the general public. That sadly is what Indian society is today.
Now that three players were caught for match fixing and their connections and operations have spread across to others and the latest is the BCCI president himself! Though as yet a rumour the stink is spreading and I hope this will put an end this monster of a game

Asghar Ali Engeneer
He passed away a few days ago. He was 74. Asgar Ali was a well known Islamic Scholar who tried his best to interpret Islam to solve the problems that face Muslims who live in today world. He also tried to educate non Muslims and help them accept the basic principles of the religion  His writing style was lucid and was free of the mambo jumbo which one often sees  in writers who try and interpret religion. His back ground [came from a an illustrious Bohra Muslim family with background of both secular and riligeous education] An engineer by profession, he gave it up and in later years devoted his life to his writing and bringing about communal harmony.
We need more of  Asghar Alis.

Reading
It was William Osler who advised doctors to come out of their shells and do something different than what they do in their professions. This may mean even reading the railway almanac!. This great physician gave this advice more than a century ago and this holds good even to day. I find my doctor friends immersed in work that they find it hard to find time to do anything else. But are they all really that busy? and then why must they do anything else? Is doctoring not enough fulfillment?
Valid questions. To answer these, firstly, one can always find time if one knows how to manage it. Most GPs I know work hours till late in the night and have their afternoon hours free when they either do personal work or sleep. Many also wake up late in the morning. Most don't exercise. Lack of other activities leaves them fairly ignorant of the world around them and as most illnesses have some socio psychological relationship, their lack of knowledge leaves them often unprepared to face patients and their problems. This also makes them that much less interesting as people.
Reading as advised by Osler is an excellent way to spend one's time. Judicious selection of what you read also makes you [if you are inclined to be one] a better human being. There is also a great variety to choose from. There is biography, travelogue. fiction, detective stories, crime, history, philosophy, short stories and the like to suit all tastes.
I began reading Robertson Davies's works five years back thanks to one of my friend's recommendation.His world is principally urban Canada set in the middle and later 20th century. He wrote several novels and presently I am reading ' The lyre of Orpheus' the last book in a triology. The others are Rebel Angels and What is Bred in the Bone. Another book of his I liked is called the Cunning man. It tells the story of an unusual physician whose methods at arriving at a diagnosis were unconventional. It is an interesting read

Return
It has been quite a while I wrote. This has made a few of you wonder if I have been ill. Happily, I am well and have completed my 72nd year![time to change my profile]. It has been more than 4 years since I have started blogging and more than 300 posts later, the interest is till there not withstanding the poverty in writing in the past few months. I promise to write more often than I have been doing.

Hoax
As write this piece, another scandal has broken out in our much hyped IPL cricket. Three cricketers were caught fixing the game. I was not in the least surprised. Given the prevailing atmosphere in the country where graft rules the roost, where top politicians and beurocrats openly practice and flaunt it, how can young cricketers be an exception?
The whole IPL is huge thamasha and hoax played on an unsuspecting and rather naive public.
It is certainly not cricket as I have bemoaned in this blog number of times.

They are killing this great and sedate game called cricket.

Are we asleep?

Some times I wonder at our ruling class, the politicians and the beurocrats and their insensitivity to issues that affect peoples health. One such example is curbing tobacco use. Despite the overwhelming evidence of tobacco related deaths the measures taken to curb use of tobacco are very casual and most cases not enforceable.

Tobacco users die early and horribly due to lung and other cancers, serious respiratory problems and cardiovascular disease. Chronic smokers have ten to fifteen years less of life expectancy as compared to non smokers and those who have quit smoking before they are 40 years.

We have rules which says on the cigarette packet that it is injurious to health. The caption should be that it will kill you 15 years before time with cancer. We have instituted laws of no smoking in public places.  I have not seen any one booked for smoking in public which is seen every where. Tobacco products are available every where and I see a worrying trend of young persons especially young women smoking.

What we can do with powerful tobacco lobby not allowing stricter measures by the government and the feeble laws are not enforced?

There are some ways. Socially boycott smokers. Don't sit with them. I f one of your friend smokes, get up and move a way and make sure he knows why you did it. Women should not allow men to have sex with them  and vise versa!

TV ads even remotely connected with tobacco should be banned and so  in cinema smoking should not be shown even if the scene demands it.

farmers must resist the pressures from tobacco companies and start growing alternates cash crops.

What you and I can do is to socially ostracize smokers. Draconian it sounds is it not but it is in their interests.

It is better to have a good friends company for ten more years than see him die after intense suffering because of lung cancer.

Emancipation

The recent spate of atrocities on women made me wonder if there are reasons other than what I wrote in my previous postings. I came to realize that there are indeed historical reasons and they are numerous.

Let us examine a few. In the present day India people can be broadly classified as those living in the plains and those living in the hills. The people living in the hills which form a tiny minority are supposed to be those who were driven to go beyond accessibly [hills and forests] by the Aryan hordes that came into this country some 2 to 5000 years ago. Women of the hill people have no problems with their men as one can see in the north east, tribes of MP, Chattisgarh and even in states of Karnataka and Tamilnadu. They have traditionally placed women on a different footing than the people living in the plains of India which is the rest of the country.

History is replete with recorded instances of discrimination aimed at women. The earliest that comes to my mind is Rama’s story in the famous epic Ramayana. We call this man, Lord Rama and worship him as the embodiment of everything that is good and great in a human. He is called in Hindi as maryada prushotham. Let us see what was his attitude towards his wife Seetha who spent some years in captivity [some DMK historians say willingly!] in SriLanka ruled by demon King Ravana.On successful invasion and rescue, King Rama returns to the city of Ayodhya with his wife Seetha. He being a noble king interested in the welfare of his people, made clandestine inspections under disguise. In one of his forays he hears a washerman make derogatory remarks as to Seeta’s character when she was away for so long in Srilanka.

This has our Marayada Purushotham Rama worried. The only way to convince his people that his wife is pure [meaning she has not slept with Ravana] is to make her walk through fire. So he proceeds to test his reluctant wife with fire. Of course the ever virtuous and devoted wife comes through this fire test with flying colors and redeems the suspect honor. This kind of horror incidents are also there in Mahabharata [another revered epic] where another King of virtue called Dharmaraja [except for his compulsive gambling] who after losing everything he has in a game of dice, bets his own wife and loses. Then this virtuous man mutely witnesses stripping of his wife in front of an assembly of nobles.

So, men even in those times [2 to 5000 years ago] treated women as commodities and not as humans. They [women] lived and died catering to the whims and fancies of their men. A woman without her man was considered an economic liability and fit to be burned along with her husband when he died .This went by the name Suttee. This barbaric act prevailed till the late 19^th century and it took an English governor General William Bentick and an Indian social reformer Raja Ram Mohan Roy to put an end to this practice of widow burning.

The present day India the widow burning is replaced by female feticide and infanticide widely practiced in many states with possible exception of southern states. Widow neglect is also rampant. There is already an alarmingly skewed sex ratio in many northern states. Single men not being able to find brides are  a major problem especially in a society which treats women as chattels.

We are now facing very serious and very dangerous social disaster in the making. Unless society wakes up to this reality, there is going to be crisis of unimaginable proportion. Compulsory women’s education, preferential treatment and creation of employment opportunities, change in inheritance and divorce laws that will give women equal rights will help, but the most important is change of the male mind set.

Will it come about?

Curse

In this unfortunate country and people, we are not only saddled with rotten political leaders, but also are burdened with religious leaders who are a century behind times if one goes by the remarks made by them.

One says school girls should not wear skirts, another says woman should stay inside the house and look after the husband and children and run the house and yet another says the rape victim is to be equally blamed!

With such leaders at the helm do we have any hopes at all of becoming a developed nation?

The more I read and watch the media more confirmed I become in my pessimism about the future of my country.