The Adiyogi.

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I would like to start with a disclaimer akin to the one which appears before any movies starts. I did not start the blog as a religious or mythological exercise. Having said so, there are times when you travel, the history of the place or a quirky story attached to it, adds a special flavor to the monument you are visiting. Rather than looking at it through the eyes of a “been there, done that” traveler, adding a dash of mythology, I feel, increases the aura of the place!

So the story goes…..

There was a terrible demon called Banasura who was troubling everyone on Earth. He performed intense penance and asked for immortality from Brahma. When Brahma expressed his inability to grant such a boon, he instead asked Banasura to choose a manner of his death. Banasura wished that if he had to die, he would do so only at the hands of a virgin.

With a sense of over confidence regarding his own immortality, he started harassing the people even worse than before. Unable to bear the pain, people appealed to Lord Vishnu to help them. On the God’s command, they performed a yagna so powerful that the Goddess Parashakti  agreed to come down to the earth as Punyakshi to annihilate the demon.

Punyakshi was a woman of extraordinary intelligence and capabilities. She lived in the Southern parts of India long long ago. She had such immense power of perception that she was considered as an oracle by the society. Akin to how Mirabai worshiped Krishna, Punyakshi developed a deep love for Lord Shiva and resolved to marry him and none other.

While meditating in Mount Kailash, the Lord came to know of her devotion and was moved. He started his journey down south to meet this courageous young woman and marry her. When the news of this reached the people around, they were worried because they would lose their mentor and guide when she went back with Shiva. The devas and Narada were scared that if the wedding would take place, then there would be no one to kill Banasura. Hence, they tried hard to dissuade Shiva from reaching Punyakshi.  But Shiva and Punyakshi were determined.

So, the Chieftain of the village, asked for an impossible kind of bride price- a sugarcane stick without the rings, a betel leaf without veins and a coconut without eyes.  As nothing was impossible for Shiva, he could materialize all the three without a bat of an eyelid.

Becoming even more desperate, Narada plotted.  He scheduled the marriage to happen before sunrise, citing that if the cock crows, then the time would be inauspicious for their union. Punyakshi, secure in the belief that Shiva would definitely reach her, prepared for the wedding with happiness and anticipation. But the elders of the village, egged by Narada, conspired against them and lit a hill of camphor on fire. The blaze was so bright that the village rooster confused it to be daybreak and crowed ahead of time.

Punyakshi got so upset that Shiva had failed her,that she left the place and went to the southernmost part of the land and stood there heartbroken and crying. She is now called the Goddess Kanyakumari, who waits eternally in the place, which bears her name. Learning this, Banasura tried proposing marriage to her. When she refused, he tried to force her hand resulting in a fierce battle, which ultimately killed Banasura. Peace prevailed on Earth.

Meanwhile, Shiva, who was equally upset about his failure, drove himself into a state of despair. He climbed the Vellaingiri mountains and meditated for a long length of time before retreating back to Mount Kailash.

These mountains are now aptly called “South Kailash”.

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Sometimes, it is difficult to ascertain where fact ends and fiction begins. There are so many such stories in our mythology which tread the delicate balance, and add to the mystery. Many are convinced that at the heart of a mythological story is an event that occurred very very long ago. Hence, in Hindu mythology, these texts are called “Itihasas”, or history.

For me, knowing a story and visiting the place have a special charm of its own. Just imagining a land hundreds if not thousand years ago, where Gods and supposedly immortal creatures existed gives me goose bumps.

Visiting the Vellaingiri mountains was one such feeling. Compounded by the magnificent, awe inspiring and majestic bust of Shiva (or Adi yogi, as he is called there), right in the middle of a circular mountain range, green, lush and covered with clouds.

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Just before daybreak, when you see the thick grey clouds, heavy with rain, passing silently behind the huge bust of Shiva, sway involuntarily to the rhythmic chants emerging from a small temple close by, hear the howling wind and feel the light drizzle of rain on your face when you look up at the statue, the feeling is surreal.

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This is one of those moments where time seems to stand still and you feel one with nature and its elements. Fact or fiction, travel surely gives you such near perfect moments to enjoy!

Have you ever had an experience like this??

 

 

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The family culture.

 

Parents are worrywarts. We worry incessantly about our children. Especially when it comes to their future. We worry about how they will handle school, friends, education and a career.

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We wonder how we can prevent them from making the wrong decisions when they are under pressure and have no one around to guide them. Will they do drugs? Will they choose the wrong life partner? Will they give up a meaningful job offer for a lucrative one? Will they care about their health once they live on their own?

We end up relying on the hope that somehow we have raised them well enough to make the right decisions. With a son on the threshold of his teenage years, my worries too, nudge me now and then. As a working mother, I cannot spend a limitless amount of time with my children or keep a hawk’s eye on them. So, do I wait for something to go wrong or is there something I can do before that?

Rather surprisingly, I got the answer, when I was a reading a book about managing companies! The book “How will you measure your life?” by Clayton Christensen, espouses lessons from some of the greatest businesses and applies them to life.

It describes a rather novel concept called “Family culture”.

The dictionary describes culture as “a way of life, especially the general customs or beliefs of a particular group of people at a particular time”.  Mostly, we use the word ‘culture’ in different contexts. For example, if we follow certain religious rules and traditions, we are called cultured. If someone displays a high level of intellectual sophistication, he is called cultured.

But what if we create a person who is “family cultured”?

Think about it. In business, a company’s culture is a way of working together towards common goals that have been so frequently and so successfully used that people don’t even think about trying to do things the other way. Each company underlines its culture when starting off, so that the employees have no doubt about the higher goal they are working towards.For example, google promotes a culture of “working how you want”. Understanding that creative people cannot be restricted to a desk, it allows its employees to work from a beanbag or a tree house or a swing! As long as you deliver what is expected.

If we apply the same to families, and evolve a family culture – a set of general rules and goals for our families to abide by, the same becomes a part of life as we practice it endlessly.

Whether we want it or not, cultures are evolving within our homes. If we plonk ourselves in front of the television and binge watch on the pretext of being tired after work, unconsciously, we are sending signals to our children, that this is what we do in the family, when tired. If we speak to our house help disrespectfully, the same carries over.

So, whether we know it or not, we have already developed some cultures within our families! If you want to develop an alternative, robust and well defined one, the priorities for your family need to be clearly and proactively designed and spoken out for all to know.

This is easy to say, but difficult to put in action. Firstly, you and your spouse come from different families with different cultures (both conscious and unconscious). There will be a lot of things which the both of you cannot agree on. To this equation, we add kids who are born with their own personalities and attitudes!

It is therefore important that both the parents strategize and plan a culture for the family to follow, whatever the consequences. For example, if a family has decided on a culture of having dinner together, helping out in the house chores and being kind, then each member of the family needs to follow it.

At first, it feels like discipline, but over time, it becomes ingrained. It becomes an unconscious choice to get up from the couch and sit with every one for dinner, pick up a mop when there is a spill or help a friend in need!

As parents,being consistent with a culture is both trying and tiring at times, but well worth the trouble taken. For example, teaching your kids to resolve fights amicably  may take a lot of time and energy at first, but that’s the behavior that the kids will will carry on, even when they are with their friends.

We like to believe that we make most of our life’s decisions by intent and consciously. But there is ample amount of research to show that this is not the case. There are many unconscious instincts at play during decision making. Like the time you sleep on a problem, and the answer appears almost miraculously the next morning. That is your unconscious at work. Scientists looked into what happened before the conscious mind made decisions. It was seen that the unconscious had made the same, seven seconds beforehand!

Hence, what better way to train the brain’s unconscious by putting in the right culture? So that, decision making comes by instinct and usually leads to the right choice?

Between busy schedules and too much homework, most parents let this chance of setting family cultures slip by them. Then we wonder, why our children made wrong choices as adults.

There is no time too late to start penning down your family’s culture. Grab your chance to make sure that your children grow up into genuinely good adults who set examples for others.

 

Doctor Diaries. The power of a “Mob”

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Life hands us surprises. But sometimes, when the surprise is unpleasant and comes as a reward for your act of kindness, it is difficult not to crumble.

Last week, a well dressed, neat looking woman in her thirties walked into my office. She sat poised, waiting for me to start. But as soon as I greeted her, she burst into tears. With great difficulty she reined her tears in and apologized. She introduced herself as a teacher Mrs.X, and said that she was not given to emotional excesses like this. “But how my life has changed!…” she rued. “In a matter of two months!”.

When I asked her to elaborate, hers turned out be a story similar to what has been in the papers in the past few months. X explained that her husband had recently inherited a piece of land from his grandmother, in his native village. The couple were naturally happy, but also scared of the land mafia. Hence, they took along their broker and an engineer and went to check on the plot. As it was quite a long way from their town, they packed along a picnic lunch to eat.

The land seemed beautiful, lush and green. Plans were made to build a vacation home and have a small farm, which they could visit on weekends. Once the decisions were done and dusted, they sat down to eat near the edge of the plot. They noticed  a group of village children gaping at their car and talking excitedly. In a feeling of joie de vivre, they handed out some chaklis to them, which the kids accepted and ran back.

The four of them were just packing up to leave when they noticed a bunch of angry looking villagers walking towards them. Before they realised what was happening, the kids pointed out to them, and they were getting beaten up with sticks and stones.

“It was a horrifying experience”, she shuddered. “I thought we were going to die. No amount of begging and pleading helped”. Their car was beaten to pulp. Luckily for them, the car still worked, and they got away before they were killed. They later realized that the villagers had been warned of kidnappers through a whatsapp video, and the ill fated chaklis had been misconstrued as bait for the kids!

Ever since, X had been having nightmares, flashbacks, palpitations and an inability to concentrate on her work. She would suddenly burst into tears and start trembling in the middle of her class. Any loud noise would make her want to run for cover. All in all, “My life is in ruins for the kindness that I showed”, she cried.

Never in our seemingly civilized life do we assume that something hooliganistic can happen to us. Or that we may resort to violence to resolve an issue.We feel that we have left our cave man behavior behind and moved on to safer shores. But is there an animal lurking within?

The villagers probably were not all violent people with criminal motives. There were parents, women, and kids in the group. So, what was it, that pushed these people over the edge of reason?

Social scientists describe such behavior as “crowd behavior” , now also popularly called “mob mentality”. Gustav Le Bon, one of the theorists who studied mobs, explains that when an incident starts a riot, the mob gets a life of its own. Deep seated resentments, frustrations about other issues and long standing disappointments about life can get a release through hitting, throwing, pushing and looting. Sometimes lynching too. Being in a mob provides cover and a sense of anonymity which makes it easier to display bad behavior. Basically a mass adult temper tantrum of sorts. Like when you are angry about lots of homework, your annoying sibling, bad food at lunch and a fight with your best friend, which all erupts into one big ball of rage as soon as your mother as much as refuses to give you a chocolate!

The members of the group are also reasonably sure that they will not be penalised for it, for how do you know whom to start with and where to stop? There is a release of subconscious pent up energy and frustration. All in all, apparently, there is a feeling of being in a trance.

In an incident which occurred in 2001, a 26 year old woman who was standing on the bridge contemplating suicide was driven to her death by a group of onlookers who kept yelling at her to “Jump, b***h, jump”. Which she did. Later, some on them who had been in the crowd, expressed that they felt terrible about their part in the tragedy and that they did not know what came over them.

Such is the power of the group. Surprisingly, there are so many instances in our lives where we unconsciously follow this very mentality that has the potential to shove us into the realm of violence. Starting from harmless parent teacher meetings, where I see a surge of complaints popping up as soon as one boisterous parent decides to voice out his problem loudly. The other parents surge up in protest as if new power is handed to them! Or the social media trolling which is gaining momentum. So, though we may not be beating or hitting, we seem to be at serious danger of landing there with the slightest push.

As a mental health professional, I was wondering whether it was better to treat the perpetrator or only handle the victims?

Surprisingly, it apparently takes very little to defuse a crowd. Start fast, observe when trouble is brewing, look for the leader, call out people by their names and draw them out for a one to one talk. Sounds easy, but then, it looks like there should be a counselor placed in all police units! A mob defusing squad like a bomb defusing one!

Jokes apart, as sensible people, we should at least start analyzing the messages sent to us on the social media, validate whether what is sent is true and only then, forward it to others. One news report claims that the whatsapp lynchings which happened recently were mainly because of the fact that the consumers of that particular video were villagers, who were new users of social media, and hence ended up believing that everything shown on whatsapp was the gospel truth.

So, though it is utopian to have mob diffusers, it would be a start to have responsible social media users and thinking news consumers so as to prevent the unnecessary deaths or post traumatic stress faced by many, like my patient.

 

 

 

 

 

 

 

Eleanor Oliphant is completely fine. Book love.

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When a book deals with issues like loneliness, childhood abuse, neglect and some degree of psychosis, the result definitely sounds like a very very depressing read. Something that you would run a mile away from, after a long and busy week. But what if the book is somehow like Rajkumar Hirani’s movies where difficult issues give rise to a compelling,  heart warming tale with a feel good ending?

Loneliness is an emotion I often see in my everyday dealings with patients. People seem to be lonely in the midst of marriages, joint families, school, children and hectic careers. Loneliness has also been described as “social pain” – a psychological mechanism meant to motivate people to seek for friendships or a purpose in life. Most clients I work with are trying desperately to get out of this bog and hence sign up for counselling. But what if there is someone who is completely alone but does not necessarily feel bad about it?

“Eleanor Oliphant is completely fine” explores this theme and was one of the reasons that I picked the book. The protagonist of this novel Eleanor, is a woman in her thirties. She works in an office, doing mundane odd jobs. She has a strict obsessive routine which she follows through the week, and the weekends.She has no friends nor does she feel the need for any. She is the butt of a few office jokes due to her reclusiveness, but takes it in her stride. And feels completely fine.

Till one fine day, her life changes because of an accident involving an aged stranger. She ends up helping him to the hospital along with a colleague from work. And gets slowly drawn into a world filled with emotions, relationships and togetherness.

Gail Honeyman, the writer has beautifully etched out a character who is quirky but likable because of her extreme straightforwardness. Eleanor seems part autistic, part schizophrenic and part personality disordered, but is still endearing and funny. As the book unfolds, we get to know the reasons behind the heroine’s behavior. Though depressing, you end up marveling at the way she has handled her life through the misery.

I loved the book.

First of all because, the protagonist is someone who has flaws. Huge ones. But still has her own place under the sun. It makes flaws quite acceptable. Something not to be ashamed of. Just like how it should be for all of us. Most people are either oblivious of theirs or are excessive about getting rid of them. With Elanor, what you get is acceptance of the fact and not making a big deal out of it. And changing when the need arises.

Secondly, it challenges us to think change the way we think about people who are different in some way or mentally ill. It prods us to think about whether they have reasons which made them the way they are. I remember the time when I had to deal with an accident on my way back from tutions. The chain of my cycle gave way and I was left stranded on the road at night with rain threatening to pour. There was this boy in our class, who was mildly retarded (which I know now)and the butt of all our class jokes. I am ashamed to say, that I have laughed at a few of them too. This boy, with whom I had hardly spoken, helped me lift the cycle and repair the chain. Then, he politely said goodnight and disappeared. We hardly even talked after the incident and through school. I now wish that I had the good sense to get to know ,understand and be friends with him. Most of the time, I feel,we are too busy trying to fit in, than to extend a helping hand to those who are left out.

Thirdly, it gives an nuanced description of a person who would fall in the autistic spectrum. The lack of grace, the acceptance of facts at face value, the simple way of life and brutal honesty make you wonder whether we are normal or vice versa.

Finally, the fact that the book ends on a positive note and a fuzzy warm feeling, makes it the perfect read on a cold rainy weekend.

 

Have you read the book yet?

 

What do you want to be when you grow up?

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I am currently working with a 16 year old who has a severe case of school refusal. Through many sessions of counseling, one of the most constant thought patterns I observed in the boy were ones of being utterly de motivated. He says that he is bored at home, but does not “feel like” going to school. When asked to imagine himself a few years down the line and tell me what he foresees for himself, he responds by saying that he would probably be continuing his father’s granite business. He also flippantly mentions that he is sibling-less and hence, the huge assets made by his parents were sure to help him continue his current lifestyle!

This got me thinking. Growing up, one of the most common questions asked of a child must be “What do you want to be when you grow up?” Parents, random uncles and aunts, neighbors, teachers… everyone seems to want to know what aspirations a child has. In my professional life too, I have asked this question to many of the kids who come to me. It has been a useful tool to start a conversation with a child that I know nothing much about, or to steer the child in a direction that I want.

But recently, I saw a vlog by Vishen Lakhani, an author, entrepreneur, and the founder of Mindvalley, a forum for the world’s smartest to speak on.  He eggs us on to change the way we ask this question. Rather than the routine “What do you want to do when you grow up?” he opines that it would be a better option to ask “How would you want to contribute to the world?”.  This he feels, changes the way the child thinks and gives him/her the feeling of being responsible, even in a tiny way about the world that we inhabit.

Children of today, at least in our country, are largely the products of second or third generation literates. Our parenting systems make sure that the child is supported through his education, both financially as well as emotionally. Even young children are smart enough to know that they are well off and that their parents would have made for them, a comfortable nest egg. The guilt of being rich belongs to an era bygone. The children of this generation take to their parents’ wealth and its offshoots of foreign travel, posh schools and techno tools with the ease of a fish taking to water.

Now, when you have everything, or almost everything handed to you on a platter, why would you have the motivation to work hard and best it? The easy gratification which comes with being handed a cell phone with internet, probably tops all the happiness that you get when you work really hard to get a measly A+ in the exams.

As the rural urban divide grows, children from cities do not get to meet their less fortunate peers on a daily basis. As we globalize and become materialistic, our kids lose sight that there is so much more to do, than sit stuck to a video game in a virtual world. Parents do have a hard time making their children conscious of the value of money and hard work.

In such a scenario, how do we make our children grow up as people who are responsible, goal oriented, conscientious and hardworking ?

The only way is probably by making them aware that they have a responsibility to the world that they live in. To make it a better place than what it is today.

In the process, maybe there is a lot we can learn from them. Because, when children dream, they dream big. They do so without fear. They are more imaginative. And to kindle their passion at a young age would probably give us thinkers and doers who have the power to change the world. Now. Rather than wait forever till they lose their passion for life and become addicted to mind numbing television.

It reminds me of this Ted talk by ten year old Ishita Katyal from Pune (who, by the way is an author already and the youngest Indian to speak at a TEDx event ) who directs her talk to asking why we adults ask children what they want to do when they grow up? “Why not now?” she wonders.

Hmm….something to ponder upon indeed.

So, the next time you spend time with a child, and are likely to pop this question, you know what to ask. Maybe if my client were asked the same, probably, he would have been a teenager with a mission.

 

 

Back to the blog.

It was a pleasant surprise when my phone notification pinged a comment on my blog, which has been defunct for the better part of a year now. The rather infamous work life IMbalance had thrown my blogging life out of gear and my kept my face book visits limited to clearing long pending notifications!

The comment and the fact that one of my very good friends started a blog, brought back a rush of feelings and memories – of the blog meet in Mumbai, my blogger friends whom I had hardly kept in touch with and of the sheer pleasure of having someone read what I have written and think it worthwhile to comment on!

With the itch to write came the ominous feeling of dread. It has been a really long and eventful year in my life which has drastically changed the way I think and work (or so I would like to believe). Kept wondering whether my writing would have a different voice, whether I could convey things which others liked too (after all, most of the pleasure of writing comes from being read) and whether I had burnt out. It took a whole fortnight full of contemplation before I actually decided that there was only one way to find out. That is, to jump in wholeheartedly and leave the rest to my readers.

I recently came upon a study done to assess which friendships would endure the test of time. Scientists analysed eight million phone calls between two million people and found that what retains the bond of close friendships is something as simple as staying in touch every two weeks. That. Is. All.

This makes me conclude that I want to make time to stay in touch with all of those who read my blog and have been supporting me on this journey of mine where I think, I feel and I say.

See you next week. Bye.

 

The magnificence of Petra.

 

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Awestruck describes me!

 

Most times, high expectations lead to an anticlimactic downfall. I can safely say that a visit to Petra is not one of those. Infact, it surpasses your expectations and quite literally takes your breath away. Whenever I saw pictures of the famous treasury, I assumed that Petra started and ended there. I did not realize that it is an actual city whose ruins are quite well preserved and akin to Hampi. It showcases the glorious civilization of Nabatheans and their mastery in carving out huge monoliths out of rockfaces.

 

Apart from feasting my eyes on beautiful haunting canyons and gorges, huge stark stone tombs, and the multi hued desert landscapes, it was there that I realized that I was an ignoramus in the history department and a  snob about twenty first century state of the art life style.

The Nabateans seem to have enjoyed the same pleasures that we do as far back the First century BCE on a much grander scale! I can only imagine the sense of awe that Johann Ludwig Burckhardt, the Swiss explorer felt, when he first laid his sights on the magnificence of Petra.

Petra was founded in the first century BCE by an Arabian tribe called the Nabateans, who made Raqmu (an older name for today’s Petra) their capital.

The entrance to Petra is through a two kilometer long trek through a canyon. Apparently the canyon was formed by a geological fault, split by tectonic forces and then later on smoothed by water.  The Nabatheans made canals through these formations for the flow of water into the city. They also built a dam!

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Huge boulders, narrow inways.

The treasury or the ‘Al Khazneh’ is undoubtedly one of the best sites of Petra. At the end of the trek, when you are getting slightly tired of seeing endless bends in the canyon, you suddenly get a glimpse of the treasury. And it is massive. There are a lot of stories about why the treasury was built. Some say that it was used by the bandits to store looted treasure, some others believe that it was a mausoleum, a few feel it depict the calendar, some more believe that the Egyptian Pharaoh used it to store his treasure and the last one goes that it was built for its wow value. The Nabateans apparently wanted to stun anyone who entered Petra with their brilliance and grandeur. They sure did succeed on that one.

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The first glimpse

 

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There are multiple trails through which one can explore the city, and we chose one which led to the monastery. For this we walked into the city which was home to more than 20000 people. The city starts with multiple tombs. Each family had a tomb where in the dead could be preserved. Like a home for the dead family members!

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Tombs, tombs, tombs.

Beyond these are the royal tombs, which are more intricate and carved in detail.

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Then on is the royal street with buildings and palaces on both sides (most of which were ruined during the earthquakes).

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Then comes the climb to the monastery. Winding stone steps with canyons as far as the eye can see. Each boulder with a character of its own, tall, bent and moulded by natural forces for more than 2000 years. They appear to be silently witnessing our ordeal of huffing and puffing through the climb!

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The monastery at the top is the highest point in Petra. A café, a chill breeze and an almost replica of the treasury welcome us to the top. It almost seemed like the ostentaniousness got replaced by piousness as the Nabateans trekked upwards!

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After a cup of sweet mint tea, we trek back, taking with us the memories of what we saw, and wondering how we could possibly explain all that we saw to our family and do justice to its beauty.

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I remembered reading a quote by Ibn Batuta which goes “Travelling- it leaves you speechless, then turns you into a story teller”. Petra does that to you!

Doctor Diaries. Patient prescribed treatments.

Thanks to a doctor’s strike in response to a very obnoxious law that the State Government is intent on passing, I finally get the oppurtunity to sit down in front of a computer without the chaos that I’m usually immersed in. Kids packed off to school, no patients waiting and my ward rounds done, I sit in my OPD and wonder how to start off. Its been so long off the blogosphere, that just the thought of writing something is giving me the heebi jeebies of a newcomer climbing on to the stage for the first time.

And then, there is a discrete knock on the door. My hired help comes in to enquire about medication for her daughter’s cold. I give her the name of a tablet and look back to my laptop screen. She hovers around and finally asks ” Ondu tonic kodbahuda? (Can I give her a tonic too?”.

And gives me my fodder for today’s blog.

Practising in a smaller city gives me an oppurtunity to deal with a potpourri of patients. Some of them young, google friendly and fit bit savvy and the others who still believe that spending a few lakhs of rupees on a puja is much better than spending a few hundred on a qualified person’s consultation. The rest oscillate between the two.

Every place and its population has its own etiquette and culture which make it unique. Apart from the cultural and religious norms that we follow, there are certain illness behaviours specific to people and their mindsets. Most of these dictims are age old and seem to have no logic attached to it, but are still followed diligently. These are a few things that seem to constitute a set of behaviours that I call “patient culture”.

Sample a few of them:

  1. Post partum mummifying:

Just as a pregnant woman can be identified by her baby bulge, so can a post partum one (in any part of India), by her near mummified state. This special garb includes a head scarf which conceals cotton stuffed ears, a heavy sweater over a nightie which is covered by an even thicker shawl, socks, (occasionally gloves) and hawai chappals.

Never mind that it may be the middle of summer with average temperatures hovering between 30 to 40 degrees. Just looking at the woman makes me feel like taking the ice bucket challenge (which was an internet sensation) willingly!

On my ward rounds, innumerable number of times, I have admonished the relatives,  made sure that the additional layers are removed and switched on the fan- only to find that the moment I leave, they sneakily get back into the same attire, tch tching about my state of ignorance about correct post partum fashion!

The lady in question accepts this with equanimity though she is sweating buckets!

2. The obsession with tonics and tonic injections (mind you, both are different and decided on by the patient, based on severity of his symptoms).

In my part of the world, patients believe that any consultation with a doctor which ends with only a prescription and some well meaning advice is a complete waste of hard earned money. Throw in a colorful looking injection and a bottle of vile smelling B complex syrup, you rise up in their eyes, as a doctor of worth.

So strong is this obsession, that occasionally, when they are strapped for cash to buy medicines, they buy the tonic and give up their antiepileptics!

I recently visited a renowned stroke center in the middle of a village in Uttara Kannada district. The center is famous for an injection which is supposed to cure stroke. Pushing through a patient line of close to 200, we met the administrator to find out what the miracle injection was. Turns out that it is Methylcobalamine (which is vitamin B12). The administrator rues the fact that patients cannot be convinced into taking physiotherapy and medication. The center does not even have a neurologist! A huge board which claims “We do not give injection for stroke” hangs desolately next to the serpentine line, with no takers for its claims!

3. The glucose panacea.

In furtherance to the obsession with injections, is the enormous level of faith that our masses have on “glucose” – which means any IV drip. Feel tired, feel woozy, not feeling like work, heart burn, heavy bleeding during your period, seizures, heart attack…. go to the nearest doctor for a glucose to solve all your problems. If the patient so much as skips one meal, the relative discretely asks me why I have’nt yet thought of the “Glucose”.

4. The concept of cold and hot foods.

Deriving directly from the concept of ayurveda is the concept that certain foods cause “heat” and “cold” in our body. When a patient innocently asks me how to cure his constipation, he gives me no clue that he knows the ins and outs of his body’s reactions to a million items on the food list. Consider this- bananas cause phelgm, milk and ragi cause cold, nothing from the fridge beacuse it causes his throat to itch, ginger and garlic give him piles and mouth ulcers, sesame and papaya are known to his give his wife increased mentrual bleeding, oily food causes cough, sour foods and peanuts give him gastritis, porridge cause flatulence,  and so on. I am left grappling with a tiny list of acceptable edibles to prescibe. So much for balanced diet!

Once you accept these stoically without batting and eyelid and nodding understandingly, your are accepted as an experienced doc!

Have you had any experiences to add?

opd

 

Lose your way to find it!

 

On a hot sweltering afternoon, at the end of our trip to Gokarn, my travel weary bones and a near empty growling stomach made me google the nearest food joint. The search coughed up a few names, among which a French sounding “Chez Christophe” showed up as the closest. We put on the GPS and followed the lady obediently only to end up in a small village with a handful of houses. We had lost our way!

Feeling hopeless, but hungry, we got down and walked up to a group of people asking for the restaurant. The “Krishnappanna hotla?, gottu, ille munde hogi, sigatte!” (Oh Krishnappa’s hotel? It’s right beyond here, just keep going) of the skinny man in a lungi made us feel all the more hopeless. Where was the French guy, we wondered. Or had he sold the hotel to an Indian counterpart? Unfortunately, there seemed to be no place around which could serve a near decent meal, so we decided on taking up the man’s offer to go in search of Krishnappa.

We got off the road, and started walking in through the lanes between the thatched roof houses, separated from each other by makeshift bramble walls. On the narrow foot roads where we had to walk single file, we were occasionally mauled by hens and growling dogs who were disturbed out of their afternoon siesta.

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The picture just does not do justice to how it actually looked!

Often in the center of the hustle and the bustle of the cities, the silence of the village in the afternoon seemed eerie at first. But then we began to take in the sights. Of the villagers working their way through their chores, contentedly, house after house.

One backyard had a lady who had set up an outdoor makeshift stove which contained a pot full of bubbling fragrant curry, while she on the other side, was cutting up fresh fish to put into the pot. There were a few cats purring on the side, waiting for any stray morsel coming their way. She stopped, surprised to see us, then waved us on, when we asked her about the hotel.

Another house had a small porch lined up with parrots of a vibrant green, which were being fed by a grandfather and his grandson. The grandfather was explaining something to the child, who was excitedly nodding his head.

A sudden spread of green burst forth, between the houses, where a lone farmer was quietly going about his work. Walking through a stretch of field which was ripe with the produce of sweet potatoes, cowpeas, beans and marigolds made for a great experience for the kids.

A blonde guy was lying peacefully on his hammock humming a small tune, in a hut with graffiti painted walls. But strangely, he did not seem out of place in the middle of a typically Indian village. He blended well with the peace it was emanating.

It was a trek to remember. The peace, the quiet and the sense of zen that prevailed, all but made us forget what we were there for. It felt as though we could go on and on. We felt the “ichigyo zammai” that afternoon. This basically means,(in Japanese) finding happiness in concentrating on the small pleasures of life, one at a time. Without distraction. Without the hurry that we might run out of time.

Our pace slowed, we breathed the air more deeply and even the kids quietly walked down the road. Just experiencing. And assimilating the awesome feeling into our beings. For once, I stopped clicking photographs like a woman on a mission, and just looked around.

At the end of the road was a beautiful beach, unspoiled and clean. And finally Krishnappa’s hotel (which was actually Christophe’s café by the way). And that, was an even more pleasurable experience.

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The place is a shack which is probably frequented more at night, and hence was completely ours at that time. The floor is covered with mattresses and cushions, which serve as seating. You can sit and stare at the endless expanse of the sea and hear the rhythmic sound of the waves. A wooden swing sways for the breeze as you munch on yum French food.

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Borrowed the photograph, but wanted badly to show the swing!

We finally found the right, motorable road to reach the place. But decided to walk back the same way we came. For the pleasure of walking down the road, which taught us the happiness of just being. Sometimes, you have to lose your way to find it!

Thank you Chez Christophe, and thanks GPS lady!

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Ratatouille

Doctor Diaries- How do I handle the bias?

cognitive-bias-modifcation

There are people whom we like and then there are those we do not. Knowing somebody up close and personal sometimes magnifies their faults and personality quirks. Now, when we handle such issues in our personal life, there is not much of a problem. There are thousands of quotes on the social media which advice us to stay away from negative influences, so that we can be sunny and positive always. Just stay away and your problems vanish. Clap, clap!

But when you are a doctor, and a psychiatrist at that, a lot of people coming to you are not only distressed but also not “nice”, to put it mildly. Within the first few visits, we know their personalities, their decision making skills and their life choices very closely. As a matter of rule, we need to be at our non judgmental best in our counseling. Allow the person to make his/her own life decisions. At best, we can steer them towards a choice, but that too, very unobtrusively.

Unfortunately, this seems utopian on paper, not reality. How can one remain unaffected when he/she hears of a man boasting of knowing how to keep his unruly wife in place by resorting to violent means? How do you react when a lady comes depressed because she is worried about her daughter in law being snubbed by her own daughters? Such a concerned woman, you think. The concern emerges from the fact that the girl’s father has paid a fat dowry and is asking uncomfortable questions about the same! How do you console a father when he cries, that we should convince his daughter to go back to her alcoholic husband’s home, because they have already depleted their life savings on the marriage? How do you convince an utterly melancholic woman (melancholic because, her parents had no male progeny, and hence died uncared for and now the daughter in law has produced two healthy bonny girl babies), who obviously will leave her uncared for too?

These are situations which arise frequently. On a particular level, I understand that these are people who have a different value system and a way of thinking alien to mine. They may have a genuinely good side to them and maybe just discussing their miseries. Atleast they are honestly bad! But these are also times which make me want to quit my “non judgmental” high horse and tick them off like a very strict school marm.

I keep squirming in my seat trying to calm the feminist in me. Most times, I am successful. Occasionally, my unobtrusive push becomes slightly more forceful. And rarely, I do scold. I do fervently hope, that  this happens to anyone who handles human emotions as a part of their profession.

We do not understand the decisions that others make and their reasons for it. Over the years and with some maturity comes the discovery that we cannot change the world so easily. Change is for most part slow, a lot of hard work and painstaking. Once the abusive husband, after 6 months of counseling, finally stops abusing his wife physically (though a wee bit of verbal abuse remains), I should consider it my victory!

Unfortunately, this victory is not all sweet! There is an itch to do something more, push a little more and dream a little. And go back to listening all over again. Maybe, this is more like the bevu bella (an offering of neem and sugar eaten during ugadi, the traditional new year), which symbolically signifies that you should swallow the good and the bad with equanimity. Probably, I should start everyday with a small bite of the same:)

Does this happen to you?