Friday, January 29, 2010

Beating retreat!!

I watched the beating retreat on TV the other day....most times I have been in Delhi,witnessing the fireworks from South Avenue or watching my uncle and aunty get ready to attend the president's dinner in Raisina hill.
I realised,I hadn't ever sat through the event earlier.
The ceremony was poignant,to say the least.
It was hard not to feel an element of pride to see the forces march to those lovely beat.What a perfect rythemn I thought,not one out of place.
It was a mixture of beauty,discipline,vulnerabilty(Abide with me..) and most of all the love of the land which is India.Sareh jahan se accha-Hindosata hamara!!

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Thursday, January 28, 2010

Circle of life!

I was in the out-patient busyly involved in my usual knick-knacks,Prabha entered the OPD,tears streaming,hair dishevelled in her night-gown with Christochit folowing closely with their six month old baby in his arms ,eyes full of tears.The little baby girl sat triumphantly on Christochit's arm smiling from ear to ear oblivious of the chaos.
She had apparently fallen from the bed and had cried continuosly which had brought P and C to the state.
I surprised myself when I found myself calmly telling Prabha and Christo -'Congrats you have become parents!'
P and C have been married for almost a decade.Unable to conceive,they finally gave in to this urge by adopting a pretty little new-born from Himachal,two months ago.After some soul-searching,P was allowed a maternity leave by the organisation and it has made a dramatic difference to the child ,in the one month that Prabha has been on leave one can visibly see that the child has entered that miraculous circle of life,only love can bring-but so has P and C ,thank God for that!.

Tuesday, January 26, 2010

Blood Brothers.

I had not cried like I did while I read a book as much as I did when I read this piece by Ellias Chacor.I read it in a single sitting on 26th of January,India’s republic day.
It’s a real life anecdote of a Palestinian Christian and the story behind the middle-east crisis from the other point of view.I thought the book was great,not because it stimulated my tear-ducts but it brought afresh the realization of the ‘Love at the cross’ and the renewed awareness of it’s worth.
It’s a beautiful book.
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Tuesday, January 19, 2010

Simplicity saving lives!

I have been meaning to write about the Newman's ventilator which has fascinated me to no end.
At a time when the cost of ventilators were not less than five lakh of rupees,our then executive dirctor introduced us to this quiet ,unpretentious anaesthetist from some part of Maharastra who had assembled this piece of machine,that would cost just Rs 60,000 and would save countless lives in a rural set-up.
Taking our ED's word for it, but with some reservations which I did not express at that time, we bought the machine and planted it in our low-cost ACU.
The machine could not be more basic,and yet over the years I marvel when I look back at the countless lives that have been saved by it.
Each time a patient with respiratory paralysis walks out of the hospital in one piece,and believe me there are hordes of them,I bless the man,I don't remember his name but I remember his offer,'if the machine conks off,just let us know we will replace it with a new one'.It's six years since,it is still going strong without a single break-down and it is the only ventilator we have!

Friday, January 15, 2010

Trying to coordinate the past,present and the future!

I found myself in a unique position of trying to connect several generations of individuals that seem to make up the Nav-jivan.
Jeevan,who joins us next year,has a burden for the area and has energy and the passion for the place and is comitted to boot,was visiting to help us with a few project matters.Dr Binks was due at the same time ,i had to do a bit of acrobatics to connect them somehow.All of a sudden the founding missonary of the place landed up.i did not have the time to sit back and reflect at the timing of it all.Praise God for His providence!!


Delimna of working in a rural India out-patients are quite unique.
I have a room to myself which I use as a clinic cum office space.The patients who visit me walk in and out of the room at their convenience and time.They peep in to ask for directions,to enquire about issues that irk them,to get suggestions and what not!When they come and they do come they enter the room all at a time,a patient and the bystanders and the rest hover around spilling out of the room,all ears on somebody elses complaints.If you are not strict with them they even put in some helpful choruses.Sometimes I find myself like an actor putting up a show for them even as I try to give them some helpful tip on health issues.Today I had that unique experience of getting some answers to the questions I had put to my patient in the examination chair from the window that over-looks the corridor!It's all in a day's work.

Monday, January 11, 2010

No controversies please! Mr Tharoor.

Mr Tharoor has a lot standing for him besides the ministerial post he holds in the centre.However,one would expect him to be a little discrete not for the sake of toeing the line for the fear of offending the bosses but for the sake of the country which might need his experience and his expertise for the greater good.We have read his books ,we have enjoyed his acrobatics in the UN now we need to see for sure what stuff he is made of by his performance in the ministry and not in the twitter…or his bylines……We enjoy his rhetorics ,there is no doubt about it ,but the great Indian sense of humour wears a little thin.. some side of the seams.
‘I deserve better’-,was what he said!In public life what you deserve often does not matter….what the country deserves matters…and matters a lot.If Mr Tharoor’s style of politicking is going to make the way India politics healthier,so be it but someone has to pay the price ,I hope it is not at the cost of some bright Indian mind,given a chance to make a difference and then reduced to running a side commentary on things that matter to the country!

Wednesday, January 6, 2010

A little bit of heaven!

It's another day in the tuberculosis clinic at Nav-jivan in Palaumu District of Jharkhand.
Budhi Bhuiya comes into the outpatient wth clasical features of tuberculosis.He is sent to the laboratory for his sputum,early morning and spot ,turns out to be positive for acid-fast baccilli.
Guddu,Amit Minz takes him to the counselling room.His fingers hooked around his belt he paces the room almost emulating a bollywood's police personal interrogating.However,if you hang around long enough,you realise how different the process is.In the fifteen minutes that he spends with the poor villager,he cajoles,bullies,advises,teaches with illustrations,affirms and understands the patient.At the end of the counselling session they have a camadarrie enough to address each other as 'Guddu Bhaiya' and 'Budhiji' and they appear to have made a connection of sorts.
When they have been through the entire DOTS hip-hop together,the next is the doctor's desk.Dr.Arpit stretches out his hands which hold an assortment of medicines in front of the patient .It's a conglomeration of colours-red,yellow and white in different sizes.The villager picks out the medicines according to the days as per their understanding.Once the doctor is convinced that the patient has understood the dosing well,the doctor,the counsellor and the patient pray together.The patient deposits an advance of 500 Rs and then goes home that day without the medicine.This starts a journey of six months of acquaintance...The counsellor visits the village and hands the medicine over to the DOTS provider the next day...
Ever so often the counsellor bikes it to the village to see the patient,talks to the DOTS provider and reminds them about the follow up visits.Every visit the patient's weight is monitered.His stipulated follow ups are done according to the schedule.Most times the patient is accompanied by the DOTS provider to the hospital.
At the end of six months,the patient comes for his final check-up,the DOTS provider comes along.Declared cured or completed treatment,they shake hands,get a word of affirmation,and the patient gets back his original deposit of Rs 500 and the DOTS provider his renumeration.
Nine out of ten the patient is won over to the system of DOTS in NJH and becomes the mouth-piece for the programme.

Monday, January 4, 2010

All in a day’s work!

This was one article which came through on it’s own even as I was sitting in my out-patients post-christmas.Shreeram Singh entered the OPD with classical symptoms attributed to tuberculosis.As the normal trend of questioning goes ,I asked him if he has a history of migration .He says he’s just been back from working as a weilder for ACC cements in Wadi in Karnataka.I asked him how the living condition there was ?He said four labourers shared a room 12 feet by 8ft with a single window….they had a fan.Did anyone in the group have cough?Crinkling his forehead,he thought for a while and he said yes he remembered one of the labourers who used to cough consistently.My next question was did you have medical facilities provided by the company and the answer was no.Apparently the company has a hospital but only the permanent employees are allowed to avail the facility.Immediately a question came to my mind.exactly whose lot are these hordes of rural population who migrate to these industrial areas to earn their living and provide cheap labour to the industries?
The government has to seriously introspect and act if they want to just stop harping on the rural-urban divide and make that critical difference to the face of rural India.This is the impressionable population whose way of thinking ,the way of living is mouldable because they are out of their comfort zones,they are also the population which are potentially going to influence the way the people live back in the villages because they would be ‘the know all’, ‘see all’ man of the world who has a mighty influence on the way the youngsters think in the villages. Even the industrialists need to make a paradigm shift in the way they think-profit is good but keeping the bigger picture in mind would make a whale of a difference to the way they function and flourish,from becoming just another profit-making venture they would become a great industry.
As it stands now,the migrant labourers when they come back from the bigger cities get back a meager amount of money but bad habits in plenty.. drinking,smoking….and ofcourse those dreaded diseases..!Yes they get back one more thing ,the bollywood culture…!what a big role the film industry can play in making in-roads into these simple minds.

The Christmas week.

It is understood that every Christmas I get a taste of God’s mercy in the form of one critical patient who tides over a critical emergency by the Grace of God.Every Christmas eve in Tumbagara ,is spent in the ICU resuscitating that vital patient who visibly walks out of the hospital from Death’s door.
This year we had the tubectomy camp.We get hordes of patients during the winter months come in from the villages for family planning .Every Saturday we do around twenty to forty tubectomies.
This Saturday was eventful ,we had sedated the patient and had started with the tubes,half way through the patient was unusually quiet,she had stopped breathing completely.It was unexpected so we went into a rampant resuscitation spree.She refused to breathe.We put her on a ventilator and we prayed,rushed in fluids even as we could appreciate her vitals collapsing.
I remembered very clearly praying before the surgery and asking God to let the lady walk home without complications,-why had it happened?-I asked myself?
While she was on the ventilator,she decerebrated once ,so we rushed in a mannitol ,observed her diuresing.We got together and we prayed-oh we prayed hard.
Her breathing did not come back that night-although she tried frantically to fight the tubes in between intervals.We shifted her to the ICU and went off to our respective quarters in introspection.
We had a quiet night, I made it to the ACU quietly in the morning to see how she was!She was conscious,oriented and awake.
I decided to extubate her,I did and after that the saturation took a dive,was wondering if I needed to re-consider putting her back as unjustified as it looked.In a propped up position her saturation suddenly began to pick up.
She was bright and perky,albeit a little hoarse.We kept her sats monitored the entire day .She had her lunch.We sighed a sigh of relief,thanked the lord for his grace.
She walked out of the hospital and went home the next morning.


Had not laughed like that for a long long time.
Put a lot of things into perspective…..taught me not to take things too seriously …just imagine entities conferring together to decide your life’s journey,changing the climaxes and the episodes according to their whims and fancies.For most of us ,life is pretty much like that ,taking things as it comes.Somehow we never make that connection with our inner selves or with the supreme source of life,so the master-piece eludes us and we live and die mediocre lives.The story of our life would read of the circumstances that took us where we went.
I find this illustration I heard from a credible source ,interesting.
One lady decided to do an experiment.She stood on the side-walk in the street of Mumbai and looked up towards the sky with an appearance of interest.Soon another man joined her ,and another,and another till a considerable crowd gathered to view nothing in particular-in the meantime the lady quietly slinked out .
Her point was, how directionless people are in general and that is how through generations a lot of people have made their living on both side of the fence.
There is,I personally believe, just one absolute truth and that is in the Word of God,everything has already been said….rest of it is bits and pieces of the absolute pulled out in different context or otherwise plain lies, the world in it’s bid to survive ,feeds you and me into believing and the lives you and I are conned into living everyday of our lives!