Santhosh's ramblings

Doctors don’t realize what they are missing by not experiencing the challenge of rural Family practice! I was on rounds along with a young FM resident at Prem Jyoti yesterday. She was enthusiastic energetic and compassionate.   2 months into this rural hospital she was having a time which I am sure would be transformational for her. One day rounds – Patients with - Obstructed labour with LSCS done, Pelvic Peritonitis – on conservative management, 8 year old kid with PSGN (Post streptococcal Glomerulo Nephritis) in severe failure and fluid over load, 50 year old alcoholic with Hepatic failure and ascites, 30 year old lady with severe dimorphic anaemia, amenorrhoea and failure, couple of neonates with sepsis, couple of other obstructed labours – forceps, vacuum, LSCS, Cerebral contusion and L1 compression fracture on conservative management, couple of patients with cerebral Malaria and a kala azar….where else but in a rural place like this one would get opportunity to care for such a v

I am traveling  from a 2800 bedded tertiary institution to a thirty bedded primary care centre and then to a 130 bedded secondary care over this week. Spending time preparing, listening to leaders, one common thread emerged. People - people are the issue! The politics of managing people is draining leaders. Dealing with varied perceptions and holding them together is yet another constant challenge. The need for more people is a constant cry, though we are unable to manage those we have! Someone said - if there were no people, leading would have been so easy.... I was reading today morning. Jesus as he looked at the crowd, His heart was moved with compassion. He saw them as haggard, helpless sheep without Shepard. And His response was, pray to the Lord of the harvest to send labourers into His vineyard.  And then He send out disciples into the villages around with no resources or support system. Teaching them to be dependant on God and interdependent on each other. Seeing people t

About 40 of our leaders came together to reflect on some of the challenges we face in our interaction with the legal systems of the country, the government offices and officers and the media. We had senior Government secretaries, lawyers and Media people listening in and giving us perspectives which health care professionals normally do not get. And there was a theologian who gave us biblical frame work to look at state and how to interact with state. As I listened in to all the sessions and interaction going on, I learnt a few things about our fraternity…. or  at least about myself…. One – Health care professionals are illiterate! Though literate in our own field, we tend not to enhance our literacy in the other fields which we necessarily need to, if we have to survive in the world of health care. Two – There are other professionals who are like us, who confuse the lay with their jargon! Like what we do with the Medical jargon! Lawyers are not too far behind. Government

After the last post on vulnerability which was written from a train journey to UP, I got out of the train and immediately faced a test of vulnerability. A personal test from which I am still recovering! I lost my purse with – all the ID cards, Debit and Credit Cards, License to Drive and a couple of frequent traveller cards. In one sense – Plastic cards which gives you Identity, Security, Mobility and Status. The immediate reaction was acute sense of vulnerability. I need to travel soon – I do not have a ID proof; I am not “old fashioned” to keep too much cash with me – and I need money (my wife’s card also is blocked for some reason); weekend approaching, I need to drive; and of course  some of the other plastics which I can afford to lose. Status can always come later…! If I has put my emotions on a graph it would have looked like this. (Fig 1) Soon, in about 24 hours the same changed! There did not seem to be much relationship between what I possessed and what I felt!

I had the opportunity to go back to one of the institutions I worked after ten years. Walking around, I observed lots of things which have changed and are still changing. New construction all around. Old buildings looking totally different. New faces all around. Few families who have stood through various Ups and downs but still persevering for years together. A sun dial which has stood as witness for 120 odd years. The junk yards which seems as if nothing has changed. Trees which have been silent witness to the changes happening around. The migratory birds which come and go every year. Like many staff who have come in and gone out. But like the green lawns and gardens which have continued to enrich the people who come in and go out, there is some thing else I experienced. The unchanging presence of God in the midst of all the changes. Assuring me again that He is the owner and the sustainer.

Vulnerability of communities of faith scattered across our country is due to both internal and external factors. Broken down walls are one reason. These communities are like city without walls. Walls of protection which should have been there due to our “being in the world” but “not of the world” has been broken down by not caring for these walls of character. We think that it is the physical walls which give us protection, but many times it is not these physical walls, but the walls of our character. Drying up of the river of compassion and care is yet another factor. Character can be assassinated and destroyed by assassins and destroyers, but out flowing river of care and compassion can give protection from any potential destroyers. We have shifted from being connected to the ever flowing source of the river of compassion to other fast drying up ones. Scattering is a third factor. Physical, emotional, and purpose scattering is evident among these communities. Established f

The running away of Jonah is generally perceived as one which was unusual and something which we are unlikely to fall into. Jonah, was already a prophet, and to one whom God was communicating. He was possibly involved in doing what God wanted him to do earlier, and now, taking this decision to run away from God’s plan and get away in a ship – was it unusual or does this draw parallels in our own life? To me this does not look unusual! As you keep walking into God’s purposes, there comes a time, when some of the directions He is pushing us into are seemingly irrational! Having questions on whether this is the right way to go, is this really from God might be common experiences for many us…At least for me – yes. Ingrained into our nature, is the nature to rebel and run away, the nature to rationally look at things, the nature to take a de-route, trying out alternatives before coming back to the right path! But the ability to sleep in the midst of a storm, deep in the hold of the shi