Santhosh's ramblings

Identity is a confusing issue. At least for me! There are two kinds of identity all of us carry. One is the bestowed identify and the other is the earned identity. The bestowed one – generally we don’t have a choice. Earned one, is in our control and all through life we struggle to earn various kinds of earned identity. We are living at a time “Nationalism” is being discussed in the media quite often. This is also in the background of various other identity issues which are being highlighted in the Media – the legitimate and Illegitimate Indians, the Hindwatha discussions, the secular Indian in a spiritual India and many such. I am confused. I am a Mallu, Protestant Christian by birth, evangelical by choice, Hindi speaking by practice, North Indian by domicile, South Indian by birth, Doctor by profession. And many such identities. Some bestowed and some earned. Of course I am an Indian by birth and emotion and I love my country! All my bestowed identity, have been empower...

One of the on-going discussions in health care in the West these days is about “ Patient Centred Care”.   What is this Patient Centred care? In simple terms, where patient is at the centre of care, or care personalized with patient preferences and customized to the patients interests and desires. “The IOM (Institute of Medicine) defines patient-centred care as: "Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions." In care homes – the question being asked is “what is important TO the patient” and not what is important FOR the patient. This is an interesting change – change from “professional centred care ” to patient centeredness. Professionals know what is good for the patient (at least we think so). But what we don't know is, what is that they want, what is important for them. In the West, this is being done through documenting “One page pro...

For a middle aged man at the peak of his carer and major transition in life, this was not a good experience to go through. He has been mostly well in control of his life. He come out into this world, holding to the heel of his twin brother, earning him his name as “Heel puller” or one who deceives. This name seemed to have grown on him. He had manipulated and got the birth right by offering his tired brother some lentil soup. He along with his mother had tricked his father to give him all the blessings instead of his elder brother. Even with God, he was either negotiating or bargaining. Taking care of his father-in-laws sheep, he had managed to expand the work much more than expected by any one. His own remuneration, he planned out a strategy which yielded huge personal dividends. As he prepared to return, he planned out his strategies so well to protect his family and resources.   A driven, excellent planner, negotiator, resource generator. Any HR hiring firm would have grabbed ...

The road on which a person and his / her family, diagnosed with a life limiting illness and approaching the inevitable end of death, passes through is laid with multiple rough patches and the journey is often a challenging one. The care providers’ primary role is – as much as possible, to smoothen out the rough patches, and accompany and journey alongside much beyond the inevitable end, till such a time that the family is able to stand without this support. A care giver, whether professional non related care giver or family member, in this journey of accompaniment, will need to hold multiple roles and responsibilities, and switch these, on a dynamic basis, as the disease progresses and needs and contexts undergo various changes. The primary role of the care provider will be one of being a “Communicator ”. From the time of diagnosis, and into months after the demise of the person, this role of being an effective but compassionate communicator remains the role which will bring hope in t...

The value of Human life is difficult to ascertain. Some have tried assessing the value of the “remains” once a being ceases to be a being – between less than 1 $ to about 1900 $ – – it all depends on what you are looking for or measuring. Some have tried putting a value based on the organs we have and how much that is commercially valued. Any way organ donation continues to be a business, and so it is like what is given in the picture here, which pushes up the value much. More than 200,000/- $ But actually how much worth is a “Living human being”? I just returned from a visit to a hospital in a rural tribal location. In the HDU a girl of 8 years died in front of my eyes, due to a potentially preventable mosquito spread viral infection. The death was seen as a “matter of fact” – nothing much can be done, the health care team (including me)  and the parents – all seems to have the similar perspective – what can be done any way – it is beyond our help, this is fate – or inevitable i...

DHFs are good testing laboratories. It tests the following things. A.       Your faith in your ability to with stand the heat and fire B.       Your previous experience of electricity failing a the right time and fire dying off C.       Your faith in a God, who might deliver you! D.       Your perceptions of this God as one who is a deliverer. E.        Your ability to stick vs run F.        Your speed of running off – how soon and how fast you can run G.      Your expectation of the enabling to walk in the fire without feeling the heat H.       Your anticipation and experience of another person accompanying you in the fire I.         The ability of fire to purge the dross away J.      ...

There are various situations where we end up giving up instead of going on. Some times we go on giving up too. The inevitable giving up – are situations of people moving on from this world, positions which were for a time have to given up, places where one has been has to be said good bye to, people  move on for various needs and situations – inevitable cycle of life… There are other situations which are forced up on us, where we are forced to consider giving up. Giving up on people, places, roles, situations and contexts. These are not always “inevitable’ but “in our control” . The circumstances and situations force us and we take considered decisions to give up or hold on. The situational cycles of life. Then there are those of us who have made our behaviour cycle one of going on giving up. Fleeting and flitting from one role to another, one place to another one interest to another and the behavioural cycles go on. Interestingly, as we read through the stories from the OT, w...