Santhosh's ramblings

I work in a context where there is always loud voices and non-physical violence (verbal violence) as part of the health care context. Yesterday morning walking into ICU – this patient has been with us for 10 days with a Chronic Meningitis and encephalopathy. There was that one particular distant relative, who has been consistently “irritating”. He would walk in and out of the wards, OPD catching you in the corridors, or any other doctor and trying to ask questions, asking for surety of success, shouting at the nurses over last 10 days. Our team had offered that the patient be referred to a higher centre, but the same person would say yes once and then turn around and decide against it. At the end of this multiple dilly dallying I decided time has come to stop and put an end to this. I called him aside and had gave him a verbal show down, whereby I asked him to make up his mind regarding taking patient off or keeping him with us. Now after 10 days, we were sending the patient home,...

A few years back I had done a study on Community which continues to challenge me as I look around and observe the various communities I have been in touch with. But the more I see, the more I see comfortable communities! Not any more the boiling pots of simmering fires. May be we have grown, or is it really growth? One end of the spectrum is what i call the "Boiling Pot community." This is where there is outright conflict, each person lives for his own plans and desires. The end point is me, mine and no more. From this stage, because of various issues, the community might move to seeming peace. This is the "Simmering Fire community". Due to contextual pressures, there is a cohabitation, but an inner cold war. There is a hai, bye relationships but still the end point continues to be me. Somewhere down the line, due to a common agenda which needs to be fulfilled, people move into a "Lukewarm community" where there is peaceful coexistence for a com...

The face book is full of “mothers’ day’s wishes”. And I also added my contribution to the same, by sharing a blog article which I had written when my mother was with us, in the late stages of Alzheimer’s. And I was at the same time reading the life story of Ida Scudder. The story of, how she as a young lady resisted the thought of being in India, but three events which happened the same night changed her life to consider a return to India. The rest is history. The events were – three young women in labour, dying the same night, because there was no lady to provide care for them. And Ida though requested, did not want to go, because she was untrained. Nor would the husbands allow her father the Doctor, to care for them because of their religious and cultural practices. (Dr Ida, Passing on the Torch of Life). This was in 1890’s, from an “undeveloped India”. I had been away for a few days and returned to our hospital this mid week. Walking into ICU the first patient I saw was, a ...

Growing old while working in an institutional framework, is a dangerous place to be. A few things could happen if you are not careful. One could constantly live in the past. Live in the past “glory” and “knowledge”. Live always looking back and seeing those olden days as the better ones and being critical of what is happening today. And keep reminding the younger ones around you, I have seen all those, I know how things work out, a place of “knowing all” and emphasising this! One could sometimes, forget the past and live in the future. Looking ahead at a retirement life, counting the number of years to move out and then slowly lose interest in what is happening around. One would do what is required - if not you will be penalized and so keep pushing, always looking ahead. Or you could live today, fulfilling roles with proactive engagement. My own interaction with the aging generation and observing them, (I am now there) I have recognized that there are three groups of seniors...

I just returned from reviewing the patient who is brain dead and on ventilator. The purposes for which they want to hold on to life is, in addition to their love for their relative, a cultural mandate and expectation that no death should happen in the family when a marriage is organized. If death happens, marriage is set aside for one year. Since the patient’s condition was worsening and the possibility of imminent death is there, we shared about our inability to give any time line, how long the person will be alive. And interestingly the family had already thought through the culturally acceptable possible alternatives to protect the marriage, which came as a great release to all concerned in the care of the patient.  Which means that every cultural expectation or self-driven interests have a loop hole or a way out! This morning my personal reading was from the book of Isaiah, where King Hezekiah was told that he was to die soon. He then cries out to God and asks that his lif...

There are a few very sick patients in ICU as of now. One man, in his 50’s who came into causality and arrested there, possibly due to intra-cerebral bleed. The admitting doctor did an excellent job in resuscitating and putting him on the ventilator. But the patient due to the underlying disease situation, was already brain dead. He is now on ventilator for the past 4 days. The family wants him kept alive, because the daughter’s marriage is coming up in the next few days. If the father dies or any death happens in the family, no marriage can take place for more than one year. And the extended family wants to avoid this complexity. And we have been requested to make it sure that he remains “alive” till the marriage is over. There is another man, in his 40’s who is in and out of supportive ventilation after a pesticide ingestion. Though he wanted to take his life, today he wants to get out of ventilator soon. But as and when his wife comes in, his attitude changes – he gets angry...

We see every day on an average, one to two suicide attempts. A few years back what we would have seen was primarily young girls, or recently married girls coming in with suicide attempts. And the issues which they faced had some commonality. Stories of dowry, in laws , and other gender related issues. Today what we see is a totally different profile. Sometime later I will try to share the detailed demographics, but for this ramblings – a broad capturing of some profiles are being used. We have seen children as young as 8 to 9 years and elderly as old as in the 70s with stories of varied issues which has led them to explore a quick way out of this world. We still see a few women with gender related family issues who come with suicide attempts, but much less than what it was.   In an era when we are projecting our nation as the next destination for the world, the next economic super power, a world leader for many of the issues which the world faces today, for some of us, who...