To Let Live or Not?

Who gets to decide whether a life is worth preserving or not? Who gets to decide the fate of a newborn who hasn't yet seen the world?

A newborn who might not be able to appreciate the beauty of life. A newborn who may forever be dependent on external support. A newborn who may never be able to fully reach his potential. 

Or who may…

Who may actually be a boon to mankind. Who may entertain millions with his talent. Who may find the cure to cancer. Who may just live a happy life. Who may survive as a fighter. Who maybe just another person LIVING.

Is it the doctor who works his best to save him/her from becoming an ‘it’? For a doctor it might just be an achievement... The 'I saved him' tag. The 'I gave him a second life' tag. But, is he going to be a part of his life forever? No.

Is it the parents who waited patiently to feel the first kick, to hear the first cry and then find out that the baby is 'defective'? Afterall, they are the ones who are going to live with the child… or maybe ‘bear’ with the child (harsh but true words). For some of them, the child maybe a 'burden'- a drain on their personal resources- time, strength and finances. But for others the child can be a pure source of joy.

I have seen the way a mother's face lights up when she sees her baby for the first time. 
I have also seen the way her eyes swell up when she hears that her child needs corrective surgery and that her child, being the tiny being he is, may not be able to survive through it. 
I have seen the way a surgeon's face lights up when the child survives the grueling surgery and the critical post-surgery days. 
But rarely have I seen a doctor getting really emotional about letting the child go. (A defense mechanism that comes with experience, to keep working and carry on with duties.)

So what happens when a neonate's fate is to be decided? What should be done when the decision is to be made? Whose decision is more important- the doctor’s or the parents’?

What should be done when a neonate goes into cardiac arrest? A doctor can save him with the CPR... But those crucial minutes of lost oxygen may render him a vegetable for life. An adult gets the option to sign a DNR (Do Not Resuscitate) to be saved from the torture of ‘hanging up there’. But a neonate? Who gets to decide for them?

What is more important? Saving a neonate from death or saving a LIFE? Giving the ability to breathe or giving a life?

The emotional turmoil of a young doctor can rarely be cleared. These questions don't really have any answers. Experience may just harden up our souls and hearts- make us indifferent to some things.

(Apologies to the Grammar Nazis for the chaotic language.)

On the way to Eradication (Feeling proud)

Today, on 13 January 2014, it has been exactly 3 years since the last case of Polio was detected in India. Continuous efforts at various levels has brought us to this landmark- India is now Polio-Free.

As a kid, I saw a case of poliomyelitis and felt sorry for the bhaiyya suffering from it. As a student, I read about polio in books and realized there is no cure- only prevention. As a fresher medical student, I saw polio cases in the hospital and saw some hope for the paralyzed victims- in the form of rehabilitation. As a senior medical student and intern, I was a part of the prevention programs. And that! That is what I can say makes me proud.

First duty. Ghonda, Delhi

My first Pulse Polio posting was in a corner of Delhi I had never heard of. When I reached the center (a government school) on the Sunday morning, I saw a long queue of kids waiting to be immunized. The awareness created for the immunization drives is one key factor making us reach this milestone today. There are prominent banners all over, loudspeakers announcing the dates, celebrities advertising on televisions and radios, schools informing people. Usually everyone knows about a ‘Pulse Polio Ravivaar’ (Sunday).

Loudspeakers announcing the Pulse Polio Ravivar. Palam, Delhi

On subsequent immunization drives, I came across the difficulties that the drive was facing- the stigma amongst the various sections of the society regarding the vaccine. The worst was the myth that the vaccine leads to infertility. (Oh! This one got me facing a mob of angry people because I gave the ‘do boond zindagi ke’ to a 5 year old Muslim boy who came unaccompanied). For some people, polio is just a disease of the poor that cannot affect their rich kids. Problems for all classes.

Health talks by medical students (in the community and at the health center). Kalyanpuri, Delhi

But, the difficulties were overcome by awareness programs, political reforms, rotary organizations, international aids and global goals. There have been huge groups of volunteers who went door to door, who sat for hours educating people, creating awareness, and putting a stop to the spread of this deadly virus.

Ice boxes being prepared for maintaining the vaccine vials. Palam, Delhi.

When we were immunizing children one at a time, none of us realized that we were being a miniscule yet vital part of this gigantic national (rather international) effort at eradicating polio. We were paid 25 rupees (50 cents) for those duties. It’s not then, but now that we have truly been paid! Paid in full with the joy of knowing that history is in the making- that polio is now going to be limited to textbooks- that no kid will be exposed to it ever again!

Child by child. Country by country. Region by region. Polio is on its way out! Cheers to that.

A sudden urge to pen down my 2 cents on life!

As a kid, there are so many things you want to do...
As you grow up, you add some, you drop some off the list.
But, everything doesn't happen the way you want...
There are twists.
There are straight monotonous roads.
There are turns.
There are diverging paths.
There are dead ends.
Sometimes, you go back and follow another road.
Other times, you decide to take a plunge and...
and...
You set out on new paths.

Wherever you are- don't just stay there...
Move.
Move forward.
Move backward.
Jump up.
Dive down.
Run.
Slow down... but never stop.

One day you will reflect back on it all.
Where you are will not be important,
How your got there will matter most.
Make the journey count...

 

Modified Kubler Ross Model for Surgical Grief

 

Disclaimer:

Iam not responsible for what is following. This is a joke and in no ways meant to hurt the sentiments of any doctor/ profession/ institute/ patient/ or anybody or anything. Also, I do not take credit for this model. Iam just putting it up.

 

"Modified Kubler Ross Model for Surgical Grief"

What do surgeons do when they are confronted with a post-op patient of theirs who isn't doing as well as expected? They undergo the following stages-

1. Cursing
• !@#@$% "Why are you disturbing me? Iam tired from the long surgeries."
2. Denial
• "Who? My patient? No way... The operation went perfectly fine (read as patient came out of OT alive!) You got to be kidding me! He is fine and you are wrong (whatever it is you are trying to tell me- Iam not listening."
3. Anger (read as cursing under breath)
• #@$&*^$#
4. Bargaining
• "Listen, why don't we try to cover this up..." (actually this stage never happens. Skip to 4)
5. Acceptance
• "The operation didn't go well. Lets do some more tests and correct it before it is too late."
6. Depression
• "My spic-n-span rates are dropping... Nobody will come to me for surgeries anymore."
7. Cursing!
• !#@#@#$@ "Why did this have to happen to me?"

Read Disclaimer again!

 

The Nepalese Drama

Nepal was certainly a trip that took me out of my comfort zone (first ‘phoren’ trip, politically unstable, rainstorm, time-bound, no elders!) But then, it also taught me that the fun in travelling is when you cross limitations, break free from restrictions and move outside your comfort circle!

Scene1- Pokhara

Our driver is writing the words ‘Tourists Only’ for the car windows. A strike/curfew is planned.

Driver- “Tourists are usually not affected in these domestic troubles. But, I suggest we leave for Lumbini asap.”

But, we aren’t willing to skip Sarangkot’s beautiful Himalayan sunrise.

The sun rising through a cloudy sky over the Himalayas

 

Scene2- Back after witnessing an amazing sunrise

The protestors are already on the street and our car keys are snatched away. This time they don’t want the tourists feeling left out of the strike.

Transport modes available- bicycles and airplanes (contrasting indeed).
No map. No companion. No guide. I want to cycle away to my hearts glory.

Nepalese police escorting some vehicles

  

Scene3- Airport-Mad dash for flights

The travel agents inform that all flights-out are completely booked. We cycle to the airport.

Airport employeeX- “I can get you 2tickets to Kathmandu. What price are you willing to pay for it?”

Me- “Are seats available?”

X- "2 chairs add kardenge-batao chahiye ki nahi."

:O Willing to add chairs in a16-seater mountain flight??? No ji! We are staying!

Rented cycles for the day

  

Scene4- ‘Hiking’

Boat rented to Barahi Temple island in the midst of Phewa Lake.

Boatsman- “There’s a World Peace Stupa built atop the hill across the lake. Want to see?”

Weather- Beautiful-pleasant-sunny. I can see mountain-flights and paragliders in the sky.

Hiking up a mountain was never on my list. But, in Nepal- amidst the Himalayas, you cant say no. It was a small hill, but for me it was The ‘hike’. At every turn a beautiful view awaits!



Hike up to World Peace Stupa, Ate fresh wild berries on the way ('Kaphal') 

 

Way back downhill, cut to drastic weather change! 

 

Scene 5- A lake, a boat, and a rainstorm

(background music- thud-thud-thud raindrops like stones)

It is pouring. Just managed to walk/slide downhill to a lone café. Chat.

Momentary pause in the rain.
Boatsman empties boat with a cola can.
Row, row, row your boat... gently harshly down the lake!

Weather- The clouds are in no mood to stop crying. Stormy winds. Waves lashing at the boat.

Cut to flashback- Driver telling us stories about people drowning and not being found.

(My thoughts- ‘I don’t want to die, not when Iam finally a doctor. I don’t know swimming. I love you mom-dad’)

Sudden snap to present- “Get off. Quick. Get off the boat.”

We are somehow back at the temple island. Around 30sane people, 2goats and some crazy people under a small tin roof.

No idea of time.

In the distance, docked boats are taking off in the stormy rain and people are swimming against the waves to get them back- amazing strength in those muscles (mental note- workout!!!)

After we reached shore safely (by Canon in its final moments :()

 

Another momentary pause in the rain.
On our way to safe shores again. Another shelter-another wait-another chat session.

Finally the rain decides to stop playing around…

Drenched. Tired. With new friends. With a dysfunctional camera (RIP Canon. You were great). Yet happy. With a big smile. With a story to tell back home.

Bidding adieu to our friends for the day

 

‘A unlucky adventure in Nepal’ is what I would call this. Unlucky was what it felt like then. But, looking back at it now- it was a fun 24hours that gave me a story to remember forever.

This post is an entry for a contest by CupONation, an online retailer of discount coupons, and The Shooting Star travel blog. Thanks a lot guys for running this contest and making me revisit my journal.

Phewa Lake after it calmed down. Quote by Cesare Pavese.

Soulless??? (Scrubs Diaries 4)

Death is all around. More so in a hospital. I haven’t been in a hospital long enough to get used to death on a daily basis. I have only been a medstudent and an intern. Both are phases of a doctor wherein everything is new, exciting and adrenaline inducing. Yet… Yet, one would always remember the first death they saw, the first death they blame themselves for, the first death that could have been prevented, the first pediatric death. What is important is that one should also remember the deaths they actually prevented, the lives they actually saved. The balance of our memories is what will keep us sane. That, and of course friends (Twitter friends too) get us through.

 

Like Dr Cox says death is joked about just to distance oneself, to get by. The doctor needs to move on as soon as possible. The doctor needs to get past the emotional aspect of it in order to carry on with work, and in order to learn from it and if possible avoid the next one. Learning from every mistake is important. Mistakes in this field are fatal.

So, doctors do tend to seem soulless over time. But, that is only to preserve the soul they have.

No copyright infringement intended.

 

Dear Mr Armstrong

Dear Mr Armstrong,

I have never addressed a letter to somebody who I know will never read it. Not even to Santa. But, this time I wanted to get personal.

You certainly decided to go out with a BANG. And you got your way yet again by going on air with Oprah to confess. You had lost your career, your respect, your following. The only thing you could do now was confess in a way that made YOU the 'talk of the town' once again (rather the talk of the 'world'). You do love the attention, don't you? First, the race, then THE cancer, then being the survivor, then the doping 'allegations' and now the 'confession'. Well played, Mr Armstrong.

You could write another biography "Livestrong to Liestrong". You lost not just the letter 'v' but an entire battle. Cancer survivor- that's what I respected you for the most. I, like many others, cried and rejoiced with you while reading your life story. Story! Thats what it was- the story that was not just about the bike.

You could have been remembered as a survivor. But, no. Greed has no end, you went on and on. I am no cycling fan, and the only people I know in this sport are the ones mentioned in your book. That is how far your book reached.

I 'un'followed you on twitter way back. (That is the way a lot of us from this generation retaliate. Doesn't mean much but yeah- that's how we do it). I followed you again in the hope that you might deny it all. That all the allegations were just that- 'allegations'. But then you were banned, more and more people were talking. I realized that there is a truth in everything that was being said. Yet, we wanted to believe.

Why? Why couldn't you accept it before? Why couldn't you have saved yourself some dignity?

Seeing your interview, it seemed you were laughing at the world. You had the audacity to laugh it out. The process. The doping mafia. By laughing it out, you are mocking the entire world. You are mocking the fellow non-doping competitors (that you yourself refer to as 'heroes'), you are mocking the system, you are mocking the fans, you are mocking the media!

"Iam not the most believable guy in the world right now..." Well, you got that right, Mr Armstrong.

You do make us look ridiculous now.

Your definition of scary, scarier and scariest-
Scary- 'It didn't feel wrong.'
Scarier- 'I didn't feel bad about it.'
Scariest- 'I didn't feel I was cheating.'
That's not being scary Mr Armstrong, that's just being plain arrogant, that's being a jerk, that's being psychologically unwell.

"I didn't know the magnitude of people following me". Seriously??? Your book was a best seller. You had fans lined up along cycling tours and outside your tents just for a glimpse of THE Lance Armstrong. Livestrong was a success because of the very magnitude of your fame that you so casually dismissed.

Striking you off from my list. My list of the people I admire. I had long ago stopped believing you, but... But, there's always a but... And

'No there is nothing heroic about admitting you fucked up. That's taking ownership. Heroic would be deciding not to fuck up. Or at least try.' (Read somewhere)

Unfaithfully yours.