Stuttering Longevity! When to shut the tap?

A couple of years back, I had written a blog titled “Longevity bane or boon!” The link for the blog is given below.  In a couple of years, our thought processes change, situations change, more information becomes available. The present blog can be considered as an addendum to the old blog.

https://panvalkarpramod.wordpress.com/2017/08/02/longevity-bane-or-boon/

Last fifty to seventy years have seen life expectancy go up and up and up! Obvious reasons for this are better medical treatment, higher incomes allowing families to afford treatments for managing illnesses. Add to this better diagnostics and a better understanding of the diseases. Life has become interesting; knowledge about exercise and diets is also improving. All this has led to improved longevity.

But everything in life always has two sides. The sides are good and evil, rosy and dark. Like the pros and cons, we have a positive way of looking at things and a negative way of looking at things. One important aspect of humans is emotions. The human brain is supposedly more advanced than that of most species, and it is seemingly flexible in thinking. Hence we look at death and maybe death like situation, in a different way.

Are we practical in our thinking? Are we pragmatic in our thinking? In most cases, the answer is no! In the last couple of months, three persons known to me, between the age of 67 to 75, died “suddenly”! The 75-year old person was leading a bonus life as he had escaped the death a few years back, miraculously. Another person did die “suddenly” as we knew her quite well and know the details. She had normal health issues which never indicated she is passing shortly. Then there was one more “sudden” death! We never knew his “real” health situation, but he looked quite unwell about ten days back. I am talking about my neighbours from the condo where I lived for 35 years of my life! Out of the three, two looked normal, moved around or travelled unattended. They attended our society meetings and took part in the proceedings.

My point is would their close ones, or they have a preferred death after they got into full assist mode? Knowing them, I do not think they would have liked to live a life where they were dependent on someone else all the time. Am I talking of euthanasia? Yes and No! What is the point in being around in this world when you do not and cannot contribute anything? By contribution, I do not mean writing some stories or treaties. But live life with minimum assistance. No harm in taking help but if you need help like we help babies to grow, then it is not worth it. I may be a little blunt, and you may think I am crude and rude! But I am not, I am pragmatic! Would an “intelligent” human being like to live like a stuttering engine? Would someone splutter all the time and love to continue living? I don’t think so!

Sometimes, it is the near and dear ones who take decisions leading to such situations. Emotions take precedence over pragmatism. Medical practitioners take Hippocratic oath when they complete their degree. I am giving below the definition of Hippocratic oath!

The Hippocratic Oath is a symbol of a collective moral and ethical promise from doctors united in a singular purpose to bring healing to their patients. It is named after Hippocrates, a Greek physician who was born in 460 BC.

This oath ensures that the doctors try their best to save the life of the patient who has come to them for the treatment. The oath in today’s times becomes a double-edged tool. Many times it so happens that patient is taken in for condition A and then condition B evolves. Since doctors are under the Hippocratic Oath, they try different drugs, procedures and support systems to keep the patient alive. At this point, the moral dilemma starts. How much intervention should be done to keep the patient alive? What aspects should be pondered until the decisions are taken? Doctor’s Hippocratic Oath is on one side, the family’s moral conflict and trauma are on the other side! These two conflicting thoughts clash. In real life, they don’t clash. The family tries to decide in such a way that life is not lost, though it is hanging by a single thread!

I remember an incident many years back shared by a doctor with me. A friend called him early morning for advice. The person’s father was in a hospital, all of 88 years of age. He was kept alive by use of a ventilator for a month. Hippocratic Oath and commercial side of the hospital wanted to continue the treatment. The prognosis was weak, and doctors had said that without ventilator the patient would die in 24 hours. The emotional turmoil of the family was not allowing practical decision. The friend finally decided to remove the ventilator. The old man died in 12 hours. The friend was caught in an emotional whirlpool for a lifetime, thinking “I am responsible for the death”!

What is the right age to allow someone to die without intervention? How does one know that the health condition is irreversible? How to know when to let go?  These questions arise, and they need to be answered. Else one may see a top-notch professional, a top-class cricketer or a dashing prime minister of a nation being kept alive in a condition which is traumatic even to know!

Discussion brings one to the good old question of who should look after whom? In the ordinary course of time, parents look after the children once they are born. They are looked after until the child becomes independent. When does a child become independent? Do we have an answer for that? When life expectancy was low, humans would support their children for almost 35 to 40 % of the child’s life span. In other species, this support could be there for about 10 to 15% of their life span. Is this an advantage or a disadvantage? To me, it is more emotional. Because of low life expectancy, the children did not have to look after their parents. Nowadays it is common to have “children” who are 50 and parents around 80. Is it children’s responsibility to look after their parents? This thought goes against the basic thinking of how we want our children to be!

Yesterday at a mall, Rhea and I were going to an escalator. I jokingly told her that I am not very confident about using the escalator. She “taught” me how to do it! That is how she has been brought up. I had a similar anecdote with my grandson Suyash. He was 2 ½ years old. I was seeing him for the first time;  we went to the escalator he simply said, “I want to go up”!  He did.

Confidence with which the children and grandchildren are brought up, the things we teach them are done for a specific reason. We want them to try to do better than what we have achieved in our lives. We want them to become better persons; we want them to become global citizens with no limits. Then we become 80, do we want them to come where ever we are living, to support us? In India, systems for handling old people are still evolving. Society will find a way of doing these things. What is the point in restricting the career path of children so that they can look after us in our old age? The same question again, what is old age? When does one reach that age?

In conclusion, I can say that each individual handles life in a certain way. There can be hired support or system support. But it is not correct or mandatory for near and dear ones to give up everything whatever they are doing, to help parents in old age. The simple reason for this is we don’t know how long the help will be needed. But I am quite sure that the near and dear ones will shed a tear or two when one is gone; they do not need to feel guilty for not being around.

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Dental Gum!

For this blog, I have used the title as Dental Gum (गम in Hindi). गम in Hindi means sorrows. People usually connect dental treatment with fear, pain, and sorrows. First, let me make a disclaimer or two. 

  • My daughter Priya is a Pediatric Dentist 
  • I had my first dental treatment at the age of 65, that too because I went through cancer treatment and had 34 radiation sittings. I was treated for dental caries. 

I somehow have the feeling that a person’s dental health quality is hereditary! My grandmother could eat raw mango (Kairi) easily in her eighties. I have the same ability, but I have a way to go.  

I chose the subject because I read an article about horror stories about dentists, in the US. Well, as in any field some people do not follow the ethics and can be called black sheep. Making a general statement about any whole group of professionals is incorrect. But not that I am not going to tell any horror stories (as I have taken dental treatment only once), but I will share with you some anecdotes shared by Priya with me.  

First things first, I have been brushing my teeth only once a day, I don’t do any flossing. I have never used any special brushes or toothpaste. I have had my share of chocolates and ice-creams, colas and candies. I have a sweet tooth, but now I don’t consume these things. So my heridetary theory should be ok!

Once I asked Priya about her young patients. I asked her, “How tough is it to handle the kids on the  chair?” She said, Baba, once my patients get confidence about me, they are straightforward to handle. It is their mothers who are difficult to handle. 

I am going to share anecdotes about patients, their parents, general situations in dentistry. Sometimes it is funny, many times it is surprising, but probably human behaviour remains very similar in different situations.  

Priya was treating a fouryearboy. He was very cooperative, but sometimes he needed a kid-glove treatment, pun, of course, is intended. One day he came inside, goggles and all; a la Salman Khan. He was a big fan of Salman. He came inside, sat on the chair and Priya started the work. After about ten minutes he signalled to Priya to stop. Priya stopped and asked him the reason. Without replying he indicated her to allow him to get down from the chair. Priya complied, he got down. He put on his goggles, put both his thumbs in the trouser pockets. He danced to the tune of the Hindi song, “Hud Hud Dabangg, Dabangg; after a couple of minutes, he stopped, climbed back in the chair and signalled Priya to restart the work! 

Some patients are too busy to take their kids to the doctor. There was one such lady, the same age as that of Priya. She always claimed that only time she could get her child to the clinic was 8 pm on a Saturday. After all, she was in IT. She would always tell Priya how difficult it was in IT and so on. Once the lady came almost twenty minutes late for the appointment and Priya had her next patient in another clinic. They met on the staircase; the lady started her usual dialogues of being in IT, but her hands were full of stuff bought in the malls. Priya apologised and said that she could not treat her child as her next patient was waiting at another clinic. The lady was upset, and before she could start her diatribe, Priya told her, “Look, I am a doctor, and I don’t know anything about IT. But let me share some personal information with you. My mother is handling Nvidia operations in Pune, my father runs his software business for the last 15 years, and my elder brother is working in Microsoft at Seattle for some time. So, there is a possibility that I may know a few things about IT, by induction. One more thing, when I was a child, my parents used to take me to doctors, whenever it was needed, without bothering about time and the day. Thank you!” The lady never spoke about IT stuff with Priya again. 

One lady came with her child. The child was fitted with a crown, and the child was not supposed to eat chocolates for obvious reasons. While eating the chocolate, the crown came out and was misplaced. Priya told her, “ I had told you not to give chocolates to the kid. Why did you not follow instructions?”  The treatment was done, and the crown fitted again; when she was asked to pay the money, she simply refused to pay saying that it was Priya’s fault, chocolate was incidental. Priya let her go and instructed her team not to give an appointment to that patient again!  

The next episode could be an incorrect diagnosis or was it the socalled horror story; I am not sure! I felt that it was a case of the wrong diagnosis. An eightmonthold child was brought to the clinic; Priya was surprised, as generally such small babies rarely have any teeth. The mother told her the following story. A couple of days back while the mother was cleaning the babies mouth, she saw a gold tooth in the baby’s mouth. She took the baby to three or four doctors, and all of them said that the gold tooth needs to extracted; treatment needed to be done under general anaesthesia. Since the baby was very young parents were not too keen about the procedure. Somebody suggested to them Priya’s name, and they came to the clinic. Priya looked at the child and saw what was inside. She had a small instrument in her hand. She put the instrument in the babies mouth and plucked the golden “Tooth”; it a piece of gold that was stuck in the baby’s gum. Out came a small earring. Priya gave it to the mother. It was the mother’s earring; she had never realised that it was missing. Somehow it had fallen and went into the baby’s mouth and became the “Golden Tooth”! The tears of joy came in the parent’s eyes! The father asked Priya “Doctor what will be the charges?” Priya said, “No charges; I am happy that I could do this without any anaesthesia”!  

How trial by media can affect a professional career can be seen in the following anecdote. A child was being treated by a dentist. He checked up with parents if any medicine was being given to the child. The mother said that they were not giving any other medicines. The doctor gave the local anaesthesia and started the treatment. After some time he felt that the child was becoming listless. They rushed the child, to the next door paediatrician. From there they rushed to the hospital. But the child died. The trial by media started; the newspapers showed the doctors name and the photograph of the clinic. The baby’s parents gave statements and hid the fact that there was another treatment being given to the child! The medical council did its investigations and in the end, found out that the dentist and the paediatrician had followed the correct procedures. But all the media trial and photographs in the newspapers made life very difficult for the dentist. He left Pune and moved to another city!  

Friends, life can be exciting, rewarding and tough at the same time for professionals. But some times, one loses control over the situation, and things do get haywire. Customer is always the king or a queen; the kings and the queens also can go overboard and need to be told so. But at the end of the day, professionals have to remain true to their profession and continue to perform! Don’t forget to show the smiling face, especially when a child is being treated.

 

Back to Nature!

My friend Anjali made a beautiful comment when she shared her observations about nature. On a WA group, there was some discussion about the bird Swallow. She said, “You may not see them much in Mumbai as we rarely watch open sky in Mumbai. But I have observed them in Pune and Vadodara. Swallows nests are art by itself, the way they create them. There are many birds which I have seen sitting on the parapet which reminds me of my childhood.” 

Thanks, Anjali for taking me back to my childhood in Mumbai and Pune. Even Mumbai in those times was leafy, and Pune is still quite green. Over a period, some trees were required to be uprooted in Pune for redevelopment, but many new ones have been planted. We humans tend to forget the nature in our rush to live! What does nature do to your persona, your mind, your stresses? I go for my daily walks. My preferred time is 5.30 in the morning. In winter, I do not hear any activity of birds as Sunrise is away. But now with the onset of summer, one hears a lot of chirping going on. Probably Moms are waking up the kids to get ready for school! I walk a treelined path, and by the time I end my walk, my body is fresh due to exercise. In my mind, I feel as if I am in heaven as I see the different shades of greens, summer flowers and listen to the songs of birds. All this is accompanied by a cool breeze Modern young fellow humans walk with the earbuds and are busy listening to music or talking to someone on the phone. Once I had the opportunity to speak to a young lady when she stopped to check what was wrong with her music system. I asked her why does she not listen to God’s music in the form of birds chirping? She gave me a look which meant, these oldies …. 

When you are nearer to nature what is the effect? The research tells us that when people are exposed to the natural environment and natural features, they tend to have a reduced stress response. When you are out in nature you have lower blood pressure, better heart rate variability, better mood. 

Research also says that the significant change that happens in our mind is in the first five minutes. Later changes are incremental. Working people have higher levels of concentration and lower strain in the afternoon if these people take a walk in the gardens during their lunch break. It may help employees in replenishing the resources needed to perform well on the job during the remaining working day. 

The idea that nature is good for us has been gaining ground since the 1980s. First came the biophilia hypothesis, the theory that humans have an innate desire to connect with nature, followed by shinrin-yoku, the Japanese concept that absorbing the atmosphere in forests can benefit your health. Researchers of shinrin-yoku have since identified plenty of physiological and psychological benefits, while globally studies suggest time in nature can restore our ability to focus, increase creativity, lower the risk of depression and even help us live longer.     

Then are we waiting for some enticement? Why don’t we at least try to spend some time with nature regularly? One can always argue that it is impossible to do it when you live in cities. But I don’t agree with this at all. This interaction with nature does not cost us anything. I can understand that people are busy with work and do not find time for such activities. To me, it is about setting priorities. Try and find out huge banyan trees that are there in your city, go just see them. I am sure there will be at least one water body like a lake or a river where you live. Just go and sit there. You need not do anything. It is exceptionally soothing to your mind, to your ears to listen to the flow of water. If you try to make it one day picnic on the weekends then you may not get much time, there are other things to do weekends. But make a quick trip to gardens, lakes or walk on leafy roads. Make before the traffic starts.  

These are tree house and Manali photos. We have taken such breaks with nature in the background and found them very stimulating. Last year we took one week holiday in Manali, and it was serene. Snowcapped mountains, cool breeze and Sun not too bright. It was a blessing. Three years back we went to Brisbane, Australia. One hundred km north of Brisbane was a tree house resort. Jaya and I went there with one of Jaya’s classmates from her school days. We just hung around in the area which was full of tall trees. One day there was torrential rain, and we could not go anywhere. We enjoyed the onslaught of rains, cards, movies and reading! It was accompanied by cups of tea with rain pouring in the background. 

If your work involves sitting in front of a screen all the time, walks on the paths surrounded by the tree are going to be beneficial in two ways. First is the obvious one, walking and second one is the green surroundings cooling down agitation and stress in you. Even though  such a simple solutions are available we tend to ignore them; instead we end up going to doctors for treatment for backache and anxiety or stress.  

There’s also a lot of work done on the psychological benefits of being in nature – on wellbeing and cognitive functioning. In general, people are happier when they are closer to nature. Happiness is a broad concept, and so we measure things like positive and negative emotions, people’s sense of vitality, being energised and also how satisfied they are with life. When people are immersed in nature, even in urban nature, they tend to have more positive emotions and vitality than when they are indoors. 

These are Nainital photos. Being with nature regularly can be compared with sleep or a power nap. When you go for a walk during lunch break in the garden, it is like taking a power nap. Going out on weekends can be considered equivalent of trying to sleep for eight hours a day. Both are equally effective. A holiday in natural surroundings helps you making up for sleep deficit!  

These are some of the photos from the area near my house. I am sure there are such areas in each city. You need to locate them and start using them.

 

 

 

 

Mediquettes!

Mediquettesis a term coined by me. It is the combination of medical aspects of life and etiquettes to be followed therein. In recent times, life expectancy has gone up. With the increase in life expectancy, people fall sick more times in their lifetime, than they would have, even 70 years back. People died much earlier in those times compared to today. Hence people were taken to hospitals less frequently. Now we are regularly required to meet a relative or a friend who is being treated at a hospital.  

There are etiquettes to be followed during hospital visitations or when we go to meet the persons taking treatment at home. To me, the protocols are to be followed by visitors as well as the medical fraternity. With an increase in life span, people face various illnesses which were not prevalent before. The treatment and the support needed in some cases are quite extensive.  

I will share my personal experience when I went through my cancer treatment five years back. I had to undergo 34 radiation sessions. My oncologists had told me that I would have a problem swallowing, after three to four weeks of radiations. Hence a feeding tube was inserted from day one through my nose to the stomach. After about four weeks, I had to take formula food through the feeding tube (8 feeds a day). Jaya had to handle this with some support in between from Sachin and sometimes Priya and Ashwini. Each feed required an hour, including preparation and cleaning, and there were eight such feeds every day. On top of this our granddaughter, Rhea was two months old; her feeds were also to be managed. Things became very hectic as Jaya had to coordinate other stuff besides my feeds. We took a decision not to receive any phone calls. We informed people that we could not receive phone calls. Most people understood that there must be a hectic schedule; hence calls were not answered. But some people were upset and said so. We informed as many people as possible by mail or WhatsApp messages. 

The first etiquette we all need to follow is to give family space and time. Don’t pressurise people by going to meet them. When in the hospital, there are hundreds of things that need to be tracked. Sometimes staff forgets to give medicines, other times they don’t come on time when the patient needs support. When a patient is in CCU/ICU, we should never go to meet them. In many hospitals, now they don’t allow visitors to meet such patients. If someone has undergone surgery, give the patient a few days to recover before going to meet them.  

WhatsApp groups have created an awkward situation. When alumni groups form, we get in touch with friends from olden times. But at my age, a lot of water has flown down the bridge. We interchange, share posts with each other. We start thinking that we know friends very well. But there are many friends on the group, whom we have never even met during college times. They become our fair weather friends now, because of their alumni contact 

A few of our friends are undergoing treatment for paralysis. In paralysis, physical functions get challenged, and patients physical activity gets restricted. In such cases, some of the patients do not like even close friends to come and meet them. Since WA groups create an atmosphere of camaraderie, many people who were unknown even in college time, go to meet the patient. Such an act is forcing something unwanted. Avoid it. Instead, try to communicate with the spouse and ask if some help is needed and give it when required. 

Some people do not know how to counsel people. In their enthusiasm to help the patient, they share some examples in which the patients worsened or died! Such instances put the patient in a sombre mood. Instead, one should hold a hand and maybe, say nothing.  

Many a time people take some food with them; avoid it. If the patient does not have a separate room, then it can become difficult even to store foodstuff. Patients generally eat food decided by the treating doctor and served by the hospital. One can take the person supporting, for a cup of tea to reduce that persons stress. Sometimes that person may want to share somethings, but the person cannot discuss such things in front of the patient. In the case of paralysis, sometimes the treatment and support are needed for a couple of years or more. During that period the persons whole family is under duress, jumping from one therapy to another, trying something different. Giving them space becomes essential rather than only meeting them. Try and take over a session or two of support, if you can. That is more helpful.  

Medical fraternity and overall hospital systems are under terrific pressure all the time because, during health issues, family members do not understand the intricacies of the treatments. They keep on probing and pushing for more information. Most of the staff and doctors manage smiling faces. But it is not easy. Medical fraternity must understand that the very nature of their job needs them to have a smiling face all the time. But many times it does not happen.  

The instructions to staff are very vague, sometimes. A patient being treated for a severe migraine attack needs peaceful sleep. But other than doctors, many people keep on disturbing the patient. Cleaning team survey team, counselling team and the list goes on and on. Every 30 minutes someone will come and make noise, put the lights on, ask the sleeping patient if she is sleeping well! Come on use common sense!  

The billing process in hospitals is one of the most distressfull methods that creates stress. Whether you are paying cash, or you are covered under cashless medical insurance, they take at least 2 to 3 hours to process your bill. I have seen an accounting staff from the hospital, soliciting the patients relatives to pay cash and the claim the payment from the insurance!  

During my treatment for Cancer, I was given a drug intravenously every Monday. It cost around Rs.6.5/ lacs. The company supplying the drug supposedly provides eight doses at a time. My body could not take more than five doses and then that treatment was discontinued and the primary purpose was served. Balance three doses, worth Rs.2.5/ lacs remained with the hospital; we suggested them to give those doses to the needy when required. No needy patient has yet turned up, even after five years! Ordering more than necessary according to me is a great shame. 

Recently, I came to know the story of a person who died. He had a heart condition and was fitted with the pacemaker. After death, the hospital staff said that they are removing the pacemaker and just took it away. 

Hospital stories can go on and on. In our culture, we feel forced to rush and meet someone who is unwell. This creates an overload on the whole medical system. The crowds that we see in hospitals are unmanageable. Medical fraternity needs peace of mind, and the patient and his supporting team of friends and family need space. We should help to create an atmosphere which will be beneficial for all. I have not touched the subject of children living in foreign countries when their parents fall sick. It would be a subject for a full blog!

 

 

 

Emotional Turmoil!

While writing two blogs about my friend Prakash regarding the major catastrophic event he and his family had gone through, I never realised the emotional turmoil I was going through. My endeavour while writing is always to make the least number of errors, both grammatical and factual. For this purpose, I had to refer to the book written by Kavita about the event, a few times. Every time I skimmed the book, the reading process did some more churning in my mind, as I read a few paragraphs. The pictures of what the family had gone through kept floating before me.  

Today’s blog came up as I read a news item in today’s newspapers, which rekindled the old memories and reminded me of the story of another friend. This story is again very touching! This friend of mine was a friend from my Bombay days. We were neighbours, he was one-year senior to me. As was typical of those days, we spent evenings playing tennis ball cricket on their terrace. He came from an upper-middle-class family, had a well-appointed home, went to a convent school. These things of course never came in between our friendship; honestly, I never realised his financial situation in those days. His father was our family doctor, so when the doctor was at home, we would be a little under pressure! The friend was ever smiling, but he was not what can be called as a mixing type.  

As so happens, we lost touch around the time when I was in tenth grade. A few years later, I moved for my engineering course to Pune. One of my classmates had also moved to join the medical curriculum at Armed Forces Medical College (AFMC) in Pune. Once when we went there to meet my classmate, I bumped into this old friend, who was also learning to become a doctor. Our friendship was renewed, and we kept in touch intermittently.

As our education was getting completed, I heard that he got engaged to his classmate. I was so happy for him. Then came the news, later, that they had broken off! Later on, our friend went to England and settled there. Another 45 years passed as we again had lost touch. Once I was scanning the Facebook and searched for my friend and lo! There he was! I sent him a private message. I, of course, called him by the nickname from childhood. I shared my email id with him.  

A couple of weeks later, I received an email from him and was I happy! He said, “Pramod, it’s sheer luck that I got your message on Facebook; I was about to close my account on Facebook.” Then he gave details.  

He became a surgeon and lived in Northern England all his life. It appears that he did not travel much to India. He did quite well financially. He did not marry, he never explained hence I never asked. Then he was reminiscent about Bombay days. Our school days full of tennis ball cricket in the evenings. When it became dark, we would chat about everything in the world, until we were called home. Our email exchange continued sporadically, and we became comfortable with each other.  

Then in one of the emails, I shared with him how I went through Cancer treatment, end of 2013! Since he was a doctor, I shared with him as many medical details as possible. His reply was very positive and helped me to understand some more things from a medical perspective. I was surprised by his in-depth knowledge about cancer. He was a surgeon, but he was not an Onco Surgeon. From his next mail, I understood the background about his depth of knowledge. He had also suffered cancer of the throat region and had gone through massive doses of chemotherapy. Then he revealed a piece of very shocking information.

He wrote, “Pramod, after taking treatments for a few months, one of my doctor colleagues (who was my Onco surgeon) had a “doctor to doctor” talk with me. He said that the chances of my surviving beyond six weeks were remote. Why don’t you inform your family?” From what I knew, he did not have much contact with his family.  But he also wrote, “At the end of one month, a procedure was done. Suddenly after that procedure, my health started improving. The doctors have now removed me from the critical list and my current status at this time is “managing cancer”. I may require chemo once in a while as sustenance dose.” 

Well, this is not the story! The story started after this, at least for me! He once informed me that he was coming down to Pune for his medical college reunion. I was thrilled, and I said that we should meet. I told him, “Taj Blue Diamond will be the convenient hotel for you!” He said, “Pramod, there is one issue that I have not shared with you. When I was told that my days were numbered to six weeks, I got my lawyer and liquidated my fixed assets quickly, and I had substantial liquid money too! I organised and distributed 90% of assets to charities. Kept about 10% for unseen expenses, if required, after my death. Now with my health improving, I am seriously short of funds, but luckily, I have a pension! So, I am managing somehow. I came to know about this reunion and decided to attend, probably my first and the last one! So, staying at Taj is out of the question!” 

I thought, Oh, my god! How has this happened? He had many expenses, but luckily his most medical costs were covered under British Medical System. But overall, he was going through tough times. Other than his pension, he had no income. What turn can life take!  As he was past retirement age and in ill health, he could not work again.

This story again put me in severe turmoil, my mind was churning, and I did not know how to handle this. There was no way I could pay for his stay in Pune, he just would have refused.  

There is another twist to the story. I knew the dates for my friend’s stay in Pune. He had said that he would call me when he came to Pune. He did call, but somehow, I missed the call. During that period there were many phone calls to me from unknown numbers. So, I wrote him an email. He wrote back to me saying that he was sad that we missed out on meeting each other in Pune. He was back in England.  

After this episode, the frequency of our communication has dwindled down to a trickle; this has nothing to do with missing each other in Pune. My last couple of emails have remained unanswered. I must find out about our friend, and I hope that he is doing alright.

I am still very uneasy! Emotional turmoil continues!

Prakash Nirgudkar, the ever smiling Buddha! Part II

This is the part two of the saga my friend Prakash Nirgudkar went through. The link for the Part I is below. 

https://panvalkarpramod.wordpress.com/2018/12/21/prakash-nirgudkar-the-ever-smiling-buddha-part-i/

Pensive Prakash

PakyaPhoto2

What is destiny? What is the definition of destiny? Prakash’s story is what destiny is all about. Destiny took Prakash through a journey which he may never have imagined when he left Pune for the trek in September 2012. At the same time the doctors, the family members were all the time hoping against hope that Prakash will overcome this illness. It was Kavita’s destiny that she was to win the impossible battle. It was the doctor’s destiny that they were supposed to cure a most difficult case. The destiny to me is crossing of destinies of various people, some of your dear ones and some unknown to you!

Prakash is made of different stuff is now taken. On a personal level, I feel that Prakash is nothing less than Havaldar Abdul Hamid, Captain Batra who fought the war for our country and won the battle against all odds! They were honoured with Paramveer Chakra! Prakash is nothing less than that. Prakash’s family background is very normal with various professionals, including him, who did well in professional life. But from where did this special trait blossom out? I am sure it was hidden in him all the time and but he never had to face such a tough situation in life where his indomitable spirit was tested to the limit.  

Healthy, hale and hearty Prakash left Pune in September 2012 but when he came back to Pune, was taken straight to a hospital for further treatment fighting the toughest battle of his life! Pune doctors had the advantage of knowing details of what Delhi doctors had done. They took over seamlessly. But life for Kavita and Nandita continued to remain tough as there were continuous ups and downs. The only advantage was that they were in their own city Pune. Going home was distant as Prakash was far from normalcy. Every day and sometimes night would come up with a different twist in the story. Kavita had decided to stay with Prakash in the hospital, would go home very rarely. Homefront was managed by young Nandita. 

The first aim of the treatment was to remove the infection completely and increase Prakash’s strength! Any procedure or surgery was accompanied by extremely severe bouts of pain. This was accompanied by strong Anti-biotics and painkillers! Trauma took him one step backwards after every surgery but Prakash is the epitome of a person who appears to have reached Nirvana. Of course, he must have felt the pain but how he could bear it without showing any emotions is one thing even Kavita may not be able to explain. This is one aspect of the human attribute which is always difficult for me to understand. Where is this power hidden? How does it come out? Where is the trigger for that? Natural human tendency is to squirm when in pain, and howl when in extreme pain. Pakya, tell me one of these days how you managed that! I feel that this is internal training and gift from HIM! 

Two major things that had remained to be done were curing the toe injury and rebuilding of the right hand. For me, it was simple, “rebuilding of hand”! But what did it involve? Since the arm was in a fully exposed state, to rebuild it in a step by step manner was an ordeal! Planning the surgery also must have been tough because things look different on paper! Doctors had decided to rebuild his right arm after the infection was gone. They decided to do the skin grafting by removing the skin from the thigh and groin area. This was an extremely delicate procedure handled skillfully by the Pune Doctors. The family and Prakash had to undergo the same pain and trauma during every surgery. 

In between, Prakash was allowed to go home. Taking Prakash home was also a major event. The complete home had to be cleaned and thoroughly disinfected as Prakash’s immunity was very low. But I am sure going home after the great trauma must have helped the spirits of the family!  

Such major health events, being treated over a long period of time has its own problems. At one stage the doctor who had performed all the surgeries in Pune was on a holiday for about three weeks. Prakash started having issues with his toe injury during this period. Kavita took a decision to see another doctor; he was competent. But doubts started creeping up if the decision to see another doctor was correct. Since the main doctor was away for a long duration there was no choice. Minor surgery on the toe bone was done, successfully.  

 

There remained many such complex issues and had to be tackled. It is simply unimaginable how Prakash and Kavita handled these repetitive but new issues. I am sure that the whole family was always operated on reserve energy because it was always a small period of peace, followed by something or the other which caused and took them into a vicious circle of operation/procedure, followed by a couple of days of anxiety, followed by the dressing of the wound.  This is like running a marathon, one after another, with almost no break! 

The last and the most complex part of the saga was the final stage of the restoration of Prakash’s right hand. He was in better health and was responding quite well to procedures. In the last major operation, after completing the surgery, his hand was stitched to his stomach; it was held in that position for about 25 days. This would help proper assimilation of the graft with the whole body! Being around in such a position for 25 days is something impossible to visualize. After the hand was stitched, putting Prakash in bed from the gurney also became a complex procedure!  

It is now almost five years! Those who do not know what Prakash had gone through, would never know that he has come back from the brink of death if they meet him. He is now busy doing normal things in life and takes life as it comes. (Narmada Parikrama trek was one such activity! That is Prakash for you!) Kavita and Nandita also have gone through a major stressful period in life! But I am told that ladies handle the stressful situation much better than men. They are more expressive and men generally go into a shell during extreme stress! Finally, Nirgudkar family is back to normal life. 

Prakash, I consider myself lucky and proud that we met many moons back and became friends! I am sure we will continue to meet and share the life’s experiences and stories, and remember our COEP days, of course I am talking of Metallurgy! In case, any one of you want to get in touch with Prakash, do write to me!

This blog cannot be complete without the slide below. 

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Jack of All Trades!

Jack of all trades and Master of none is a figure of speech that has been very famous for a long time. Since I am not an Etymologist, I had to work hard to understand how this figure of speech came up. 

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The shortened version “a jack of all trades” is often a compliment for a person who is good at fixing things, and has a very good broad knowledge. A “Jack of all trades” may be a master of integration, as such an individual who knows enough from many learned trades and skills to be able to bring the individual’s disciplines together in a practical manner. This person is a generalist rather than a specialist.  

There is also a longer version “Jack of all trades, master of none, but oftentimes better than master of one” which refers to a person who is not the best at all skills, but is better than someone who is only a master of one.  

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The “master of none” element appears to have been added later; which made the statement less flattering to the person receiving. Today, the phrase used in its entirety generally describes a person whose knowledge, while covering a number of areas, is superficial in all of them. When abbreviated as simply “jack of all trades”, it is an ambiguous statement; the user’s intention is then dependent on context. However, when “master of none” is added this is unflattering and sometimes added in jest. 

Over the last fifty years, things are going in the direction of specialization. I am told that in the medical field this specialization is quite deep. General Surgeons, Orthopedic Surgeons was the initial norm. Now we have Surgeons for different Organs. We have Spline Surgeon or maybe a Spleen Surgeon. We have Knee Surgeons and we have Shoulder specialists. In dentistry now we have a Pediatric dentist and Implant Dentist. We have experts for our 7th tooth and so on. What happened was that these experts got themselves trained in specialities and later they became such experts that they continued to work only in their specialized areas. Don’t be surprised if you have an expert surgeon who works only middle finger of the left hand!  

But all this is likely to change over a period. At the same time in the times of super specialities, there have been generalists who have done well. There are certain areas in life which need the human being to have knowledge of many things. Super specialization occurs when humans work with their own hands, or they do research in a very specific area e.g. molecular biology. But there are many general-purpose work areas which need cross-functional knowledge, leadership, understanding of commercial aspects. (I have just mentioned a few disciplines.) A superb knee surgeon may not be able to run a hospital. A nerdy computer expert like Steve Jobs came up with fantastic products. But Apple as an organization was way beyond him, though he was one of the founder members.  It requires deep knowledge of the area in which you are an expert, but you need to get the ideas on paper, converted into reality. The specialist may not be an expert in getting these ideas to become a commercial success or be able to convert it into a publicly usable product.  

A new concept is already on the horizon for knowledge of those like you and me, but it is existence since last 10 to 15. But now it is discussed more openly. It is an idea of making use of Supercomputing power, Data Sciences as powerful tools which will help humans to cross new boundaries. How will this happen? In which area could this happen? What are the views of experts?  

Human biology is one area where the impact could be the maximum. We have had great thinkers, great designers in history but to me, HE is the greatest of them all by miles. Human body is a real complex design made by HIM! We have now started understanding many things about humans, the functioning of the human body, diseases, repairs and so on. Ageing of the human body is one area where a lot of work is being done. Why does a human die other than by diseases, accidents? The main reason is old age. Though ultimately the death could be because of heart failure, kidney failure, liver failure; but generally, the reason for death can be described as multiple organ failure. As we grow in age, things start going wrong.

Let us understand how the word “Age” is used. As a noun, it means “the length of time that a person has lived or a thing has existed.” As a verb, it means “grow old or older.” So, when we Age, as in the verb, our body also ages, its functions slowly start diminishing. One area where humans have always been fascinated is overcoming death. Immortality with aged organs, bent back, poor digestion, joints creaking, not able to see and hear properly will be meaningless. Hence there is a lot of research going on in the area of overcoming death and consequent research in the area of reversing ageing of our organs. We already know that knee joint and hip joint replacements are reasonably common surgeries. Some heart replacements are taking place but are not very common.  

Imagine the new Ashwathama who never dies,  having a weak heart. I am sure that there is research going on somewhere to make an artificial heart at a reasonable price. Will this be made by a heart surgeon? Will this be made by a hydraulics engineer? Will it be designed by an electrical engineer, as heart gets electrical impulses to keep pumping on and on! To me, this person will be a generalist or a jack of many (if not all) trades but may be master of none. That entity has to understand hydraulics for a heart pumping, medical knowledge to understand the concept of what heart does and an electrical engineer to understand impulses. (I have considered only a few areas for the purpose of discussion) This generalist will also need to have good computer programming knowledge required for simulating the concept of an artificial heart. 

Jack of all trades term said in jest can become history. You need a jack of all trades. The knowledge of how the huge collected data can be processed using data science will also be useful! Are we talking of a Superman? Are we talking of a “Super specialist Generalist”? Is it already getting complicated? But to overcome the Yamaraj (the god of death) humans need to work hard, work smarter. It is definitely not a job of a super specialist but a super generalist!  

In the medical field, results of the Jack of All trade concept has become commonly known to us. Knee joints, Hip joints, putting stainless rods in place of bones, words like Stainless Steel and Titanium have become common. This is a language of a mechanical engineer and a metallurgist! Then there are teeth implants! Use of Gold in dentistry is quite common for years! Scattered usage of such combination of expert generalist has been happening for quite some time. 

But AI and supercomputing are going to give a real boost to such efforts as these are powerful tools. AI is self-learning as it can learn from historical data generated, as the project progresses. What will Immortality project involve? To start with, stop ageing of your skin, a 150-year-old person would also like to have young looking skin. Then stop the ageing of joints! Revive heart function, revive brain function and so on. This means the whole-body function will need revival. This will involve more generalists than having super specialists! Combination cross functional knowledge comes into picture. 

So, stop calling “Jack of All Trades” to someone in jest! That is going to be the need of the hour! Do you know who can replace the super specialist? It can be Robot made by Super generalists! Amen!

To me the best example of Jack of All Trades:

JACK OF ALL TRADES

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MASTER OF ALL