Hats Off!

I read an article about a song and dance program held in Cipla Center of Palliative Care, in Pune. The article was written by the lady who was the main performer. She knew that this centre gives palliative care for Cancer probably terminal patients. The program was for the entertainment of these patients. She was apprehensive as she had never done this before. She was wondering how these patients will accept her program. The program was to create the joyous atmosphere in these patient’s lives. She reached the venue and the hall started filling up with patients. Some walking in, carrying their own drips, some coming in the wheelchairs. Then a few beds were brought in. The lady was awed by what was happening and she did not know what to expect. Patients were brought in to the arena on gurneys and transferred to their beds!

The program started and the rhythm picked up! Some of the patients started blowing whistles, as is the tradition in Tamasha songs. People started clapping and shouting. The peak of the show was when one of the lady patients, lying on an inclined bed started moving to the rhythm. She was very ill. She was wearing a Saree. In her bed, she did some sensuous movements using Pallu of her Saree! What courage? What attitude?

Here was a lady, very sick. Maybe terminally sick and I am sure she knew it! But she was not only enjoying the moment but her attitude must have given encouragement to other patients. It is such people who make this world a great place to be in! These people are the beacons of society. The lady did what was unthinkable though at the back of her mind she must have known that these were her last months on the earth. How do such people have the courage to look death in the face? Yamraj must have thought after tracking her activity, why not keep this lady on this earth for a longer time and make earth a better place! I am writing this based on the article written by the performer. I do not know anything about the lady but I feel like getting up and to go and give the lady a hug! Hats Off Mam!

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We have read about historical accounts where people have reacted bravely knowing that their action would result in an imminent death for them. The battle of Sinhagad fort during Shivaji’s time is the classic case. Tanaji and his cousin Suryaji attacked at night and climbed the treacherous fort using ropes. In the battle, Tanaji died and Suryaji took over. The soldiers panicked and started to run back towards the ropes. Tanaji’s uncle Shelar mama cut the ropes. Soldiers had no option but to come back and fight. Marathas won that battle. Shelar mama took the action of cutting the ropes thereby he took a grave risk where his own life was also in danger. He knew that they could lose and that he would surely get killed. But he was not afraid of this eventuality. He took this decision knowing the grave risk to him. Such people make the armies that win the battles. Picture of Sinhgad Fort below.

Sinhagad

There was the similar battle of Pavan Khind. Shivaji Maharaj was trapped on Panhala fort and decided to try and escape to Vishalgad. But his escape was found by the enemy quickly. They started hot pursuit to capture Shivaji. Baji Prabhu Deshpande suggested to Shivaji to move further and waited at Pavan Khind which was a narrow pass. He fought with a small army and fought the enemy till Shivaji reached Vishalgad. When Shivaji reached Vishalgad he ordered two gunshots to be fired as a signal of safe arrival, to Baji Prabhu. Baji Prabhu though was severely hurt fought valiantly till he heard the signal. His death was imminent but still, he volunteered to save Shivaji. Painting depicting Pavan Khind battle.

PawanKhind

Next is one example which gives me goose pimples, even thinking about it! This is about a friend of mine Prakash. He is a happy guy but I never knew that he was made of steel! Rather his mind was made of steel, his body was not! He has been trekking and used to travel all over India. After completing one of his treks, he was returning to Delhi to fly back to Pune. After the episode, he remembered that there was some scratch mark on his right hand which started the episode. He ignored it as he thought that it was a scratch due to something pointed from a bush.

As he reached near Delhi, he started feeling very uneasy. Within a matter of hours, he realized that skin on his right-hand was looking different. It looked very harsh and gangrenous. His hand looked shocking to the naked eye. He reached Delhi and went straight to the airport and wanted to travel back to Pune. Airline staff correctly refused to take him on the flight. He spoke with home and within a short period of time things got organized. He immediately rushed to a major hospital where some family friends also arrived. Luckily the correct treatment in ICU was started immediately. His family travelled immediately to Delhi but I am sure that nobody was prepared to the saga that was to unravel!

He was diagnosed with Necrotizing Fasciitis (Flesh-Eating Bacteria)! One of the rarest things that can happen to humans. The death rate in such cases is as high as 30%. He was lucky to be in Delhi where excellent doctors and facilities were available. The link below gives details of this condition.

https://www.webmd.com/skin-problems-and-treatments/necrotizing-fasciitis-flesh-eating-bacteria#2

During the treatment, most of the flesh from his right arm, about 3 to 4 inches from shoulder, had to be removed and bones were totally exposed. Doctors could arrest the progress of the attack. What happened was simply horrible. A normal person would have been extremely nervous, could have gone into depression. But not our Pakya. He and his family took it in a very positive way. Just guess how much time it took for the arm to get to almost normal? About 4 years maybe more! His arm was rebuilt stage by stage with plastic surgeries. I am sure you will agree with me that Pakya is made of steel! I will just share one detail which will show Prakash’s grit and determination. During the final rebuilding phase of his hand, his right hand was stitched, yes stitched to the stomach for a couple of weeks so that proper skin grafting could take place!

What makes such people so strong? We read a lot of war stories where kids in their early 20’s show valour that will make any society proud! What gives them the inner strength? Since Prakash is a friend from college days, I know him quite well. But I never thought that he would have such a steely determination. This strait is only in a very few people and I consider it is my luck and honour that Pakya is my friend! Hats Off Buddy!

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What to do with galloping Technology?

Exponential

The curve above is representative of how technology is developing at a breakneck speed. The title is neither a rhetorical question nor a controversial statement. This thought came to my mind while I was reading about the galloping speed of progress in many areas the humans are making. In the movie “Back to the Future” (1985) the person goes back to the year 1955 using a time machine. The differences he sees are interesting but not surprising. There was nothing exceptionally different or path-breaking in those 30 years. Had the movie been produced in 2015, the time machine would have taken the person to 1985, with 30-year logic. That change would have been exceptional for the person to guess!  What is the meaning of life with no PC’s, no Cell phones, no Internet, no WA, no FB? The person would not believe that life only 30 years back was so different.  

Just imagine that a human being was transported from 12000 years back, pre-farming era, to the year 1500. The cities, the carriageways, farming equipment would be such a big change that this person suddenly exposed to so many changes, might die of shock. A person from the year 1500, will be reasonably shocked to be taken to the year 1750 but he won’t die! How much change can human mind accept and absorb at a time? The rate of change is really galloping in the recent past. Change from the year 1500 to the year 1750 and the change from 1750 to 2015 cannot be compared. Change of scene that we see in the year 2015 compared to the year 1985 is really vast. But the human mind will not be able to accept changes from 1750 to 2015, the person could also simply die! It initially took 12000 plus years for such deadly changes to occur but later it took only 250 plus years for similar deadly changes. We can call such changes as “Deadly Change” (DC).

This comparison tells us that the rate of change is dependent on how advanced the society is at that time, it is the datum level that is important. For obvious reasons, we see terrific changes happening in the Bay area in the USA. We know that such change was happening in the area of Electronics, Computers and the Internet; but along with these changes, it appears that this area may also surge ahead in Car manufacturing as indicated by Tesla! We really don’t know where Apple and Google are the car domain but one thing is sure, they have technical wherewithal, passion and money. All changes are not DC type but the rate of change is galloping.  

If such changes have happened in the first 18 years of 21st century itself, what is lying ahead, we simply do not know. The changes that happened between the year 2000 to the year 2015 could get squeezed to seven years between the year 2015 and year 2022! Enormous changes can happen initially in 7 seven years, then in 3 years and then one year and then one month and then one day! Friends you may think that Pramod is dreaming and writing a fictional scenario of how things will change. But I get a feeling that changes that are going to happen in future will take an exponential curve.

The curve shown above displays the rapid speed at which things are moving.

  1. The rate of change can be represented up to the year 2000 by the slope at value –1 on X axis! What we are going to get in future will be slope after that! The high growth slope at +1 value is due to Microsoft, Google, Facebook coming in the picture during that time period between years 2000 and 2005. 
  2. Our historical perspective has been up to –1 value so we keep on thinking and expecting that the change will always be gradual and slow!  
  3. We are “Old people” of the gone era and I am talking of people in 50’s too! We are stubborn and we say that change can happen only so fast! How can change happen exponentially?  

But something is already happening in the background; you, me and the general public think that AI is something that is shown in Sci-Fi movies. It is for graduate students to take up the projects as a requirement, it is not real life! When we talk of AI, we always think of Robots; Robots are containers for AI stuff. AI is the brain and Robots is the body. When we talk of AI, we always think of computers but do not forget that another area which is making progress in leaps and bounds is biotechnology. The progress in this area is the result of tremendous progress made in the last 30 years; along with this terrific progress is made in the medical field too! These technologies are going to be the drivers of rapid change.

All this lead leads to a question of how much is the shelf life of technology? To me, some will evolve slowly and the concept will continue for a long time. For example, aeroplanes. Aeroplanes have been there for more than hundred years, only major has been jet engine! But no other path-breaking stuff is visualized. The telephone also has been around for a similar time but this technology has also changed slowly. The change now is faster after cell phones arrived on the scene. But now cell phone is really evolving in a different animal, fast! It is getting converted into a personal tool which might do everything for you, from phones to camera, to photo repository, to the music system, to chat system, to a chequebook and a bank! This change has really happened fast in the last 15 years and what form and shape it will take, only God knows. 

Biotechnology and medical fields are progressing rapidly! Last hundred years have seen some major breakthroughs in reining in epidemics. People dying in hundreds of thousands or in millions due to illnesses,  was a norm, in old days! There was plague, there was black death. The systems and the doctors just could not contain them and the way was you die or you run away elsewhere! Medicines and cures were, more prayer and faith-based than science-based. Last fifty years have seen the dramatic change in this scenario; when AIDs became rampant, doctors found basic details about it, in 2 years and now they know that it is an Auto Immune thing and per se is not as dangerous as it looks. A person with AIDs dies with other infections! Had AIDs appeared 500 years back, half the then population of the world could have been wiped out. Ebola came but was reasonably well controlled, quickly!  

This speed is good for humans but technology changes in day to day stuff can be difficult to handle with galloping speed. We have seen in front of our eyes, pagers come and go, so did fax! Cameras with the film are a history and music pieces can be composed in two different continents and a song gets created in the third continent.  

Some of these changes, humans will handle well and others can be tough to absorb. The working population will have to get themselves reskilled every ten years (am I too optimistic?) or perish. You can’t become a banker and a chartered accountant and work lifelong in the same career. Block Chain technology may eliminate such concepts! Experts may make a lot of money by the time they are 40 and may want to retire! And do what? Some young friends of ours are already contemplating this scenario.

Average Deepak or a John did not have face Cancer or Heart Attack because he never lived that long. With better products, diagnostics tools,  and cures, better solutions from biotechnology, the lifespan of Deepak and John is increasing rapidly. With better cures, these dangerous diseases are also more controllable and many times curable. Now more people die of old age instead of dying due to illnesses.  

Friends, I am very positive that humans will find a way to handle these galloping changes but some thoughts and concepts will change on their heads! Don’t be surprised if you meet a banker friend of yours after ten years and find him growing organic farms or has become potter of beautiful ceramics! We always find our path, some find it quickly, some find it late and some don’t find at all! Darwin’s theory of “Survival of the fittest” is one thing that will never change!  

 

 

 

Procrastination!

काल करे सो आज कर, आज करै सो अब | 
पल में परलय होयगी, बहुरी करेगा कब ||

This is a famous Doha (couplet) by Sant Kabir. He has said that if you have to perform some important task, why wait for tomorrow, do it today; then why wait for today, do it just now. But the modern Doha would be, if you have to perform a task just now, do it later today. If you have to perform a task today, then do it tomorrow; what is the hurry buddy, there is day after too!  This picture below is the perfect definition of procrastination.

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What Kabir has implied is that for some important work, if you delay it, then what will you do, if some catastrophe takes place and your important work could get delayed or you may never get the opportunity to do it again. In Hinduism, there is a concept of rebirth. If some things remain pending at the time of your death then, one’s soul will remain dissatisfied and will not be able to transcend into the next yoni. Procrastination can be bad for both body and soul!

See the slide show below which throws further light on what I am trying to say.

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There are of course funny sides and serious sides to this problem. We assume that people procrastinate simply because they are lazy but it is not as simple as it looks. There many reasons for this issue and of course there are solutions. But we need to decide that we WANT to do it.

The reasons for procrastination are

  1. Perfectionism
    1. Perhaps you are worried you might make a mistake in your work and expose a weakness. The fear of making mistakes is a real thing, and it can cause people to put off some of their important obligations for another day.
  2. People forget that they can learn from mistakes. Why not try?
    1. This means that they avoid doing certain tasks because they fear the risk of making a mistake and looking anything less than perfect. They want their work to be perfect. Because they believe that they will inevitably fail if the task is not in line with their given talents, it is best to set it aside for another time.
  3. Fear of the unknown
    1. This is a natural reason and sometimes valid, but we must not forget that it is not going to be helpful
    2. One might see a growth or a mole somewhere on the body. The person is afraid to get it checked from the doctor for the fear that it may turn out to be cancerous. But will postponing or delaying going to help?
    3. This can happen due to half or lack of knowledge too! Somebody might tell you that cancer is hereditary; nobody has cancer in my family so why bother? Cancer is not curable hence the fear but there are some cancers which are curable if treated on time.
  4. A similar thing can happen in a relationship also. It could be in love, it could be with friends or the boss. There are some issues which need to be resolved, by delaying them, the issues are not going get resolved.
  5. I will do it later
    1. One always thinks, “Oh, I am little tired just now, let me do this task, two days late.”
    2. But it may so happen that after two days you really be tired and one will go in an endless loop
  6. Working on small tasks because they are easier
    1. This is pretty obvious
    2. Humans look for a path of least resistance
    3. We might look for small pending tasks to perform instead of the one which needs to be done.
    4. More the time and effort the task is going to take, the more the thoughts of procrastination will come in mind
  7. Lack of Motivation
    1. Lack of motivation has many reasons. But we need to check the priority of the task you are trying to do; and the effects of not doing it or delaying it
    2.  Fatigue
    3. Lack of confidence
    4. Negative surroundings
    5. Wrong environment
    6. Other priorities
  8. No clarity as to how to get started
    1. Sometimes problems are too complex so one gets confused
    2. Try and put things down on paper point by point
    3. See which are the points you are confident about
    4. Take help or guidance from someone for points which you think are tough
    5. Remind yourself that putting off things is not going to complete the task, in fact, the delay might lead to some more cascading problems
  9. You get distracted
    1. In modern times following distractions come in the way. According to the study, people spend 35/40% of the productive time on distractions
      1. Email
      2. Text Message
      3. Social Media
      4. Phone Meetings
      5. WhatsApp
      6. Others ……………
  10. The knowledge that task is hard work and will require efforts
    1. Working on a long project can be really difficult because of the amount of effort that it takes to finish. There are also opportunity costs along the way where you have to give up something you would rather be doing to get some work done on your project. This often leads people to lose their motivation and choose to set aside their projects for a later time.

There can be many reasons for postponing things that need to be done. One of the most important would be to judge the risk of postponing a particular task. If the risk analysis says that it should be done, then it needs to be done. In my first job after a few years of good work, my boss tried to make a contract with me which was unfair. I had to act immediately or I would have got stuck. I met a professional contact who was a big boss in another factory. He immediately offered me a job! I saw the risk of not acting quickly. When my voice tone changed suddenly five years back, I went by the guidance of my ENT surgeon and within a few weeks, my cancer was detected and successfully treated. The fear of the unknown would not have helped.

How to correct Procrastination issues?

How do we correct this problem of Procrastination? Experts say Change Your Outlook, Stop punishing yourself for procrastinating. Tackle your most important task for 15 minutes. Break tasks down into small chunks. Start your day with the hardest tasks. Give yourself a pep talk for motivation. Promise yourself that you’ll get a reward when it’s done.

I am going to give highlights of what can be done to overcome anxiety causing procrastination.

  1. Break your work in little steps
  2. Change your environment and be with positive people, have someone close for discussing things with
  3. Identify when you feel like procrastinating
  4. Talk to someone who has already achieved similar goals
  5. Don’t wait for the perfect time to do it. It may too late
  6. Share with someone what you want to achieve, it will help you to go ahead with the task.
  7. Just do it

There will be many ways to achieve the final goal besides what I have suggested. Similarly, there will be many more reasons to fall into this trap. But to me, point number 7, “JUST DO IT” is the real solution! So friends just do it!

Procra5

Medical illiteracy!

Us non-medical people are known for their Medical illiteracy! But my recent experience tells me that people from the medical field are also not far from us, when some event, which does not happen on day to day basis, occurs. At least Jaya and I have a curiosity bug so whenever someone known to us has a health event, which we don’t know much about, we go to Google baba and ask him questions, I think sometimes he gets fed up of our questioning!

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Health literacy is dependent on individual and  communication skills of lay persons and professionals. 

I was detected with vocal cord carcinoma five years back, I avoid using word cancer, as carcinoma sounds fancier! I was hardly aware of the treatment. The only words I knew were radiations and chemotherapy! Sachin, Priya (She is a doctor)and Jaya took up the googling part and I opted to face radiations! I thought at that time, that one or two radiations are given to attack and hopefully beat the cancer back. Then maybe a few chemo tablets, and I would be done! But that is not how it was done. For my carcinoma, Immunotherapy was a better treatment in place of Chemo. There were 34 radiations! I simply did not know anything about cancer treatment. Ok, I will share with you the knowledge I picked up. 1 or 2 radiations are given as a palliative treatment when the patient is in real pain. But in that case, it is not THE treatment. When the possibility of a patient getting cured is good, 20/30/40 radiations are given depending on factors too complex for me to understand. Various improved therapies are given as newer ones are made available to mankind. Chemo remains cost effective, as it is a well proven old therapy.

Recently, a friend called me to seek an appointment with a neuro physician from my family. His 40-year daughter had difficulty in walking. Our common orthopaedic surgeon friend suggested taking advise of a neuro physician. They took the treatment and the lady is advised a certain injection to be taken, life-long! This lady had finally reached a doctor, five years late. The story does not end here. My friend while talking with the doctor said that he also has diabetes which is well under control. But he also said that he was required to perform dialysis twice a week, most of his teeth are damaged due to diabetes. What is the meaning of controlled diabetes? Do these people give such a low importance to their health? How can they not know about the illness they have after what they go through? Do they not want to accept it? How could my friend say that he has controlled diabetes?

I have chatted with a few friends, who are doctors. The various reasons for the apathy shown have come out. Mainly its human nature to avoid facing facts! If I do my yearly check-up and find that there is an issue, instead, why not delay it by a few months. Some are like butterflies, who go from one doctor to another and keep on going. This they do till they get an advise which is close to their expectation. I know of someone who went to ten different doctors for his cartilage problem. Nine said that surgery is needed, one said let us try medicines and physiotherapy. When asked, he claims that he is doing good, but cannot ride his big bike, his leg pains. Cannot drive a non-automatic car as he is in pain if he is required to operate the clutch pedal.

Then there are some patients, who have monetary difficulties, which is understandable. Some have a marriage in the family so will get themselves operated after the marriage, acceptable. But some will postpone their blood sugar checking, want to do it after they come back from their dream holiday! Reason? If sugar values are bad then they can’t binge on their holidays. A friend is doing Dixit diet, recent “In Thing”, making rounds on WhatsApp! It’s a good program suggested by a medical doctor, with a rider. Take it up under your doctor’s advice. This friend binged on ice creams and sodas and chocolates for a couple of months. On checking, for sugar value found them alarming; in normal course too, he is a dibetic. A month after starting this diet, his sugar values miraculously improved, they still showed that he has diabetes. He is claiming that due to this diet, there was a terrific improvement. The simple fact was that since he binged his values were bad and when he stopped those sweet things his values improved!

Now here is a very interesting story. Here both husband and wife are doctors. The lady is having some symptoms for 15 days. Initially, her husband says, oh you are getting old now. So, to prove him wrong, she would try and show that things are normal. After a few days, her husband says, “See, I was telling you, show positive intent and you will be all right.” She calls Jaya (they are friends) and shares her health issues. Jaya suggested that she should see a specialist. Four more days are wasted in this. Finally, she goes to see the specialist! Both were somehow bent on following their physician’s advice, rather than meeting a specialist. The husband drops her at the clinic and goes for some “important work”; to him she is just making a fuss. The specialist checks her, does some tests. The doctor diagnoses a major health issue and insists that she should immediately get hospitalized. Our friend says, “Is it ok if I get hospitalized later in the evening after my husband comes back?” Specialist insists and gets her hospitalized. She said that 15 days back when the first symptoms were felt, there was a possibility that a major event had started in her body. Fortunately, it has not culminated in a catastrophe. We need to arrest this event as early as possible.

With both being doctors they are expected to have better knowledge. Why they did not want to meet the specialist? In the best case scenario, the result would be a false alarm. But life is never simple. The catastrophe did not happen but her body was hurtling in that direction. How do you analyze this event? What could have led this couple, especially the husband with a casual approach? Even after treatment had started, he did not meet the specialist for two days, to ask details. One day we went to meet her. In the same hospital, we met a common friend, also a doctor! Our friend still does not want to accept the diagnosis, it seems. He told the common friend, “My wife is having suspected xxx!”

Another case was a person who had some uneasiness, he could not use his left hand to get his two-wheeler down from the stand. His left eye looked to be drooping. After a couple of days, he took a decision to see an eye specialist! He explained the details but the doctor felt that eyesight  was ok; the beauty was that the eye doctor also did not realize that something different was happening. To cut the story short he was forced to see the correct specialist. The specialist on checking said that a major event could be happening in his body. He was rushed to the hospital and in a couple of days, he underwent brain surgery; he was fast going towards stroke. In a couple of months more, he needed to undergo triple heart bypass surgery. Ok, I understand that a commoner may not understand that he was going to have brain stroke. But when left eye and left hand were having a problem, he should have gone to a physician at least! Though finally, it was a neuro physician who diagnosed the issue. When the body is near such a catastrophe, I am sure there is a strong signal from the body that something is seriously wrong! But people just seem to miss it!

How to make people aware of such things? How to train them to look for body signals? My worry is if trained doctors can misjudge the situation so badly, non-doctors are obviously going find it difficult. Body or mind has the natural instinct of fight or flight. Why such instincts do not come into act in situations mentioned?

Friends, I strongly urge all of you to be safe rather being sorry! Don’t go by statement that doctors always squeeze you! They only work for money these days. Don’t keep on doctor hopping. Go back to GP concept. Keep on going to the same physician regularly. He or she will always give you the right pointers as they know about your health conditions the best. And don’t avoid or postpone that yearly check-up. Its for us!

Loneliness & Isolation!

Loneliness is a feeling of sadness or distress about being by yourself or feeling disconnected from the world around you. It may be felt more over a long period of time. It is also possible to feel lonely, even when surrounded by people.

Isolation is being separated from other people and your environment. Sometimes this occurs through decisions we make ourselves, or because of circumstance e.g. doing a job that requires travel or relocation.

loneliness-and-isolation-quotes-2

The above picture shows a positive way of looking at life!

The above two are definitions of two feelings, that human being gets some time in life. This can happen at any age and can happen due to different reasons. There are different remedies to the same. But one thing is sure, these feelings are bad for the humans and earlier humans overcome them, is better. Though age is no bar, chances of this happening at an older age are much more. World over these two feelings are discussed together hence I am also treating them as same but one thing is well proven that these conditions lead to early deaths!

What are the reasons for Loneliness & Isolation?

Though the reasons are many, the most important being living alone, introverted personality, major long-term illness, loss of job and death of the spouse. Some of the reasons I have mentioned are a real shock, like death, to each of us but some are not able to cope.

I will try and separate them into tangible and intangible reasons. I am using this word in a slightly different way. Tangible means perceptible by touch but I am taking it as something for which there is a visible reason, like death.

  • Death of spouse, close family member or a close friend is an event which puts everyone in a state of loneliness for some time. Many of us overcome these shocks within a reasonable period of time but some people take much longer or they need medical or psychiatric treatment. This could be because such people are
    • Born that way, introverts
    • Don’t have close family ties or ties with friends
    • Live away from the family
  • Living alone for various reasons can be is another thing that creates loneliness within us. This can be because of loss of the spouse, a job change resulting in other family members living elsewhere.
  • Some are introverts by nature and find it difficult to meet new people. So, when the people whom you meet regularly, go away from your life, things can become difficult. Some people have a feeling that they don’t belong! They also feel a lack of purpose or meaning in life.
  • Poor physical health, frailty, mobility issues are some of the issues that can lead to the feeling of loneliness. Long-term illnesses and treatment make you feel that you are alone in this world. I was treated for cancer in 2013 end. My treatment went on for three months and rehabilitation was another three months. Luckily my own and my family’s positiveness helped me. In such situations having a reasonably comfortable financial situation is also helpful.
  • Some people have a mental health condition such as depression or anxiety. This is an illness of the mind. It creates a situation such that there is a fear of rejection from others or feelings of being “different” or stigmatized by society. What happens in such cases is that others in the society do not know how to react to such persons.
  • Inability to participate in activities due to access issues, mobility, illness, transport. This really is an issue which can be easily resolved but you need to take support from people if required. During one of our alumni get together, one of our friends who has very poor eyesight called me to say that he wanted to attend the gathering. I coordinated with one friend who lived in the same area. Our friend really enjoyed the meet!
  • Retirement from work, home relocation, starting out in a new role or community puts some people in difficulties as they are not able to cope up. These changes in life are level two events after death in the family! I know of someone who left his home in Mumbai fifteen years back and stays with his children in Pune and Bangalore. But he still cannot overcome this change simply longs for his Mumbai home.
  • Language or cultural barriers, or reduced connection with your culture of origin is one more reason. This can easily happen in India, especially for older people, when their adaptability is reduced. Living in foreign countries for six months, post-retirement can be tough because of the language issue, weather conditions like snow. People feel in Geographic isolation.
  • Feeling lost in the crowd is another mental condition that needs treatment.

How to cope up with Loneliness & Isolation?

It is very easy for others to say, you do this and you do that but persons who face the problems find it difficult to reach the solutions. Those who are born with natural positiveness, also face these difficulties but they overcome them. Another example is, we think that Public figures and stage personalities do not have stage fright. That is not true, they also have the same issues like all others but they overcome them, mask them, hide them well.

  • Connect or reconnect with friends and family: staying in contact with loved ones can prevent loneliness and isolation. If your family does not live nearby, technology can help you stay in touch. Speak to them on WhatsApp or talk on Skype video. These are free. Keep in touch with them regularly.
  • Get out and about: Regular outings for social functions, exercise, visiting friends, doing shopping, or simply going to public places can help. Don’t avoid functions either public or private. If not, take long walks in gardens where you will see many people and maybe you will like a few of them, you may want to know them.
  • Volunteer: Helping others is a great way to help yourself feel more connected. Besides that, the feeling of goodness that comes within you because you are able to help somebody boosts your happy feelings.
  • Consider getting a pet: Pets are wonderful companions and can provide comfort and support during times of stress, ill-health or isolation. They give you love without expecting any returns. Expecting returns and NOT getting it, is one of the reasons, why the isolation starts. But don’t forget one thing. There is work involved in having a dog as a pet. Their food, their walking, their poo poo collection and so many things. Then along with your visits to the doctor, Vet visits get added.
  • Get support: If loneliness and social isolation are causing you distress, you should discuss your concerns with a doctor, counsellor or a trusted person. Don’t feel shy to openly asking for support. Remember people may not know that you need help unless you tell them.
  • Focus on others needs: Focus on the needs and feelings of others, give less attention to your lonely thoughts and feelings. You can be involved in yourself all the time or you can think of others too! Interacting with others is better! Enjoy the site of different people in their own thoughts and their own moods, you can smile at strangers too!
  • Try new things: Try to do some different things but don’t expect perfection and don’t expect people to appreciate what you are doing!

Ultimately, one has to find his own solution and there is no formula for this. Attempt different methods to interact with people, you may find some givers or some takers but don’t give up if you meet only takers initially; those people may have their own problems but keep on attempting. The world is too beautiful to live alone, try and enjoy to the best of your ability with others, with or without someone’s help!

There is a saying, if you see someone without a smile, give him one of yours! In the same vein if you see someone looking lonely, forlorn, isolated go out of your way to bring that person back to normal life! Tomorrow that person could be you!

Cancer Survivor!

This is a term used to describe cancer patients who did not die though they had cancer. To me this a very derogatory term. I have undergone cancer treatment 5 years back. I came out the illness successfully. Why call such a person a survivor? The patient has undergone a major treatment, faced it bravely, lived with dignity, how can the patient be called a survivor?

The word “Survivor” has following definitions which I am trying to understand.

These definitions give a different flavour to the experience of going through cancer treatment. About 50 to 70 years back, C-word was a scary word and anyone who had cancer, it was assumed that the result will be death. Hence the term survivor came in use. Due to early detection, improved treatments, family and friends’ support, these days not every body detected with cancer, dies within a short duration. In fact % of people recovering the condition has gone up, drastically. Following points have jointly changed cancer scenario so much that I do not like being called cancer survivor. Why not a heart attack survivor? Why not a stroke survivor? Why not a nephritis survivor?

I will share with you the information that I gathered while I was undergoing the treatment.

In recent times there have been major changes in cancer management due to

1. Early detection

With awareness, with improved diagnostic tools people do go to their doctors early. It is definitely proven that early detection definitely improves the chances of getting cured like any other disease.

2. Advanced imaging technologies have created sophisticated diagnostics.

In olden days the only way to look inside the body was an x-ray or by surgery. With CAT scans, MRI’s doctors can really “see” inside and can even understand the different types, by looking at images.

3. Improvements in chemotherapy and its side effects

You will be surprised to know that in developed country England, first Oncology department was established as late as in 1970. The word chemotherapy brought out pictures of a patient losing hair on the scalp, patients having terrible side effects like diarrhea. But so much progress has taken place in this science that these symptoms are not seen in some patients. Instead of intravenous chemotherapy, now chemo tablets are available. The cost of the treatment has also gone down substantially.

4. The advent of treatments like Immuno therapy which has a couple types

  • Stimulating your own immune system to work harder or smarter to attack cancer cells
  • Giving you immune system components, such as man-made immune system proteins
  • This treatment is still costly but very effective in the certain type of cancers.
  • Sometimes this is given in place of chemotherapy
  • I was treated with Immuno therapy instead of Chemotherapy and had reasonably less side effect with no hair loss at all and minor weight loss.

5. Progress in surgical techniques which allows lesser and lesser removal of tissues.

In olden days, surgeries used to be drastic and a lot of body tissues were cut away. When I was in school, one of my father’s friend had cancer in the facial area. His left side including the left nostril, was simply removed! In my case, luckily, the only surgery that was needed, was for biopsy purpose!

Now with improving surgical techniques where surgeons use probes, many times surgery is not drastic.

6. Radiation treatment

  • There have been tremendous changes in radiation therapy. It appears that Radiation therapy will be the cancer treatment of the 21st century. There two major new methods have been proven and are used extensively
  • Image-guided radiation therapy (IGRT) is the use of imaging during radiation therapy to improve the precision and accuracy of treatment delivery. IGRT is used to treat tumours in areas of the body that move, such as the lungs.
  • Intensity-modulated radiotherapy (IMRT) uses linear accelerators to safely and painlessly deliver precise radiation doses to a tumour while minimizing the dose to surrounding normal tissue.
  • The radiation oncologist will speak with you to determine whether IMRT is the most appropriate treatment for you. If so, your doctor will perform a physical exam and use CT scanning to conduct a treatment simulation session. Other imaging procedures may be used to help determine the exact shape and location of your tumour, and a special device may be created to help you maintain the same exact position during each treatment. Your doctor will give you specific instructions based on the type of exam being performed. I was treated with IGRT.

7. Progress in awareness

  • Perhaps the biggest change of the past 60 years has been in our attitudes. It’s no longer a disease to be mentioned in hushed tones, and increasing survival rates mean that more and more people are alive to share their story of beating cancer.
  • People no longer have to hide a diagnosis of cancer for fear of what others might think, and numerous celebrities have gone public with their personal stories. Fundraising events for cancer charities are commonplace, generating vital money for research, advocacy and support.
  • But, more importantly, we’ve also seen a big change in public awareness about the things that can cause cancer and the warning signs to look out for. Many organizations are working hard to improve early diagnosis of cancer by raising awareness of symptoms amongst public and health professionals.
  • But sadly, one thing has not changed. Some people still believe in alternate medicines. These treatments rarely cure patients in large numbers. These people finally go for treatments discussed above, but many times its too late!

8. Progress in preventing cancer

The reason why someone gets cancer are many

  • Scientists have slowly understood that it can be caused by some viruses too!
  • Smoking is definitely the number one reason for cancer
  • But some cancers also show hereditary links, out of which obesity is one of the main reasons

Friends, I have tried to explain the progress in the management of cancer. Deaths due to cancer are decreasing year by year but the number of cases is increasing. The reason is our life expectancy has gone up and the possibility of cancer increases with age. Another cause is smoking control; smoking  is controlled world over in public areas. This is another reason for the decrease.

I am sure now you have understood why I am unhappy with the term cancer survivor. Now it is no more a dreaded C word. Any person undergoing a major health issue is nervous, tense and uneasy till the cure is achieved. Some achieve it some don’t! Heart attack deaths are even more in numbers than cancer deaths but people somehow accept heart attack event more easily. One good thing is now people openly talk about cancer! Public figures like Manisha Koirala, Sonali Bendre, Cyclist Armstrong are some names. On personal level, I was moving around for three months with feeding tube inserted in my nose. A friend asked me why I did not  cover my face with a scarf to hide the tube, when I went in public? I asked him, “Why should I do it? I am undergoing a treatment and the tube is my major support device? There is nothing to be ashamed of to hide it!” Help cancer patients to remain more dignified by treating their disease as any other major disease by NOT using word Cancer Survivor!

Two facets of our mind!

Human is a funny creature and human mind is even funnier! How our mind will react to a situation is difficult to tell. I am not sure but the reactions of mind are generally consistent in similar situations. At least I hope so! In routine situations which generally get repeated in our lives, reactions of the mind will be quite consistent, most of the time. Like sometimes, getting late while going to office. Our mind calculates the average time required, considering traffic patterns, time of the day when you are traveling. Then our mind internally calculates the time to leave from home, so that we reach on time! It helps you recalibrating so as to reduce your anxiety.

Do two humans react in the same way? No never. I feel that how one’s mind reacts, depends on the how you grew up right from childhood. The environment in which you have grown up, shapes the mould of how you react or how you decide. But do you really know how your mind will react to a certain situation? No, you won’t know especially in difficult situations. I found this when I was undergoing cancer treatment a few years back.

My treatment was going on for about three months, it included a treatment called immunotherapy and radiations. During the first one week, there were not many effects on my body. My body started reacting from the second weak onwards. I would get coughing bouts, I had rash on my back and on my head. Jaya tells me that I used to have a tough time because of the coughing bouts and sometimes had trouble because of the rash. My mind it seems is designed to not remember difficult and tough periods during difficult times. Honestly, I do not remember most of the details that caused the problems. Yes, I remember that there were many issues but Jaya remembers the details more than I do! Maybe I am lucky that by design, my mind forgets the difficult part of the process. I remember the basics but do not remember any details.

I did a bit of research on internet and it looks like there is a lot of research done on “our two selves”! This research is done mainly about these two selves and how their behaviour helps humans to take decisions in life or react in life! Wow, I honestly had not heard anything about these two fellas! This research is done mainly in the field of psychology! Well known expert and Nobel Laureate Kahneman says about this, “I am my remembering self, and the experiencing self, who does my living, is like a stranger to me.”

This thought process can be a bit confusing to begin with but once we understand it, its meaning is simple but fascinating. Suppose that you are on a holiday with your small kids. It is a well-planned holiday but with kids around things can be a little complex. Basically, adults take a holiday to enjoy change of scene, different places and food; add to that the family time. Children do not to love any change in their steady state life, so they are a little uncomfortable with daily travel, new hotels (they may be posh but they are not home). With this uncertainty, they are a little quirky. Now here is the concept. The experiencing self is the “you” who in the moment lives through the event. The remembering self is the “you” that writes the history. With discomfort of both adults and kids, the experience of holiday can be stressful while it is on but the memory of the holiday that forms in the mind of adults, after the holiday is that of happiness. The remembering self is the one that that takes decisions, for future! This means though during the holiday, there was stress, overall experience was a good one.

It is also the remembering self that is consulted when planning the future. Choices are made, based on the remembering self’s construction of what happened in the past. Now here’s the problem. The experiencing self and the remembering self don’t agree on what happened.

An experiment was conducted where subjects had a hand immersed in ice water at a temperature that causes moderate pain. They were told that they would have three trials. While the hand was in the water the other hand used a keyboard to continuously record their level of pain. The first trial lasted 60 seconds. The second trial lasted 90 seconds, however in the last 30 seconds the water was slowly warmed by 1 degree (better but still painful). For the third trial, they were allowed to choose which of the first two trials was less disagreeable, and repeat that one.

Eighty percent of the subjects who reported experiencing some decrease in their pain in the last 30 seconds of the second trial chose to repeat the 90-second experience! In other words, their remembering self-selected the option that required an additional 30 seconds of suffering.

What is the conclusion from the experiment? The duration did not matter but end result mattered. In the second method, pain started diminishing as the temperature was increased. Though the trial was longer, people preferred that trial.

Coming back to my cancer treatment. Treatment lasted for three months. My pain and difficulties increased with time. But my overall experience was satisfactory; why was it so? When the treatment ended, the doctors told me that everything worked out well. Since my cancer turned out to be non- spreadable variety, chances of recurrence were almost nil! My mind processed the end result and probably made me forget the pain and issues during treatment phase. My remembering self, processed the information that I wanted! So, am I happy?

Being happy used to be a simple process, now it is difficult to discuss this as it has become a complex process as our knowledge level goes up. It turns out that the word “happiness” is just not a useful word anymore, because we apply it to too many different things.

The second thing is a confusion between experience and memory, between being happy in your life, and being happy about your life or happy with your life. And those are two very different concepts, and they’re both clubbed in the notion of happiness.

Friends, will our mind work this way when events like, business loss, break-up in relationships, loss of job? Don’t forget that remembering self also remembers the peak events (best or the worst) from any process!

Maybe, some of you might just want to chuck the complex theory we have discussed,  and be happy the old way! Cheers!