Life’s Journey!

This is about passing of friends and musing s about life’s journey

We have different phases in our lives from childhood, youthful student, working professional, married person with family, and retired person. All these phases are like mini journeys that we take up in life. Longest and most enjoyable journey that I remember is our so called “educational tour” I had taken during final year of engineering. It was a train journey for three weeks where we had one bogey to ourselves and did we have fun! But it’s not the journey that I am writing about today. It’s the end of journey that I am writing about.

When we entered Maharashtra on the way back to Bombay, I remember someone got down at Bhusawal, then Nasik, Thane, Dadar and finally VT. The reason for there getting down was  that these friends’ homes were at these places. So it was natural for them to get down there. But in our life’s journey we all have the same final home, address is known, “station” to get down is same for all! But it is like musical chair and when music stops those who are “left standing”  have to go. Though the “station” is one, the timings to get down are different in perpetual journey of life.

These thoughts came to mind when I came to understand about Prakash’s death this morning. Some are lucky enough like us, who have reached “retirement” phase, though we may not actually retire physically. When our “ultimate” time comes, though we may not know ourselves, we have to get down from life’s train and there is no option.

The difference between all our previous “journey’s” and the ultimate journey is that knowing the exact time when our journey is ending. In all previous journey’s sometimes we remember the end, sometimes we don’t. When I completed my first two years in college in Elphinstone Mumbai, I simply don’t remember when this journey ended. There are many very happy memories of those two years but for some reason I don’t remember the end distinctly. Same thing happened with my COEP journey. After I completed my Bachelor’s degree, I continued with my Master’s degree. The ending phase also coincided with my courtship with Jaya, in fact six months before ME we got married. Most of the friends left COEP and started new life of professionals. My being busy in Master’s degree and courtship, made the end of journey at COEP a bit hazy.

I distinctly remember my last day of working for someone. I was in Bombay with Premier Automobiles on company work. My boss had requested me to complete one pending issue! Since then I am on own and continue to work full time in my “retirement” phase.

For around last 15 years sporadic information about friends and relatives going on their ultimate journey started trickling in. But 2017 has been watershed year. Swati Ekbote (Sudhir Ekbote’s wife) on 1st January, Pappy Deshmukh, Maheshbhai my friend and mentor, Dilip Panjikar, Chandar Mekhale, Pendse- Jaya’s guru in computers and now Prakash Karandikar; so many till date.

When I heard about Prakash’s death today I felt empty the way I felt when people were getting down on different railway stations at the end of educational tour, as I got down last at VT and  I was feeling empty! But at that time I knew that I am going to meet all these guys again after a few days. Today I know that I am not going to meet these guys again, ever!

Every person handles death in a different way. But I am sure all of us get that melancholy feeling when we hear about death of friends and dear ones. Today morning things looked dark and bleak, I was mechanically getting ready for office and was trying to write this piece. Out of blue one of my seniors from industry, he is ten years elder to me, called and said, “Hey Panvalkar, how are you doing?” I was happy to hear his usual pleasant voice and chatted with him for about ten minutes. I asked him,” Sir, is there any specific reason you called me?”. He said, “No, since we had not spoken for sometime I thought why not speak to you today! I keep on reading your blogs and I am keeping track of what you write.” We ended our conversation and he invited me for a chit chat at his home! This event, I feel was the God’s way of trying to bring me back to normal and this chat was definitely a bright light that suddenly shone through the dark clouds surrounding me. Thank you Doctor for bringing me back almost to normal through this melancholy period.

God has designed the human in such a way that probably in a day or two we will all be back to normal. In our retirement phase we should try different things to keep ourselves busy besides the normal things like walking, yoga, religious stuff. With the help of net we can study new languages, start writing own experiences, not necessarily for sharing with others! My friend Sudhakar has taken up painting in big way. Try to complete your wish list which in modern language is called bucket list! Travel, read, listen to music do something which you could not do before.

One good thing about the end of journey is when ones time comes, that person does not know that his/her time has come! So live your life King size as if there is no end! Happy journey folks! Every day try to talk a friend or a cousin or an  uncle on phone! You never know ……

 

Good Samaritans!!

Doctors as a group are good Samaritans. Most of them are in the service of humanity, money of course matters but of many doctors that I have met and know of, are good human beings. My friend Vijay sent me a video in which a physician was speaking about heart ailments. This doctor had a very nice way of putting things across in a humorous way. He was putting his thoughts across that heart ailments can be cured without surgery, angioplasty and invasive procedures in general. Vijay asked me if this is really possible. When he asked me this question the whole kaleidoscope of my interactions with doctors, throughout my life, passed by quickly. This made me think of two things, about doctors in general and about getting well with their help.

My first reaction was that, when  doctors treated you as individual doctors they were simply good to superb, as is natural in any group of people. They always cared for you, they would try to give least amount of medicines as possible, and try and allow the nature to take its course; they would intervene only if needed. Over a period I have observed that doctors explain things in details about your ailment. On the flip side I know a doctor who instead of explaining gives you a link to his YouTube presentation about your ailment, which I thought was very impersonal.

The personal attention however changes when you are required to go to hospitals, where you are theoretically in a corporate environment. You would expect quick and efficient actions followed by continuous tracking as would be expected, as patients go to hospitals only when such need arises. I do not know what happens in that environment but things are sometimes at the other extreme. You will see inefficiency galore, delays, late responses, doctors just not being available and so on. (Oh don’t worry the intern will take care of you!) I remember when I was required to take my father to a large hospital due to heart attack. He was admitted under a senior physician. After initial checkups I was promised that the senior physician will shortly come and see my father. After a couple of hours I was coolly told that the doctor will now come the next day as he was now busy in his consulting rooms. For me it was it was simple, if the senior doctor is too busy to see my father then I would rather go to another hospital. When I said this to the junior doctor, he said we should not do that as my father was critical! I said if he is critical then why the senior doctor is not checking him? Within 15 minutes the senior doctor came!

I remember a case of one of our relatives; he was admitted to a major hospital due to stroke. He had diabetes, he was on dialysis, and he had high blood pressure. For two days doctors would just not share details hence I was called to talk to them. Hospital was trying to force a brain surgery on the patient (had put him on ventilator) but as layman I could see that it was meaningless. I took a young doctor to side and asked him his blunt opinion; he said the patients’ brain is 85% damaged and he has no hopes; he gave a sad smile and said well looks like commercial aspects have taken over the case! We managed to remove him from that hospital to another one where we knew the doctors well. Doctors gave the same opinion and advised that he should be allowed to die peacefully! We did!

But I know of a physician who treated a friend of mine for heart ailment; my friend did not have sufficient insurance coverage to have bypass surgery. This doctor explained to my friend how this can be handled without surgery but he needs a drastic life style change. This was 20 years back; my friend and I had coffee last week!

This reminds me of a story told to me by a young doctor. He was working for a small hospital. He checked a patient and felt that no tests were needed. So he let the patient go. When the hospital owner came he asked the details. When he shared details about this patient, the owner said “Is my father going to pay installments for the new test machine?” Our friend simply said “looks like it” and calmly resigned and walked out!

A student hurt himself while playing badminton. His friends took him to a large hospital. When his parents reached the hospital this student was very upset and said “Dad lets go elsewhere”. His father told him to let the doctors handle the basics then they can move. The student said that they took x ray of his ankle and later found out that the doctor had forgotten to put the film in the machine!

The stories can go on and on! But as in life there are good doctors and there are not so good doctors. There will always be some black sheep. But why the basics change in large hospitals is beyond my understanding. Are doctors not good managers? Are good managers incapable of handling intricacies involved in running a hospital? Well hospitals these days have software to handle their administrative work. What a hospital system does is to provide services required by patients. This is very similar to running a hotel or running an automotive workshop. These two also provide services. Did you ever find that garages and hotels took 3 to 4 hours to give you or your vehicle a discharge? Why is that hospitals take so long to discharge a patient? On the other side, I have experienced an extremely efficiently run pathological lab. They are very efficient and at stipulated time you get your reports by email! But the norm is inefficiency.

Coming back to the video, the doctor aptly said that if you want to get well then the patient has to follow ALL things told by the doctor.  He gave an example saying that if a tank has 15 holes, how can you fill it up completely? It is obvious that ALL 15 holes need to be blocked to fill up the tank. A patient with liver issues says what is going happen if I take a peg or two of whiskey? Then the patient is asking for trouble. A senior physician once told me that in diabetes, most of the patients keep on having issues as they do not follow the basic discipline of diet, medicine and exercise! He said a very small percentage of patients have really erratic body responses and have a tough time as diabetes remains erratic even after following ALL instructions. He also told me a story of a disciplined patient who in yearly checkups found that he had very high diabetes. But by following the regimen to the last dot on I’s and slash on T’s, in three years’ time the patient has become non diabetic, with medicines!

Friends I wrote this blog to suggest how health issues are handled and need to be handled. These thoughts come to mind probably because I am a senior citizen now!! I will add a few more points. All “Pathys” are as good as the doctor who uses them. Each pathy has its own benefits and down sides plus limitations. When you are having jaundice there is no known cure available in Allopathy! You have to take Liv 52. Similarly other pathys also have limitations. But we should not be very rigid in our thoughts about up & down sides. That Allopathy has certain side effects is a known fact but that does not mean there are no good sides! Allopathy is the best researched pathy and offers cures to many ailments, even the toughest of the ailments. Homeopathy and Ayurved have their own advantages and limitations. What happens is after reading something about side effects of Allopathy, some people tend to just ignore it, to me at least, and it is to their own peril. There are diseases like cancer, dementia and many such tough ones. Very strong Allopathy medicines are also not able overcome such ailments. In such cases people should NOT experiment! I will share with you an anecdote about a patient with blood pressure problems. He went to the doctor and got himself checked. His BP was 200/120! Doctor suggested that he get himself admitted to a hospital or take 100% rest at home for at least four days and then prescribed to him strong medicines. The patient probably did not understand the meaning of 200/120. He asked the doctor, “I am worried about Allopathy side effects. Can you tell me the side effects and try to reduce the dose”. Doctor said, “Let us experiment later, and at this stage let us act fast”. Patient still insisted on knowing about side effects before starting the treatment. Doctor gave him all the details and said, “As against these side effects, if you do not take medicines there is only one side effect”. Patient said “what is it?” Doctor said, “You may die”. Amen!!

 

Trial by Media- an Assault?

In last few days I have read about two unfortunate medical cases one in which a young man, 30 years old, died a sudden death, in Southern India. In the second case a small child died while a dental treatment was going on, in Pune. Both cases are an extremely tragic events; my sympathies are totally with the families.

In the case of the young man, Facebook post written by the young man’s wife was printed verbatim by Daily Bhaskar with a headline, “Monster Doctor did nothing while patient had cardiac arrest!”. At least at the end of the Post they have printed a disclaimer saying that they have just printed the Post Verbatim and do not necessarily agree with the views etc.

But in the case of the child, media trial is on, from the day one, after the mishap took place. The so called leading news daily of India printed the photo of the Doctors’ name board!! When we watch these things from far, everything is hazy. But some decorum needs to be followed. One can understand the parents & close relatives of the child, making strong statements, as they are in grief; this cannot be justified though understandable!! There was a discussion claiming that maybe the doctor was a quack. Come on, the Doctor is PG in pediatrics from a renowned institute. Even in criminal cases like murder, unless the criminal is caught red handed at site, his/her name is not declared, if it is practical. What right the reporters and for that matter the society, in general, have to judge a person without knowing details!

We hear about cases where families have attacked the Doctors physically, when a patient has suddenly died. This has usually happened in case of uneducated families. How is this assault justified in any way? Media attack and social media attacks are Assaults with a different name. In the latest cases, the headline about the “Monster Doctor” is a veiled slap on the face of the Doctor and not any different from physical slap, “disclaimer” being a balm applied after the slap. In the case of the child, the attack is exactly same as the physical attack. It is not that the doctor ran away when he saw that child was in serious health issue. He tried his best. So why assault him intellectually? Is it because he is defenseless? If the doctor tries to give any statement it will be misinterpreted, so he cannot say anything. So the media and society keep on slapping him.

From medical point of view we need to know if the correct treatment was given. Were the correct procedures & or protocols followed? Was the child going through some other treatment, at that time, and was on medication? Was this informed to the doctor? Was the child given local anesthesia? Did the reaction occur immediately or after some time? There is a mechanism in place where such cases are referred to a medical panel. This panel is empowered to study the cases and decide if there was a mistake by the doctor or negligence by the doctor. If the negligence is proven then the doctor can be charged by the police under due process of law. We do not expect a doctor to overcome such police cases with same impunity as many big shots from the society are known to do.

How this events should be handled. This is not politics where party A will attack party B and so on. Politics is a business. In current medical cases, individuals involved are normal human beings like you and me. Is it right for the media to give “exposes”? Is the doctor hiding anything? Is the medical council hiding anything? Due course of action has to start, yet. If some hotch potch happens in this process of inquiry, then the media can go into depth. Here media is trying to show as if the doctor is a villain. What does society achieve by taking candle march? Was this a rape case? When a child dies in road accident we don’t have candle marches! We don’t start publishing history of the driver! (It may not be drivers’ mistake to start with) What are we trying to achieve here? Are these the drawbacks of TRP related stuff? Is this the drawback of having Facebook platform being readily available?

I have personally experienced what can happen due a reaction of an injection. Years back when penicillin was used regularly, my mother was injected with penicillin. From the same ampule my nephew was also injected. I was sitting next to my mother; within one minute my mother just collapsed and fell on me. Her hands and feet started becoming cold and she started becoming black and blue! This all happened within 2/3 minutes. Luckily an Oxygen Cylinder was readily available so was Adrenalin injection. She was treated with all this immediately and she came back from the brink, after fifteen minutes! We were all just praying or maybe we just did not know what was happening!! Was this attempted murder? No, it was not! My mother had taken penicillin shots before and had no known reaction history but her body still reacted differently. These things are known to happen, that is why doctors take a consent form before anesthesia is used or a surgical procedure is done. In current case of the child, the reaction of something (still not known) had started 30/40 minutes later. The concerned doctor took help of another expert and a hospital overcome the reaction issue and to revive the child. Sadly this did not happen.

Does consent taken absolve doctors of the responsibility? On the other hand  will the doctor ignore the reaction just because he/she has taken a consent for the procedure? This case could be drug reaction, misjudgement of the doctor but this is decided not by you and me. Let the law take its own course. What the society can do is to ask for quick report from the medical committee and let the action start as quickly. “Justice delayed is justice denied” should not happen in such cases. But let us not become judges, juries or maybe God and try to fix the destiny of a human being without following the right procedures! There is no short cut to anything and that applies to justice also.

God bless both families in which deaths took place but also let us give the professionals involved leeway of trying to prove their innocence. Ultimately they also have a family!!