My miniscule world

The  display of sarees and salwar kameez stared at me from the shops. Some hung loosely under the eaves while others were draped on mannequins. As they danced to the breeze, they resonated with a nostalgic charm and stirred something dormant within me…

Something girlish and romantic.

Something profoundly Indian.

Something long-forgotten.

Something left behind in the alleys of history and tradition.

Like a beautiful silk scarf that had dropped off the shoulders of tradition, only to be trampled upon by the horses of ‘globalization’.

I could no longer see the people on the street. All I could see was fabric.

Deep shades of green, blue and red that contrasted with pastel colors. Bright shades of yellow and orange that contrasted with dusky shades of brown and black. Georgette, chiffon, crepe and silk that gleamed against crisp cottons. Transluscent flowery designs that veiled opaque fabric. Embroidery, sequins, zari and beads that glimmered against the backdrop of plain fabric.

Most of the shops here belonged to Muslims. Some of the embroidery was handcrafted. It was exquisite and reminiscent of traditional Islamic embroidery. The kind of embroidery that I had only seen in salwars designed in North India. The kind of salwars that traditional Punjabi women wear.

I remembered that evening long ago when I had walked the streets of Southall, amidst shops that specialized in zari embroidered lehangas, salwar suits and wedding sarees. Amidst eateries that served North Indian sweets and savouries. Amidst makeshift stalls that sold Bollywood CDs.  Amidst signboards in Punjabi script. I remember the disbelief I had felt at what I saw. This was a slice of Punjab, transported to a different continent. A Punjab that was reminiscent of the pre-independence province of Punjab- a province that was as much populated by Sikhs as by Muslims. It was hard to tell the difference. Here, people appeared to live as they had lived for years in their motherland, before the partition. The border did not exist in the minds of the people here.

And that takes me to the serial I have been watching lately. Buniyaad. Who can forget the delicacies that Doordarshan had served us in its early years? That was a different era altogether.

I have always found myself drawn to the Punjab province and to the story of its partition. It may be on account of the numerous Punjabi friends we had when I was a child. Many of these families had their personal tragedies buried in the story of partition. It was as if they had been uprooted from their motherland that contained their most precious memories…as if they had left behind a precious part of their own self on the other side of the border. Films, books and serials that were centered on partition, added to my sentiments.

It is therefore not surprising that Buniyaad resonated with me and with the minds of many Indians, particularly the ones whose past lay buried in the Punjab of pre-partition times.

I watched the first few episodes, and felt a bout of nostalgia and heartache. The Punjab of those times. The houses that were homes. The community life of Indian villages, the open air, the slow paced life, the warmth and intimacy, the raw human beings. Those infinite moments that made one feel alive.

I was drawn to the manner in which love unfolds in the minds of the people in this serial- as a free-flowing emotion that is to be felt.

A gentle, slow awakening. Sublime. Spoken more through the silences than through the words. That irreplaceable feeling awakened for a person that permanently changes something within, never to be reversed.

As I watch the women in this serial, I am reminded of who I used to be. I had never longed for independence. I had only wanted to be a woman- a woman bound to tradition. A woman who was comfortable veiling herself in the garbs of tradition. A woman secure in the companionship of a strong man by her side. I had only wanted to dream; I had nothing to prove to the world. I was happy in the anonymity and privacy of my world. My dreams, I had wanted to keep to myself. They were secrets I did not wish to share with the world. In my moments of solitude, I wished to stroll aimlessly, and feel. I wished to talk to the trees and call out to the birds. I wished to chase the butterflies and the gurgling brooks, and I wished to lay on the soft grass and sleep under the skies. I wished to write poetry and prose, and hide it from the world. I wished to sing and dance, and I wished to soak up the raindrops, reveling in my perceptions. This world within me, was my secret. My only dream was to nurture it.

But life had other plans for me. I had to run away from my traditional garb in order to survive. Nothing feminine can survive in a world barren and devoid of love, and so, I put on a man’s shoes and walked. I adapted to a man’s ways, but deep within, these contrasted and conflicted with the feminine nature of my personality. But the need to survive propelled me in this new role.

It amuses me as much as it saddens me to think of the garbs we wear in order to survive. Anything, just to survive. These garbs of masculine aggression, of insanity, of feigned numbness. These masks that we learn to wear permanently and that eventually become our identity.

All that I am today- the roles that define me and the roles that I have learnt to revel in, is the outcome of the need for survival. The need for rising above the emptiness and loneliness. The passion for physiology, for teaching, for writing, for psychology- they were all born out of the emptiness and loneliness that caused me to find a higher meaning in life.

But beneath all these roles, is a woman. An Indian woman who unseen to the world, appears in the solitary and private moments of my life. Within her are all the soft feminine emotions that can no longer find a place in the world. She lives, somewhere within me. I can feel her at times- in that occasional throb of girlish excitement, in that occasional shimmer of a dream that crosses the eye, in that occasional quietude that fills the heart.

I can see her, somewhere in between the pages of the books I read, in the emotions that unfold on the screen as I watch these old serials and movies…in the words scribbled in my diaries. I am left with a longing to go back to her, but then I realize that there is an infinite distance between us now. And that longing then transforms into a mute helplessness…

 

 

 

 

 

 

 

 

 

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Part III: What should a doctor dream about?

The inability to savour and cherish the doctor-patient relationship perhaps lies at the crux of the ailments that have afflicted the modern doctor.

In the past, the maximum filtering in education was carried out at the ground level. This perhaps enabled students to be steered towards career domains that they had greater inclination to. Today, such filtering is absent at the school level. Also, the number of private medical colleges are ever expanding. As a consequence, we have a surplus of young doctors passing out. And yet, there is no channeling of these doctors towards rural and government sectors, where services are most needed. Also, since these medical graduates from private medical colleges are largely from the higher socioeconomic strata, their aspirations almost always revolve around urban and elite jobs.

This surplus generates a need for further qualifying exams, wherein young doctors are compelled to write endless competitive exams, specializing and super-specializing- a process that has no end. They are forever on the move, with one foot resting into the future. Where then, do they have the time or space to savour a doctor-patient relationship? They never really settle, and by the time they attain a certain career stability, they have been stripped off the last vestiges of human essence. They find themselves robbed of the true meaning of their lives. This is the sad story of a doctor’s life today. Unless young doctors wake up to this fact, and refuse to be swept away by this overpowering tide of market-driven forces, they shall lose hold on the actual path of their lives, and end up as victims of the system.

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Perhaps it is the need of the hour to slow down. When one takes up the medical profession, one must understand and accept that a doctor’s journey is a slow process of ascent, sometimes spanning a lifetime. It may be worthwhile spending some time working in a small hospital or a clinic, without setting any immediate goals. Ideally, in a rural setting where there is greater exposure to life. Just so as to get a feel of the profession. Allow oneself to experience its joys and pains- at the ground level. That is when one is able to hear one’s inner voices. There is nothing that can provide better guidance than one’s own instincts. It may be worthwhile taking up an apprenticeship under a doctor that one looks up to. It may be worthwhile working as a resident in a field that one has a liking to, just to get a feel of it.

It is only when one exposes oneself to a domain at the ground level that one can rise up to the role that is demanded of oneself in that domain, as one steps into higher levels of hierarchy. 

Work in a ward. Do everything. Be a doctor, be a nurse, be a pharmacist, be a lab technician, be a clerk. Be a human being. Talk to your patient. Talk to your peers and to all the staff involved in the care of your patient. Talk about your patient’s condition, talk about life. It doesn’t hurt to crack a few jokes. Liven up the place. After all, a hospital is a place where there is so much suffering. Bring a little optimism and happiness into this suffering. Communicate and coordinate between members of your team and give your highest involvement. Make things easy for people. Make it a place where your patients and peers are eager to see you and look forward to your presence! And slowly, you will see the light within!

A little light on this through a personal journey:

https://vchathoth.wordpress.com/2015/06/16/an-icu-story/

A few more instances of the doctor-patient relationship:

https://vchathoth.wordpress.com/2014/08/06/glimpses-of-life/

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Part II: What should a doctor dream about?

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Dr. Gangadharan  is a distinguished Oncologist who combines high professional skill with compassion, and hence is a source of hope for cancer patients generally steeped in despondency‘, reads a profile on the website of Caritas Hospital, Kottayam.

Dr V.P.Gangadharan is a name that is familiar to every Malayalee. A name that cuts through all barriers of caste, creed, religion, wealth or social status- just as the disease he treats….

A disease that does not distinguish between its victims…

A disease where all the illusions of the material world crumble, exposing the vulnerable and terrified human being within.

To his patients, Dr Gangadharan is God himself. But the doctor brushes off the ‘larger than life’ image that his patients confer on him and maintains that he is just a human being who is committed to his role as a doctor.

In an era where there is a palpable lack of role models and references, there is much that Dr Gangadharan’s life speaks for itself. For a young doctor, there is much to learn from his life.

In an interview at J.B.Junction in 2014, the doctor illuminates those forgotten aspects that once defined the medical profession, by sharing experiences from his own journey as a doctor, rekindling the dormant spirit of young doctors, awakening the seeds of humanity in them, and planting dreams in a career that has transformed from what was once regarded as humanitarian service of the highest order to what is now a commercial industry.

 

 

At the start of the interview, the doctor makes an important observation:

A doctor represents a cross section of society. Now, if society has changed, it is quite natural that the doctor would also change. The change that we see in doctors today, is a reflection of the change that has afflicted society as a whole. And so, the greatest challenge that a doctor faces today is- Is it possible to remain committed to one’s ideals and principles, in the setting of such change?

This is the question that young doctors must ask of themselves. What needs to be understood is that the practice of Medicine is an art. The real doctor is an artist, not a scientist. And so, he must possess the quality that defines an artist- perseverance. A true artist must demonstrate perseverance. Only then can he remain committed to his art. It is this perseverance that will eventually enable him to carve out a space for himself…that will make him distinct and irreplaceable. Dr Gangadharan’s life is a living example of such perseverance.

In this context, Dr Gangadharan discusses the joy of the doctor-patient relationship. He believes that once a young doctor has experienced the joy of this relationship, it is impossible to choose materialism over this joy. He insists that teachers and doctors are the most fortunate, for their professions bring them ample love. This love that comes from their students or patients is the secret of their undying zeal and energy. He regards his patients as people, and not as cases. He feels they have much to offer him as human beings who have traveled their own paths in life and whose souls are enlightened by the suffering they have experienced. The doctor emphasizes on the need to communicate and converse with patients and breathe life into these interactions.

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Love is the fundamental principle of ‘Medicine’

This message resonates with the previous post on Dr Rosamma who enjoyed her interactions with patients. Her interactions were unhurried and had the feel of a heart-to-heart conversation between two human beings, rather than the mechanical exchange of words that characterize a doctor-patient interaction today.

Yet again, this point illuminates the difference between a dream and an aspiration. As young doctors aspire for degrees, awards and materialistic rewards, they lose sight of what they have to live with every day, for the rest of their lives. They fail to see the daily routine of their lives that revolves around their interaction with patients. Unless one can transform these interactions into moments of joy, the degrees and all other achievements lose their significance. 

Dr Gangadharan describes the role of an oncologist thus:

There is this narrow bridge between life and death. I carry my patient on my shoulders and walk across this narrow bridge. On one side is disease, with all its horrors. On the other side is treatment, with all its horrors. I carry my patients through these horrors, and that is the magnitude of challenge that an oncologist must confront!

Dr Gangadharan reflects on how a doctor is a student for much of his life. He recounts the numerous instances where his patients opened his eyes to numerous aspects of his profession that one cannot learn from text books.

I asked the patient to lie down. But I was called away for something, and I left abruptly. It was only when the patient said to me that it does not befit a doctor to make their patient lie down in order to be examined, and then leave abruptly, leaving the patient in the dark, that I realized the lack of sensitivity I had displayed.

He emphasizes on how the greatest lessons are always learnt from life. Formal education can only be a preparation for the lessons that one must learn from life.

Upon receiving an MBBS degree, the doctor is only formally qualified. But in effect, he remains a student who has much to learn from his encounter with his patients‘, he concludes.

In his book ‘Jeevithamenna albhutham‘ (The miracle that is life), Dr Gangadharan talks about the powerlessness and fragility of human life as he recounts his helpless moments as a doctor in the context of disease- the heart attack that killed an individual who survived cancer, the relapse of cancer in a patient who had been cured of it, and so much more. Perhaps the greatest tales of resilience are also found in these cancer wards where one witnesses individuals who manage to smile and keep up their spirits, despite their poverty, deprivation and the dreadful illness they fight.

 

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Actors Sreenivasan, Innocent; artist and cancer survivor Eby N Joseph; and noted oncologist Dr V.P.Gangadharan, share a lighter moment at the inauguration of Eby’s exhibition at Durbar Hall Art Gallery in Kochi. Photo re-posted from ‘The Hindu’.

It might be worthwhile compiling such inspiring stories into documentaries that could be screened in medical colleges. A lack of inspiration haunts our medical education system today and the medical curriculum must incorporate activities that inspire and motivate. Also, it must introduce sessions that focus on goal-devoid doctor-patient interactions. Students could be made to visit the community or palliative care units or hospices, talk to patients, and write about their experience. It is then that they engage with life and with the human being and discover the joy in these interactions!

Read: http://2609-11340.el-alt.com/ShowArticle.aspx?ID=37437&SECTION=31