Health – a subjective phenomenon.

Health is a broad topic as such and here, I do not intend to provide text book definitions. Because, with the definitions, it is easy to score marks in the exams, but it only becomes meaningful when it is understood and applied in our daily lives. Not surprisingly, even doctors ignore their health and well-being and have suffered. So, the usual saying goes, “Are we not human-beings?” It is utterly true. Yes, we as doctors too suffer from physical and mental health issues and from my own experience, I feel that our near and dear ones never feel like caring for us or advising us on health issues just because we are doctors and we can take care of ourselves.

I also remember one proverb now – “To err is human”. So it is natural and ok to be human and not be like machines. When it comes to the issue of health, the trick is to attain that subtle balance! Everything starts in the mother’s womb itself. Some of the conditions of ill- health are unavoidable if genetically attained, as the wrong genes are incorporated in each and every cell of our bodies. But most illnesses are acquired from our surrounding environment, and many other factors which is why we say health is determined by multiple factors.

A child born in a rich family is considered lucky because he is able to access most of the comforts as also health care more easily than the one born in a poor family. Moreover, ignorance is such a bliss that the poor are often less educated and don’t even know or think about how a disease is caused or what the complications or outcome could be. Infections, also called communicable diseases are so common in them because of poor habits and living conditions and they are almost ready for any consequence, blaming their ill fates most of the time. Moreover, with newer diseases like the present Covid-19, it has become impossible to say that the richer are exempted from infectious diseases. Every species tries to thrive and in the process, learns slowly to adapt and change itself to become more virulent to attack the other species for its growth and survival.

With time, everything changes. The high standards of living also has its own pros and cons.The richer and sedentary people started suffering from other set of diseases now known as the non communicable or chronic disease conditions such as diabetes, cardiovascular diseases etc. As time evolved, and with globalization and internet speeding up spreading its nets into each and every corner of the world, it has become very easy for urbanizing the rural habits! So nowadays it is no more a surprise to detect the non communicable diseases even in the poor.

More research is needed to understand the whole complex mechanism of disease causation. Most of the time, it is multifactorial and the effects are enhanced by the presence of multiple risk factors. Risk factors are the ones that when associated are known to increase the causation of a particular disease. For example, smoking is a risk factor for the causation of heart attack.

We can also find many people who have one or the other illness time and again but when asked, they say they are healthy. So that is the subjective feeling. On the other hand, with no detectable or clinically discernible ill health, some people always feel that they are ill. Inevitably, they go doctor shopping and without their own knowledge, frequent visits to health centres becomes a part of their lives. When a patient says he has headache, the doctor has to believe he has headache and even if a machine can detect lies, it is not at all ethical to doubt a patient.

We go ahead with treating the symptom and also further examination and lab tests to detect and diagnose any hidden illness. Once a patient, he/ she need not be so the whole life. The silver lining is that with scientific advancements, many of the diseases are either curable or controllable. In every country, with overall improvement in the socio-economic conditions, there has been an increase in the life expectancy of its people.

With an increasing percentage of educated people, there is a need for integrated and concerted efforts to dispel many myths associated with health and ill – health, to identify the disease condition in its earlier stages, timely and regular treatment to control the diseases and prevent the complications. This will definitely help in preventing the disease progression and improving the quality of life.

Self care is the most important in being healthy, as the individual’s own habits determine his/her present and future ill-health. Rather than blaming the health officials or the government for many avoidable or unavoidable flaws, it is time for the people themselves to decide whether they want to live healthy or not. For example, if there was nothing like alcohol ever invented, many lives and families would not have suffered of it’s grave consequences. But, if not alcohol, it would have been something else! The need of the hour is our own decision. To be responsible for our own actions and change the habits by changing our perspectives. I will not say that then there will be no need for health care system or doctors, because, as I said earlier, there are many more disease conditions that are inevitable and need to be treated. Most of the preventable conditions are in our own hands.

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At the pinnacle of mechanical life.

The 21st century is marked by remarkable changes in the way of living of man owing to tremendous technological and scientific advancements. The cohort of people born in the second half of 20th century and continuing to the 21st like myself can definitely appreciate the changes brought about. The Covid – 19 pandemic has been instrumental in changing many life perspectives and I believe it came in just when we were at the pinnacle of leading the so called mechanical lives – to try to master anything and everything but forgot the value of inter personal relationships and inter species symbiosis.

It is not easy to forget our childhood days when  it was a common thing to replace a tungsten bulb when it got burnt due to high voltage. Then came the tube lights, initially the longer ones which got slowly replaced by the shorter led tubes and bulbs of today which are both brighter and longer lasting. The nights are no longer dark, with the advent of brighter lights and night working environments. I can no longer appreciate the starry sky from the city dwelling, I feel really lucky if I can spot the Ursa major, Orion constellations along with Canis major and Sirius, the brightest star of the night sky and I will be overwhelmed if I can locate the pole star with my bare eyes! Yes, I did this often just two and a half decades ago.

The cathode ray tube television got replaced with lcd and later led sets and that too they come in many sizes. The comforts offered by the latest technology also demanded that people should start working 24/7 which was earlier only common in limited departments. With female literacy rising slowly and the increasing freedom to decide on family planning, life only meant that to have a comfortable life, both partners have to work, come back to sleep in cozy homes, try to buy as many comforts as possible, have one or two kids, educate them in good schools and retire from work, either survive till old age or succumb to any cause in between.

It also meant that bigger joint families be broken into nuclear families for the ease of life and other good or bad reasons as the case may be. Freshly prepared food started getting replaced by refrigerated, or fast food or canned food etc, which people may choose according to their needs. It became highly difficult for most of the urban dwellers to have daily dinner together with the family unless all members are highly motivated for that or lucky enough so to say.. It continues to be so. When we are pre occupied in achieving the set goals of our work, there is hardly time to attend to the needs of our own family, the dependent lonely kids and perhaps lonely life partners. Is it really so easy to take a leave and be at peace for even one day? The weekends, needless to say, goes in sorting the haphazard things at home, cleaning and washing chores.

The mobile that has replaced even the television and radio and which come so handy for all is of course the most dreaded and unavoidable distraction of the present times. With the mobile in hand, all have become tuned to their own favourites, comfort zones. There is just no time left for most people for sitting back on the couch, thinking about their own selves, whether everything in life is going in the right direction. I agree there maybe many more stalwarts who may be so disciplined in their lives as to be quite systematic. I believe they too must have passed through testing times before they became so.

And just when the second decade of 21st century was about to end, there came the deadly pandemic when all of us were forced to lock ourselves at home. Was it not such a great thing to be no longer afraid of the boss to have arrived late to work due to heavy traffic or any such thing? When especially work from home concept emerged. This was such a major shift of human mindset, when that was the only way left to save our precious lives, not to contract the deadly infection, not to die of it!

I believe, the wives who loved their husbands and longed to see them in front of them for one whole day would have had exciting days and the children too were so happy to have unlimited holidays and to have online classes wherein they can just off their cameras and start munching something or the other even during class hours. With the mechanical life of keeping everything according to prefixed schedules and people caring so less for even the neighbours nextdoor, suddenly started helping each other, when it came to donating food, water and ration for the homeless and vulnerable and donating funds or sophisticated machines for the hospitals where there was round the clock work, work and work..

Pandemic is not a desirable thing. If we think for a moment what if there was no pandemic at all, then health care would not have been a popular agenda for many countries, some other achievements would have occurred in some fields, moreover money would have got spent for other things than vaccines, ppe kits, oxygen etc. Probably we would have built machines to go to other planets easily just like that. Probabilities are many. But it definitely gave us time and opportunity to become aware that advancements in science and technology doesn’t mean that we have conquered the whole universe. All kinds of hazards are always around us and we are as vulnerable as we were decades and centuries ago. We have to be thoughtful of our own environment and try to be as less polluting as possible. Every person’s contribution adds. It is for our own species survival and for better future of our children that we have to strive. Each country has its own challenges. It is the human species itself that is dominating on all resources compared to others and thereby, human contribution is more meaningful to the planet which can fetch greater dividends to our future generations as far as the quality of life is concerned..

Let us try and build better future..                   Image courtesy: Pixels

Third wave of Covid 19 and beyond.

As expected, the third wave of Covid 19 is here in India and many other parts of the world and there’s a lot of speculation and discussion going on. There has been still a great deal of carelessness around with many people waiting for government mandates to follow any protocol to curb the spread of the infection! The weekend lockdown also despite strict regulations imposed, have been taken lightly by the general public. It is not uncommon to see that masks are worn below the nose, which is as good as not wearing at all! Moreover, masks should not be a cause for a false sense of security.

Scenes of people standing in groups, relaxing at restaurants and outside coffee/ tea shops, bakeries and other eateries is not at all uncommon. Man is a social being and hence it is highly difficult to isolate oneself for a longer time. It takes a high deal of conscious decision to hold on and continue practising the required behaviour the so called “Covid-19 appropriate behaviour”. No single person or the health department or the government can be held responsible for anything that is being unfolded as ultimately it is the collective action of all in the society that decides how the pandemic fares. Not only for a pandemic situation, but it applies to each and every aspect of social life. In democracy, it is the people who should decide what they need and then put forth their demands to the government. When people can be more responsible in taking decisions for themselves, then nothing can stop the country from developing as a country is but made of countrymen.

Now there are two different schools of thought coming up, one to allow the Covid 19 pandemic to takes its own natural course and learn to live with it as recently announced by some European countries and the other one is to prevent the spread and thus reduce the detrimental effects it can have especially in countries with larger populations where some percentage of people have remained unvaccinated.

The level of knowledge required to understand and follow the things may not be the same with people in every place. Culture and practices, education levels, income levels all affect the people’s demands and aspirations. The third wave is just another phase of this pandemic of the century and no one knows how many more waves are yet to come before it disappears or at least ceases to be a public health problem. But presently it is a public health problem and the public needs to support fully on implementation of the required mandates in order to minimize the losses due to pandemic and help themselves take recourse to a near normal way of life.

Innocent, ignorant, arrogant, careless etc…all attitudes can affect the pandemic in different ways. It is not so easy to predict the spread based on models and they can only give a rough estimate. Even the reported number of cases maybe an understimate as a result of the ice berg phenomenon wherein the sub clinical and undiagnosed cases escape from the clinician and thus remain unreported. Testing of family members and close contacts are helping to detect the hidden cases.

It is highly important for the more vulnerable like the old aged and children and those with other chronic diseases to take action to prevent themselves from being infected and continue the medications and keep their conditions in control as relevant and as advised. Some people are fed up of the Covid news and some are tired of masks and some want to go on long trips and have fun. However, if we can protect ourselves now, we can always plan for the fun time later when things settle down. Life is to be placed above all. We must learn to make ourselves less vulnerable to the infection , as it is highly impossible to always be vigilant. The new tagline coming up is to learn to live with the virus.

Photo courtesy: Pixabay.

Denial to Depression – A silent pain.

Denial of anything desired is considered a negative emotion. It only depends on the intellectual capacity of the human mind how it is perceived. For some, it brings a positive change in the behavior such that they try to gain the lost appreciation by trying to mend their ways. But that can also be taken by many negatively! The common man cannot think or act like a learned saint who takes everything positively. The whole journey which starts from the perception of the pain of denial of love and care to “depression” is long and silent.

For example, if I tell my son that he is not good at something, initially he feels sad, and then he decides to correct his ways and try to gain my appreciation. But this process remains subconscious. What if he feels sad again and again and then he decides to rebel instead of trying to change himself? It is a disturbing feeling and again what he turns into later is a subconscious process. The result of which is taken into serious consideration by me only after it becomes visible clearly and the situation has gone beyond control and becomes quite difficult to handle! The way the children are being forced to grow up in the present world makes me think deeply about their future. I feel that we are unable to give that extra hug or a reassuring word or simply pay attention for a few seconds to their small innovations which they may crave for without our knowledge. We are far too engrossed in meeting the needs of the ever-competitive world that I feel that they miss what we once enjoyed in our childhood days. I still remember how my mom used to walk 2 kilometre distance to our school to feed us freshly prepared lunch with her own loving hands. I have never been able to feed my kids at school. It is almost an obsolete practice. It is taken care of by the school staff now. Children do not even have to walk back home as they have the comfort of vehicles be it school bus or bikes or cars.

Working outside of the cozy home has become a great necessity for everyone that surprisingly we at one end say that we earn mainly for our daily food, clothing, and shelter, and on the other end there have been many days when we would have skipped our meals for the sake of hectic work schedule, we would have gulped down some fast food without even enjoying the taste of a single bite. At the end of the day, we would have even fought with our family members out of some other unwanted frustration. Needless to say about the uncountable sleepless nights for one reason or the other. Someone denied to appreciate us at work, we denied love and care for our family. Ultimately, we always feel that whatever we are doing is mainly for ourselves, our family, our society, etc. How much satisfied are we with our own lives? Is achieving a professional goal everything that defines a person? Many questions do not have an answer.

The joint family concept of the older generations offered the much-required moral support to one another in times of need. The present generation has slowly changed to the “small family-happy family” concept for many reasons. One has to face the adversities of life alone. One has to mask his real face with an ever-smiling face to portray as if “All is well”. That is what is expected of everyone. There is a general notion that well-educated people can handle every situation in life. Our parents may deny sharing their knowledge or experience just because we are more educated than them. They feel that it is unnecessary or irrelevant to do so. There seems to be a communication gap along with the generation gap. The real fact is that any person be it less educated or more educated feels good to have someone for support. Is it not better to be under an umbrella of protection than to drench in the rain of sorrow and loneliness?

The last one and odd years of the Covid-19 pandemic had given a great opportunity to nurture family relationships. So much so that now, to once again leave the children to school also feels like losing something. The value of something is known only when it is lost. The only hope is that the relationship continues subconsciously and becomes stronger and stronger with every passing day whether we stay close physically or not. They say that too much of pampering hinders the child’s overall development and they become home sick and do not learn as good as their peers. But I feel that today’s children are pampered not with our love and attention but with the crazy junk food and mobile games addiction which drives their attention well away from us. In the far end, the consequences are not imaginable. It can be anything. When we age, we may find ourselves craving for their love and attention and lose ourselves to Depression. It is something like a vicious circle. As you sow, so shall you reap.

Is he or she lonely?

The dusk of life..when it all feels never ending.

Few decades ago, our grandfathers and great-grandfathers spent their days working in the fields or any such outdoor activities and came back home by dusk to just eat and sleep after a strenuous day. Not many except the elite were educated. Their days went in hard physical work and nights in a sound sleep that was worth all the hard work. Those who suffered from any disease either got cured most commonly by natural immunity or if it had to be the worst outcome, they died. That was their way of life. Life expectancy was not even 60 years.

The situation today is far different. Life expectancy has increased and many can celebrate by becoming centenarians. The old aged especially, what would they do when they don’t have to work in the fields and after their retirement from their formal jobs? Not many jobs can be continued even after retirement. To those people, the only pastime becomes playing with the grandchildren if they are around, watching the TV and such simple activities.There seems to be a kind of vacuum in their lives which is harder to fill. To those who have lost their life partner, it is still harder. I have heard my father talk in despair when he feels he has nothing to contribute now to the society. He becomes sad and sometimes irritable and my mother tries to pacify him. That also is perceived by him as ‘pity’ and not otherwise. It is usual for him to hear about many of the friends and relatives of his age die. We are very happy that he had a new lease of life after he underwent surgery for benign prostatic hypertrophy and later for pacemaker insertion as his heart had slowed down due to age related changes. I always thank the advancement of the medical field for saving innumerable such lives when treated in time. He has been successfully living with diabetes and hypertension from the past forty and odd years. This is not only a personal triumph but of the whole aged population who have been successfully aging, fighting all odds.

In my opinion, they should not think that they are not contributing to the society. Whatever bit they can do to the limited number of people around them, and taking as much responsibility of themselves as possible is more than enough. There needs to be a self- motivation to keep themselves engaged and happier. It is however harder to convince for learning new things which they would not have done before. It is highly difficult to initiate new techniques. For example, if my mother asks my father to try meditation, he gets highly irritated! But he loves to go for a walk or to read newspaper. I feel that being a literate, capable to read and write is one of the greatest blessings for anyone. I wonder what he would do if there’s no newspaper. He doesn’t want to get acquainted with the smartphone. He owns only the older version of mobile and that too only for calls. I feel that he is representative of the behaviour of majority of people of his age. They cannot be grouped into either very old fashioned or modern.

There is a need for empathy and not sympathy for the aged people. They must be left to decide what feels good for them to do. They must be given as much of convenience and aids as possible both at home and outside, especially when they need to travel out in case they need to visit a hospital or any other necessary business. It is highly recommended that the outside world is old-aged friendly. For example, even though seats are reserved for old aged in a public transport, the others hardly leave the seats to the vulnerable. This is something that has to be learnt without any one saying. Having lifts in working conditions, a separate queue for the old aged at offices, temples and other public places makes it easier for them to explore their own world. Otherwise, just for the fear of them being vulnerable, they hardly decide to go out of the house.

Financially empowering the aged is another challenge both for the family and the government. Without that, there is no good quality of life as they feel miserable and helpless, unable to meet their daily basic necessities. Everything comes at a cost. Moreover, with age, chronic diseases are evidently becoming more common and they need to take regular medications as well as a healthy diet. Taking care of their mental health is also required as many conditions like depression, stress and anxiety etc go un- noticed and not cared for especially of the aged. It is a great privilege to have our elders around us as we always feel younger in front of them and being blessed by them. Their intellect might have decreased but their experience and knowledge is something that comes only with age. For example, the best remedy for sleeplessness according to our elders is to work hard physically as the body needs rest naturally after hard work!

Aging successfully is on the international agenda as some countries are already aged whereas many countries are slowly aging with new challenges to face with regard to the unique problems of  the elderly. It is an important task for the society to balance their busy life schedule taking cognizance of their aged counterparts and for the government to make suitable policies for the welfare of the aging population which can make aging both successful and graceful.

The favourite pastime of the elderly..

A short story of my Tiger.

He came in a medium sized cardboard box which when opened, hardly did I ever imagine it will be someone as special as him. This incident is about 12 years old. He was so cute that I fell in love with him almost at the same moment- love at first sight.. Anyone who saw him and made friendship equally fell in love. Such was his activity. Though small, he was not skinny or bony, but was plump and soft, feathery, silky and milky and what not!

Initially, I resisted at the idea of a canine member being brought home as I thought it’s always a mess and then the fear of the anti rabid prick that inevitably follows a bite or a lick on the minute cuts over the hands especially which we females always have during our kitchen and other household chores. But it was my husband who was fascinated at the idea of keeping such a pet for the protection of the house since we lived in a quarters in a remote village when I was working in a primary health centre. He that day surprised me with that unwanted gift.

The first few days of his home-coming were horrible for him as I think he was taken away from his mom. He pissed and pooped within the same cardboard several times on the first day, as I had guessed right that it’s a mess.. And then a separate place was made within the house itself as he was too young to be left outside according to my husband. He cared for him so well that he became busy in feeding him milk often and cleaning him thoroughly. I maintained my distance as I was too busy to get involved.

As he started to learn barking, it was a funny voice, feeble yet firm! I don’t know why but even though he did neither have the stripes nor the colour, I chose to call him ‘Tiger’ but the others at home called him ‘Jimmy’ . I didn’t prefer Jimmy as it existed already at my parents’ place. His thick white fur and his authoritative bark made me to stick to that name. But he responded well to both names. He started eating soft food cooked at home. He was a great entertainer to my elder son who was the only kid at that time. Those days we had only TV and Radio as popular media for entertainment. In a rural area as that in which we lived, hardly was there any power. So Tiger became the favourite pastime for all at home. I admired him from a safe distance. I could cook and talk to him, listen to him and managed to give not more than a few gentle caressing strokes on his head and neck. To do anything more than that, I was too apprehensive. Everything else in caring for him was my husband’s duty.

We changed our residence and came to the town after a year or so and then my daughter came into our lives. Here, he was tied in his own large space near the entrance gate itself. Morning walk was his favourite. He would look for bones hidden in the soil outside of the house as we were not able to serve him the non vegetarian stuff at home. My mother-in-law had a name for him too as ‘Ramu’! and she loved to feed him more and more. It was his habit to growl in a peculiar tone when I would place his food in front of him and then try to talk to him… It was a strict no no for him to talk during meal time! It was his ‘me time’ after all I guess. He always kept the strangers and probably the unknown thieves and enemies at bay. He scared the smallest or the biggest creature that tried to enter into our house! The only reason I remember him getting terrified was the sound of crackers during Diwali festival which we would not burn but the people around would. Some of our neighbours, I feel, envied us of his possession as they often complained that his barking would disturb their nights’ sleep!

One fine day, we had to leave him for 4 to 5 days alone as I had to attend an exam at a distant city and all of us at home had planned to leave. We arranged for his food through our maid. We left in our car heavy heartedly as we never had left my Tiger, my friend who had already acquired his own special place in all our hearts. He was hale and healthy, regularly immunized and dewormed. There was not a single incident of him falling ill that I can remember. The second day itself the maid called up to inform that he’s not eating his food. We were quite disturbed at the news and we requested her to somehow feed him milk or water or any thing he likes and promised to pay her more than what she gets from cleaning the house. We were too far to return and I was unable to miss my exam too… The next day was my exam which I attended in the morning and soon after lunch we headed back. Although we had plans to visit some famous temples on our way, there was some uneasiness within with least excitement of that particular travel. By evening, as we were still on our way and too far yet, she called up once again, this time to inform that he’s not responding and probably not breathing…

Tears rolled down my cheeks uninterrupted, harder to hold back. My husband stopped driving for sometime. Never did I imagine in my dreams or thoughts that such a tragedy might encounter. To this day, I am unable to understand the cause of his sudden death. My husband controlled his emotions and instructed her to perform his last lites in a respectable way. There was no way left. It was so sudden. Alas! We could not even have a last look at him. We came back home only to find that large space of his with the bare belt. Yes.. there was his peculiar fragrance which every soul leaves behind. We could hardly eat or drink or talk to each other at home for many days thereafter. We wept and wept silently in our own places until it was enough. We had his photo framed and my husband was always worshipping him in his daily puja.. Now, after multiple inevitable change of residences and new responsibilities to take over, his photo is now safely kept at our native place.

After this beautiful experience, no other similar dog was able to gain a place in our hearts. We decided not to…. We blamed ourselves for the whole thing. It looks strange for me as to why the maid stopped working at my home after that incident. We had to search for another. Neither did she explain convincingly as to what exactly happened with our lovely Tiger. I neither had any proof nor could I hold her or any one responsible for that sad incident. However, I want to thank God for the short time that we spent with my Tiger. To this day, I keep searching for a similar puppy as if to believe that he’s back.. The faithful, innocent soul who loved us unconditionally..

To whoever feels why this story, it is only to spread a message to never ever leave a dependent in the hands of others, especially our pets. My Tiger did not know how to communicate with or befriend a stranger I think (although the maid was not a stranger). I remember that I spoke to him a day before I left to take care of himself until we come back. Why did he not? He missed us so badly that he did not eat or drink. “Come back…Dear one.. as I’m still waiting for you, searching for you in the streets every now and then if you have arrived. For we don’t want any other to fill your space…”

He was closer to this cutie…

The will power to move on…

There is no doubt that the modern education and amenities have made our life more enjoyable. As long as we are in the safe umbrella with our parents, life is all good. Once we take up our roles independently in the society, not many lessons that are learnt in school come to our rescue. There needs to be something else to tackle with some situations in life.

I was new at the general hospital some 15 years ago and a young lady in her early twenties came to my OPD with history of not getting her menstrual periods since 1 month and odd days. The first thing to rule out will be pregnancy. I convinced her for the test and she agreed. It came out positive. She said she’s married but her husband died few months back due to some illness. She has got this pregnancy from someone else. I asked her what next. She replied to me that her parents have looked for another guy for her and she now doesn’t want to carry on with this one. With the long OPD queue still on, I wanted to listen to why she had to go for a relationship that too without safety measures and end up in this trauma.( In my view, it is a mental trauma). She said, “What could I do madam?My husband left me and I need a partner too..” Although her thoughts may not match the societal expectations, still as a human being, I must respect her feelings as she had approached me with utmost faith for a help in this difficult situation. I referred her to the gynaecologist and advised her to go with a family member probably her mother. She then went and she might have been successful in safely aborting the unwanted pregnancy.

After few days, she came again, although there was no reason for her to end up in my OPD. This time she was with her brand new husband and was decked up with a new silk saree and ornaments! Smiling at me, she stood there. I had forgotten her face and as usual, I asked “What’s your health problem?” to which she said,”Madam don’t you remember? I had come that day and you cured me of my fever. I told you about my marriage. This is my husband.” Saying so, she winked her eyes, bent forward to whisper, “Madam, don’t tell about my past to him please..” I didn’t understand why she came as she didn’t ask for any medical help but then I thought that she was happy and wanted to share that with me..

She doesn’t know that I as a doctor, follow my ethics in keeping the patient information confidential. I nodded simply and wished her the best for her marriage. I didn’t forget to advise her to plan her pregnancies. However, I never saw her again.

Some thoughts came to my mind that what if I was there in that position, would it be easy for me to be as happy as her? How is it that for some, such situations seem to be the end of life and for some, it is easy to move on in life? She did not seem to be more educated and life from her perspective is something like to leave behind the past and enjoy the present and expect good things for future. It would have been like a mountain falling on me. I can understand that she would have had moments of war with herself in decision making. Ultimately, she was successful. I don’t know what happened later but I remember that I only prayed to God that the person responsible for her pregnancy should not trouble her in any way.

If we think deeply, until we die, there’s one or the other problem that we have to face. It is nothing but a do or die situation. If we decide to live, there has to be a compromise, to accept the facts, take responsibility for our actions and be ready to face the consequences. Resilience to disasters that we face in life is very important as that capacity enables one to learn the art of living and can be developed by awareness of the self and the will power to move on and face the challenges with more strength than before.

Public health – health of the public

The textbook definition of “Public health” is very broad. But not everyone needs to learn it. But the term is understood to be very non specific among the general public and if we try to know what people understand, the opinions differ a lot. Some think public health is the duty of the doctors and field workers working in the government hospitals, some think it is the responsibility of the local government, the constitution says it is the responsibility of the State government, but ideally, in my opinion, it is for all people, by all people and of all people just like how we define democracy. Anything not supported by the public will be a failure in terms of implementation and success.

The role of a public health officer:

Any doctor is not just a curative person but a public health person. Because, along with his treatment, he always ends up giving some tips or health advices.When it comes to a government medical officer, his services are so valuable in the prevention of ill health in the whole population since he not only gives medical treatment to the ailing patients in his daily out patient department, but is also constantly involved in the preventive and promotive activities at the community level and in the implementation of various national health programmes. He has a multitude of responsibilities and has to work in co ordination with the local government. And that’s the reason why his post is not called by the name “Doctor” but by the name, “Medical officer”.

The role of the public:

Anything done even if it is for the sake of the betterment of the people at large, the people’s i.e the public support is very much essential for the success of the programme and for the value to be added to the money spent for carrying out the  health activities. Hence, it is greatly required that the public tries to understand and implement them and also actively take part in the decision making process itself. Healthy nation building starts at the individual, family, community levels. Public health is for all to understand and take a role in the society largely by self- motivation and adhering to the expert advise based on scientific evidence.

The need for a public health expert:

Public health has not been a favourite subject for many post graduate aspirants but nowadays, it is very obvious that public health will be and must be given equal priority as any clinical subject. The opportunity to serve in this field is also lesser compared to the demand for a treating physician in any health set up. Just as an anaesthetist’s opinion is very much required before a surgery as well as a fitness to be given by a general physician for the same surgery, health policy must prefer that any or every public health challenge must be solved by taking the expert opinion from a public health specialist in the fore-front along with experts from other fields. The unique problem with this speciality is that even after a solution has been arrived at by the public health specialist, the implementation of the plan or the solution depends mainly on the extent of political commitment.

With many public health challenges existing since ages that keep increasing in number and with newer and changing scenarios depending on various factors, the requirement of public health specialists is being recognised by one and all. Compared to yester years, a handful of public health specialists are getting graduated every year through various courses offered by  universities or any recognised institutions. At this point, there is a felt need to create more posts suitable for the public health specialists as this will be a win-win situation for both the aspiring public health experts as well as the population served by them. Ultimately, the goal of such health reforms must be towards the achievement of the developmental goals of our country and set an example for other countries as well.

A thankless job:

Everyone pursuing this degree knows that the job itself is not a very thankful one; but a strong inner urge to do something useful for the society as a whole pushes many doctors into this field. With due respect to the ever- in- demand clinicians as well, I would like to explain a situation why I call this a thankless job. Imagine a person who was visiting a primary health centre physician and was so impressed by his knowledge, attitude and clinical skills that he made up his mind to quit smoking. So that would have (if we imagine that other than that he did not have any other additional risk factor) added his years of healthy life by greatly decreasing his risk to acquire any disease related to smoking. Incidentally, imagine the doctor getting transferred to some other place and the person resumed his habit of smoking. Later, if he suffers from any complications related to his habits and then visits a clinician or surgeon as relevant and then by their treatment and by God’s grace, he gets well, it is obvious that he will remember his treating clinician for the rest of his life as his saviour.. Rarely will he ever thank the good old friend at the primary health centre who had advised him years ago against his habits that are detrimental to health.

To conclude, I would say that it is human nature to not worry about things that are not of an imminent danger. And not to get scared or panic when not in pain or until his life is threatened. But for a public health expert, it is not a matter of a single individual. He always strives for the health of the population. The learning in this field or in any field is never ending. And the contribution of each and every doctor is priceless be it a clinician or a public health expert. The only difference being that when a clinician can save hundreds or thousands of lives, a public health expert can save millions of lives.

Im…perfect

Perfection is a myth. It’s a goal not reached by any man. But, do we accept this? No. But we always strive to be as perfect as possible in the eyes of the ones we like the most in life. Is this right? I’m unable to come to a conclusion. It’s true that it feels nice when my parents are proud of me, if my family members adore me etc. But is it a true achievement? It’s equally true that I have heard them talking displeasingly when I was not able to keep up my promises. It hurts then. So now what should I do?

There was a time when everything in life seemed to be perfect.

As days and years flew by, it
seems now that all is but imperfect.

Why from others do we at all expect?

I pray God that He gives everyone the courage to fight with the inner conflict.

Because only inner peace can make life near perfect..

Pleasing others is ought to bring disappointments. Because others’ opinions depends on their mood, their perspective etc etc. Instead, it is better to think over and understand what is my goal in life and what is it that I’m contributing to this beautiful world so that I can answer God who has given a chance to be born as a human being who is gifted with a brain that no other species has.

My first step to accomplish this-

STOP EXPECTING ANYTHING FROM OTHERS. Give me to myself. Think day and night. Who am I? Why am I still here? Yet to find my answers…

More than a year of Corona panic..Have we won as a human race?

Yes, it has been more than a year for the world of how the Corona virus started disturbing the whole planet in terms of sustainability of human lives and how to cope with all that stuff.. For a layman, or I can say any human being,it is hard to get scared of something again and again..One can get scared of anything say ‘X’ only once. And then after surviving ‘X’, if ‘X’ recurs it’s not as scary, but definitely some other thing say ‘Y’ can scare us! So after few more months or years with the decline in the graph of Covid pandemic,people would not be as fearful of Covid as before but surely some other potential bacterial or viral strain can become a cause for panic. Reaction to anything is nothing but brain stuff! Covid did become a cause for existential anxiety for many if not for all and atleast for some time during the year that passed by, if not now.

It is a known fact that Influenza virus strains can mutate to new strains.What is occurring silently in nature matters only if it is damaging to a greater extent to man!What everyone should consider is that the preventive measures for Covid-any strain remains the same.We cannot relax back without protective measures such as to continue practising social distancing,wearing protective masks in overcrowded and ill – ventilated places,hand sanitizing measures etc. These measures are surely effective in protecting us not only from Covid but also from a range of many other communicable diseases, air borne,those caused by droplets/micro-droplets or by surface touching.

“Prevention is better than cure” is an old and apt saying which has proved to be true time and again. And now, vaccines for Covid are around the corner and at the least,they have been effective in generating the positivity in general in terms of man’s quest to win over the diseases. (As if to say”Yes!!We did it.We won!!)The effectiveness of vaccines in terms of cases averted by getting vaccinated as also the safety profile and successful seroconversion are yet to be confirmed by large scale studies in future. But vaccines are not meant to give false protective notion in that those vaccinated would stop practising the preventive measures as listed earlier. Because a single or 2 doses will not assure life long immunity. Studies are yet to be done to prove the length of the time that we are protected. So the only defense are our changed habits and sustaining them into the future! There are umpteen number of threats visible and invisible as far as health is concerned and it will definitely not end with Covid. Think of the number of people who succumb to accidents,to suicides,to the invisible effects of polluted environment etc etc…

The overall concern for man to protect his own health and to maintain the species on this planet is to be friendly with our ecosystem through a broad range of activities not counter productive but productive! ‘Go green’, ‘Save water’,’Say no to plastic’,’Save tigers’,Save this.. that…are all limited to only few environment savvy individuals and organisations across the world. And most of the time they are deemed to be irritable,interfering (with the comfortable  techniques and things which we have been used to since many years),and eccentric enough! Who would like to pay an extra 5 bucks to buy a cloth bag instead of the cheaper plastic bag? While some are deficient in money,some are deficient in knowledge and some are lacking in both.Who would take pains to throw the waste into waste bin only when one can throw on the road itself after confirming that no one is observing! The list can go on!!

This is something to think over! Wishing ourselves the human race to sustain not only ourselves but the whole planet,an inclusive growth and interdependent and happy eco-systems.