Monday 26 December 2016

“SUN LIGHT!”



“SUN LIGHT!”

In 1925, when Andrew and his mother came to Calcutta (it was not Kolkata then!), he was only a boy of 5. When they arrived at the Howrah Junction railway station, one of the oldest and largest stations in British India, Andrew’s maternal grandfather, Mr. Watson, who served in the East India company was in attendance to see the sight of his grandson for the first time. Mr. Watson was apprehensive of how his grandson would react when he meets him for the first time. However, amidst the raucous voices of hawkers and hagglers, Mr. Watson was pleasantly taken aback when he heard little Andrew rushing towards him shouting, “Grand Paa!” Yes, the little boy had recognized him from the portraits he had been shown by his mother back home in Manchester.

Andrew’s father, Mr. Samuels, who was originally from the Scottish descent, served as a commander in the British army. However, as had happened with many European families during that time, the World War-I had left Andrew’s mother a widow. With nobody to fall back on, Andrew’s mother, Mrs. Scarlett had decided on the advice of her father, Mr. Watson to take Andrew with her and come to Calcutta where he served in the East India Company. It had been a long travel. They arrived by ship to Bombay and from Bombay it took them another 3 days to reach Calcutta by train.

A few days after arriving in Calcutta, little Andrew took ill and despite trying all the limited medicines available in those days, his condition kept on deteriorating. An Indian fakir suggested them to take Andrew to higher altitude, to a hill station with clean air which would help Andrew recover from the infectious bug he had caught while playing on the filthy streets of Calcutta.

Scarlett was a broken woman. She had recently lost her husband in a war and now she was scared if she would lose Andrew too. She was ready to even climb the Mt. Everest if that would save her son from what was appearing to be an incurable illness.
Sensing no other alternative, Mr. Watson permitted his daughter Scarlett to take Andrew to Darjeeling, a pristine hill station 600 km to the North of Calcutta where he had a few friends who would take care of them.
Mrs. Scarlett could not have found a better place than Mr. Holding’s wood house on the top of a little hill which presented the most alluring view of the valleys and the mountains. Mr. and Mrs. Holding who ran a small English medium missionary school in Darjeeling were good friends with Mr. Watson before they left Calcutta and arrived in Darjeeling 10 years back. When they came to know that Scarlett and her son were coming to their place, they were more than happy to treat them as a part of their family. Mr. and Mrs. Holding had no children of their own and when Scarlett arrived, they started treating her as their own daughter and Andrew, as their grandson.  
It was almost miraculous that Andrew began recovering slowly, his fever started receding and soon he was up on his feet playing football in the warm winter sunshine in the tea gardens of Darjeeling. Was it the air of Darjeeling or was it the natural course of the disease which helped Andrew recover? Andrew’s mother thought it was the former rather than the latter and she was soon in love with Darjeeling. It was hard not to fall in love with Darjeeling.  She immediately wrote a letter to her father Mr. Watson informing her of improvement in Andrew’s health and told him of her plans to stay back in Darjeeling for some more time. Scarlett, who was a lover of literature would always carry her books wherever she went. It was no different in Darjeeling. Every morning, she would read Andrew a story as they would snugly sip hot tea sitting on the steps by the verandah with sun kissing their cold feet and the giant Kanchenjunga offering a golden smile in the distant foreground.
As days passed into weeks and weeks passed into months, many new books arrived and Scarlett took up the job of English teacher in the school run by Holdings. With an excellent teacher like Scarlett at the job, many parents who were earlier skeptical, started sending their wards to the school in Darjeeling from as far as Calcutta. Far away from the hustling bustling British Indian city of Calcutta, the little hill station of Darjeeling was the closest British families living in Calcutta could provide their kids of the European weather- clean air and cold climate.
Scarlett and Andrew took to Darjeeling like fish to water and it was only later that they realized Darjeeling was going to be their home for the rest of their lives. As years rolled on, Andrew went to Kolkata and got his masters in literature from University of Calcutta and began writing short stories for some reputed magazines in India. In the years that followed, India gained independence from British rule, many families left the Indian shores and also took away the students from the school. Holdings too decided it was time to shut the school and leave for England but Scarlett had different ideas. She had nothing to go back to England and decided that she would take over from Holdings and continue to run the school. Andrew who had now grown up to be a young man in his 30s had grown passion for writing and tea plantation. With the money that his grandfather, Mr. Watson had left him in his will, he purchased the ownership of a large tea estate in Darjeeling and decided to help the locals in developing the flourishing business by providing employment and modernizing the tea plantation industry. Andrew decided not to marry and dedicated his life for the upliftment of tribal communities living in and around Darjeeling while Scarlett decided to continue with her mission to educate the locals. Her classes were unique. They had no classrooms but only open garden beyond the verandah of their home, no walls but only tall pine trees all around, no blackboards but only Kanchenjunga in front of their eyes. And she would sit in the center with a book in her hand, reading it out loudly to the inquisitive pairs of ears around; Shakespeare one day, Shaw the other and Tolstoy the next, Charles Dickens the next and so on..
It went on like this for many years. Mrs. Scarlett gingerly stepped into old age and with the wisdom of all the years behind her, she grew into a beautiful old lady.
One day, when Andrew was working in the fields and his mother Scarlett was reading stories in her open-air classroom, she suddenly stopped speaking mid-sentence and fell to the ground. Afraid, one of the kids called Andrew out from the fields. When Andrew arrived, he saw his mother lying supine with a Charles Dickens book by her side, palms open to the sky and tender sunlight playing on her smiling face. He checked her pulse, her heart had stopped beating. Tears rolled down his cheek.



Tears roll down his cheek once more as he reminisces the scene now lying on his bed in one of the most advanced intensive care units of the country.
It is Christmas of 2010. Andrew had a heart attack 3 days ago, and his condition has since been deteriorating. He had lost orientation for some hours and in a state of dizziness had tried removing the intravenous line following which he has been kept under restraint by tying his hands with bandage to the cold steel rail of his bed.
Since this morning, he has been feeling severely breathless. It is becoming difficult for him to utter even a single word. He squirms on his bed as he realizes his lungs can take no more. The pulse oximeter beeps loudly as his oxygen saturation levels begin to fall. A nurse comes running to his bed with his file. She sees Andrew whispering something through the oxygen mask on his face.
“Some light!”, she hears him say. Frantically, she keeps his file on his bed and rushes to the switchboard to switch the lights on.
The monitor beeps once more.
Supine position, windows closed, an ICU room instead of the open verandah, a bed instead of the comfortable green grass, restrained hands instead of palms open to skies, an oxygen mask on the face instead of a smile, an artificial LED light flickering on his face and his case file instead of Charles Dickens by his side.
Andrew has breathed his last.
“Sun light!”, were his last words.

-         DR. DEVASHISH PALKAR.

Friday 23 December 2016

"INDIA SHINES?"

"INDIA SHINES?"

"In some corners still,
A girl of fourteen,
Trapped in a society so mean,
Only one becomes a Geeta Phogat,
Rest succumb to lifelong slavery..
Through the dark corridors of uncertainty,
Indian shines
But only like a dimly lit lamp.


A thousand struggling good men,
Only one becomes an Abdul Kalam,
Many other humanitarians and academicians get smothered by the serpants around..
Through the dark corridors of uncertainty,
India shines
But only like a dimly lit lamp.

A 100 talented batsmen,
But only one becomes a Kohli,
Many others either lose their wickets to good bowlers
Or to the black politicians in white collars.
Through the dark corridors of uncertainty,
Indian shines
But only like a dimly lit lamp.

A land of 100 crores,
But only a handful heroes,
Like a raging fire we should burn,
With all our latent potential,
Like a golden flame we should become,

But,
Through the dark corridors of uncertainty,
India shines
Only like a dimly lit lamp.

Sadly,
The only flame that burns is the funeral pyre,
When these daily unrecognized heroes,
Die a nameless death.. "


~ Devashish Palkar

Tuesday 20 December 2016

THE SONG FOR THE FIGHTERS!!



THE SONG FOR THE FIGHTERS!!

The mountains are tall
But we’ve striven not to fall!!
Champion or powerful, we shall challenge them all!!

As the uncharted seas beckon us to swim
Its time to chase a big dream!
With commitment, let our hearts brim!!

The night is going to be dark and deep,
And we just can’t afford to sleep;
For its time to make a giant leap!!

The roads are going to be tough and lonesome
The journey, weary and tiresome!!
But we are sure we will pull off something handsome!!

Team is our strength and unity is our power
We will never rush for cover
But fight till all is not over!!

We’ve nothing to lose but all to gain!
Come, let’s embrace the pain;
Because only after the scorching sun can we enjoy the rain!

-Devashish Palkar

Thursday 1 December 2016

THE MAN WHO CAN BEAT MS EXCEL- A Case worth discussing

On those rare days during OPD when I am not just doing entries on computer, I always find it fascinating to hear a patient's and his relative's story while the consultant is trying to take out the relevant history of the case.
It becomes even more interesting when it is the OPD of Dr. Bhalendu Vaishnav sir, the head of our Medicine unit 3. I have to confess here that I am an unabashed fan of his communication skills and I wish to inculcate some of those one day. Sitting in his OPD is appealing to the kinesthetic learner in me. It is said, "You learn more by observing a great man than you will ever learn by reading a great book!" It is perhaps true after all.

Wednesday, 30th November 2016, was one such day when I got a chance to attend his OPD as a part of my internship rotation. 30th of November also is the death anniversary of Dr. H M Patel, the founder of Charutar Arogya Mandal, of which my college Pramukhswami Medical College is a part.
Every year in his memory, we hold a memorial lecture which is delivered by some of the most eminent people in the health care fraternity who have done outstanding work in their field. Over the years we have had speakers like Dr. Abhay Bang, Dr. John Oommen, Dr. Keshav Desiraju. This year we had Dr. M R Rajagopala, the father of palliative medicine in India as our speaker.
He talked at length about the importance of the basic human need to die painfree and stressed on the issues of solace for the suffering and how humanity is slowly but sadlt declining in our profession which is perhaps the very foundation of Medical field.

I was very impressed with the talk and after attending the talk came back to Dr. Vaishnav sir's OPD, a place where you can perfectly study the basics of humanity and doctor patient relationship.

Call it serendipity or call it coincidence but exactly a few minutes after I had returned, we received a patient, an 83 year old lady and her 60 year old son to the OPD.

And as if on cue, Dr. Vaishnav sir asked me to go outside with the patient and the caregiver and asked me to interview them on aspects related to elderly health care and the importance of care giver in maintaining health of the elderly.

What I discovered about the caregiver through the 45 minute long interview was pleasantly surprising.

I was dumbfounded by the meticulous care giver who, I think, can make MS Excel proud!
Yes, therefore I have titled this story-
"The Man Who Can Beat Excel!"

Here's a breif account of the patient-

Ansuyaben N Goswami is an 83 year old Hindu widow, residing in Borsad. She is a known case of Diabetes Mellitus type 2, Hypertension and Hypothyroidism since last 30 years on regular follow up and medication.

She has had 5 episodes of Angina in the last 20 years, the last of which occurred in April, 2016. Through all these years, she has been admitted to Medicine ward around 20 times.

She came to Medicine OPD on a wheelchair and requires assistance for her all her day to day activities including bladder and bowel.

Her son, 60 year old, Mr Mahindragiri Goswami, a voluntarily retired government servant, divorced for last 20 years has been taking exclusive care of her.

This may not sound so unusal but what I discovered left me spell bound.

1. Maintaining a health diary~

This man maintains a notebook where he notes down his mother's RBS(Random Blood Sugar), Blood Pressure and Oxygen Saturation levels. He does this religiously for 3 times a day and has been doing and maintaining records for last 20 years.
He also notes down the medicines taken by his mother.

2. "Working knowledge of basic health related instruments"

He has working knowledge of sphygmomanometer, stethoscope, glucose monitor and pulseoximeter.

3. "Giving Medicines On time"~

Most of the time, the sugar and blood pressure levels of elderly patients keep fluctuating since they are prone to forgetting their medicines on time due to age related senescence.

So, on days when he is not with his mother, Mr Mahindragiri keeps the day wise packets of medicine ready so that anyone from the family or neighborhood can give her the medicines on time.

4. "Easy Communication"~

In this fast placed world where of social networking it is often found that old people have difficulties in using high-tech equipments.

To tackle this, Mr. Mahindragiri has provided his mother a basic Nokia handset with his own number saved as speed dial mode so that she can contact him whenever in urgent need.
She also has an electric bell next to her bed at night which she can press anytime during night if she has to wake up for urination or due to bout of cough.

5. "Saving for health"~

Mr. Mahindragiri who worked as a Class 4 employee with government now survives on meagre salary but still saves rupees 20000 to 28000 per year which he keeps aside exclusively for emergency health related condition since neither he nor his mother have mediclaim policies.

*These are some of the most basic steps which can be easily inculcated by all those who have elderly people at home.

In Gujarat alone there are more than 2 lakh people above age 60 years living alone without any caregiver. The geriatric population is extremely vulnerable to many of the life threatening conditions which can be prevented by simple implementation of the above steps demonstrated by Mr. Mahindragiri Goswami.

All they need is some time, love, affection and a caring heart.
Is that too much?
Don't they deserve this much after having worked so tirelessly for our generation during their prime?

Sharing some of the photographs of the patient and the caregiver after having taken verbal consent.


~ Devashish Palkar



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