HAPPY DEEPAVALI INDEED

For the longest time I can remember, Deepavali always meant lots of savouries, free goodies, joy, crackers and new clothes. This Deepavali was a wee bit different. Of course, gifts, sweets and new clothes were a part of the festivities this year too. But this time, I celebrated mine working on all 3 days. I spent my time talking to my patients, sharing their happiness, joys and fears. I celebrated it by sharing my sweets with a cute little 3 yr old suffering from an acute form of leukemia, who has now been in the hospital for over 2 weeks. All he gets this Deepavali are beautiful visuals of the light studded sky from the window of his hospital room. 

It is sometimes frustrating that we work tirelessly day and night. Personal life, loved ones, parties, family gatherings and sometimes even important exams may take a backseat. But it disappears when you have even one person coming and thanking you, making you realise that every little minute you spent for them was worth it.

The festival this year has been extra special because we have also done an autologous bone marrow transplantation for a patient suffering from multiple myeloma. It would give her a chance to live disease free for 2-3 years. For people whose expiry date is more or less known, even one extra week makes such a difference. These procedures are huge for the hospital (also in terms of income. He he.) These people are extremely prone to infections post transplantation and have the risk of high morbidity and also mortality in about 5% of the cases. That may seem like a small percentage only. But even one patient we lose is a big loss to us and their families. Hoping that she breezes through the next 20 days safely. 

I don't know how the transition happened - dolls to people, playing doctor to being a real one, a real stethoscope replacing the toy one I used to pocket all the children in the neighbourhood. But I am glad it happened and I know I would do it all over again if I had to. 

WHERE THERE IS A WILL, THERE IS A WAY...

"I had amenorrhea for 2 years. I never bothered to pay attention to it because I was so busy taking care of my family. When I finally visited my gynaecologist, she recommended that I undergo a scan, which was suggestive of chocolate cysts, a relatively benign condition. She told me that a laparoscopic surgery can resolve my problem. The operating surgeon, on the contrary found cauliflower like growth all over. She was shocked. She immediately closed me up and informed my husband. It was 1992. I was diagnosed with stage 3 ovarian carcinoma. My girl was 10 and boy was 4. Eventually a debulking surgery was performed. I was given high doses of endoxan (a chemotherapy drug) which made me lose my hair. I fell sick often. I would endlessly retch and vomit. Those were dark days. But I was almost cured of it. I travelled all the way till Apollo Hyderabad for my follow ups. All was fine, till it resurfaced in 2001. My daughter was a medical student. My abdomen had to bear the brunt of another surgery. Coincidentally, I met the gynaecologist who had operated on me for the first time. I couldn't help but stare at the wig she was wearing. She seemed to have read my thoughts and promptly told me how she was diagnosed with breast cancer and had to undergo mastectomy. I was speechless.

Post second surgery, I went to the hospital for a follow up. That's when I learnt she went into coma and passed away in the same hospital. What a cruel twist of fate. The lady who gave me a second chance in life lay there motionless.

Soon, my daughter moved to another country and I lost my husband. I've changed a few doctors. I've had near miss events happening in my life. A lot of people and things left me, but this damn cancer doesn't seem to. But I am not going to quit fighting. I am a survivor.... "

I hope this incredible woman who has tirelessly fought cancer for the last 2 decades serves as an inspiration to every single person out there in the world because out of difficulties grow miracles!

THE POWER OF TOUCH

I have comfortably slid into my daily routine of seeing sick people and trying to nurse them back to  health all in good time. Most people look at us either as God or monsters, but the fact really is that we are human beings like everyone else .Today was a little different. Appreciation for your work makes you work harder. When it comes from your patient, it makes you realise why you got into this profession in the first place.

We have a patient who has been with us for over half a decade now. She explained to me the importance of "touch" in our profession. She explained to me how a very small thing like me patting her shoulder gave her so much of satisfaction and more importantly, courage to go about doing her daily chores.

Patients who carry the burden of a disease which is still considered stigma today are always looking for more love, in addition to care. These little things are never taught to us in med school. They are a mere reflection of our personality. She narrated to me how her previous oncologist always wore a mask face and would never answer queries, leave alone anything else. She, being a doctor herself,also spoke to me about how times and health care have drastically changed in the last 2 decades, when she was first diagnosed with cancer. 

Before I left her room, she thanked me for spending some time listening to what she had to say and did something that caught me by surprise - she held my hands and kissed them. That's when I truly understood what she was trying to say. 

...BECAUSE EVERY DAY IS A SECOND CHANCE

"According to Elizabeth Kubler-Ross, when we are dying or have suffered a catastrophic loss, we all move through five distinct stages of grief. We go into denial, because the loss is so unthinkable, we can't imagine it's true. We become angry with everyone - angry with survivors, angry with ourselves. Then we bargain. We offer everything we have. We offer up our souls in exchange for just one more day. When the bargaining has failed and the anger is too hard to maintain, we fall into depression, despair, until finally we have to accept that we have done everything we can. We let go. We let go and move into acceptance."

We take our lives way too casually. Suddenly, one day you realise you're sick. It dawns upon you that you have very little time to do everything you wished to/planned to. You wish you could freeze time. And then it's too late. And just like that, you're gone.....

Hello everyone. I work in the department of Haem-Oncology at Columbia Asia hospital. In a matter of a week, I have seen a lot of different kind of cancers, head to toe. Right from the more common breast and lung cancers to pretty rare ones like mantle cell lymphoma. Though the cancers have varied, the response to a person's diagnosis when they heard it for the first time hasn't. Sometimes it hits you that despite being a doctor, there is no way to possibly alleviate everyone's suffering. 

Back in the 90s, cancer was still unheard of. Diagnostic tests were minimal. Chemotherapy was expensive as hell. There were so many people who died even without being diagnosed. Come, the new millenium, things took a turn. Today, we have treatment for so many different types of cancers and we have new revelations and path-breaking research happening every single day. Yet, the stigma of having cancer is almost as bad as it used to be for tuberculosis if not worse. What we need to understand is that cancer is a diagnosis just like diabetes or hypertension. The number of people who die because of complications of diabetes and hypertension far outweigh those who die of cancer. Cancer does not mean the end of life. It just means that it needs to detected, treated and accepted in the right manner. We do have patients who have lived for 2 decades after initial diagnosis and who continue to maintain well. We should never stop believing in hope because miracles do happen every day! 

Today, a 50 year old lady walked in to our chemotherapy unit. She was diagnosed with early stages of breast cancer. She was shocked and then she was suddenly crying. It dawned upon me that knowledge is not the most important thing about my job. Knowing how to console a person and believing that they can come out of their illness, or training them to be mentally strong about it in terminal cases, is perhaps the single thing that differentiates a "good" doctor from a "mediocre" one.

I feel so lucky to be working in a setup where I am not only learning to effectively communicate with my patients but also learning to be a better person in general. That's my learning curve.


“The things you do for yourself are gone when you are gone, but the things you do for others remain as your legacy.” 

IN(Not So)SUR(e)ANCE: Learning the hard way

For me, hospitals have always been about work and treating sick people with all kinds of ailments. But that perspective changed when my father got admitted to the cardiac ICU at the hospital I was supposed to start work at in 2 days. I saw a whole new side to it. A side where a security guard had to permit me to let me into an ICU. What I had taken for granted before was something that came to bite me in my back. Thankfully, becoming a prospective employee and some pull got me in without much hassle for the rest of our brief stay there.
I, for the first time actually understood the proceedings of insurance and their policies. At first, I was mostly ashamed that I had no idea whatsoever about insurance policies being a health care provider. But hey, there's a first time for everyone and I am glad mine happened, albeit the hard way.

In comparison with the hospital where I imbibed the tricks of the trade (read as Davangere, a small semi urban town where you lawyers and filthy rich doctors breed), corporate hospitals are a whole new chapter. Corporate hospitals have changed the dynamics of health care. Health insurance, a thing that was almost unheard of in India in the last century is the way health care rolls these days (in an urban area of course). It has also reduced the burden of middle class fellows like us. But with the bouquets, come the brickbats. Remember, that insurance companies are very good in convincing you to buy a policy and are very happy as long as you're paying your annual premium. But when it actually comes to doling out money for your hospital expenses, they don't give in without a tough fight from their end. Query after query finally resulted in a 70% payment from their side and us getting discharged after 10 whole hours!! In a small way, I felt pretty cheated. Looking back, all of the above said about insurance companies would seem very obvious. But unfortunately I never paid heed prior to this experience. So here I am sharing my experience with you briefly so that you don't feel as lost as I did.

1. KEEP COPIES OF YOUR INSURANCE POLICIES FROM THE PREVIOUS YEARS TOO. DO NOT DISCARD THEM. (They are retards who want to see your policy from 3-4 years even though they have documentation of your loyalty to them)

2. As soon as your kin gets admitted, hunt for the insurance and billing department (I&B)of the hospital. They'll guide you with the procedure. You just fill in a form of your TPA and hand it over to the staff so they can email it to the respective TPA for approval.

3. Approval should roughly take anywhere between 2 hours - 24 hours depending on the insurance company.

4. Once you get a nod for discharge, inform the I&B department. Be nice to them and bat your eyelids to get your work done quickly. (Everybody is put off by shouting. Even though it can be frustrating, remember that they are also tending to a lot of other patient requests. Hence, be patient and dignified).

5. Insurance companies will never sanction the amount right away. They need proof for everything and will always have a gazillion queries to know how genuine the illness was. Let the staff of the hospital deal with that.

6. Also, constantly check with your insurance company the status of your submission by dialing their toll free number. A lot of times lacunae in communication may result in unwarranted delays.

7. Pray that everything gets processed fast.

8. Once the amount is sanctioned, walk out of the hospital better and happy.

(The above mentioned is merely for the cashless facility. For the reimbursement facility, I'll have to wait to learn all about it)


With changing times, sedentary lifestyles and a polluted environment, more people are falling sick. When prevention isn't an option/happening, cure is the next best thing. With more corporate hospitals and tertiary care hospitals cropping up, tiny nursing homes are disappearing. The entire nation is also aware of the rising cost of health care in our country. So my personal recommendation to everyone is to buy a health insurance policy as soon as possible. Make sure that you find a good one which fits your bill and processes claims fast. You never know when you may need one. 

My thoughts are stars I can't fathom into constellations

I had a very interesting conversation with one of my friends recently about human greed and expectations with respect to relationships. He gave me really good advice. We are forever in pursuit of, let us say, lusher pasture. It’s such a vicious cycle. But isn’t this greed the very thing that makes us so human? That makes us err and do right? That gives us enormous experience. Is there ever an end to it though? There is. It is when you decide to mature and realise that hey! I am happy with what I’ve got. It apparently happens at some time. Waiting for my turn….

Life as we know it

A few days ago, I went rafting in River Kelani, Sri Lanka. At a point of time, I jumped off the raft into the river. It was the single most LIBERATING experience of my life. Its funny I would like to term it so. It was probably symbolic of a life I was leading and didn't want to lead anymore. I initially thought I'd drown and die. But my life jacket came to my rescue. It was only minutes before I felt at ease. I swam and floated for about three quarters of a km; I could lay on my back, watch the blue skies dispersed with white clouds drift away from me and let the sparkling water push me forward. I thought of nothing. Open space and open mind.
If only we could extrapolate this to our real lives. If only we weren't scared of dying. If only we weren't so scared of living. If only....