...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....

SEX, DRAMA AND EDUCATION

The latest controversial headline doing the rounds is “Sex education should be banned”. Well, here is my 2 cents on the issue:

I was posted in the ultrasonography department during my internship. I was sitting next to my PG who was explaining the basics of identifying structures on the computer screen in front of me. He showed me a gestation sac with a tiny little creature inside. The little heart was beating on our monitor. Our patient was a 15 year old unmarried girl from a nearby village who was 3 months late according to the history she gave. She was referred from the OBGynaec department to rule out pregnancy. She was initially suspected to have severe anemia which was treated with a pint of blood (Anemia can be a common cause of missing your period). My PG, being a rather old guy, asked her if she had indulged in sexual intercourse in the recent past. She vehemently denied it. And then he posed the question to her, “Then how are you 17 wks pregnant?” She was shocked. Honestly, so was I. She looked like she was going to cry. But she was trying to be completely brave about it. She begged us not to tell her parents about it. She being a minor, and this being India, the PG said he had to inform someone about it. So, her elder sister who had accompanied her was called inside and informed. Barely 2-3 years older than her, she was at a loss of words herself. I felt so sad for the little girl. The consultant radiologist, a lady in her late 50s had nothing nice to say about it. She thought the girl had no culture and these people are hopeless. I really hope she didn’t find a well.

This incident made me believe that sex education is such an important aspect of education in a country with such a huge adolescent population. This is more so in a rural population where adolescents don’t have the knowledge or the access to internet and media, in comparison to their urban counterparts. This girl, all of 15 had no idea that she should be worried about a missed period after having sex. Had she known that, she would have probably come to us earlier when it would have been so much safer to terminate the pregnancy.

Our health minister, himself a doctor, thinks we need to weed out this western culture of pre-marital sex and extra marital affairs. Which era are you living in? When was it ever western culture? Our epics are all about pre-marital sex and multiple sexual partners. (Of course, it had its fair share of downfall) Banning sex education isn’t going to stop people from having sex. Let us face it, we are all animals. Our carnal instincts always get the better of us. The more forbidden something seems, the more you want to indulge. What can be done instead is to learn the ways to protect our adolescents from unwanted teenage pregnancies, life threatening sexually transmitted diseases and a lifetime of hell. Boys and girls are peaking by 12-13 years these days. This is why sex education should be imparted by the age of 13 – safe sexual practices, personal hygiene, the advantages of monogamy, awareness about rising incidence of cervical cancers attributable to multiple sexual partners and earlier age at the time of first coitus, and sexually transmitted diseases. It’s not just enough if sex education is being imparted. It should be imparted effectively. If teachers are shy, call upon health personnel who are ever willing to share their views uninhibited.

Our culture is such that parents also refrain from discussing these issues. I never got “the talk”. We resorted to books, peer and the internet. For the less fortunate, the government has to do something, if they want their adolescent population in safe territory. 

Dear health minister, our culture was never about monogamy. Men have always been men and indulged in what they pleased, married or not married. Uneducated women, who were barely exposed to the world never suspected anything and even if they did, put up with it to uphold traditions. But today, women are educated and hence, it’s a different story. He said, “Condoms promise safe sex, but the safest sex is through faithfulness to one's partner. Prevention is always better than cure.” Although it makes sense, trying to preach this to a million horny people is futile, I believe.

I am not suggesting the adolescents of this generation to be rabbits. But being prepared and knowing how to tackle a problem can make a difference. Disaster management demonstrates the steps to tackle situations, should disaster strike. You can’t just sit back and ask Nature to stop taking its natural course. 

CHANGING TIMES

I went to the chaat cart near my house that I've been going to since I was 11. This is the first time I went there after he introduced the disposable plates system. The vendor and I got talking when he told me that his daughter is planning to pursue a course in engineering this year. Having seen the frugal life he has led, I was pleasantly surprised and genuinely happy for this man, who had made it to my sister's wedding with a small gift about 3.5 years back. Nobody wants to be left out of the rat race anymore.

My second anecdote is about the headmistress of a government school near my house that I recently visited. A distraught looking mother came to the headmistress and told her that she wanted to take back her 13 year old daughter who was studying in that school and lived in the school hostel. On inquiring the reason behind this sudden and drastic decision, it came to light that the father was opposed to the current setup due to a financial crisis. The class teacher came with the school records and exclaimed that this child was doing extremely well in class (3rd in class) and would surely get a distinction in 10th if she pursued and worked harder. The headmistress sent the mother back saying she wouldn't permit this withdrawl from school and she would personally make sure that the child got education and accommodation free of cost. This attitude of the elderly lady I was sitting in front of, really won my heart. Education in India, especially of the women makes such a difference in the quality of the life a family leads. If there are little children willing to be educated, there are always large-hearted people who are willing to help.

In another incident, I visited a village for a diabetes awareness camp. I saw a 7 year old girl running about the place with an infectious smile. I caught hold of her and started talking to her. Found out that she loved dancing. She showed me a few good moves. She was unbelievably good for her age. She also told me that she loved going to school and wants to become a doctor like me when she grows big. The very fact that she had such a huge aspiration given her humble background is the stepping stone to achieving something in life.

Dream big, because the sky is not the limit, we ourselves are.

THE GIRL WITH NO NAME

The sky was a mosaic of colors. Grey clouds dispersed among patches of blue and red along with ribbons of gold. As it turned purple, it eventually dissolved into the darkness. Sitting on the dusty stone steps that had once seen daylight, night and more, we sat there lost in ourselves. We poured our hearts out, filling in each other with every thing we had missed out on so far to the most intimate detail. We sat and wondered how it felt like time had almost stood still, like 6 years had never happened. So much had changed, yet so much was the same. Took us back to ancient sunny afternoons when we'd bake a cake religiously after school, try all these absurd culinary stuff on each other. While some memories reminded us of how insane we were to have a girl band without people who play any instruments, some others took us back to "Girlfare awards" which we had completely rigged. Sunday morning painting classes, combined study sessions, holi celebrations with ujala water, insanely competitive bulletin board competitions, discussing crushes and eventually love lives, innumerable auto rides back home with her sitting on top of me, running up the hill clinging on to our bags, long walks and long talks and sharing our dreams paint vivid pictures on our timeline.

When I look back, I see 2 little girls happily running to school, so late, yet managing to make it just in time. I have known this girl since we were all of 3 years of age. We went to the same play school, kindergarten, primary school, middle school and high school. That's indeed a long time to know someone. And then we parted ways to chase our dreams. Today she is an architect and I am a doctor. We are back in the same city ready to renew our threads of friendship. I know for certain, that with this girl, I squared my knots right!