An empathetic doctor, or empathy for a doctor?

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The picture has been taken with consent.


An empathetic doctor, or empathy for a doctor?

My ENT rotation for fourth-year ended last week; the crazy schedule that it saw me dealing with, however, did leave behind a few worthy lessons, like the importance of patience while communicating with patients, and some intelligent understanding at the patients’ end.

Doctors – especially in our part of the world – are also under the constant shadow of suspicion. From the ‘useless’ and ‘unnecessary’ tests that they are accused of prescribing to the truckload of medicines that they weigh you in – the majority of the population will always double-check the doctor’s diagnosis and management plan with a source that they find a bit more reliable – Google.

While it’s good to educate oneself and be aware, it must be noted that Google is a search engine that links you to often inauthentic information. Very few sites – like Medscape – carry up-to-date information and are hence, used by the doctors themselves. Years of hard work and a precious youth spent over amassing all that clinical knowledge cannot contest the incomplete knowledge that one can gather from a few reads of an internet article, without any prior background knowledge of the complex workings of the human body. Every disease has a different prognosis, a different course. Every patient responds to every disease, every drug differently. How so? Because factors like age, gender, biomass index, race, co-morbids (other pre-existing diseases), and personal history matter more than we give them credit for. So yes, every patient certainly is a different story and that is exactly why bedside learning is highly encouraged.

One of the many problems plaguing our society is the unfortunate fact that unless its the pending electricity bill that threatens to cut off the power supply, our people will not pay immediate heed to any problem at hand. The majority will not head over to the doctor unless the disease has progressed to a stage where not much can be done. Be it a recurrent pain in the ear or a suspicious lump in the throat – a visit to the doctor is always the last option. How so, I wonder, can the doctor treat a disease that has already progressed – due to mere negligence on the patient’s part – to a stage where it can only be symptomatically managed and not ‘cured’? Yes, it’s the ‘too late’ scenario here that needs to be considered before harbouring unrealistic expectations from another human who has spent years studying from various resources, training for over thirty hours straight every three days irrespective of birthdays, weddings, festivals.

Similarly, a single medicine can be used to treat multiple signs and symptoms. Often enough, a medicine’s side effects are used to achieve the desired result. For instance, Ventolin (Albuterol) is a drug used commonly to prevent and treat difficulty in breathing, wheezing, shortness of breath, coughing, and chest tightness, caused by diseases such as asthma and chronic obstructive pulmonary disease (diseases affecting the lungs and airways). One of its side effects is hypokalemia, low blood potassium levels. So if the doctor deems it safe, he/she may prescribe a dose of Ventolin inhaler to a patient with high levels of potassium in the blood. In such a situation, a seemingly harmless Google search will only confuse the poor patient or his family simply because of lack of prior knowledge and understanding. It must also be noted that every drug interacts with another and often enough, they work together to achieve the desired result – lesson learnt: it is very important to take the medicine as directed by the physician. As is with antibiotics, leaving a dose as soon as the symptoms disappear only makes matters worse because the drug needs to act on its target for a specified time period for it to completely eradicate the cause and to also prevent recurrence. Failure to do so always results in the patient coming back to the doctor with the same disease – often worse – and almost always holding him/her responsible.

Another important thing to remember – and what many patients and their families have reservations over – is that laboratory or radiology tests are important investigations that help present a clear picture of what really is going on inside the human body to cause the signs and symptoms that the patient can experience; only then, can a definite diagnosis, and hence, an adequate management plan be reached.

While it’s definitely true that the healthcare set-up has become notorious for exploiting patients, that is not always the case. Some basic primary-level science teaches us how complex the intricate, interlinked system of the human body is – so how can ‘fixing’ an abnormality in this complex system be an easy task? The different subjects taught during M.B.B.S. – anatomy, physiology, biochemistry, pathology, pharmacology, behavioural sciences – are all deeply interconnected which is why the modern curriculum is structured around a module based system – the cardiovascular system, the respiratory system, etc – that helps build up a strong understanding of how the human body really works.

If only half the population understood some of the above, it would ease the lines of frustration on many a doctor’s forehead as they try to reason and counsel patients and their families.

So the next time you feel unwell, do not – for your own sake – delay consultation with a good doctor. And when you do consult one, remember that they, too, are humans in need of some empathy!


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This picture has been taken with consent.




Of men and household chores

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Times are changing and so are perceptions about gender roles. Men aren’t the only ones stepping outside comfortable homes and women aren’t the only ones taking care of the household. The modern relationship has also evolved with the walk of time — and it’s great! An increasingly large number of young men and women are growing to realise that together, they can achieve so much more, and at the end of the day, there’s no set of rules defining what a man should do or a woman shouldn’t do because, really, it’s all about the sort of companionship that looks out for the other, cares for the other.

An archaic practice that has been ruling the lives of the people of the subcontinent is how the kitchen isn’t the man’s domain (are you wondering who works in the kitchens of the finest restaurants of the world?).
It saddens me to write this, but there are still households — and there always will be if the media doesn’t halt with stereotypical productions that feed easily influenced masses — where girls are told to serve food to their brothers, but never the other way around; where women are seen toiling away in front of the stove, mastering the art of making ‘gol rotis’ and the perfect biryani because “the way to a man’s heart is through his stomach”, but never have we had the rare pleasure of witnessing a husband lovingly cook for his wife.

These unappreciated women wholeheartedly look after the entire household — cleaning, cooking, doing all of those little chores that ‘some’ men (yes, one must be politically correct, no?) are just lazy to do — but never have we had the rare pleasure of watching these men help her wash the plate that they ate in.

We — yes, we — seem to forget that a home is made a home by the efforts of two individuals sworn as one, and not just the woman’s. Sadly, the ideas of companionship and compassion have been unjustly brushed aside as ‘unrealistic expectations’.

A common complaint that one hears from married men — and that makes you sad for their boring lives — is that their wives are always too busy with the household chores to spend time with them. One wonders if they’ve ever tried to work this out by offering to do the dishes together? Or the laundry? Or cleaning up the mess in the living room? Maybe the fact that doing things together strengthens the relationship is just an old wives’ tale. Just like going on a vacation? Or for a movie?

With a pair of perfectly healthy arms and legs, it’s a surprise – and a shame -that most boys expect their mothers to iron their clothes, to clean the mess that is their room. With an attitude that demonstrates how dependent these men are on women, one naturally wonders why they consider themselves to be the superior sex.

And the men who already do that?
It’s safe to say that they have every right to be proud of themselves because they’re doing things the right way, and have earned the respect of their mothers, sisters, wives, and daughters, along the way, and have set a laudable example for their sons. They have broken stereotypes — if women who rise above stereotypes are celebrated, one can clap for these men, too! — and have the eye and the heart to see beyond the tired smiles on the faces of these women — extraordinary homemakers — who selflessly look after them, sacrificing, perhaps, their own dreams and ambitions for theirs.

And as I approach the end of this observation, I am very proudly reminded of a dear cousin and friend who taught her son the basic survival skill of cooking as a way of demonstrating the scientific phenomenon of melting, boiling, freezing, crystallization, and the likes; and taugh him that by picking up his own clutter, he’s been a responsible man. More power to you, lady! (Ladies and gentlemen, you may want to take that up!)

Venus Versus Venus.

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The rustling of the leaves around her was playing a mellifluous tune that seemed to soothe her heart. Looking around, she tried to breathe in the beauty of the golden floor of autumn leaves, the dry, prickly, cold wind. It was beautiful. And where there is beauty, there is grief. There is something very mundane and cliche about the companionship of beauty and grief. You cannot escape it. It crosses path with you at least once in your lifetime. And the bitter truth was that her broken heart was conceived by none other than those she called her own. Instead of receiving sincere congratulations , all that had greeted the news of her eagerly anticipated motherhood were the very Asian tenebrous comments of her mother, “Beta hona chahiye taakay susraal myn position strong ho.” (It must be a boy so that your position amongst your in-laws is strengthened.) that were later validated by her mother-in-law as a vocal hope of a grandson to carry on her son’s name. She wondered if they realized that it was not through her that the gender of her child will be determined. She wondered if they were ashamed of their own existence as women.

Happy Women’s Day.

The silent tears of grief and hurt stained the soft track of her cheeks as the conversation that she had earlier with her mother clogged her brain. Fury and disgust had flowed through her veins when she had recounted to her, her first encounter with harassment from the opposite sex, only to be later questioned if her actions in any way whatsoever were indeed not responsible for the unsolicited attention. It was beyond her why it was a universally accepted notion that a woman absolutely MUST have committed an act that had aroused unwanted interest in her. It was beyond her why despite being a woman, her mother was oblivious to it. It was beyond her that despite being a woman, her mother had failed to understand, let alone even acknowledge, her predicament.

Happy Women’s Day.

Silently sipping on her hot tea, she killed her faith in humanity as she overheard a group of her female colleagues conniving to malign another female colleague’s character in hopes of sabotaging her chances at promotion. The green eyed monster was a monster worth fearing.

Happy Women’s Day.

A psychologist by profession, she encountered several cases where one woman played the devil for another – be it the ‘other woman’, the insecure mother-in-law, or even a jealous sister. General observations had mournfully led her to the repulsive conclusion that the vicious cycle of female oppression was conceived, nourished and propagated by none other than women themselves ; women who believed in incarcerating another woman’s dreams and aspirations, women who believed that the only way they can domineer is by being a tyrant oppressor of unlived hopes, women who believed that ‘man’ was an asset, a treasure to be won, women who had absolutely no identity other than A’s daughter, B’s mother, everydayC’s wife. And with that realization, a little part of her every day.

Happy Women’s Day.

Exhausted after the day’s work, she stepped within the comfort of her house, looking forward to a relaxing nap. She should have known better. Her younger brother had returned from work too and was hungry. He must be fed. And she must smilingly forget her aching back and serve him food. Why? Because he is her ‘brother’. He is a ‘boy’.

Happy Women’s Day.

She was told not to work. Why? Because pots and pans were her destiny, and marriage her aim. It was only ‘natural’, she was told. Blindfold us to the fact that it only seems natural because we have been taught to consider it natural, thanks to our society’s very own, clear-cut ideas regarding gender roles, leading to gender stereotyping. If staying at home is synonymous to child-rearing and domestic work, then it should not be forgotten that a home is made a home and not just left a “brick house” by both the husband and wife, i.e. a man and a woman. Therefore, it is their joint and equal responsibility to “stay at home”. The bottom line is that it is every woman’s right to choose between staying at home, between pursuing a full-time career and between juggling them both. The choice should be her’s and her’s alone and should be respected and supported at all costs. Because if a woman chooses to stay at home and look after her children, then that itself is laudable. Again, it does not mean that any woman is forced into it. But again, her arguments and reasoning fell on deaf ears.

Happy Women’s Day.

He always expected his wife to do all his chores, from making a cup of tea to ironing his clothes. After all, that is what he had seen, what he had been taught. His mother did it for his father too. He clearly remembered how his sister would be told to perform even the simplest of his tasks, not because his own limbs were not functioning, but because his status as the male child gave him privileges that his sister could only dream of, and poison her own sense of self-esteem during the torturous process.

Happy Women’s Day.

Staring at her healthy reflection in the mirror, she pondered deeply over the words of her ‘friend’. Running her hand over her wheatish skin, she stifled a sob. She had been sadly mistaken in thinking that the genuineness of her heart, the strength of her character, the goodness of her nature, the intelligence of a mind well read, and the morality of her dogma would define who she was. Her dear ‘friend’ had just pointed out the obvious – a woman’s worth was weighed depending on the adjective that was used to describe her physical attributes only ; pretty, fat, chubby, beautiful, short, tall.

Happy Women’s Day.

Men may be from Mars, and Women may be from Venus.
Before we stand up to fragile male egos, we must deal with our own.
Before we declare all men to be the ultimate threat to female prosperity, we must inhibit the baseless, egoistic vengeance that we women are thriving on.
Before we formulate laws against abusive husbands, we must teach the sons that respect is earned and every human being matters.
Before we rally against female genocide and infanticide, we must embrace the idea of celebrating womanhood.
Before we utter blasphemies disguised as appraisals like “You’re better than a son ” or “You’re not less than a son “, we must embrace the rude awakening that there never was any comparison, that sons and daughters are unique in their own capacities, that a daughter is as good, sometimes even better, than a son.
Before we preach, we must act. And we must act now. Otherwise, this horrendous cycle will fail to meet its Waterloo, and this archaic malpractice will brutally be the death of many innocent souls.

Do not be a mere statistic attending walks and seminars in favour of feminism.
Be the difference that you wish to see.
Bless the change that you wish to catalyse.
It’s a matter of humanity, not feminism.

Yes. Happy Women’s Day.

Women and financial independence

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Sad as it may sound, a large percentage of the female population willingly chooses to endure physical and emotional abuse at the hands of their guardians (let us conveniently ignore the fact that an adult woman here is still in need of a guardian), namely their husbands, fathers or brothers. That is a solid fact that you will have to come to terms with during your clinical years as a medical student, at least, specifically if you are a female attending to another female patient. Tending to patients with very obvious marks of physical abuse can be more infuriating than heartbreaking. Why do these women choose to stay in such abusive relationships, one may ask.
The majority of the women, especially in our part of the world, choose to remain in abusive relationships because “Hum phr kahan jayn ge?”  (Then where will we go..?)

You – an educated individual, completely in charge of our own life – will declare with great anger that life-changing decisions like these should not be based on something as temporary as money, but rather, on mutual respect, and love. If one wants to stick by someone and beat all odds, and the ups and downs of that particular relationship, then that should be out of unconditional love, not because one is financially dependent on anyone. Financial independence may not liberate one from a lot of incarcerations, but it does help terminate at least one of them, you argue.

It’s a fact: besides the infamous “Loag kya kahyn ge?” (What will people say?), financial dependency plays a major role in such voluntary acts of imprisonment. And let us not disremember that acts of oppression are not merely limited to physical and emotional abuse, but also opprobriously encompass the relentless trampling of frightening dreams, the ruthless murder of camouflaged ambitions, the communal poisoning of censored desires, the scathing judgments on personal likes and dislikes. Naturally, without any means to support themselves, the victimized women continue to bear the brunt of fragile, male egos because they ensure the sole means of their survival.

If they are to seek freedom from this mental inferno, then it is peremptory that they learn to stand up on their own two feet – whether it is by learning basic skills like sewing and stitching, or by acquiring a professional education. This vicious cycle of female oppression that begins with female infanticide and ends at the death of a woman used as a reproductive machine, must stop. This is (one of the many) the ignominious shadow that has been hovering over hypocritical generations since time immemorial and is guilty of inhibiting our social, moral, and intellectual growth. And till that shadow is scared away, we – the ‘saviors’ tending to them, not just physically, but morally, too – must tend to their wounds, must lighten up their way. And as we do that, let us not forget to show some gratitude for the opportunities that we’ve had, the freedom that we’re flying with, the innumerous ways in which we are blessed. Because, indeed, we are.

When Humanity Becomes History….

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It has been ten days. And every eye still has tears. And every heart is still aching.

How CAN anyone slaughter innocent children? Innocent angels who had not even embraced their youth..those ambitious minds that wanted to reach out to the sky, and make impossible possible…
How CAN anyone slaughter the very people who were responsible for educating the future of our country? That too in front of those innocent souls, preparing them for their own death.
How CAN anyone raise the slogan of “ Allah-o-Akbar” (God is Great) before barbarically massacring Allah’s own creations?
How CAN anyone actually praise God before killing angels; innocent angels who were not even old enough to tell right from wrong?
How CAN anyone actually testify to His greatness before ruthlessly setting those beings on fire who were moulding the future of our country?
How CAN anyone praise God before brutally killing little children?

I fail to answer that question.

They are not Muslims. They are not Christians. They are not Hindus.

They are not even humans.

They are a competition to the Devil itself. In fact, even the Devil does not lurk near innocent children. Even the Devil forgives them for sins yet to be committed.

This heart-wrenching act was committed by creatures from another planet.

This is not about Islam. This is not about religion. This is not about trying to paralyse the education sector. This isn’t even about retaliation to the Operation Zarb-e-Azab. This is about humanity.

This is about the humanity that has now become history.

Yes, humanity is now history.

When angelic souls are barbarically killed, humanity becomes history.
When innocent, helpless children are used as means of retaliation, humanity becomes history.
When such national tragedies are allowed to happen due to major security lapses, humanity becomes history.
When mothers lose a part of themselves to monsters who do not think twice before murdering their children, humanity becomes history.
When fathers have to suppress their tears and put up a weak façade of strength while burying those little bodies that they had once cradled in their strong arms, humanity becomes history.                             When a child has to stuff his tie in his mouth to suppress his frightened shrieks while witnessing the wild slaughter of his friends in front of his own eyes, humanity becomes history.

The fact that today the entire nation, in fact, the entire world, stands united to face this calamity, the fact that our political ‘leaders’ have decided to turn ‘oblivious’ to their differences, the fact that we are all deeply shaken, the fact that we are all struck with the kind of grief that only deepens with time, does nothing, nothing at all to restore my faith in humanity.

You are very welcome to call me a pessimist.

But, really, does it take more than a hundered innocent, young lives to be terrorized before being savagely massacred in front of each other, to awaken the ‘humanity’ within us?

The worst is often said to bring out the best in us.
Really? Really?

When ‘the worst’ is the blood of the once cherubic souls that dreamt of seeing the ‘wonders’ of this world, when ‘the worst’ is the dead body of a child who had yet to bid goodbye to the innocence of childhood, when ‘the worst’ is the coffin of a fourteen year old who had just started enjoying the adventurous breeze of teenage, then I do not want ‘the best’ in us to be revealed.

I do not want ‘the best’ in us to be revealed.

We are all in grief. We are all infuriated. Yet, what are we doing? What can we do after all?

Talk shows and verbal condemnations? Thank you very much.

There were blood donations needed. How many of us actually gave our blood to save those who saw the blood of their fellow beings being spilled like water?

We need to eradicate this plague from the world.

Educate your children to spell ‘actions speak louder than words’, so that they act to kill this menace by befriending courage and determination forever; so that they empower themselves to empower the rest their countrymen to swim in success, so that they frame human life – human life alone, regardless of religion and sect – as sacred.

And finally, pray.

Pray not for the forgiveness of those traumatized, angelic souls, but rather, for their families to combat this agonizing loss with infinite courage and patience, for what sins could these little children have possibly committed?
Pray that the injured children regain their health and defeat the murderers of their friends in every way possible.
Pray that the sixteenth of December, 2014, turns out to be the last of such bleak days in the history of our country.
Pray that those bestial predators who have barbarically tortured the apples of so many eyes, suffer unmitigated pain before meeting their end so that they too experience what they have so mercilessly inflicted upon others.
Pray that the nation stands undettered in its resolution to turn blind to all religious, sectarian and political differences to combat the traumatizing threats that are slowly and painfully extinguishing the sparkle from ordinary households.

Get up and do something.
Keep your eyes and ears open, and walk with enough courage to point out any suspicious persons and/or activities.
Cooperate with security personnels and abide by the laws.
If you are employed in any law enforcement agency, then do your job, armed with sincerity and honour.
Establish more educational institutions. Not to turn out a laudable number of ‘literates’ every year, but, to gift to this shackled society educated individuals who will not stop their children from joining the army, who will question the questionable standards and morals of our society, who will hold human life sacred, and who will think beyond religious, political and personal agendas.

Don’t let this incident go down in history books only for the number of casualties, the date of the incident and its political repercussions to be memorized by the future generations.
Don’t let this incident fade away from your memory. Let it remind you of the screams of those children as they were mercilessly slain.
Let it remind you of the blood stained walls of that unfortunate building.
Let it remind you that humanity is, indeed, history.