BLOG - Dr. Javeed Nayeem

The I-card that made me a convent resident

2006-12-29T17:35:00.000-08:00

Read in the papers about the central Government plan to give us brand new multi-purpose identity cards. This is an exercise that has been attempted, at great cost and effort, once before, only to be done shoddily. After two subsequent attempts to rectify errors the Government realised that the cards so issued were no good and served no useful purpose.

My reference is to the electoral Identity cards that were meant to serve as a vital proof of identity, address and citizenship and were supposed to be a mandatory requirement for casting your vote. But their utility was tested with comic results, at the polling booths, where they were most needed. That, in many cases, the card holders’ names did not figure in the voters lists was quite another matter, and yet another example of our bureaucratic inefficiency in executing even the simplest of jobs.

I wonder why we cannot make it mandatory for every citizen to have an identity card with a permanent registration number, and the thumb impressions, as is done in Singapore and almost all countries in the Middle East. Every person there either has to have a passport or an identity card as proof of his or her status as tourist or citizen .This move, if implemented well, will also serve as an effective deterrent to many criminal and fraudulent activities that are increasing at an alarming rate.

As for our elections, such I-card would end the menace of our favourite Non Indian Residents playing a role in the outcomes of Indian elections, an accusation that is made, rather conveniently, by the losers, all the time. The cards the government plans to issue this time should be prepared with a sense of seriousness and commitment, with the job being entrusted to agencies that have a good track record in this kind of work and which can be held accountable for any lapses and losses.

The mistakes made in our earlier attempt have to be seen to be believed, and I do not know whether to call them comic or tragic. I know of individuals who have as many as three or four cards with different addresses. While my own name figures in our voters’ list, but only at every alternate elections, for some unfathomable reason, the address in my election identity card would have one believe that I do not live at my own house. Instead, I am stated to be staying at Anitha Convent, presumably, with a group of nuns. While I may not mind this impropriety, the nuns there are certainly bound to resent my intrusion in their private quarters.

Wither Indian morality

2006-12-28T22:15:00.000-08:00

Recently I saw on page one of a daily the picture of a pretty girl skimpily clad in a minuscule green bikini. She was striking a provocative pose, and, reportedly, Pakistan’s representative at the Miss World contest. The photo caption asked; ‘Is Pakistan watching?’

Why Pakistan, I wondered. Are we, Indians, watching what our entrants showcase at such events? Is the present generation of parents and grand-parents one bit concerned about how our youngsters are presenting themselves in fashion shows and beauty contests, both at home and abroad? Why do we allow and encourage ramp shows where the participants showcase attire and apparel that no one dares to wear in public, even in our metros? Are our youngsters’ attitudes and behaviour and our obliviousness to them in conformity with our culture and heritage? Do think about it.

Living longer; how, and at what cost ?

2006-12-21T21:57:00.000-08:00

The latest issue of ‘The British Journal of Cardiology’ has a thought provoking editorial entitled “How long do you want to live and at what cost?”. Though addressed to the fraternity it is free from medical jargons and simple enough to be understood by layman. It makes sense to the rest of us although the edit discusses the topic from the point of view of a society that depends entirely on medical insurance for health care.

We are now going through a brand new era of rapid scientific development in all spheres, including medical science. Consequently, better nutrition and medical care have helped this generation have a lifespan that is significantly longer than our immediate ancestors'. It has been estimated that in our quest to live longer, utilising all modern treatment options now available, the well-to-do spend nearly 40 percent of their earnings and savings on medical care.

Unlike in the west where medical insurance has been in existence for long, a large chunk of our population still directly pays for the health care it opts for. It is pertinent to point out here that medical insurance too, for those who go for it, only comes at very expensive premiums after middle age; precisely, at the period of life in which we need more cover for a wider array of problems. Irrespective of the financial status of a family, these days people are under an automatic obligation and pressure to opt for the best available treatment which despite its uncertain outcome seems indispensable.

Often people do this, only to give the impression to their immediate relatives and also to satisfy themselves that they have not shirked their duty. This being the case, it so happens that the meagre savings that may have been put aside by an average middle-class family get instantly depleted, if just one member in the family happens to fall sick. As a practicing doctor I have been, of late, seeing umpteen cases where with a half-dead relative lying in an intensive care unit, the family is hopelessly lost between desperately clinging on to hope and letting go while literally paying through its nose for every minute of the agonising uncertainty.

And, under the pressure of extreme urgency, people are forced to raise loans at unreasonable rates of interest which they simply cannot repay without the ‘distress sale’ of their assets. After having invested crores on hi-tech infrastructure, while doctors and hospitals are only too willing to recommend every drug and device they have at their disposal, to delay if not defy death, it is the patients themselves and their kith and kin who have to exercise caution in selecting them, basing their decisions on sound common sense.

Most often the prohibitively expensive treatment, which can have a devastating effect on the family’s financial reserves, only serves to prolong life, of doubtful quality, for just a few months or days. It is very important to realize, both from the medical and financial points of view, that although treatment options have increased today, every line of treatment is not suitable for every case. Every treatment, however expensive, has its limitations and it has to be applied only after understanding them. The odds have to be weighed fairly instead of just being blindly challenged, as falling sick today may not just be an adversity, but the ultimate disaster for the entire family.

Despite all the progress we see in medical science the fact that ultimately stands out is that there is still a hidden force that eventually has its say in all matters of life and death; a philosophy that has always been enshrined and espoused in every religion. That is why death, although the most unwelcome guest, visits the rich and poor alike, unfailingly at the appointed hour.

(Print version appears in Star of Mysore, Dec.22, 2006, under the heading - The high cost of living long - in my column Over a cup of evening Tea.)

Patriotic Plagiarism

2006-11-20T01:31:00.000-08:00

“Ask not what your country can do for you. Ask what you can do for your country”. Ask any school kid who uttered these noble words and pat will come the reply: John F. Kennedy. It was on November 22nd 1963, when he was hardly past his first thousand days in office, that Kennedy’s assassination shocked America and the rest of the world in equal measure. He was the youngest man to be elected the US President and he was the youngest to die.

For me, when I was in the third standard, it was the first death I remember which gave us a day off from school. Until then I never knew that the death of someone important would mean an unexpected holiday too. School then used to seem such an overpowering presence and such an inescapable pain that even a day’s relief from it seemed like a great boon. I therefore decided to find out all I could about the man whose death brought my daily grind to an abrupt and welcome halt.

Charismatic Kennedy was an impressive orator and his speeches and statements still continue to inspire the Americans and help rouse the American spirit in times of any crisis. Even today, this one quote is identified more with JFK than any other. Uttered with passion at a very crucial time, it did as much for his image as did his bold handling of the Cuban missile crisis. I even have a special stamp on Kennedy with this quote inscribed and attributed to him on its First Day Cover. But what most of us do not know is that more than fifty years before Kennedy rose to fame, this phrase was actually penned in an article entitled “The New Frontier” by Khalil Gibran the controversial Lebanese mystic philosopher, poet and writer. He used these impressive words while addressing his countrymen, urging them to revolt against the Turkish occupation of Lebanon.

If in doubt, please read Gibran’s book; Mirrors of the Soul, especially the edition with the translation and biographical notes by Joseph Sheban. Strangely, even though this phrase impressed the Americans very much well within his lifetime, which Kennedy knew very well, he never once gave credit to its original source. Perhaps he thought most ordinary Americans would only read the more popular of Gibran’s books and never bump into his lost or lesser known works, to realise that their super hero too was not above ordinary plagiarism. So JFK, Rest in Peace for I am only an Indian

Waiting for the Green Light

2006-09-08T05:41:00.000-07:00

Waiting at traffic lights has become a part of life for almost every one of us. In an urban setting, only the lowliest and humblest , and, perhaps the most high and mighty, are the ones who are free from the indignation of having to wait for the lights to change before moving on. And, waiting for traffic lights to change has become the greatest source of impatient irritation today; especially when it comes to waiting for the green light to come on. The red light seems to take a lifetime to turn green, while strangely, the green one always seems so short-lived. The greatest exasperation is when you try so hard to quickly slip through while the light is still green when it suddenly changes to a mocking red just as you are about to pass it.

It was after one such futile attempt to beat the fast closing gate at a railway crossing, recently, that I discovered how useless it is to be impatient with life. The train was unusually late in coming and like me there were dozens of impatient road-users who were cursing their fate on either side of the now closed gate. All our pleas with the grim gate-keeper to open it just for a little while to let us pass bore no fruit. He was content with following his rule-book and would have nothing to do with our sense of urgency. If we were in a hurry and the train was not, it was clearly our problem and not his.

It was then that I happened to see the old lady. She was nearly a hundred and although stooped and bent over with the burden of her years, she was ambling along albeit unsteadily from vehicle to vehicle, trying to sell jasmine-like wild flowers which she had strung on a thread. A strange but sobering thought came to my mind. I wondered whether I would live that long. It did not seem likely at the present pace. But I just might, if I slowed down a little. Wizened, I thanked the train for being late.

Life never ever respects our impatience. Life too is full of traffic lights today and there are as many red lights as there are green. So it is stop and go all the time. Sometimes it may even be stoop and go too. It can never be smooth sailing all the way. So learn to stop as you go through life. Give yourself some traffic lights of your own. Take a little time off to smell the wild flowers along the road, to marvel at the rainbow and to admire the sunset. Who knows what wonderful things you may discover during these brief stopovers? You may even meet someone exciting and interesting. It may be the beginning of new friendships. And also learn to occasionally stoop as you go through life. You may perhaps avoid many a bump; maybe a very painful one too. In my rush towards my goals I used to long only for green lights at every cross-road. Now, after seeing that old lady, I long for the red ones too.

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Back from the jaws of death

2006-07-27T19:12:00.000-07:00

I am writing this in the context of GVK’s Zine5 piece about the writer Art Buchwald his being admitted to a Washington Hospice, in what was then believed to be a terminally ill state, and yet not only failing to die as expected but walking out of the hospice on one leg, rejuvenated and raring to write another book.

No, it does not speak of lack of efficiency of Hospices in fulfilling their intended role of helping people to die in peace and comfort, but only about individual unwillingness to extend the foot a little and kick the proverbial bucket. Perhaps, Art tried doing it with his amputated ‘phantom’ leg and that must have made all the difference, leading to the unusual and unexpected outcome of his five-month stay there. Normally, inmates are known to have emerged out of hospices fully and irreversibly dead. Rarely does an odd inmate break the rule. It is under such rare circumstances that the subtle functional difference between a Hospice and a Hospital gets clouded a little, creating some confusion about their roles and also leading to some interesting situations.

Like, for instance, I once had under my care a very sick and very dejected elderly widower, who desperately wanted to die but could not find a decent enough place in Mysore from where he could commence his journey to the after world. While he was in the process of searching for a suitable launch pad, circumstances in his life changed and so did his intentions. His daughter, an only child and his only reason to continue to live, who had initially refused to marry a man of his choice saying that he was not sufficiently well off to give her a decent life, made the monumental discovery that the prospective groom was indeed a potentially rich man only having to wait for his father to die before gaining access to the family fortune.

Her unexpected change of heart induced one in her father too and that is when the search for the hospice ended. For someone who seemed to be totally immune to the beneficial effects of the best medicines he made a dramatic recovery without my help and bounced back both in body and mind. Twenty two years have passed and the exuberant grandfather now in his mid nineties never tires of playing with his two grandchildren and never wants to die now or anywhere in the near future.

Cows of the unholy kind

2006-05-21T10:26:00.000-07:00

While I was planning to write something connected with my elbow rubbing with patients I happened to read GVK's blog about how Americans rub shoulders with unholy cows. Let it not be forgotten that only Indian cows are holy because only we think they are above any animal feelings of pain and sorrow and, therefore, treat them as we please, to get maximum gain from them, while remaining insensitive to their pain.

How else could we account for their plight? We see them in on our streets, munching on lethal plastic bag, rummaging garbage heaps, risking electrocution while rubbing away their itches against metal electric poles and running the risk of being run over by trucks all the time (with suicidal intent to escape from their plight?). And if all else fails, their kind owners hand them over, once they outlive their purpose, to the neighbourhood butcher who, perhaps, seems the kindest of us all.

Cracking coconut, US style

The way American ladies escape from being gored by murderous cows may seem a needlessly anxious response but I am not surprised, as there are always two ways of handling a job. One is the American way, which we are witnessing in parts of the world, rather too often these days, and, the other is the universal way that the rest of the world adopts. I have with me an American book published by none other than Reader’s Digest that purports to be a guidebook to ‘easy and simple’ ways of dealing with just about everything.

To cite an example, I refer to their way of breaking open a coconut and, here I quote from RD, verbatim: “......If you carefully look over the coconut after you remove all the fiber, you will find three dark 'eyes' grouped together. Now if you carefully probe with a sharp ice pick, you will find that one of them is softer and more easily pierceable than the other two. Pass the ice pick through this and you will enter the hollow cavity inside. Now remove the ice pick after widening the hole as much as possible and completely drain away all the water that is inside. Now place the coconut in a preheated oven at 250 degrees for 20 minutes and you will invariably find that the nut has neatly cracked along its middle after which separating the two halves should be easy.

Now, doesn’t that explain why American tourists watch and photograph with so much of awe and interest our humble temple priests who have such divine powers that they think nothing of breaking coconuts, in hundreds, with their bare hands. Wow !!!

Blogging medicine, I might as well…

2006-04-24T22:31:00.000-07:00

Although I have been regularly logging onto ‘mymysore.com’, like an anonymous intruder or rather eavesdropper over the past three months or so, it is only now that I have ventured to contribute a piece for the scrutiny and analysis of my fellow readers and bloggers. Incidentally, because the former only read without writing while the latter (bloggers) do both, are these two different breeds? Since I notice that most folks who contribute their intellect to this web site tend to stick to their professions or areas of interest I also feel that I should do likewise, though not very strictly (for fear that I will end up proving the accusation right that doctors always tend to talk shop).

Yes, even the most eloquent doctors, who, in seminars and clinical meetings, can make the most complex and boring topics childishly simple and interesting (and often vice-versa too!), are usually poor conversationalists whenever they talk about anything other than their specialties. And every doctor who is a specialist thinks and firmly believes that his specialty is the toughest and the most challenging while being the least remunerative. I am no exception for with the long hours and the short cash that I always have I cannot believe otherwise.

I don’t blame doctors entirely for being such poor talkers, as we are programmed to be good listeners. However it is not often that we listen to everything that is said to us. Talking of patients, about whom we doctors can do only with their total anonymity ensured, I would like to point out here that when it comes to their symptoms and problems most patients really can talk much better than most doctors can listen. To realize how patients can embellish their most trivial aches and pains you have to be a doctor. They can describe the gas in their guts or the guts in their gaseous stools better than most writers or even poets. But more about 'us' and 'them' in my later writings, which I hope to do with some regularity in the days to come.
KJN