Support Nurses & Midwives

From medieval to modern age, the treatment of the sick has had three elements.
Cure, Care. Compassion. Cure by God/ healer/ physician. Care by the family/nurse. Compassion by the community.
Today is World Health Day. April 7. This year’s theme: Support Nurses & Midwives.
Wish them well. For Nurses walk miles and miles amongst the sick and the wounded in very difficult times and conditions to provide care. They are truly the Angels on Earth. In flesh and blood.
Here is my personal story of a Nurse who taught me the crux of care in my early days as a house-physician. In my pedestal of teachers, she sits very high.
1990. I was a House Physician in Shambhu Nath Pandit Hospital, Kolkata. A fresh graduate from Medical College. Suddenly thrown into managing patients in the Medicine ward of one of the busiest hospitals of the city. Wards overcrowded. With huge case-loads. I was in the learning phase. From text book to bedside medicine.We had a Nurse. Jagat -Di. We called her. She was aged. She was unlike other nurses. Stern. Strict. Sombre. Serious. In nutshell. She was no-nonsense. She scolded us when we forgot to sign a discharge certificate in time. She shouted at us when we forgot to write the dose of a medicine. And she shouted at patient parties. When they stayed back beyond visiting hours. She shouted at patients who did not eat their meals. She shouted at ward-boys who did not do their duty well. Everyone was scared of her. Because of her temper.
Sometimes, I asked her why she shouted so much at others. She replied because she can not tolerate negligence of duty and indiscipline. I grew used to her temper. Her shouts. And her scolding.
That was a busy day. My admission day, I think. I was on night duty. Late in the night I received a call. For a patient who was having severe asthmatic attacks. Male ward. I went. Saw the patient, Did the needful.
I then decided to visit the female ward just to check. The lights were dim. I watched from the door. Everybody sleeping. Quiet. As I was turning to return, I thought I saw a figure at the last corner. By a bed. I walked.
Beside a girl, on a tool sat Jagat Di. I came close. She had a plate in her other hand. Some chana/paneer. Home-made. She was feeding the girl. I stood there. I did not ask any question. After a few seconds Jagat Di looked at me. And said very softly almost in a whisper “Have you noticed that this girl has no visitor ever? Her family is in Bankura. They do not come to see her. I thought…….” She did not complete her sentence. I did not ask her any further. For even in the dim light I saw the moistness of her eyes. I stood there for few seconds more. Jagat Di sat there on the tool. Embarrassed that I had seen her in such soft care.
I knew the patient. A case of fever of unknown origin. Had been in the hospital for a couple of days with anaemia and fever getting treated for Typhoid.
Jagat Di and I never spoke of this incident again. And she resumed her scolding and shouting at me from the next morning. As if the night yesterday never happened.
In her scolding, shouting and seriousness she taught me bedside care in those two years like no one could have ever.
I support Jagat-Di. I support every Jagat -Di standing and sitting by those who need care and love in times of their ailment.

Just Saying. Three things. In times Covid-19

1: It was just a few months back. Some young boys and girls with a stethoscope around their neck and a white apron over their dress sat on indefinite protest. What were they protesting against? I had forgotten. But after deep thinking I kind of remembered. Better security. Better infrastructure. Better supply of essential medicines. At hospitals. When the Government did not hear their pleas and demands they went on a lock down. Lockdown of routine services. Emergency services open. I and you were furious at these men and women. Boys and Girls. Frivolous. Bahanas of a bunch of kam-chors. We called them three names. Criminals. Rowdies. Anti-Nationals.

2: The last time I had met a jan-pratinidhi in a closed door meeting. Before the National elections. In our Society premises. He had asked us ‘What would you like me to focus on once you elect me?’. I asked for a nice park for my morning walk. Claps followed. My neighbour asked for a good school in neighbourhood. Clap. Clap. Her neighbour asked for a speed breaker in front of the society. A roar of applause. His neighbour asked for better security. And his neighbour asked meekly ‘Can we have a police Chowki close by, Sir.’ Daru peeke bahut bawal korte haiN gaoNwale. None. None. None of us asked for a hospital with good infrastructure. None of us said that we do not have good ambulance services. We just did not talk of matters related to health. Health is not my demand. Therefore, health is not an issue of the politician. Health is not an electoral agenda for the local politician. Because you and I do not demand Health from our politicians.

3: Our soldiers are fighting in Siachen. They are protecting our land. And we pray for them. And we should pray for them. Everyday. Prayer is strength. When I think of a soldier I think of a man with a gun lying on snow by a fenced border. Alert. Gun ready to response. And my hand automatically rises to salute. But who feeds the soldier? A cook. I do not salute. Who built the barrack where the soldier rests the few hours he has. An engineer. I do not salute. Who treats the frostbite of the soldier? A doctor. A nurse. Salute? Huh!! You must be joking my fellow citizen. Professionals are professionals doing their bloody work for money. Professionals do not do a service to the Nation. They do a service to themselves. They earn while others work.

All of the above are fine. In normal times. In times of our daily life when we pray for our daily bread. To the Lord.

In times of Covid-19 we think. What were those young boys and girls in white aprons shouting hoarse for? Better infrastructure? Better supply of medicines? Better security? Hmm.

In times of Covid-19 we think. What did I ask Mr Pankaj Singh. My MLA? A Park? A speedbreaker? Hmm.

Did I remember to salute that engineer who built that bridge in Ladakh on which I merrily hummed a Rajesh Khanna tune holding Mousumi’s hand? Did I say ‘Thank you’ to the nurse and the pharmacist who I met in the forlorn PHC many miles away from Leh? They stay there to serve around five patients a day. Hmm.

Please read. And forget. For the Lord is kind shall forgive ‘all our trespasses.’

(Photo courtesy: Self. Location: A PHC miles and miles and miles away from Leh)

Cleaning the Garbage

Shanta Prasad Chaturvedi. Brahmin. Scholar. Vedas. Recite. Front to back. Back to front.
Woke up early morning. Very disturbed. With what had been troubling him. For months.
Woke his Master up. ‘Master, master, I have a question. Without an answer. I can not sleep.’
Master sat. Straight. ‘Oh, but you should have asked long back.’


‘Master, in our loom factory. There works. Untouchables. Not for cleaning. The dirty job. Cleaning the trash and garbage. But working alongside. Me. You. Other Brahmins. I stay away from their shadows. But why, Master why? Must they work on looms? Why on earth, you the learned, would allow them to work by a Brahmin? Why must they too find a place in a loom where Brahmins like me stay?’


Master smiled. ‘Sit. I hear your complain. Surely, but you may know that if God has a place for them in Heaven, my mill is too humble a place to not deny them a space.’
‘In Heaven? Surely you are joking Master. Why would God find a place for them in Heaven.’
The Master smiled. And said.


‘ For there must be someone in Heaven to throw away the garbage and trash from Heaven when the like of yours enter through the Gates. For sure, Heaven must be clean and free of souls and minds that are trash and garbage.’

The Master: Sant Kabir


कबीर कुँआ एक हैं

पाणिहारी अनेक

बर्तन सब के न्यारे न्यारे

पाणि सब में एक।।
(With apologies for any spelling mistake in the Hindi Text)

If I ever start a Company, my Mantras.


Many years back, there was a person. Very close to me. Not a relative. Not a close friend. But someone who I knew and adored for his passion and energy. He had started a new company. Healthcare consulting.

He trusted me. I trusted him. We met over coffee. To discuss his new company.
He had just received his first grant. 250K $. And therefore it was his treat.


Coffee done. Pastry eaten. I said ‘ Well then. Good luck.’ He smiled and said. ‘Did you think the coffee and the cake was for free? Huh!! You may pay too. Give me some guidance on how you would have run the company had you been in my place.’


This was not what I had expected. But he was insistent. So I said ‘ Well, order another coffee then. Latte with double shot. Let us discuss them.’


This is what came in our conversation. I told him that I would have followed a 4-C approach.


First. Build capacity. The 250 K is a very small funding. Nothing compared to the scale I dream for. Therefore, I would have transparently discussed on using some of this fund for capacity building of my team. To prepare the team to develop proposals and execute projects better. Most importantly to learn how to document well. Capacity building. In these aspects.


Second. Be creative. Even if the magnitude is small, I would encourage the team to do something innovative. Be creative in thinking. An innovation that will be picked up by us in future projects or by others in other projects. But every work that we do must have some element of original thinking. Creativity.


Third. Make connections. Nothing can be done alone. Connections are critical. Connections for complementary work. Connections for collaboration. Explore multiple partners. Find those that are complimentary. Then connect. With connection the power is manifold. Connect.


Fourth. And this one would be most important for me and my team. Be courageous. Every new idea. Every new thought. Needs courage to express. When you have to express your idea. Your thought. Never be scared. Be courageous.


So four things. 4Cs. For my company. If I ever have any.
Build capacity. Be creative. Make connections. Be courageous.


The guy was happy I think. He ordered a mutton patties for me. His way of thanking. I loved it.


As a footnote, I must write. I have not started a company. And will probably never. And the guy and his company is doing moderate. All he did except I think he was not courageous enough. It is the most difficult of the 4 Cs. Particularly when you are at the receiving end.

Let there be light #COVID -19

There are many who I know personally who are publicly vocal against the lamp lighting ceremony today.

For many of them I have high respect. Because I know their scientific and rational bend of mind. I know they love their Country no less than any other.

Yet. Today they choose to criticise the call by Prime Minister. And they decided not to participate in the activity.

Firstly, I salute them for their courage. In today’s India. In these very trying times it takes courage to be a critic. Not everyone is courageous to speak his or her mind. Those colleagues of mine who speak against this with their deep knowledge of science and social science. I respect them for they speak their mind withstanding criticism.

I do not challenge them either. Who am I to challenge these friends of mine who I know are most rational in their thinking, love the Nation as much as I do and think above politics. And in times ordinary, these friends of mine participate in Nation building as much as any other Indian does. If not more.

So, I ask myself. Why did I participate?

When I know the three broad questions that these critics, my friends ask.

1: What good will lamp lighting do? This is a coverup to distract a billion mind away from the real issue. The lack of resources. The unpreparedness.

2: It is almost unethical given that so many lives have been lost and the economically weak are in deep distress.

3: The PM said to light lamps. Some citizens burst crackers too. This is defeating the whole purpose. People are celebrating when they should more focus on bracing for a tragedy to come.

I do not refute any of these. All of the above have elements of thought in it.

Yet I and my family celebrated.

We celebrated because:

1: We wanted to be one again as a community with loud cheer from children from their balconies. Children do not come to the park anymore. We miss them. They all came out today. They clapped. They cheered. They sang the National Anthem. Mousumi and I felt very happy. We were deeply hungry for this happiness. We were missing the laughter of children of our society.

2: I am reading a lot on the fallout of Covid 19 in short and long term. One prediction is that this will heavily impact mental health. People are increasingly getting into the phase of loneliness. In a country like India where social connections are about prime driver, the adda, the gup-sup, the bakwas party, the hang outs, we are beginning to feel the brunt of distancing. Netflix is no solution. Nor is Facebook. Skype and Teams. We are no more beting able to shout at each other ‘abbé gale lag ja’ or able to click our coffee cups and daru-glasses. Today as I had expected we saw each other on balconies. Some waved. I felt good.

I know we have not made one step forward today in fighting the Coronavirus by lighting a million lamps. But today, we have felt together one as a Nation. A Nation together. Present. In balconies. In front of houses. Resilient. Together. Fighting back.

Mousumi and I celebrated for a selfish reason. To see my neighbours. To hear cheering voices of children. And to come out of loneliness.

Nothing more. Nothing less.

Love’s Mysterious Moments


‘Today is your first day as House Physician. A full fledged doctor. Will you not wear a new shirt to work today?’ He asked. My father. On his cane chair. Glancing through Anandabazar Patrika. As I left for my first day of duty. As House Staff. Shambhu Nath Pandit Hospital.


I was a Charminar smoking, Guevara swearing , Mao eulogising youth from Bengal. I scoffed. I frowned. I shook my head. I said ‘No’ softly ( because it was he, my father ) and touched his feet. A custom before a special occasion. A culture. To me, I said ‘What is in a shirt, that we call a shirt, by any other name would have been a mere wear.’


My father also said ‘But today. At least you could wear.’ I said ‘No’. To me, I said ‘Pari Burjoa byapar-syapar jotto sob.’
Ma was there too. As I touched her feet, she said ‘Mithu, Baba bolche. Ak bar dakho na.’


I shook my head. And moved on.
Late evening. I returned. From Hospital. Baba was in the drawing room on his cane chair. He asked ‘How was your day?’ I sat. Over tea. I told him all about the day. He listened to everything intently.


All done. I went for bath. Bath done. I opened my almirah. For a new payjama and a vest.


On top of the few shirts and trousers I had then, there was a cream coloured shirt. New.
I pulled it down.


This was a shirt my father had bought for me to wear on my first day as a doctor. A surprise.


I had ruined his pleasure. I had deprived him of the pleasure of witnessing the sparkle of joy in his son’s eyes. On opening the cupboard. Morning.
I wanted to run and embrace him. And tell him how sorry I was. But that would be too dramatic. I was too vain. And my father too prosaic for such drama.


A guilt I shall live with.


I remembered the above incident because I watched a movie yesterday which had a similar story.


A youth was going away from home. To a distant city for work. From a modest income family. As he was to leave, his father said ‘Open your trunk. I want to check .’ The youth refused. He was bitter that his father suspected. His honesty. He left without the customary greetings.
After he reached his city, still bitter from his father’s suspicion, he sat down to unpack. As he opened his trunk. Lo and behold, on top of it all was a box. In it a watch. The family’s only fortune. A gold plated watch. A note. ‘ If in distress, with no sadness, sell.’


The child in the youth cried.


And legend has it that he ran all the way back to embrace his father. To say ‘Sorry’ . For he had deprived his father. Of the pleasure.


Love is a mystery. More mysterious is the way in which the mystery manifests.

The man who defined “No” for me.

Allow me to introduce you to Gavin de Becker. De Becker is a global expert in prediction and management of violence. He and his firm have provided security to world leaders including US President. Considered a global authority on the subject of threat assessment, he teaches at University of California and chairs many boards on security and terrorism. You can learn more of his work at https://gdba.com/.

De Becker has written a couple of books and developed a few methodologies like the famous MOSAIC methodology that helped police in USA address increasing spousal violence. His first book “The Gift of Fear: Survival signals that protect us from violence” is an all-time best seller and challenged many conceptions around fear as a weapon against violence. The book is long. You may not have the time. Read a summary to begin with here. https://blog.12min.com/the-gift-of-fear-pdf/  

De Becker’s primary domain of work is against violence against women, Sexual violence. Spousal violence. Terrorism. And violence in society in general.

In these very uncertain times globally, let us ponder on some things that de Becker tells us. He says, we have forgotten to rely on our instincts to look after ourselves. We believe there is someone there, the government, the police, the doctor, the scientist who is protecting us. But often these authorities come very late in our lives in times of crisis. And we trust technology. Alarms, high fences will protect us from danger. They were built to do a job. Protect us. We believe. And we neglect the most important signal that should drive us. Our intuition. Our gut-feeling!

His famous quote from the Gift of Fear runs thus: intuition is always right in at least two important ways: it is always in response to something; it always has your best interest in heart.

The argument that de Beer puts is not around the power of our intuition but the lack of our trust in our own trust on our own gut feeling. He proposes that in fact trusting one’s intuition is the exact opposite of living in fear. He says, real fear does not paralyze. It energizes. And enables one to do things that normally one could/ would not do.

He illustrates this by a story of an attempted rape victim. A trapped victim’s reaction when her attacker said that he was going to the kitchen, her intuition told her to tiptoe him to the kitchen. And as the coward opened the drawer to look for a knife, she made a break for the front door and ran away. Later in her recollection she spoke of her intuition to follow the criminal but she had no recollection of any time when she was afraid.

Another wonderful theory that de Becker proposes is around an act of violence. He refutes the theory that some humans are born criminals. He says that there is nothing called a criminal mind separating some people from others. In fact, according to de Becker every human is capable of committing violence. It is how he or she justifies it that matters and is different. And he says that an act of violence is not always a spurt of the moment act. Rather it is a chain of thoughts and acts. 1) Justification, a judgement that one has been intentionally wronged. 2) Alternatives, there is no other way but violence to seek justice or redress. 3) Consequences, the decision on whether one can live with the consequences of violence and 4) Ability, the confidence on the power of muscles, brain, bullet or bomb to achieve their ends. And he concludes on this almost dramatically, violence is predictable. Almost as much as that water will come to a boil.

I will end by stating two last statements from de Becker. One on spousal murder. De Becker had said that most spousal murder does not happen in the heat of the moment. It is usually a premeditated decision.

And the final statement of de Becker, which for me is framed in mahogany in my heart. And I will quote it as it is “I will encourage people to remember that “no” is a complete sentence.”

21 Days for Victory

The next 21 Days. What I shall do?

1: I will refrain from any political conversation. Any National and Global Political discussion. Political discussion for me is fun and part of an adda. I do not have mood for that now. I will not discuss politics. I will not argue on politics or for that any matter. I will ignore any comment on social media that has any political odour. For me there is only one Party now. The National Government. Period.

2: I will be as frugal as possible in my lifestyle. I will eat less. Less quantity. Less variety. May be adjust to a style that will help me learn modesty in my expenditure and lifestyle. I will try my best not to put any additional burden on my household members. They are anyway overstrained with disruption of normal services. This will be a challenge to me. I am generally not very frugal in life style. It is bad practice. I will now be frugal. Beginning with less number of orders on tea and coffee from home members.

3: I will try to remain safe and remind my family members to remain safe. Avoid cuts, injuries as much as possible. I have a 2 year child at home. Who is not able to go out to play in parks. Confined in house. Double caution there.

4: I will lead a life that is very different from my usual vacation/ weekend/ WFH lifestyle. Not joyous in celebration. I will be worried. I will be somber.

5: I will call at least 3 friends and family members every day. I need to hear voices of loved ones.

6: I will pray. I believe in prayers. It will help soothe me. I am married to science. But I love to Pray. For the Peace that I get just from those quiet few moments for me, from me. Science and prayers for me go hand in hand.

6: I WILL NOT ENTERTAIN ANY GUEST AT MY HOME. 21 DAYS. OUR DOORS LOCKED.

These are most difficult times. Frankly less for me and you who read this post. But for the men and women who we know and who live on their daily wages. For them who do not have shelter. For them who do not have the power to stock or buy food in such times. It is a very difficult time, my friend.

Now we must remember them and know that they too exist. We will not see them. They too will be off the road and off from our sight. But I must remember that they exist and they do not have privileges that you and I have.

My and your Prime Minister has come to us as a family member. With folded hands. He is my leader for the next 21 days.

This is a challenge for us. We must stand up and face this challenge as One. One Nation, one Family.

We must. We do not have any option.

INDIA will win. Because of the sacrifice it is making. Today.

Jai Ho.

3+1 T in Corona Times in India

3+1 T in Corona Times in India

It is now generally understood that the way to effectively manage COVID-19 is the 3 T principle. Track. Test. Treat.

Allow me to propose a fourth T. Trust.

For all the scientific brains here, there and everywhere, TRUST four things unless you have a definitive evidence otherwise. If you have a counter evidence, do share.

The four things I want to say:

1: Everyone at this point has the interest of the Country and its population in mind. Those decision makers know if they make wrong decision and you are infected, they too stand a higher chance of infection.

2: The scientific advisers to the Government on COVID-19 are some of the best scientific brains in the country. They understand virology. They understand epidemiology. They understand public health. They understand clinical medicine. Rely on them for once. They are thinking sound unless proven otherwise.

3: A decision is taken based on its scientific merit and feasibility. For example, long back when polio eradication efforts were adopted in the country, a school of Indian scientists thought and provided evidence that injectable vaccine would be a better choice than oral vaccine because of many reasons. But India chose to go for the oral vaccine. Because of many reasons. Cost. Feasibility. Herd immunity impact. Among the reasons. Whether injectable would have given better results than oral, we do not know. But what we know is in the long run with a heavy cost, we succeeded in stopping transmission. And then when we could we introduced injectable. That too in fractional doses. Again there were questions. Why in fractional doses? But now the world is looking to adopt India’s strategy of fractional dose Injectable Polio vaccine. Therefore, know that we are blessed that we have the best scientific brains in the country that have the country’s interest in mind while advising the government. And also know that in making policy decisions there is something called feasibility. Something may sound very attractive scientific scientifically. But may not be feasible. The balance between science and the feasibility of its application is very important.

And finally.

4: Be a critic. But not always. Particularly in areas where we do not have the full knowledge. In Democracy, the role of the critic is super important. As a citizen, you have another very important role. Stick to it. Be a spokesperson of Science. Speak loudly and repeatedly about the public health measures that Government is asking its citizens to take. Trust that we will do a more effective job together as soldiers in this battle than criticising our government and our scientific institutions at this hour.

Who Am I?

WHO AM ‘I’ ?

Prelude:

Vienna Psychoanalytical Society. The first President and the most illustrated member. Two different people. In fact, two very different people. One, a humble plain looking son of a grain merchant growing in the outskirts of Vienna. Second, a very aristocratic elite highly educated imposing person from a well to do family in Vienna. Former, Dr Alfred Adler. Latter, Dr Sigmund Freud.

We all know of Freud. We may not have heard of Adler but surly we have heard of the term he coined ‘Inferiority Complex’.

Adler’s famous book ‘Understanding Human Nature’ was a key publication of his times on what the title says. Today with more advanced understanding, there are refinements and counter theories in psychology on the subject.

But today we will stick to what Adler has broadly said and I will state that with an anecdote.

In loose and very plain terms, a broad non technical interpretation of Adler’s suggestion of how a person would respond at any point of time to the question, ‘Who Am I?’, can be simply determined as an interplay of three I s in that current situation.

The person’s sense of Inferiority, Inadequacy and Insecurity. In life. At home. At work.

The Anecdote:

Those were a little difficult times in office. People were working in their jobs for long. Increments were meagre. Promotions were not an option. Relocations were not happening. For a year, things were moving on at a very slow dull pace.

It began with one or two staff. ‘Sir, it has been long. The job feels dull. I am thinking of looking for a new job. Can you help? Will you please let me know if there is a position vacant? I do not know how much more I can contribute to the current organisation any more. I do not know about this job’s security also. It is a yearly contract.’ I heard. Then the trend increased. More and more staff came. Each with more or less the same request.

When the number of staff wanting you change swelled to ten, the supervisor called a meeting. Of all the staff. It was a two hour meeting. After the meeting was over, he requested the ten to stay back.

Mr Supervisor then said I have asked the ten of you to stay back because I wanted to share with you a new job opportunity that has recently come to me. I thought of you when I read the job.

He then shared the job profile with them. The job description. The Terms of Reference. The salary. The perks. The contract. To be renewed yearly based on performance. The location. The Organization’s name was missing.

And he asked. ‘Well let me know if you are interested. There are enough positions.’

Nine hands went up. ‘This one is not bad. It will be a good change.’

The supervisor waited. Five minutes. For the ‘Thank you’ s to subside.

Then he put up a slide. On the screen. A job. With description and terms of reference. And salary.

The ten watched the slide. As they read, the Supervisor asked ‘Do you read this job?’. They all answered in unison ‘This is our job. What we are doing.’

The Supervisor then asked them to take out the piece of paper with the new job advertisement.

‘In the new job piece of paper in your hand, put the name of your current organization. And spot the difference between the new job and the one on the screen.’

For the next few minutes, there was silence.

Then one of them tore the new job paper. Then another. Then another. Then.

When all the papers were torn, Mr. Supervisor said ‘Well. Now that you know, your idea of a better job is almost an illusion, it is time for you to go back to your office. Think for a week. After a week, if you still want a new job, come to me. I will genuinely try to find a new job for you.’

They all left after another round of tea, biscuits and some laughter.

For nine months, no one came. After nine months, the Supervisor found a better job and left.

A sense of inferiority compared to other peers, a sense of inadequacy of opportunity and finally a sense of insecurity. That is what had summed up who they were as employees in the Organization.

With revelation and renewed trust, they stayed back in the organization.