## Newton’s laws of motion……….. Extrapolating it to human actions.

Newtons first law of motion or the law of inertia states that a body at rest persists in its state of rest, and a body in motion remains in constant motion along a straight line unless acted upon by an external force.

A tired child in deep slumber with sweet dreams will continue to sleep unless woken up by physically shaking him up to break his sweet sleep, else the kid will continue to enjoy his sleep. Imagine a small kid running towards his mother for her to pick him up, nothing will stop him from reaching her, but if you try to obstruct his path by force he will take a detour but find the path to be in his mother’s arms. How well Newton’s first law of motion gels with our daily life activities. It’s not just physics but human actions in real life also always follow Newton’s first law.

The second law of motion states that the rate of change of momentum of a body over time is directly proportional to the force applied, and occurs in the same direction as the applied force.

The teacher insisted the student repeat the poem again and again till he could say it at a single stretch flawlessly. Initially the student repeated after the teacher slowly and carefully. After several repetitions the speed of the student improved , now he would not repeat after the teacher, he now recited along with the teacher . The force exerted by the teacher had the desired effect. The student had mastered the poem. The directions of the teacher was being followed, the change in the momentum at which the student could recite the poem was exactly proportional to the force exerted by the teacher . Newton’s second law was being followed.

Newton’s Third Law of Motion states that for every action, there is an equal and opposite reaction.

I was was all of nine years old. The boy I was playing with was irritating me, I couldn’t bear it any longer, Zap… I slapped him, the sound was resonating , a wry smile developed across my face. Good , he needed it …..and then suddenly for no reason I could feel the slap in my face, it was painful and burning, the sound was again resonating in my ears. No one had slapped me , yet I felt being slapped with an equally hard force as I had used. Was it the reaction to my action?? My little mind understood one thing, what you give you get back. I hadn’t yet studied Newton’s laws, his third law of motion which stated that every action has an equal and opposite reaction had just come into play. The Newton in me had already understood the theory. Newton studied the laws of physics, my tender age taught me the laws of psychology, it wasn’t any different from the laws of physics, whatever you give you get back equally if not more. Just like the biblical proverb, you reap as you sow.

Why Newton or men after him were unable or didn’t relate his laws of motion to human behaviour one shall never know. Each of Newton’s laws of motion can easily be extrapolated to human behaviour and actions in our day to day lives. There are innumerable examples that can be quoted to justify this. Hope this blogs brings out the Newton in each one of us.

## Air hostess…..The multitasker

Have you ever thought of these different personalities, how their job status differs yet their work profiles are nearly the same. Not many have perhaps tried to study in depth the realities of these different professions , one highly appreciated and loved , the others looked down upon. The air hostess is a glamorous proffesion, a high flying job. The sweepers, waiters jobs finds no glamour, no one would want to be one. All of them have their uniforms, all are well paid , they all cater to the public yet they are looked at differently.

Shantabai was the lady who cleared our garbage, cleaned our gutters . She was the sweeper in our locality . Shantabai wore the blue saree, the Municipal dress or uniform for sweepers then. The saree was mostly unkept and not very clean, she never cared. The chappals she had were worn out and dirty. Broom in hand she would sweep the streets , collect the garbage and carry them over to the huge garbage bin. She would clear the small gutters in front of our houses and the other open drains. She would call out to all families to pour some water into the gutters while she cleaned it. She would sit under the tree to take some rest in between. She usually lit a bidi while taking the break and would inhale deeply on the bidi smoke. After a while she would be back on the street. She would collect all our garbage and food leftover so that our homes would remain clean, alongside she would lecture us on segregation at source and home composting.She also would sell us Brooms, which she would make in her spare time. That was an additional source of income. After the days work was over , she would go back home , take care of her family , rest and get ready to repeat the same chores for the next day. She did her job well, the residents were satisfied, but no one ever seemed to appreciate her work, not a single kind word for her. The job though necessary to all was looked down upon.

Neelam was the smart, good-looking kid in the neighbourhood who had recently been selected for the job of an air hostess with a reputed airline . She had been working for 5 months now. Smart uniform, dark blue skirts, dark blue stockings pulled over her legs, black heeled shoes, a small cap, name plate across her chest, hair well done and tied into a bun, deodarant sprayed across her body, eye brows well done. She looked smart and beautiful. She had a decent paycheck and was happy with her job.

Today was her off day, no flight duty today. She woke to the sound of Shantabai asking to dump the garbage for her to collect. She picked up the garbage bag, opened the door and handed it over to Shantabai. She smiled at her and inquired if she was well, Yes said Shantabai and asked Neelam whether it was an off day for her. Shantabai colleted the garbage into her wheel barrow and moved ahead to the next house. Neelam stood there looking as Shantabai moved ahead, what a similarity she thought. Shantabai too had a blue dress just as she had. The only difference was, it was a saree unlike her suited skirt, ofcourse the saree was unclean unlike her dress which was always spic and span. Shantabai too was collecting peoples garbage moving from door to door just as she collected garbage from seat to seat before the flights landed. Shantabai picked up garbage strewn around and put them into the barrow just as she did on the flights. How similar their jobs were she thought. Shantabai kept the locality clean, she her aeroplane. Shantabai had a few brooms stacked at the side of her barrow, she would keep asking every resident if they would like to buy one. She would be all smiles when she could sell one. Neelam reminicened, she too would be trying to sell things on the flights to passengers, she too would be all smiles if she could manage a sale, her commission would be there. Their jobs were different, the work they did was nearly similar.

Neelam closed the door and took the tooth brush and paste. As she brushed her teeth pictures of her job crossed her mind. Getting ready for take off, she would be demonstrating to the passengers how to tie seat belts and all safety measures, Shantabai too talked to people and demonstrated how to segregate waste at source and the importance of home composting. How funny, they both did educate the public in their own ways. Each time as the flights got ready for landing Neelam would walk along the asile , garbage bag in hand collecting leftovers and trash from each passenger to keep the aeroplane clean for the next flight. That was exactly what Shantabai did in her locality daily , what a striking similarity in their jobs she thought. The pictures of her pushing the food cart and handing over meals to passengers came to her mind, that’s what waiters did in restaurants, she was doing the same in the flight. Clients called out to waiters for a glass of water when thirsty, on the flight passengers pressed the bell for water which she carried for them. Her thoughts went across to Laxman, the waiter at her favourite nearby restaurant. Laxman was well dressed in his maroon shirt and pant uniform. He too moved from table to table telling the customers what food the restaurant had to offer, asking them what they would like to have. He then took down orders and carried them on a tray to serve them on the tables. Yet Laxman’s job didn’t have the glamour her job had, though both of them were actually doing the same thing.

Air hostess she was. A waiter, cleaner, garbage picker and peddler selling wares all rolled into one. Yet there was glamour in the name….Air hostess. The sweeper, the waiter, the house to house peddler selling his wares all worked hard and earned their living but had no great status in society. The airhostess had status, glamour though she was doing exactly the same work that they were doing.

What’s in a name they said. Its there for sure, the name airhostess is a fine example of this. It has an identity, credibility and a psychological advantage. The work profiles may be the same but the name matters!!.

## The power of prayer …….. Unbelievable………….The Lord’s prayer & Mahamrityunjay mantra……Power unleashed.

Prayer is an invocation to a person or an object of worship. Prayer seeks to establish a communication, rapport, relationship with that person or object of worship. It is a act of pleading for help, gain or just Thanksgiving. Whether a person is religious or not, whichever religion he follows or even an atheist will at some point in life have definitely prayed . It could be for help , forgiveness, for benefits or just peace of mind.

Irrespective of, to whom the prayer is made, in whatever form, alone or with others , silently in ones mind or loudly, whenever it is answered it gives happiness and peace of mind to the person praying for it. The prayer could be to your teacher asking for a leave , to the judge in court, to a diety, to a imaginary god, to idols of worship or any one. An infants cry is also a prayer, it’s asking for milk, it’s a prayer to the mother who obliges with love, just an example that prayers stand answered . What is normally thought of as a prayer is usually to God. In every religion there are prayers written by our forefathers , be it Hindu, Christian, Zoroastrian,Muslim,or Sikh, Jain or Buddhist. Even tribals have their own gods and ways of prayers .There are prescribed prayers of various modalities. Depending on which religion you are born into, right from child hood one comes to learn them and recite them. Some pray religiously others just say them without any conviction. But pray everyone does.

Having been born into a Orthodox christian family from Kerala, India, naturally I learnt my prayers too. Not well versed in my mother tongue that is Malayalam, I learnt them all in English . At the school I went too, a Swiss missionary convent, I learnt my morning prayers, before and after meal prayers and my evening prayers . All of these prayers mentioned no god or religion , they were of Thanksgiving and help to keep me safe throughout the day. I never disliked them, saying them did make me feel at peace and thankful for all I was given. Not being overtly religious I never tried to analyse any prayer deeply . But pray I did.

The prayers taught to me at home were the Lord’s prayer, Hail Mary and the Nicene creed. The Lord’s prayer I loved, it mentioned no religion, it named no gods, it was a simple prayer of Thanksgiving, prayer for help , food, and forgiveness . Yes, the prayer itself is attributed to Jesus Christ. In the Gospel of Luke 11:1-4, Jesus teaches the Lord’s Prayer to his disciples when one of them asks, “Lord, teach us to pray.” … It is one of the most commonly prayed prayers by people of all Christian faiths. Everything covered in a short sweet and simple way. My difficulty incoming to terms with that there is a god or my tendency towards being more of an atheist didn’t let me say the other prayers often but the Lord’s prayer I loved and believed in. “Give us this day our daily bread”… so simple and logical , I shouldn’t go hungry. ‘ you are not asking for a years stock, only your daily need. Forgive us our sins and trespasses as we forgive them who trespass against us‘ clear and loud….”Lead us not into temptation but deliver us from evil”……Everything in this prayer is simple, straight, clear. That’s the reason it had always been my favourite .

The fact that I was born into a Christian family didn’t stop stop me from looking beyond my religion. I was brought up in the developed and cosmopolitan state of Maharashtra in India. I had friends from all religions , I enjoyed and took part in all their festivals too. I learnt prayers from many if these religions too. I had read the Bible , I read the Upanishad, Vedas, Mahabharat, Ramayan , the Holy Koran and other religious texts too . I somehow never really believed any other prayer too.

Then this incident happened. The prayer that I got to know about was a powerful prayer . The moment I heard it , I knew it had something in it unlike other prayers. Mahamrityunjay mantra…… A most powerful prayer. A hindu prayer written long ago. It finds mention in the vedas..Rig-Veda to yajurved . Mahamrityunjay means that person who has defeated death, who has overcome death. Maha Mrityunjaya Mantra, protects us from our deepest fear – Fear of death

oṃ tryambakaṃ yajāmahe
sugandhiṃ puṣṭivardhanam।
urvārukamiva bandhanān
mṛtyormukṣīya māmṛtāt ॥. Worship that fragrant Shiva of three eyes, the one who nourishes all living entities.
May he help us severe our bondage with samsara by making us realise that we are never separated from our immortal nature. Source: Maha Mrityunjaya Mantra, Rigved 7.59.12

This mantra has to been attributed to various persons,Rishi Markandeya,
Shukracharya, spiritual head of demons, it is said that Shiva gave this mantra to them, yet
– another says is said to have been composed by Maharishi Vashishtha. Mantras are  eternal truths which were discovered by Rishis or Sages who dwelled on specific aspects of life and living. These truths will never change or cease to exist.

Now the true story which will give an idea of how powerful a prayer can be. It was some time in 2006 or 2007. I had developed a vague vibrating feeling in my epigastrium with dull pain which was not responding to any treatment. My colleague Dr Patil advised a ultrasound to rule out anything. My friend Dr Sanjay Pote accompanied me to the radiologist , Dr Sanjay Gosavi who too was a common friend and college mate. After having the ultrasound done Dr Gosavi suggested we do a CT scan. He said just to be doubly sure, nothing was wrong, of course that didn’t convince me, but I agreed a little fear crept into me. The scan took too long than normal , I was very apprehensive by now. After we were done with the scan he explained that there is some lump , growth along my stomach and further investigation would be needed . I drove back home but didn’t discuss the matter with anyone at home. Next day I went to an oncosurgeon friend of mine, Dr Shailesh Punthambekar and showed the reports to him. One look at the scan film and he said it looked to be a leiomyoma , he inquired as to who the patient was, little knowing that these were my own scan reports. He said nothing to worry , a surgery would help. When I told him it was my own reports he was taken aback. We were classmates at the medical college and good friends. Then he sat back having a relook and suggested we go for a MRI . I drove back home, involuntarily the Lord’s prayer on my lips. I still didn’t disclose the matter home.

It was during these days that he person who had rented my office had disappeared without paying my rents for over three months. I had broken open the office premises and taken custody of the office . While rummaging through his belongings in the office I came across many CDs, which I carried back with me. When in my Tata safari SUV I put one of those CD into the player, a deep husky voice was heard explaining the Mahamrityunjay mantra. What it meant, how who so ever recited or heard it could conquer death. The atheist in me was unwilling to accept that any mantra could save me, but the wonderful voice reciting the mantra , the husky voice explaining it kept me stuck to it. This continued daily , for the next week or so the only CD played in my vehicle was the Mahamrityunjay mantra. The drive from my home to the hospital I worked in, at Akurdi was hardly a kilometer, I deliberately drove slowly to work hearing the mantra two or three times and before leaving the hospital and same while travelling back home daily. There was a inner peace of mind, the fear of any possibility of death vanished from me. The Lord’s prayer I said and repeated a million times at bed time, that put me to sleep peacefully , two prayers one I was used to and another that had visited me changed my mindset about the reports and what could happen to me. No more fear, in my subconscious I knew I had conquered death.

During this period my chief officer Dr Iyer had come to see me at A kurdi hospital. I informed him of the reports, the diagnosis and my pending MRI investigation. He just said don’t worry nothing will happen, I don’t know why but I smiled yo myself and said to myself , I know nothing will happen.

A week later my friend Dr Pote and myself drove to Nobel Hospital, where Dr Sanjay Gosavi had his MRI setup. Dr Gosavi had a talk with Dr Shailesh on exactly what he wanted in the MRI, what he was suspecting and looking for. I was told it would take approximately 45 minutes. I was wheeled into the room put to the MRI machine, the aircon was at max and it was cold . Somehow I was cool, no thoughts passed my mind. The two powerful prayers that I had discovered were recited by me in my subconscious. The procedure took more time , I was more than an hour in the machine, suddenly scary thoughts again passed my mind, was it worse, why were they taking so much time, had they found out something worse, the prayer and the mantra again played in my mind, I wasn’t saying it, but I could hear and feel it being recited. Then suddenly the purring of the machine stopped, the doors opened and I was wheeled back to the changing room. I immediately changed, dressed and went to the doctors room, both Dr Pote and Dr Gosavi were looking at the plates , were a bit confused and perhaps worried . I looked at them and they at me , not a word was uttered, then suddenly Dr Gosavi spurted out, “Boss, there’s nothing to be seen, that’s why we were retaking shots, the lump,Tumor seen in the CT scan had just vanished“. Then they smiled, laughed aloud, happy for me. I just stood there a smile on my lips and the prayers again in my mind. Miracles do happen.

I came back home with all the reports, told my wife and mother of the happenings of the last week . They were wild, how could I have hidden the facts from then, they accused me of being irresponsible, I tried to explain that I did want them to be worried. It was difficult convincing them, but the reports showed it all. As for my self I slept peacefully that night, Dr Gosavi had informed Dr Shailesh of the MRI findings, none was sure why it was so, maybe they said the one seen in the scan was an artefact, maybe, but that didn’t explain my complaints, which too surprisingly vanished . Just to reconfirm had a gastroscopy done with all negative results.

Next morning I got ready to go to work , full of energy. As I started my SUV and pressed the play button, no sounds, checked the player, the CD was missing. I searched my vehicle, office and home, it was not to be found anywhere. For the next few weeks I searched in vain, I never found it. Perhaps it’s work was over , it had rested itself .

After this I tried purchasing the mantra CD , on three different occasions I did, but it never worked on my players. I accepted that perhaps it was done with me, it needed to help others too. I gave up trying to get another one ever. The experience is difficult for another person to understand, but I have gone through it. Prayer is a powerful tool I have accepted, for me The Lord’s prayer and the Mahamrityunjay mantra will always remain a comforting prayer until I live. Prayers need not be to any god, it needs to be sincere, and the confidence that it will be answered.

## World Heart Day. Is it needed……. counterview

Organized by the World Heart Federation, World Heart Day is a global campaign during which individuals, families, communities, around the world participate in activities to create and spread awareness about heart health .

Should we have such a day? is the moot question . Or is it another modus operandi of frightening the people all over the world to induce them to go in for a multitude of tests, investigations, meet doctors and spent their hard earned money. The people more interested in others hearts seems to be the medical brotherhood taking cover under the world heart federation. Creating awareness creates doubts in peoples minds, when doubts are created it creates fear, the fear of death, the gullible and scared will now visit their doctors . The physician is thrilled, one day of awareness and so many new suspect heart patients. Fear is the key. Instill fear in humans by creating more awareness , bring them to the doorstep of the doctor , leading to increase in buisness and revenue.

Man was born and must die. Just as a flight from New York to Mumbai takes off at NY but lands and ends in Mumbai, so is every human born destined to die. The heart starts beating the day you are born it has to stop beating some day. A heart is healthy and will keep beating, but it must land to stop one day. Death is inevitable, will creating awareness about death prevent it, never . The heart has to stop one day and it will. No amount of awareness can stop that.

One look at the above picture will give your better explanation of the truth as to why a world heart day is needed . Every major pharma company is a partner. Why? More awareness leads to more doubts amongst people leading to increase in visits to doctors and in turn more prescriptions , more sales of medicines , more money for the pharma industry. Who cares about others hearts , it’s all about money.. honey. The pharma companies will spent on the federation members expenses, their good, drinks, travel and hotels. They will decide what should be labelled as high blood pressure, they will decide how to put in fear in to human minds, how to create doubts in mans mind, they will plan the awareness so well that by the end of every years heart day campaigns the number of so labelled cardiac patients will increase manifold. All doctors organisation world over will be funded to celebrate this day in a grand manner , the doctors will conduct free health camps and diagnostic test to unearth s heart problems so far unknown to the patients. Press ,print and digital shall be roped in to get maximum coverage . At the end of the celebrations they will sit back in their luxurious offices and make calculations as to how many new doubting Thomases will be patients and which drug sales will increase, by how many times ..post the awareness campaign , what will their bank balances be?. The doctors will be happy with the increased number of probable heart patients visiting them, the cardiologist will be coaxing someone to put in a stent, its money making time. Little do they know , stent or no stent life years or span don’t change. The stent companies are happy, now half the world’s population have a stent in them, the diagnostic firms are happy too, so many tests , their coffers are filling. It’s a happy time for all . Then again 29th September will come year after year with newer celebrations , more awareness , more cardiac cases and still more money.

To every individual his heart is as important as all his body parts. The fact that this magnificent machine keeps pumping and keeps one alive is not because someone makes it beat. It has its own power. It is bound to go through ups and downs, man the brilliant creature that he is has created a variety of medicines to encourage the heart to keep it’s rhythm, strength , to overcome any hurdles in its performance. So far so good. Then why the need to scare the global citizens with unwanted awareness. The world heart federation is of doctors , by the doctors , for the doctors , manipulated and funded by the pharma industry. An excellent example of circular economy.

Ignorance is bliss. Atleast true in matters of heart. Any person unaware of his heart problem will probably live a normal happy life , getting to know of it will make life miserable for him. Doctor visits, medicines , money stress and what not. It doesn’t guarantee he will live any longer , but will make his life full of agony . On the other hand if he is unaware he will lead a happy contented life just as same . Die he must, heart one day must stop for sure, then isn’t it better to lead a quality life or is it quantity you are interested in?? To hell with awareness..Live life kingsize.

## Acts of kindness

Kindness as described in the dictionary is the quality of being friendly, generous, and considerate. To perform such an act of generosity, help, or share with someone if you know they need it may be defined as an act of kindness. Every act of kindness has been proven to increase ones happiness and reduce stress. At the same time, spreading kindness brings happiness to innumerable people in this world. Acts of kindness are innumerable, they depend upon the situation, any act of yours that brings happiness to others is an Act of kindness.

My father was juggling with the seat of his bicycle. He was a tall man and hence he had fixed the seat a few inches higher. Our neighbour had requested to lend him the cycle for some errand. Those days in the early sixties in our locality hardly any one owned a bicycle . Our neighbour was a short man and would have found it difficult to ride it with the seat so high up and that’s why my father was working on it to bring it down to make it comfortable for him to ride. To share your bicycle with someone who needed it was kind enough, to make it comfortable for him was even kinder. It was a small act of kindness which my young mind noted, never to forget.

Mr N had to send his wife to Kerala, her home yown. Her father had come from Kerala to accompany her. Those were days when money was sparse , you needed it but didn’t have it. He needed money to buy them the train tickets, he didn’t have any. It’s then that he came to my mother for help. We werent any rich either. My father’s pay was hardly enough to pay for the rent, the school fees of us three siblings , bus fees and home expenses . Naturally my my mother had no money. She knew that this person needed money desperately, he was our friend, she needed to help him. As I watched, she pulled out two gold bangles from her hand and handed it over to him. Go , she said pawn them and use the money to buy the tickets, you can get them back when you have the money, two bangles less on my hands until then for a few months won’t hurt. As she smilingly handed over the bangles I could see tears of happiness in the persons eyes. You don’t need to be rich to be kind, you need a large heart. Another act of kindness got imbibed in me as I grew up .

The school I went to, St Ursula was run by Swiss missionaries. Mother Nicholas, the principal was a stern, strict disciplinarian yet very kind at heart. She would at times walk into class rooms during lunch hours to see whether each child had his tiffin. Whenever she noticed that some child had not got his tiffin , she would round up all such kids, take them to the staff room and give them meals . When those kids walked back into the class room the sparkle in their eyes was enough to see that they had been overwhelmed by this act of kindness. These incidents happened throughout my school career , bless the kind Mothers soul, her actions again imbibed in me the need to be kind.

I was in class 6. The month of July, it was raining heavily ,many of the school children had got drenched. They were shivering , it was still raining incessantly. Mother Nicolas took rounds of each classroom, picked out all those who were wet, took all of them to the staff room. She managed to arrange a new set of clothes for each of them. Of course many were ill fitting . But now each one was now dry and warm in their new set of clothes. So thoughtful ,she had each child towelled dry and into dry clothes. Kindness personified, who wouldn’t love such a sweet personality. My principal.

My father’s salary could take care if all the monthly expenses. Rent, school fees, bus charges, the shopkeepers bills were more than what he got. So naturally he would default on some payments. The payments he would mostly default on was school fees and house rent. The house rents were pending for over a year now. The landlord would pay him regular visits with no success. One day Narayan Kalbhor the landlord came home, he spoke to my father, he said he understood that with three school going children it was difficult to pay the rent, but he couldn’t waive it off. He placed a proposal , he said you pay my rentals every month from now on, the pending rentals , you just add rupees five every month and over the next five years your past amount will be cleared . This was a magnanimous offer. That night I overheard my father tell my mother , there are very few understanding and sympathetic landlords. We are lucky to be Narayans tenants. Another act of kindness which I witnessed, imbibed in me the need to be kind as I grew up.

When still at school, a classmate Debashish mother passed away. Mother Nicholas went over to their house to console them. One of our teachers who too was there later told us that Mother prepared some tea herself for some of the people who had gathered there. They were surprised , a swiss nun, a principal in her white habbit was such a simple personality. Acts of kindness vary with situations .

The train was packed beyond capacity. I travelled to my junior collage daily by train. It was the same story daily you never got a seat to sit. The old man was bent over, he had a small cloth bag in his hands, his grey hair was cropped short, his beard was grey. No person who was seated offered him a seat to sit, neither did he ask anyone for one. The boy at a side seat was lame, polio had affected his legs at childhood . His eyes fell upon the old man, Baba , he called out to him, please come and sit here. The old man slowly came towards him, the young man got up as he got up the old man noticed his disability and refused the seat saying he would manage. No way the young lame man stood up, gave a gentle push to the old man and seated him even as he with his disabled leg stood , his body distorted holding on to a berth for support. The sparkle in the young mans eyes were evident, the wetness in the old mans eyes couldn’t be missed. Each able one who were seated in the train put down their heads in shame, this disabled person had done what none of them did, which they should have done. Acts of kindness is not for everybody.

I was in my second year of medical college. My senior Naresh and I travelled by train to college. One day as we were on our journey back home and alighted at Chinchwad rail station , we were walking back home, there was an old man pulling a hand cart full of packed gunny bags. The man was old, he wore old leather chappals, a dhoti, kurta and a gandhi cap. He was pulling with all his strength, sweat trickled down his forehead , his was panting. Naresh ran to his cart and began pushing it from the rear, the man felt the lightness, the ease with which he could pull now, he turned around and smiled at Naresh. This went on till his destination was reached . All the while I was walking along. The old man thanked Naresh, we both now continued walking towards our homes. I looked at Naresh in awe. He came from a very rich family, he was in his final year of medicine, yet he willingly and happily pushed the cart to help the old man. This incident reiterated in me the need to be kind to others always. This was an act of sheer kindness .

I was in my car at the junction, the red signal was on. A little girl in dirty tattered clothes was knocking at cars windows ahead of me. The lady in the car rolled down her windows and handed over a packet of biscuits, the girl nodded her head and pointed at something inside the car. The lady smiled , took the doll she was pointing at and handed it to the little girl along with the biscuits. The girls eyes glittered , there was a large smile on her face as she walked away doll and biscuit in hand. The lady too was smiling, happy that she could make some lesser privileged happy. The act of kindness had made two people happy, each in her own way.

It was late night party, we were 7 of us. Having settled our bills we walked out of the restaurant, it was a cold December night. We were busy saying our good byes when I noticed these two children on the pavement. Unkept, dirty, the girl mast have been 7 or 8 years old, the boy 2 or 3 years. Her hands spread out in my direction. I stop there watching their misery, I walked towards them pulled out a hundred rupee note ,bent over and handed over to the girl and turned around to go back. She called out to me the note in hand,asking me to take it back and give her some food instead . I looked into her eyes, hunger was evident. I walked back into the restaurant and asked for a fried rice and some dal. The manager said the kitchen had closed down, I pleaded, one parcel please, he conceded and packed it for me. Carrying the parcel I came out, my friends had dispersed, two of them were still waiting for me. I handed over the food parcel to the girl, she again tried to return the note to me. I refused, I looked at her slowly open the parcel, put in a dirty hand ino the packet, pull out a handful and put it into the little boys mouth. The happiness on their faces was there to be seen. One of my friends went back to the restaurant and got a couple of disposable plates and two bottles of water for the children. In all this, the best act of kindness was the little hungry girl feeding the hungry little boy first oblivious to her own hungry state. Sharing and being considerate to the little boy was an ultimate act of kindness.

There was a huge rush at the out patient department. I was seeing my patients. A patient in the que suddenly felt giddy. He was middle aged and unkept. He lay down on the bench. Some one called out to me to come out and see him. As I was busy examining another patient it took me time , when I came out the patient was sitting on the nurses chair , she had given him a glass of water and some biscuits. She had ordered tea too. Happiness was evident on the mans face, how caring was the nurse. She had picked him up , ushered him into her chair , given him water , biscuits and tea. Kindness, what else was this.

She was with her two year old at the hospital. The doctor had seen her child and prescribed medicines for 5 days and nebulization daily. She was at the pharmacy counter. All she had was 10 rupees, that would be the charges for 5 days of medicines , how would she pay the 2 rupees for the nebulization. She requested the pharmacist to issue her 4 days medicines and return 2 rupees. He asked her why, she explained, the pharmacist looked once at the sick child, he handed her 5 day medicines and also the 2 rupees she would need for the nebulization. She smiled shyly , the pharmacist slowly took 2 rupees from his pocket and put it into the counter. What a silent act of kindness!!

Incidences are innumerable, I don’t intend to keep writing each of them. This blog is only to make all of us realise that one act of kindness from our side can bring succour and joy to someone who needs it most. My primary teacher in this aspect had been my mother , she always believed in the art of giving, be it love, food or money. She always said whatever you give you shall always receive twice as much. Today she’s gone to her heavenly abode, eight years now, but her teachings have had the necessary impact on my life. Let’s all perform atleast one act of kindness daily.

## An insight into life after death.

It was a cool October day, the sun was out but it’s rays didn’t hurt. It was a really pleasant day to travel. We were travelling towards McLeod ganj , Dharmashala from Pathankot. The bus was rickety, no luxuries, hard seats covered in cheap rexin covers. The windows rattled . As the experienced driver drove up and down the Ghats the breeze was lovely, the multitude of fragrances of the greenery, flowers and fruits filled my nostrils. The creator must be a engineer, scientist, botanist , environmentalist all rolled into one. Who else could have arranged in so much minute details, all the wonders of nature all along this route.

Even as the bus driver manoeuvred the curves of the narrow roads giving way to the traffic coming from the opposite direction I wondered how the driver could keep his cool. As I looked out of the window I felt dizzy, the valley was deep , the buses wheels were always almost at the edge of the road but it never veered out of it. My thoughts went back to the driver, how could he possibly not be tensed, may be years of experience, same roads , multiple trips had hardened his nerves. He kept his composure, he drove at a good speed with absolute confidence. The trees, shrubs, flowers whizzed past me, each time I looked out I wasn’t sure it was a safe journey. I admired the engineer and workmen who built these roads and Ghats, the creator who had put so much of varied flora and fauna along, those beautiful waterfalls along the route . Only I feared those deep valleys, the dangerous narrow curves. I pulled out my hip flask and took two gulps of whisky to soothe my nerves. I closed my eyes hoping we would reach our destination safe and soon.

Then it happened . There were loud cries, people on the bus including my friends and my self were being thrown around, my worst fears had come true, the bus driver perhaps had misjudged a sharp turn and the bus was being plunged deep into the valley. …………. Period……….I am floating through air, my physical body seems to have left me, Am I a dead man????? Many co passengers and some of my friends to are by my side floating at ease. As I turn back to see what has happened I can see the bus has gone a few thousand feet into the valley. It is now all mangled steel. I can hear wails come from that location, may be it’s those unlucky few who survived .

As a human I had never been a religious person, I always believed I was partly an atheist. Partly because at times due to family and social pressure I did take part in many religious ceremonies. Today as I float with others leaving my body behind, I am not scared, there is an uneasy peace within me. I had always been taught about heaven and hell ever since childhood . Having been born into family that followed the Orthodox christian church in India, I too studied the Bible , the concept of god as in the Bible , that Christ was the only saviour. As I had grown up amongst Hindus, Parsis, Sikhs and Muslims I found it funny that there were so many gods. But I never questioned. As a child I said my prayers regularly, the Lord’s prayer,, Hail Mary and the Nicene creed. I also knew many of the hindu prayers. My favorite verse from any prayer had always been,” I belive in one true God the Father almighty, maker of heaven and earth, and of all things visible and invisible “. Yet the concept of heaven, hell never appealed to me. I always believed that if there was any God he could have never created hell .

As I along with others from the bus floated along , invisible to any one, I could look back and see all the human efforts to help the survivors. The bodies of us who were now no more dwelling in them were being stacked aside, numbered, tagged, photographed for insurance purposes, postmortem, press reports etc. A smile came upon me, how foolish are humans,everything is a number for them, name , age, sex , cause of death. Little did they know once life leaves the body it is ultimate bliss, that’s what I am encountering now. We all kept floating until we reached our destination. A cool well lit universe to itself, no doors, no windows , hundreds of thousands of humans who had give up their bodies long ago. Each one of us was welcomed in, there was space for a hundred times the world’s population here. Many who were known to me and had passed away during my lifetime were here. Each one seemed contented. Each one could see what their near ones and friends back on earth were doing. They could only watch, they couldn’t interfere, that were the rules of this universe of after death people.

There was no heaven, no hell, no paradise…..Only this unique universe that defied all human laws. Newton too was here, but his laws on gravitation didn’t apply here. Shakespeare was here, but nobody read books here. Edison was here but his bulbs were not needed. Grahan Bell too is here from a long time, his telephone redundant here. Mahatma Gandhi too was an inhabitant, the chakra wasn’t needed. Elvis Presley was here too, but didn’t play music or sing. The wizard Pasteur was here but his vaccines weren’t needed. Alexander the great was here, he didn’t need to conquer the world any more,he had conquered himself . Karl Marx and Lenin were happy to be here, their dreams of a classless society was what this post life universe was . Shahjahan didnt need to build a Tajmahal here. Every body you read about in history or science was here. There was no shape, no form , but you existed here in all glory. There was no day or night, no dates or calenders, no fixed routines . I happened to notice my parents too here , resting in real peace, which no amount of money would I have been able buy for them on earth. My mother acknowledged my presence, after all I was her favorite son. She was happy that I had attained freedom from life on earth. Many of my relatives and friends were a part of this God kindom. There were no enemies here, each one was now an enlightened one. It was a different world where you were now invincible , knowledgeable, where there was equality, no caste, creed , gender or religious divide.

There were no gods here. Each one here was an enigma who had left back his physical body on mother earth. No Christian gods, no Muslim gods, no Hindu or Sikh gods, no Zoroastrian , Jain or Buddhist gods.

Each one here was a god, which he failed to realise when living in his mortal body on earth. The sudden realisation that a life time had been spent in vain searching for God, was shocking. All along it was you who was God, and you kept looking for God in churches, temples, gurudwara’s and mosques, you simply failed to look within. Had you looked within and found the God exists in you , just imagine what life would have been like.

They welcomed us, inquired of our journey to the new universe. We looked around , we weren’t tired inspite of the long journey. Gravitation was absent, all I had to do was turn my self horizontally and lo!! I was resting. There was no sound , all of us communicated via mental telepathy. Hunger and thirst was not part of this universe hence search and preparation of food was not required. It was then that the darbar of the lives of those who have left their bodies was called . It is a regular meeting of all departed who are now in this new universe. All automatically congregated mentally into the darbar. There was no monarch here, no democratic elections. Each one placed his views which others tried to understand. There were no orders here, only talks of wisdom.

The truth was spoken. The oldest inhabitants of this universe explained to all new comers, You are now part of the universe , not as it’s slave but as the Gods. There are no gods except you. Gods , you have always been, also on earth, why you were taught to believe that other gods exist, and they created you is nothing but fictitious . God never made man. Man made Gods for his own selfish ends . Today you are all here in your own kingdom where you are a God to yourself and all . You cannot change the occurrences on earth, but your conviction that you have a power, as you are a God will help you to change minds of people on earth. In this manner you can help your near and dear ones. In case you fail you won’t be depressed, because Gods can never be depressed. You can keep an eye on evil on earth, you cant stop it, but you can usher in good thinking into evil minds. The real power invested in you is all of us are the Gods are guardian angels of the child. If any child suffers on earth you have the power to intervene and help save them because they, the children are our gift to humans. It becomes our responsibility . Every time we help save them from harm and pain, you the God will feel the pain, you will have to suffer for it so that Gods children never suffer . Apart from this you Gods are a privileged lot, you shall know no pain, no hunger, no thirst, you shall have no needs, people on earth will soon forget you, but you will get solace , as for a few years atleast they will burn a light or candle for you , little knowing that they have actually just lit a candle to God. Their own God, which they will fail to realise as long as they live .

My journey from life on earth to this universe where I too am a God was wonderful. The realisation that I am God just as all of you are, has made me happy. The sad fact is that man still searches for imaginary God’s all over the universe. When will man look within to find the God in himself?? That day would be human kinds most beautiful day. Else each of us will have to wait for that day when leave our body to travel into the next universe.

## Cut practise ( referal charges ) in medical practise.

My next blog will be on the cut practise system amongst the medical professionals in India.

Inviting all of you to share your experiences regarding this. Need all of your inputs.

Please state whether you approve of this practise or not.

Your views are important and shall be incorporated in the blog. So put up your comments in the comment section or mail them to anilroy2000@yahoo.com

The blog will not be against or for the system, it is for placing realistic facts about the cut practise followed and to remove misconceptions that appear in the media.

Looking forwards to maximum inputs.

## Increasing violence against doctors in India …. a frightening phenomenon.

One the most common news in Indian the print or digital media today is about violence against doctors and of hospitals being vandalized. A doctor beaten up, a hospital ransacked, another doctor shot at and yet another lynched by the mob, for reasons best known to the assailants. This is now a common phenomenon across all states in India.

The violence is seen both against the medical professionals both in the government sector as well as private sector, neither has been spared. This violence ranges from verbal abuse at workplace or even over the phone, manhandling of doctors, physical dangerous assault, use of weapons and fire arms and vandalizing of the clinic or hospitals.

There was a time when doctors in India were worshiped and revered. Not long ago they were gods or demi gods. What has gone wrong??? Why this sudden and sustained events of attacks. Here I am making an attempt to analyze some of the probable causes as observed by me in my 34 years of the medical profession. The blame game is perpetual, is the doctor or hospital wrong or is it the citizens/ patient and his relatives at fault for this violence. Let me make it very clear in most of the cases the attacks are unwarranted and the doctor is rarely at fault. I am not denying that in a few cases, very minuscule number of cases the fault has been with the medical professionals.

Did the doctors and medical profession bring this upon themselves or is it that patient attitudes and expectations have changed with time. Has there been a loss of trust in the medical profession, are half baked knowledge of patients regarding medicine responsible, is poor communicating skills of doctors responsible, is it the arrogant behavior of the medical profession with the patients and relatives or vice versa, is it the financial angle, huge bills, is it political interference or is it lack of adequate facilities that has led to this state of affairs or is it plain misunderstanding.

## Unrealistic expectations coupled with poor medical awareness……

One the major causes for this unprecedented violence is poor medical knowledge amongst patients and relatives. They fail to understand the situation, the need for the treatment, they do not realize that the doctors can only diagnose and treat patients with the best of their judgment with available facilities and medicines. The doctors are not magicians, each illness will follow a course, and there is no shortcut to treatment and recovery. A magic cure or an immediate recovery is their usual expectation. They are bewildered if B-complex is given for oral thrush when last time it was given for plain debility, they are not satisfied if paracetmol is prescribed for pain when on another occasion it was given for fever, one doctor prescribed tab stemetil for emesis and another for migraine and so on.

Take this case where a person hanged himself, his relatives get to know of it after half an hour, they break open the door, take him down and a mob now collects and carries the body to the hospital. First thing on reaching the hospital is the mob barges into the doctor’s room and pleads for him to attend immediately as it is an emergency case, though knowing very well that person was dead even as they had brought down the hanging body. Yet the expectation is the doctor should do something to revive him. The doctor feels for the pulse…none felt…blood pressure not record-able…he auscultates…. No respiration …no heart beats…pupils are dilated , rigor mortis is setting in… the person is dead for sure, the doctor knows it, the mob knows it, but the moment the doctors declares the person dead, the verbal abuses begin…. Doctor you******* you did nothing to save our patient, you rotten***** we shall ***** your happiness. What could the doctor have done when a person who is dead by hanging is brought to him after an hour?   This is one classical case of unrealistic expectations.   Many a times these verbal abuses turn into physical assault and later to vandalizing the whole place.. Who was wrong, was it the doctor, definitely not. There had been violence.

The lady was wheeled in, she was full term, the young resident attended to her, and she examined her carefully. Oh! She had a transverse lie, there was meconium stained liquor, the fetal heart sounds were erratic and low, the lady would need an emergency caesarean. The resident explained to the relatives. No they wouldn’t hear of it, the husband retorted that his wife had a normal delivery last time, so why a caesarean now, the young resident explained, all in vain, they wouldn’t hear her out, they accused her of making a fool of them to increase the bills, they were adamant a caesarean was not warranted and the choicest abuses began. A tear trickled down the young lady doctors eye, how could they not understand, why didn’t they trust her, after all she was trying to save two lives. She had put in innumerable hours of hard work and study, burnt her energy to get to this position today, she wanted to serve the people coming to her, she was meticulous in her work , then why this,She cursed the day she had decided to become a doctor. There was mayhem until the security stood round her and the senior doctor arrived and ultimately convinced them that the surgery was necessary. There had been violence.

A middle aged known diabetic and ischemic heart disease patient who is on irregular treatment is brought to a primary health centre. The doctor sees him records his history and complaints, gets his ECG done. It is showing changes indicative of massive infarct, the doctors gives the primary treatment and refers him to the higher centre or cardiac centre.   Again the abuses begin…. Why can’t you treat him here, are you a real doctor, we shall leave with our patient now but we shall be back to see you. Similarly in this case had the patient passed away during primary examination all hell would have broken loose. Is it the doctor’s fault that the patient does not follow up regularly or not take his treatment, if the patient is non-compliant, does not follow the doctor’s instructions and ends up with a massive infarct, how one can blame the doctor? There had been violence.

## Large number of patients in government hospitals, lack of adequate manpower, facilities and medicines.

Lack of adequate finances are the reason for the large number of patients turning to government centers for treatment. Inadequate manpower puts a huge strain on the available medical and paramedical staff. Many a time equipment is not available or not functioning, medicines too are in short supply leading to clashes and arguments and later to violence at these centers.

The man had brought his father all of 80 years to the hospital for his monthly checkup and medicines. The old man was a hypertensive. As the queue was big it took him an hour before he got into the doctors cabin. He had been coming here for the last 7 years and was happy with the hospital and doctor. The doctor saw him and recorded his blood pressure and was happy to note that his blood pressure was well controlled, he prescribed the medicines and went on to see his next patient. It was then that he heard the commotion, abuses were being hurled, a window was smashed, and there was a banging of the doors. He rushed out of his cabin, nearly another 50 to 60 patients were coolly waiting for their turn, he walked towards the area where the sounds came, it was in front of the pharmacy, the pharmacist was being manhandled, he walked across and placed himself in front of the pharmacist, other employees too had gathered around.  Reason….. The stock of anti hypertensive medicines was over and the old man was requested to come two days later as the stocks would come by then. The man lunged at the doctor, you rotten fellow, why you run the hospital if you have no medicines, the doctor tried to explain, he wouldn’t listen, the old frail security guard just stood there watching, the younger staff managed to pull away the person and take him out of the building.  Whose fault was it, definitely not the doctors, but suffer, he did. No gratitude in treating a person for 7years.  There had been violence.

Similarly at times there would be a staff nurse in the injection room on leave and none to replace her, dressing of wounds could take time, a doctor not well and hence not on duty would lead to more waiting time at the other doctors consulting rooms, an ECG machine would suddenly malfunction, at times patient demand medicines which the doctors feels is not necessary and hence refuses, patients demand injections where there is no need for one. Any refusal will lead to abuses. If an emergency case is taken out turn there will be a big hue and cry as to, is that a patient a VIP. Then again influential people want immediate attendance, if refused again verbal abuses. The doctor and his staff are always at the receiving end.

## Political interference and pressure

Another major reason for violence stems from political interference in the medical and health system.

The man walked in with a case paper for a medical fitness certificate. The doctor looked up and asked who was the person mentioned on the case paper. He said he is at home but needs a medical fitness certificate. The doctor refused, he couldn’t possibly issue such a certificate in absentia, the man pulled out his cell phone and connected to the local politician and informed him that the doctor was unwilling, he passed on the phone to the doctor who explained that he could issue the certificate without examining the patient and the expletives started, abuses were hurled at him, the doctor sat grim faced, he couldn’t possibly hurl back abuses at him. What was the doctor supposed to do, he stood his ground, and he refused. In half an hour the Politician and his cronies came and started a ruckus, the police had to be called in There had been violence..

She had been admitted 8 hours ago, she was a primi gravida, she was in labor. She was being monitored regularly, she would deliver normally. The senior consultant too had seen her. No problems. Just then the phone rang, the on duty nurse picked up the phone, and he asked to speak to the doctor. The doctor took the phone, the politician demanded as to why the lady hadn’t delivered yet, the doctor explained how long it would take as she was a primi gravida, the politician was in no mood to listen, he demanded that she be delivered immediately, the doctor explained it is a natural process and it would take its own time, the politician demanded that she be injected to fasten the process, the doctor refused and the abuses began. There had been violence.

It was a 100 bedded private corporate hospital. They had a 20 bedded ICU. The beds were full, so was the ICU. A road traffic accident patient was brought into the casualty. The on duty doctor examined him, he was given initial treatment, the specialist saw him, and he would need an ICU bed with a ventilator. The doctors explained that as no ICU beds were available they would have to shift the patient to another hospital, nothing doing said the relatives and friends, and you have to provide us an ICU bed. They wouldn’t see reason, the patient was sinking, and he would be needed to put on a ventilator in the ICU, the mob refused. They called for their local politician who rushed in. He demanded that a patient be removed from the ICU so that this patients could get in. No explanation was enough to convince them, they wouldn’t shift the patient, precious time was lost, the patient breathed his last and the violence began, they thrashed the doctors and staff on duty, broke windows smashed computers and printers, broke the chairs, this continued till the police came in , as usual they were too late, the damage had been done. There had been violence.

Similarly these politicians demand medical unfit certificates for their cronies when they are hale and hearty, they want false medical certificates to get their henchmen in jail out on parole, they demand their patients be seen on priority, they demand hospitals give huge concessions arbitrarily, they demand that certificates in medico legal cases be issued as per their directions and what not. Any refusal by the hospital administrations invites verbal abuses and at times violence. Will this ever change, if it does not very soon lesser and lesser intelligent people in India will opt for medicine as a career or they will look for greener pastures abroad. This violence has to stop.

A newly married lady was rushed to a small nursing home; she had apparently consumed some organophosphororus compound due to some domestic violence. Luckily she hadn’t taken much, the doctor and nurse immediately gave her a gastric lavage and started the treatment, soon she was out of danger. The doctor got down to preparing his case sheets and informing the police. He was legally bound to inform every medico legal case to the police. The husband, the in-laws of the lady objected, they knew she was out of danger, they didn’t want to mess up with the police. The doctor coolly explained the law, they wouldn’t budge, the doctor a law abiding one went ahead, and the husband snatched the papers, slapped the doctor and shook him by the collar. The staff called in the police, the doctor filed his complaint, the cross complaint by the husband stated that the doctor had molested his wife, luckily the lady refused to support the husbands statement.       There had been violence.

## Misunderstanding and distrust in doctors

The doctors of yesterday, the gods and demigods of society have seen the trust in them being slowly eroded. Unlike previously when there was blind faith in the doctor, today with advent of internet, they are being questioned, misunderstanding and distrust has crept into the system.

Every diagnostic test advised by doctors is questioned, the patient has a misconception that he is being fleeced; he feels all those tests were not necessary. He takes opinions of friends, paramedics, other doctors and even Google’s out knowledge and then concludes he is right and the doctor wrong. This develops in to gross distrust in the doctor and grave misunderstandings.

When advised any surgery the patient and his relatives will follow the same route of multiple opinions and then feel surgery is unwanted. This mistrust in the doctor leads to misgivings, apprehensions and later violence if something goes wrong.

## Inflated bills and unwarranted tests.

Perhaps the only place where a doctor or hospital might be the reason for abuse and assault is the hospital bills or the battery of tests done. We must understand that with the bringing of the medical profession under the ambit of the consumer protection act, the doctor needs to be doubly careful. He will definitely advise all test which perhaps he would otherwise have not advised. Cases in consumer forums always finds fault with the doctor for not having a test done, hence the cautious doctor will do every test remotely related to the disease or diagnosis, he can’t take chances, he can’t afford to not do it. This is mist rued as the doctor or hospital trying to make a fast buck by fleecing the patients and is a major cause of arguments, abuses and violence.

The doctor or hospital needs to take extra care and time in explaining to the patient and the relatives regarding the need for the tests and the approximate costs. The daily room charges, consultation charges , administrative charges, oxygen, procedure charges and ICU charges all need to explained to the patients and relative in advance and on a daily basis if any violence later is to be avoided.

One grey area where most of the violence is seen is when a patient unfortunately passes away and the relatives refuse to pay the bills especially when it is a large sum. Legally they have to pay up, ethically and morally the hospital administration should take a lenient view and either give major discounts or waive off the bill on humanitarian grounds. This is not always possible considering the financial aspects. Patient relatives should settle for a reasonable discount and pay up. But they are prodded, by friends, politicians, anti social elements and so called social organizations not to pay up. Most of the activists do not care about the patient or relatives, they just want some cheap publicity, the politician feels it’s his birthright to demand waiver of the bill. The hospital administration too is at times unyielding and refuses to hand over the dead body unless the full amount is paid up. This invariably leads to violence at the hospital with large adverse media coverage for the medical profession. Immediate steps need to be taken to address this and find an amicable solution.

It is high time society learns to pay up services rendered. If you to travel by air, rail or road you always pay up first and then travel, the lawyer takes his fees first and only proceeds with his case; the passport office takes their fees and then gives you a passport. All fields and business the dictum is pay up first, but not at doctors and hospitals, no one wants to pay up, they haggle over fees and bills. Even the best criminal lawyer can lose a case but his fees are not waived off, then why the violence against doctors only. Simple …..The doctor fraternity is a peace loving community and are sitting ducks for everyone, patients, relatives, friends, social organizations and anti-social elements.

## Can the violence be avoided

Attitude of patients towards doctors has to change, behavioral change is very necessary. Medical and doctors associations have to take the lead to bring about this.

The trust which has been eroded has to be reestablished. Doctors need to give adequate time to their patients good counseling and improved communication skills needs to be established. Unnecessary tests and inflated bills should be curtailed. The patient should not feel he is being fleeced. Many a times the patients relatives feel that the doctors are not discharging the patient on time and that the purposeful overstay is to increase bills, this misunderstanding can only be removed through proper counseling and detailed explanation of the situation to the relatives. In cases of deaths hospitals need to take a more humanitarian view regarding payment of bills and handing over of bodies.

Patients should go only to doctors they trust and place all their faith in them, they should not dictate how a patient is to be treated, the doctor has spent a life time learning the intricacies of diagnosing and treating patients. Politicians should desist from interfering in the treatment process and stop dictating terms to these highly qualified doctors. In fact no one should interfere with the way the health system functions, the doctors know best to handle it.

There are laws for violence against doctors in India; they need to be made more stringent, better is to have them actually implemented. Hospital should have CCTV systems and good security men. Hospitals have to invest into the aspect of security heavily. The government has to improve manpower and equipment and medicine availability at all their health centers. The doctors attending to patient should never be rude; they should be kind and empathize with their condition. They need to instill the confidence in the patient that they are in proper and good hands. When the doctor/hospital and the patient / relatives change their present attitudes we shall see an India where there shall no more be any violence against the medical fraternity.

Looking forwards with hope to that day when violence against doctors shall be unheard of in India.

## The Indian family doctor………. an institution on the brink of extinction

The family doctor is synonymous with primary health as well as comprehensive health care in India. Scattered all across India, be it towns, villages and even cities, they were always the first line of contact of a patient with the health system. Highly respected, revered, and loved. They came from different faculties of the medical system; some were Allopath graduates, some Ayurveda graduates, yet others Homeopaths and others Unani graduates. Alongside also flourished a breed called RMPs or registered medical practitioners some of whose credentials were definitely doubtful. They had a basketful of varying degrees, MBBS, BAM&S, BAMS, BMS, DAMS, LCEH, BUMS, GFAM, not that the patient ever cared for his family doctors degree, he in fact never even understood what those letters meant. Crosspathy was the norm, each one practiced a mix of all pathies in their endeavor to give their best to the patients. His mode of transport in the towns and cities was invariably the ‘Hamara Bajaj’ scooter and in villages mostly the Rajdoot motorcycle which could take on any terrain.

The family doctor ensured both primary and emergency treatment and continuing medical care to the patient. He knew all his patients well, their families, their economic and social problems, their habits and vices. He knew their genetic dispositions which made diagnosis of any illness very easy for him. The family doctor was perhaps never wrong in his diagnosis. He didn’t need to take any detailed family history; he already knew it. He was well aware of all their dispositions, his hand percussed well, his palpation dug out hidden indispositions; his stethoscope heard any note that was not in tune with good health. His clinical acumen helped him to diagnose perfectly with these few methods and give good and ethical treatment to his patients. In short, he provided for very affordable treatment which was also very easily accessible.

Not for him were the multiple diagnostic tests as of today, only if he was unable to come to a conclusion would he advise any test, definitely not a battery of them. There was a very limited use of technology in his diagnosis.

He would diagnose and treat your fevers, diarrhea’s, respiratory tract infections, urinary tract infections, renal calculi, monitor your pregnancy, any skin infections, in fact he could and would treat everything. He was the jack of all trades, you had a fall, and he would clean and dress it with a jab of tetanus too. If it was a bigger contused, lacerated wound that too he would clean, suture and dress. Any foreign body in the eye, he would easily remove, similarly with foreign bodies in the ear or nose. if you had corns that too would be easily removed by him, so would he easily remove a sebaceous cyst or even a lipoma. Any lady needed an auro plasty, at  that too he was an expert. There was nothing he didn’t know nor could not do and that too for a minuscule fee.  He was the physician and surgeon all rolled into one. He would even provide day care if necessary and would administer intravenous fluids. His clinic or dispensary was of mediocre settings, maybe 2 or three rooms. A table, a chair, an examination table, a few posters on the walls, a calendar, stools for his patients. It was a sparse but well-equipped setup. An electric sterilizer in the corner, his shelves would be filled with medicines, cotton, dressing material, suture material, intravenous fluids, iv sets, sticking tape and all necessary accessories. There would be an emergency tray at one corner, a Xray viewer, his stethoscopes, hammer, forceps and scissors all well stacked, a small refrigerator in one corner for the vaccines. In short, he was well equipped to handle any type of patient.

He doubled up as a gynecologist, obstetrician and pediatrician too. Immunization of the children too was his responsibility. As he stocked and dispensed medicines too he was also the pharmacist. Everything under one roof. His patients were a happy lot, after all he was part of their family, and he joined them in their household celebrations as also in their sorrows. He could be called for house visits regularly, he never refused. There were long queues but no prior appointments were necessary. If you had monetary problems, you could pay later or even the kind doctor would many a time just waive it off. He family doctor also gave advise to families on the education of their children, he counseled his patients and family members to give up smoking, alcohol, drugs if they were addicted to it and successfully too. Family squabbles too would be settled by the shrewd doctor. He provided his services for both acute and chronic illnesses. He provided rehabilitation advice and care. The family doctor gave quality time and advice to his patients, he always avoided unnecessary investigations. He was a boon to the community. He was a trusted person. Even if a patient needed a referral to a secondary or higher center, he would facilitate that too. No wonder he was called the family doctor.

But as usual good things never last forever. The early eighties and later decades saw the influx of the specialist doctors. They specialized in different fields. There were physicians, pediatricians, gynecologists, skin specialists, ophthalmologists, ENT specialists etc. Slowly some patients who were better educated and financially stronger began preferring to see a specialist rather than the family doctor. Of course, the specialists too were very good doctors in their respective fields, but they cost more, prior appointments were needed, long lists of tests were asked to be done, yet the patients had the satisfaction of having gone to a specialist to get the right treatment, but at odd times and hours they still rushed to the family doctors in times of emergency.

A foreign body removal from the eye would cost a few hundred rupees at the family doctors place, it cost a few thousands at the ophthalmologist, but the satisfaction that a specialist took it out was in the patient’s mind. Similarly, all the small surgeries and suturing of wounds he conducted very skillfully at nominal cost would cost ten time more at the specialist but the trend had begun, the out flux at least for specialized treatment’s was towards specialist doctors. People began visiting specialists even for trivial illnesses and began killing the concept of the family doctor. Now he had begun losing these patients and with that his skill too in these matters began to rust.

As he started losing these patients it now was affecting him financially too. The newer generations unlike their older generations didn’t think much of the family doctor, they were happy going to specialists and newer hospitals if treatment was needed. Then came the super specialists. DM, McH and what not. They were masters in different systems and organs, heart, liver, kidney, hand foot, neck, spine, practically every part and organ of the body was catered to by a super specialist. Trends kept on changing; now even for a minor headache patients would line up outside the neurologist’s consultation place, any with UTI would travel to a nephrologist, even the slightest burning sensation in the chest would need a visit to the cardiologist. To make matters worse soon came the corporate hospitals which had every faculty under one roof. They offered all diagnostic services too. The hospitals were swanky, centrally air-conditioned with five-star facilities. The financial status of the patients too had improved drastically coupled with it were huge medical allowances paid for by employers and also the insurance policies offered which ensured cashless treatment. All of this led to the declining number of patients going to the family doctor, some of them mostly the seniors silently wound-up business and went into retirement, the middle-aged formed groups to set small size hospitals, younger ones put money into bigger hospitals as partners, slowly the family doctors both in towns and cities began vanishing.

Those old enough had retired, the younger ones had shifted to newer hospitals, the patients lost out, it was their loss, no more the luxury of calling a doctor home to see his bedridden parents, no more walk-in emergency services, no more cheap quality services, no more heart-to-heart talks with a doctor, the patients unknowingly and unfortunately lost out.

It’s not that only the patients have lost out, the health system has lost out. We need a strong primary health treatment base which is both accessible and affordable to patients if we have to lift up our quality of health services and the key to it is the family doctor. Today no doctor seems to be inclined to do this, none is willing to set up a practice as a family doctor, it doesn’t give any good returns in the current scenario. What every new doctor is interested in today is forming groups, opening a new hospital with diagnostics facilities. There is no more any motivation to work as a family doctor anymore.

Urgent steps need to be taken by the government and medical associations to revive this system immediately before it finally disappears. The trust in the family doctor needs to be reinvented to keep the primary health vibrant. Nothing can replace this very important link at the primary level, lets hope the new generation of doctors realize this and develops the ground for a stronger first point of contact for all patients as their predecessors did.

## Another virus…. ZIKA…another attack, this is not from any laboratory

As we are slowly coming to terms with the after math of the covid pandemic, a new virus poses a threat to us. Zika.

Covid 19 many say was man-made by the researchers and scientists at Wuhan and deliberately let upon us, was hence difficult to tackle. Many of course do not agree with that theory, howsoever, it is still looming around us, a third wave is predicted but luckily not yet to be seen, touch wood, no idea when it will be back to haunt us.

But Zika has made a comeback. From Kerala where it popped its ugly head now to my home state of Maharashtra in India. Looks like it’s a virus’s year out, as one recedes another raises its ugly spike.

Zika virus was first discovered in 1947 and is named after the Zika Forest in Uganda. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands.

What can we as citizens do??? Well, we have to first understand the virus and the mode of transmission and its vectors to tackle it.

Zika virus is a single-stranded RNA virus of the Flaviviridae family, genus Flavivirus. Zika virus is transmitted to humans primarily through the bite of an infected Aedes species mosquito Aedes aegypti and Aedes albopictus. The Aedes mosquitoes usually bites during the day, peaking during early morning and late afternoon or evening. This is the same mosquito that transmits dengue, chikungunya and yellow fever.

Zika virus is transmitted primarily through the bite of an infected female mosquito. Mosquitoes become infected when they bite a person who is infected with the virus. The virus then replicates and spreads within the mosquito so that when the infected mosquito bites again, the virus is spread to another person.

The one good thing is, it can be prevented as the epidemiology is known and studied.

Zika has begun affecting some in the district of Pune in Maharashtra and the government is taking all necessary measures to counter and stop it from spreading.

This, season gives an advantage for its breeding. Eggs of these mosquitoes can remain alive for more than a year and even tiny collections of water is sufficient for it to breed, hence all measures to avoid collection of water has to be looked into.

The way we collect unwanted bottles, broken furniture,scraps of utensils, tires in our backyard, surroundings and roof tops, all spell danger for us. Water in our house planters, pots, in roof drains are all going to help the mosquitoes breed leading to dengue chikungunya and Zika. Hence it is each individual’s responsibility to see that all such unwanted stuff is cleared off immediately.

Care should be taken that water during these rains drain off properly and does not collect giving space for the mosquitoes to breed. All residents should follow certain preventive measures including proper garbage disposal, integrated pest management, and make a collective effort to keep the areas mosquito-free.

Spraying activities and fogging if needed shall be taken care of by the government authorities. Use of larvicides, adulticides, space sprays will help to prevent breeding of mosquitoes and also help eliminate adult mosquitoes. Our responsibility is to see that no mosquito breeds, we should be giving them no chance.

Of course, all the mosquitoes can’t be wished away, hence other measures are also equally important, like prevention of mosquito to human contact, use of long sleeves shirts, full length pants, mosquito repellents and nets are some of them. If breeding and the prevention of mosquito contact with humans is achieved, we will have won half the battle of Zika.

Most people infected by the virus won’t have symptoms or will have mild symptoms like fever, rash, headache, joint pain, red eyes, muscle pain. The symptoms can last for several days, and if it continues for long, the patient might need admission to a hospital.

Though in most cases, there are no symptoms. in a few cases, Zika can trigger paralysis (Guillain-Barré Syndrome). In pregnant women, it may cause subsequent birth defects.

While there is no specific treatment, paracetamol and rest may help.

Zika is a virus that can cause serious problems during pregnancy. If a pregnant lady gets infected with Zika virus, she can pass it to her baby. Zika infection during pregnancy causes a birth defect called microcephaly and other brain problems. It is also linked to other serious problems in the baby.

There is no specific medicine or vaccine for Zika virus. Treat the symptoms, take plenty of rest, get hospitalized if needed.

Zika virus has been identified in several body fluids of infected individuals. In most cases, it remains detected in blood from few days to one week after the onset of symptoms, and is known to persist longer in urine and in semen.

Zika can be passed through sex from a person who has Zika to his or her sex partners. Use of condoms is recommended to reduce the chance of getting Zika from sex.

Yet the fact remains that the major mode of transmission is from the bite of the infected female mosquito, so our focus should be on mosquito control and prevention of mosquito human contact and thereby bites.

To achieve this citizen compliance and cooperation is most necessary. We don’t just save ourselves from Zika but also dengue and chikungunya. Looking forwards to a government citizen collective and combined all out effort in not letting Zika spread. This will give succor to all of us as well as the already overburdened and nearly burnt-out health personnel.

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