I am a carrom board. Just a piece of wood. Happy to help.
They enjoy playing on me, whenever they can, wherever they can—in the corridor, on the lawn or in a room.
When they are all around me, playing or encouraging the players, you can’t tell the patients from the family.
Of course, if you were around the day I was on the tray table and you found them applauding every feeble strike that just managed to touch a coin, you would have known that they were trying to cheer up the once-brilliant high-school teacher on the bed, who was depressed because now she could not even manage to teach her 10-year old son.
Otherwise, who is patient, whose patient, who is family, whose family—these are all irrelevant questions.
One of my players once described me more philosophically. We are all helpless coins, she said. Every pocket is a state of mind: joy, anger, sorrow, and acceptance. The striker is not in your control, and no one knows where you will land next.
I don’t understand all that. I am a piece of wood, just a game that may help you forget tomorrow and live today. I am just happy to help.
Originally written some years ago for the Cipla Palliative Care and Training Centre, Pune.
Does your cure end with your surgery, dressing your wound or restarting your heart? Or is that just the beginning of your recovery? Guess what, they don’t teach recovery and convalescence in medical school.
“Many of my tutors seemed to assume that once a crisis of illness has passed, the body and mind find ways to heal themselves,” Dr Gavin Francis, the author of Recovery: The Lost Art of Convalescence recently wrote in The Guardian. “But nearly 20 years as a GP has shown me time and again that the reverse is true: guidance and encouragement through the process of recovery can be indispensable.”
Dr Mazda Turel, a neurosurgeon, agrees. “We are not taught this in medical school,” he says. “But if you are attuned enough as a student while you sit in the clinic or OPD with your mentor you can learn it from your teachers in the way they respond to a patient’s needs in the recovery phase, from their ability to patiently answer umpteen questions (most of them repetitive). Eventually you imbibe care and concern, and that’s enough.”
Dr E K Ramanandan, a senior ayurveda physician too thinks most doctors pick up on their own how to help a patient through recovery.
Dr Nagesh Simha, Medical Director at Karunashraya, considers helping the patient and family through recovery a matter of compassion. “Yes, the doctor’s personal values matter. However, I believe compassion is something that can and ought to be taught.”
Recovery matters in an infected world
As new strains of coronavirus continue to give us all a physical and emotional pounding, the concepts of recovery and convalescence require deeper contemplation.
Convalescence is anything but passive. It’s an action that needs us “to be present, to engage, to give of ourselves.”
Anyone who has been through the viral infection is aware of the fatigue that follows. Physiotherapists encourage those in post-viral recovery to push the limits of physical effort. Else, “sufferers can become trapped in a cycle of effort followed by collapse,” with each collapse requiring lesser effort.
Recovery must act in concert with natural processes. Florence Nightingale believed that “nature alone cures.” She said what nursing had to do was to “put the patient in the best condition for nature to act upon him.” Nature's healing touch apart, people recover more quickly if they think their physician is sympathetic and there for them.
Dr Simha remembers the time he was recovering after a major surgery. “There I was, flat on the bed and everyone would be looking down upon me. Except for one doctor who always made it a point to sit so that he could have a conversation at my level. That made a big difference.”
“Every illness is unique,” Dr Francis points out. It follows every recovery is unique too. There is no easy solution or a formula. “It’s a landscape we all have to visit sooner or later. From time to time, we all need to learn the art of convalescence.”
Thou shall not abandon
AETCOM, a manual on attitude, ethics and communication published by the Medical Council of India for the Indian medical graduate, cites a case study. It is a letter to the oncologist from the husband of a patient who succumbed to breast cancer. Here is the gist.
“As you may recall, Alka was diagnosed with breast cancer 5 years ago. We rushed to you knowing your reputation as a talented oncologist and we were not disappointed. Your aggressive approach to the disease made all the difference. Alka beat the disease and she lived disease-free for 2 years. We were very happy and still are very grateful to you.
“Then the disease came back with a vengeance. Even at this time you did not give up hope and took on the disease like a warrior but then there came a time that it was clear that the disease had won. We were devastated.
“Alka looked up to you as a doctor to provide her with support, but it looked like that you were unable to confront the failure. While you did prescribe pain medications and your office helped us find a home nurse, you were reluctant to meet Alka or talk to her. When we called for appointments, your office would tell us to contact our family doctor for pain medications.
“When we did get to see you, you would not even look at Alka’s eyes. You would distractedly talk to her, refill her pain medications and dismiss us quickly. It was as if we were seeing a different doctor than the one we had seen when all was well. And when Alka was admitted to the hospital where she breathed her last you would not even come and see her.
“We made so many requests for you to come and visit with her. I even called and told you that it would mean so much for her to see you before she departs but you did not. Would it have been too much for you to come and hold her hand for a minute or say a kind word?
“We come to you not with the expectation that a cure is always possible but always with the expectation that you will support us in coping with the disease and the tremendous effects it has on our lives. We don't always expect you to succeed but we always expect you to show us care and compassion. You abandoned Alka and us at the time we needed you most. You, sir, abandoned us when we were most vulnerable.”
Some of the best communicators I have met have taught me that you are truly big when you communicate small. You get up from your plush designation, push aside the corporate façade, slide down the hierarchy banister and stoop to talk and connect with a simple, solitary individual.
There was this owner of a group of companies, a true monarch of the market. He would look everyone in the eye, greet by name and enquire about the immediate family. Last I ran into him, some four years after our last meeting, cruel circumstances had reduced the monarch to a pauper. But he still greeted me by name, asked about my wife by name, named both my sons and correctly guessed their grade. He remains a communication king in my heart.
Of course, not everyone is blessed with that kind of memory. However, if you think it is important to communicate small, you will find a way.
The CEO of one of the country’s largest companies used his secretary and his laptop to communicate small, big time. I helped him with a few templates. Just by adding a name and changing a few words, he would convert each into a very personal communication to suit every occasion—from congratulations to condolences. Before he started a telephone conversation or his secretary ushered in a visitor, his database would bring up the gist of their last exchange—personal and professional.
Goes to show you can’t blame technology for the all-pervading disconnect. Use it right and it can help you connect—if it matters to you.
True healing touch
She was not just a doctor, but a demigod. I was sceptical. She treated the same diseases and prescribed the same drugs as every other doctor. Yet, people loved her and stayed put in her waiting room for hours. Why?
I realized the magic was not in her stethoscope when I was with one of her patients. She was 30 minutes late and my friend was in serious pain. Just then, he received a call. It was the doctor. She apologized, explained the delay, and told him when she would reach. That call acted like a placebo. My friend settled down comfortably for a longer wait.
That doctor’s reputation and her healing touch was as much in her prescription as in the small, thoughtful communications like that one-minute call.
Back the pat
Talking of calls, I can never forget the Monday when I got one from a very senior executive of a client organization. My regular contact was about five levels down the hierarchy, so this was a surprise. He told me that the presentation I had helped his team make was very impressive and did its job well. That one-minute call made my week.
The irony? My contact never bothered with mundane things like feedback. Unless, of course, I had made a Himalayan blunder. Or what was needed yesterday till a minute ago, was now required the previous week.
Months later, when I ran into the big boss, I told him how his call had had such a positive impact on me. He had no clue what I was talking about. But he shared a secret. “Someone told me a long time ago that you should never miss an opportunity to pat someone on the back for a genuine reason. And you must do it without delay. I just try to follow that always.”
Back the pat to work wonders.
Grace under complaint
I wish my bank would grow up to be big one day. I had emailed a complaint about a wrong charge. When there was no response even a week after the promised 48 hours, I followed their protocol and took up the issue with “higher authorities.”
Four days later, someone from my branch called. “Did you check your account before you escalated the problem?” he sounded very irritated with me. “The issue was resolved two days before you complained higher up.” But no one told me the problem had been resolved. Else I would not have bothered to escalate the issue. And am I supposed to monitor my account every minute?
“When you escalate any issue, the branch must answer. I have to answer.” Did he want me to apologize? “You should understand customer complaint emails are handled by a different department,” he growled.
All he had to do was tell me the issue was resolved. Instead, he made it amply clear that me the small customer was being a nuisance to him, the busy boss of a big bank packed with so many departments.
Talk beyond script
My internet service provider, on the other hand, is beginning to cheer me up. I am used to tiring cut-paste email responses and scripted answers when I post a complaint. This time I had almost given up even before sending an email.
Surprise! A live human being, who knew my name and my problem called up to admit they had not figured out a solution yet. Two days later, he called again to say that the company had sorted out the issue and went on to share his personal number, in case I faced the problem again.
Admitting a problem, taking the initiative to make a call and conducting a conversation with a small, solitary customer, without a script. Yes, my ISP has suddenly grown big in my eyes.
Maybe it helps to have a degree in language. However, effective communication often requires simple schooling in making a proactive connection.
A version of this was first published here on February 15, 2017.
When what used to be your home is destroyed by the rising waters, nothing can ever be “normal” again. The residents of Chiplun, one of the places in Maharashtra that drowned in July, can never forget those days.
Yes, help arrived soon. To feed, clothe and rebuild. But how do you rebuild your mind? Especially when you are a teacher who is responsible for shaping minds and lives?
That was the prime motivation for Vaijayanti Thakar, always ready to help others cope and heal, to conduct a workshop for a group of teachers on August 26, 2021.
What follows is based on the information and emotions shared by her.
Bundles of joy and sorrow
Some of the teachers had already resumed work. Some were visiting children at home. They were all making a good effort to be normal. They were all dressed well—in clothes that were borrowed or had been donated.
We started with a prayer to the Sun. “Please rise again every day.” It was a plea. It was an expression of hope.
After they had settled down, I began with a story.
There were two women in a village. Both faced similar situations. Violent, alcoholic husband, not much to eat. Yet, one was always sullen while the other was happy. The sullen one could not stand it any longer. “Why?” she asked the other. After everyone goes to sleep, the happy one said, I sit before the idol and pray that everyone should be happy.
The sullen one tried the same thing, nothing seemed to happen. Then the sullen one had a dream. She was walking towards a light coming from far. She reached a cave that had several bundles. And a beautiful woman sitting on a throne. She was the source of the light.
“I am the servant who looks after these bundles of joy and sorrow,” the one who looked like a princess said. The sullen woman opened her bundles. There was hardly any joy. But the other woman, her bundle of joy was so heavy. What was the difference?
They both had had similar experiences. They were both unwanted children because they were girls. Yet the other was happy with her mother’s love whenever she was held close and fed. Yes, her father would beat her. But she remembered the times he would hold her close. The clothes she got occasionally were all old and torn but she was happy to get clothes. She loved the moments she spent with her children.
Story over, I requested all of them to congratulate themselves. You have suffered so much, yet you have emerged strong, ready to teach again.
It was time for the “trust walk”. I requested them to choose a partner who was a relative stranger. One would be blindfolded and had to totally trust the partner to lead her right.
The floods too had presented a situation where they quickly realized whom they could trust. Calamity or not, we must learn to trust. And we have to teach our children, our families to trust, to help one another.
Then I invited each to share her feelings. There was anger, there were tears. I let it all flow, without interruption.
“I … my child … no. I can’t speak.” One of the other teachers filled in for her. “She has a six-month old child. When her building got flooded, she picked up her child and went up to the terrace. It was impossible to go back down the stairs. The terrace did not have a parapet. There was a tin roof which was somehow holding up against the howling wind and lashing rain. She held the child close to her chest and stood there in the dark for 28 hours.”
Another teacher said, “All of us had moved up to the upper floor but the water kept rising. We decided to abandon our house. We used a ladder and went to the adjoining house. There were about eight of us, including children. Then we all went to the terrace of that house. We could see various things floating away but we were numb. Our only thought was that we had managed to save ourselves. There we stood for more than 24 hours.”
For another, it was time to realize what really mattered when everything was at stake. She took her jewellery and money and put it on the floor above. Then she decided to move some grains and, like a true teacher, some books also. Then it occurred to her that her life was more precious. Everything else could be earned or bought again. She was happy to get out of it alive. But the next time?
Get it all out
I asked them to write down all their thoughts, their fears. To let their anger flow. Forget you are teachers and supposed to be role models. Use the worst swear words you know. This is for yourself.
At the end of it, we collected all the pages they had written in and set those on fire.
Then they were given pillows. I encouraged them to hit the pillows. Let all the anger come out, transfer the pain to the pillows. There were giggles to start with and just light taps on the pillows. Soon, the mood changed. There were tears, screams. Some just could not continue.
We ended with a meditation session. Soothing, calming and, hopefully, rejuvenating.
There was a lot more to do. But, right now, it was time for a fresh start.
The sun will rise again. We must too.
Vaijayanti Thakar may be contacted at email@example.com
Four-year old Gulab was at a busy railway station with her father when someone came close and stabbed him. As he lay dying, and as the world around them rushed about its business, she quietly shut the world out.
All I knew was Gul was a puzzle and one of the problem cases when I took charge of her and a bunch of other children at the orphanage, where I used to work.
Her face would always be blank. No expression at all. Normally, we would quickly know every new child’s likes and dislikes. Gul had been around for weeks. There was no sound, ever. We had to anticipate everything—from washroom breaks to food to even a few sips of water.
Once the background story sunk in by and by, I knew that more than psychology, Gul needed to reconnect to love, to belong to someone. Long before he was killed, her father had been the only one for her. Her mother and a sibling had gone away after some family dispute.
Being there for Gul
I started giving her extra affection. I would be with her every possible moment of the day. She would go to sleep on my lap. Whether she responded or not, I would keep up a chatter with her. I would laugh and not bother about her response.
I could sense her eyes following me. There was no expression on her face, but her eyes would be on me and would tell me a lot—sorrow, helplessness, loneliness, frustration, depression and so on.
Later, she was comfortable enough to put her hands around my neck. Those hands would transmit her unspoken words, her fear, her worries and, simply, her need of a hug and lots of love. She used to wait for me, and her eyes would follow my every act until I finished with the other children. Then I would take her in my lap, hold her hands or kiss her.
Others in the orphanage were getting sceptical. I ensured that I did not neglect any other child in my care. Just that the physical and emotional attachment was strongest with her. Though there was no reciprocation of any kind.
Depending on the weather and the time of the day, I would often take the children to the terrace. There we had books and drawing materials. I would read them stories. We would draw stuff and sing songs.
When playtime was over, all other children would rush down on their own. Gul would stick around until I took her down.
That day, the children had run down. I was putting the books away. Gul was there too, as usual waiting for me.
Suddenly, I heard a little voice behind me: “paani …” I dropped the book and turned around. Gul was looking at me. She repeated, “paani…”. I grabbed her and kissed her wet eyes. I was laughing and crying. I crushed her to me and just didn’t know what to do or say.
Sometime later I carried her down and excitedly shared the news with my colleagues. Gul had spoken. She had asked for water. They had difficulty believing me. Because Gul had clammed up again.
Opening up to love
Gul started changing. It was slow. She would continue to cling to me. It was quite a task to get her to accept the other “mothers” in the orphanage. Gradually, Gul was as normal as she could be.
The day she was taken away by her adoptive parents, I was not sure if I was happy or sad. I was not around to wave bye to her. Maybe it was better that way.
Months later, someone told me that Gul was paying us a visit with her parents. I was thrilled. This time I was determined to see her and talk to her, even if she did not remember me.
I was in one of the inside rooms and saw them get out of the taxi. Gul was looking taller and prettier. Suddenly, I noticed a change in Gul’s expression. She was looking at the building and it was as if a cloud had passed over her face.
I was all set to rush out when I stopped myself. Did the place remind Gul of the dark days of her life? If she were to see me now, won’t it be worse for her?
I remained hidden and moved to another part of the building. Far away, I could hear the supervisor calling out for me. I ignored that and moved towards the terrace. Maybe an hour later, I could hear them getting ready to go back. I peeped out carefully. Gul appeared to be happy. Yet, I sensed she did not want to look back and was in a rush to get into the taxi.
I waved out more for myself than for her. Once again, I was crying and laughing. Then I gathered myself and went down.
There were other flowers needing help to bloom.
Based on a true story narrated by Vaijayanti Thakar. Some details have been changed to protect privacy. Art by Shravani Panse.
One of the privileges of being a writer is meeting people like Vaijayanti Thakar, whose work is to connect, heal and, simply, love. Recently she remembered an unforgettable Holi celebration.
The month of March 2021 ended with the festival of colors, Holi. Traditionally, it is a time for people to come together and color one another. But this year the virus did not allow that. It kept revelry at a forced, colorless distance.
My friend, Vaijayanti, whose lifetime work is to care for others, shared the story of a different Holi celebration—with a group of blind girls.
Holi with those who see only black
Some years ago, she used to handle the corporate social responsibility (CSR) function of a company. When she invited volunteers to join her to celebrate Holi in an institution that cared for blind girls (some of them had limited vision), there were questions galore.
Is that a joke? How do you celebrate colors with someone who can see only black? How do you even spend three hours with them?
“When we arrived, the girls were all in their uniforms, sitting in a neat row. I asked them if they wanted to just sit there or play. They were immediately up with great enthusiasm,” Vaijayanti remembered.
She reminded her colleagues that everyone there had the same inner vision. It was just a question of letting go, of accepting, of sharing love.
They started with balloons. “Someone whispered a doubt. Can you blow a balloon without seeing it?”
You can and they did. The inhibitions began to crumble. The balloons made all of them little children again.
They sandwiched a balloon between one person and the next and made giggling trains that went on some merry trips. Not once did anyone fumble, touch the balloon or lose direction. They were too busy enjoying the journey.
Letting in, letting out
Back in the room, it was time for a fight with the balloons. It was the time to truly let go. There were several displays of aggression and anger. The black within was yielding to color. The balloons were harmless, but somehow, they were powerful in drawing out the deepest feelings.
“Then we held hands and went round and round. It was a time of connection, of reassurance.”
Out came the colors and the musical instruments. It was clear that art did not require perfect vision. And from chaos can emerge some wonderful music (again requiring more instinct than sight) that touches the heart.
“Those were a few short hours. We gave and gathered a lot of love. Often the canvas before our eyes is washed black, but everyone has a rainbow inside that is just waiting to come out.”
Before they reached that place, everyone was going on about blind girls. “When we left, blindness did not figure either in our conversations or in our silence.”
“Everyone has a right to love and be loved. It just takes effort. We were all lost in the little effort that we had made and what more we could do if we just let the colors enter our heart."
Images: Shirish Ghate. +91 98230 18328. firstname.lastname@example.org. Insta: sigafotopune
It has been nearly two months after I last visited my shop located about 20 km from my house. It is a trip I have done millions of times over nearly a decade; a route so familiar that I can do it blindfolded. Today my eyes are wide open as I cautiously drive down deserted roads.
A policeman stops me at a junction, about 7 km from my shop. His expression changes as he looks at me closely. I explain where I am headed and what I do for a living. “I know,” he replies. I wonder if he is being sarcastic.
“I have been to your shop,” he clarifies. He is not happy that my wife is accompanying me at a time when even one person has no business to be out and about. But then I am out on business, running a shop selling essentials and he knows that for a fact. He points me down the only route that is open.
Finally, I reach the shop. It is mid-morning and the neighborhood is unusually quiet. I start pulling up the shutter and then stop, worried that it was very loud. My wife and I do some cleaning, rearrange the shelves, and sit in the shop for a while.
There are no customers because I had not told anyone I was planning to open the shop. And I didn’t want to do that until I had official clearance from the police. For that I was determined to go the police station nearest the shop. We close the shop and head there.
Policing for protection
The inspector who heads the station emerges from inside just as we enter the station. I introduce myself.
“I know you,” he stops me halfway. I can sense my wife looking at me. How come this fellow is known to so many policemen, she is probably wondering.
“I started my duty before 7 a.m. keeping people away from the road,” the inspector continues. The last meal he had was the previous evening. So, he had just finished a late brunch before duty took him away again.
I apologize for not recognizing him. I did have a regular customer from that police station, but that was—
“I had come with my senior and you had given us both some coffee.” He mentions the name of the senior and it clicks.
Before I repeat my apology, he asks another question. “Your shop is the one that always has those long south Indian bananas hanging outside, right?” I agree. No point in reminding him about my shop’s name.
“If you are supposed to be selling essentials, you should have been there all these days, at least for limited hours. Why do you want to open now?”
I explain that I was scared. And I wanted to make sure I obeyed the restrictions. Which is a polite way of saying that I was afraid of being beaten up by the police. From his smile, it is clear he understands.
“Do you know that we are in a red zone? That means we are all in big danger from the virus. You think that the virus will simply go away? The virus will remain with us, even in our lungs at least for a couple of years. So, we have to take care. That is why we have to be bad and rude with everyone. Because people don’t understand that we are all in danger. All—you, me, them. We have to do our duty. We can’t work from home,” he pauses. I wonder if he has read up on the virus.
“Listen, I am not complaining. We have nothing against the people we keep driving away. Our biggest problem is all the news and videos people share on the mobile. Everyone believes anything. And they love to show us worse than we are. After all, it is fun to share a video of a policeman supposedly beating up a poor vegetable fellow. We may not get to eat. We may share our food with 10 others who have nothing to eat, but that is not fun. Right?”
He shrugs as if trying to shake off the mood he is in.
Is corona goading us?
He tells me I can open the shop for a limited duration as applicable to the zone. Then he describes how I can avoid overcrowding and the precautions I must take. All his directions make perfect sense. Before I leave, he warns, “If we find your shop is responsible for causing overcrowding, we will close the shop and take action against you.” There is no malice, it is just a statement of intention.
On the way back home, I pass several policemen on duty. They are out in the sun, not safe at home. The only protection they had was a mask and a lathi—one against the virus, one for the people. In this fight against an evil entity we can’t see, are we and the police making each other the visible evil? Would we be happier with the virus if the police didn’t use their lathis? Is Covid setting us up, goading us all to be lesser beings?
I reach home and send a WhatsApp message to all my customers that I was opening again and what they needed to do to help me stay open.
As I head to the shop the next morning, I wonder if this is the return of the normal. After all, normal never stays new for long. We make sure it doesn’t.
This post is triggered by the tone and substance of the WhatsApp message my anonymous shopkeeper friend broadcast. Far from being a dry announcement, it was eager to serve again, apologetic for staying away for long, joyous to be with friends again and anxious to ensure everyone bought well and stayed safe. Yes, it was infectious.
About the graphic. It must not have been easy for a busy designer who takes appetizing images of food to digress into illustration, but sportingly she went bananas for this piece. Thanks, Tasneem Syed!
Many happy returns, we say. At least once a year. What should we say when that wish is no longer a blessing but a curse?
You never see him at rest. If you hear the gate opening when the birds announce the rising sun, it is him with a vessel full of frothing milk, that he has just drawn from the cow.
Are you willing to forgo your afternoon nap and walk a few meters to the coconut plantation that kisses the edge of the backwaters? You will see him there at work. He will not stop working but if you can walk along and pay attention, he will readily share his wisdom in gentle words. If you are not distracted by the water birds following the tractor, he will explain the mechanics and commercials of cultivating paddy. He may even offer you a tender coconut to savor.
During the day, you will find him zipping about on his motorcycle. Errands never end. There are at least five homes of the extended family that count on his visits so that things get done. Then there are visits to the bank, to the panchayat office. He barely has time. If he spots you walking by, he will stop, park the bike and talk as if he has all the time for you.
You will not want to get too close to the cows when he is tending to them in the shed next to the house. They do not look very friendly and are given to shaking their heads, making their horns bang noisily against the wooden railings. He remonstrates with one for not eating properly. There comes a prancing calf that gets a hug and a kiss. He has simply become one of them. You watch and wonder.
The pages of the calendar keep flipping, bringing along the special day. He makes a special visit to the temple and there is a special sweet dish cooking at home. Looking at his hearty smile you sincerely wish the day would return many happy times. He is special. He deserves it.
When that day came the last time, you did not want to wish him that. He was laid low by cancer. You flinched at the sight of the helpless figure on the bed, all bones and bedsores. You saw an apology on his face for not being able to get up and talk to you and share tea with you.
He is gone. At last.
All of us must. But not the lingering way he did.
What do you say when, to wish for even one more return of the day, would be so insensitive, so cruel? Keeping in mind the only gift that matters and the inevitability of the end, perhaps it is time we learned to say, “Live full, die well.”
Dr Sanghamitra Bora
State Lead - Palliative Care, Assam Cancer Care Foundation, Guwahati
I was chosen to contribute to the Covid-19 mission and asked to supervise infection control in the screening area, potentially the most infectious area. My job started immediately after the nationwide lockdown, on March 22, 2020.
When we started, we did not have adequate number of personal protective equipment (PPE). The team started working with whatever was provided.
Getting to know a patient
On April 1, I noticed that one of the persons who had come for screening had red eyes. As he waited in the queue, his body language appeared to convey that he was sick. His wife was in tears. As a palliative care physician, I considered it my duty to talk to her, comfort her and find out what was going on. So, I went to her.
Of course, I was maintaining a safe distance. I had put on one N-95 and two triple-layered surgical masks. I was wearing my apron, a disposable surgical gown and three layers of gloves. The wife told me that her husband had a history of asthma going back 12 years. He was on and off medications. Recently he had had fever and an attack of asthma. Their family physician had prescribed some medications. As those didn’t work, the doctor had advised a CT scan of the Chest. The scan revealed pneumonitis, which had prompted their doctor to send him for Covid screening.
On probing further, I also came to know that he had travelled to Delhi and returned around February 29, 2020.
Meanwhile, her husband was called in by the doctor. That being a screening area, the doctor was supposed to ask questions from a distance of at least two metres. The doctor had two layers of masks and the patient also had to have a mask. To me, it was the perfect situation for a possible miscommunication. Maybe the patient would say “I have fever” and by the time it reached the doctor, he would possibly hear it as “I don’t have fever.”
It was important that the doctor filled up the registration form correctly. Because the doctor decided if there was a need to take samples, based on the history as he understood and recorded. The next stop for the form (and the patient) was the laboratory technician who would take samples (if the doctor called for it). I was trying to do what I could to reduce the communication gap so that the doctor was able to record the history correctly.
I was trying to talk to everyone who was there for screening to try and avoid any miscommunication. As a protocol I had to recheck the filled-up standard form of sample collection, and hence a second conversation was necessary.
I definitely did not want any miscommunication with this particular patient I was observing. Both husband and wife told me they felt really good after they spoke to me. They were advised medications and home quarantine. I told them that if the tests yielded a positive result, the superintendent’s office would contact them. They would be instructed about the standard procedure to follow thereafter. They appeared happy that they had the complete picture. The couple thanked me and went home.
Negative times follow a positive result
Two days later, I came to know that the man was Covid-positive. The moment I heard that, a fear gripped me. I did not regret that I had helped the couple when they were undergoing emotional trauma. But my fear was what would happen to me.
I went to the authorities and reported that this positive patient had been screened during my duty hours. I was advised to watch out for symptoms over the next seven days. After that they would do a test and that was that.
Nothing happened for seven days and I was relieved. However, on the eighth day I developed slight fever and I was on the verge of panic. Why fever? Why now? I tried to look for reasons.
Every morning I would take my bath before leaving home for duty. Once I finished my Covid duty, I was sprayed head to toe with D-125, a disinfectant. That would really drench me, clothes and shoes and all. Then I would reach home and take another warm bath. All that drenching must have caused the fever, I tried to justify. But there was still a 0.001 probability of infection and that was frightening.
In isolation and on the edge
I went to the doctor on duty and told him I needed to get tested. He rolled his eyes and asked me why I had not told him before. But the seven days had gone off well, without any problem. How could I have told him before?
“You may develop symptoms after 7 days or 14 days or even after 28 days. This virus is so tricky, the symptoms can come at any time. You must not take any chances,” the doctor explained. He called for the Medical Officer, who was in charge. My samples were taken.
The Medical Officer spoke to me for about 45 minutes asking me the same questions over and over again, maybe just to check if I was consistent. By then, I was really very scared. Then he pronounced the verdict. He immediately sent me to the isolation ward for 24 hours. If the tests turned out negative, I would be quarantined for 14 days. “If the results come back positive, you know where we would send you,” he said ominously. All positive patients were being sent to a Covid facility in a different area, that had facilities for isolation and treatment.
My throat was dry, my mind empty, and I had no idea what to do. After some time, I called up my husband and briefed him. Fortunately, I had sent my husband, my son and everyone else in my house to my father’s place, that was close to my house. When I did that, I was simply being very cautious as we were in a vulnerable location and I was dealing with Covid patients.
I landed in the isolation ward. Yes, it was secluded. It was on the third floor of what we called the Covid building. It was scary to be all alone. The whole ward was silent. There was no conversation. Those who were on duty looked like robots, dressed up as they were in their protective suits. They never talked. They would come and do their job and then they would thoroughly wash their hands and go away. The silence was absolutely fearful.
I had simply not anticipated what lay ahead. There were so many messages and calls on my mobile, but I did not feel like responding. I had become very emotional and wanted to stay aloof from the world. I even switched off my phone; something I never do.
Many fearful scenarios passed through my mind. I will never see my husband and son again. I will be moved to another isolation ward. If my immune system is not strong enough, the symptoms will start.
Breathlessness would be the first.
It is very difficult to even see someone else experiencing breathlessness. Because there is nothing you can do to help. It is so frustrating.
I imagine myself struggling for breath with a ventilator pipe inside me. With all my knowledge and experience, I can’t bear to think of anybody trying to give me false hopes, telling me everything is okay, and I will be fine soon. I can’t see expressions of the medical staff around me. They are all wearing masks. Are they smiling at me? Are they frustrated? Are they angry? I can't see them. But they can see me. And that is so difficult to accept as a patient.
Then sanity kicked in. Why am I shutting myself away? I am a professional, a healthcare worker, and this was to be expected. My friends are genuinely worried. Why am I pushing them away? I started replying to messages and returning calls.
Positive thoughts follow a negative result
After almost 36 hours in isolation, my test results came back negative. And I am writing you this from home, where I have begun a 14-day quarantine. I am now so relieved. I am so grateful to all for their love. I just want to share my thoughts that would hopefully help someone somewhere somehow as we all go through this difficult phase.
Those 36 hours spooked me, and I am supposed to be a doctor. Imagine people having to live through this for days together!
It is so easy for us to point fingers at someone who is infected. But why not focus on what we can do to help?
Can we spare some time and compassion to counsel a patient who has been sentenced to isolation?
If someone in isolation is not eating (I did not) and not accepting calls, can we reach out and ensure that he or she has not slipped into depression?
We may have to maintain distance physically. But should that stop us from getting close emotionally? This is when, more than medicine, you need comfort and care from a fellow human being.
Now I am clear that I do not want sympathy. Neither did I do anything extraordinary. You may attribute it to my palliative care training, but I think a Covid-19 patient (proven or potential) deserves the same compassion and care that you would not hesitate to offer someone who is terminally ill.
Today, I feel more charged up to carry on with what I am best at—providing palliative care. I have more than one reason to justify why it must be an important part of a humanitarian crisis. I wish to improve my skills, especially in the area of communication so that I can convince authorities to adopt a palliative care approach in every setting. And of course, the biggest challenge will be to demonstrate a visible change in the patient as well as the whole scenario of caregiving. I do hope that the science of palliative medicine will be allowed to play the key role it can, when we are trying to copy with such a calamity. We have the ability; we can reinforce the confidence.
Will I go back to the screening area? Absolutely! I will go there and continue talking to people. I have seen the positive effect of a simple conversation.
Yes, I cannot interfere in the isolation area. However, I have realized that there may be unknown fears in the minds of those working in the isolation ward. Perhaps, that explained their behaviour? I would like to tell those workers that they can talk to me, tell me about their fears. I am sure that would bring about a positive change in their approach, and ultimately benefit the patients.
Personally, in the last few days, I have learnt the skill of detachment from worldly pleasures. They don’t mean anything unless you put a price tag to each.
We do not know what tomorrow holds for any of us. At least today, when we still can, let us care for one another. That can be priceless.
Based on a video posted by Dr Sanghamitra Bora and subsequent conversations with her.
After the virus pushed the office and the school into the house and locked the door, life has been rather strange. Imagine having to live every minute of the day with people like husband, wife, children, parents, in-laws and some combination of the above, without a break.
Yet, despite the horror stories and jokes, surely something positive must be happening on the bonding front?
So, I went hunting for positive stories. Nobody opened the door for me but some friends (mainly counsellors) had some snippets to share. Of ordinary people working magic. Of cracks healing over. Of I and mine giving way to we and ours.
They had major differences. Age and culture were just two. After prolonged therapy, they had decided to go on a holiday. For the first time in three years, they spent a few days together without arguing and fighting. When they came back home, it was back to the boxing ring. Until the lockdown happened. Soon they realized they were stuck together. First the husband learnt to say, “we’ll stop now” and walk away whenever an argument threatened to get out of hand. Then, she, the more abrasive of the two, learnt it too. They learnt to adjust. They are managing well now. Who knows, they may even go on another holiday, whenever they can.
They are into their 50s. They had a good, healthy arrangement of living in the same house efficiently for decades. Then the children left home. Suddenly, they were all by themselves day and night. No servants, either. So, they decided to do some spring cleaning. In the process, they came across a bunch of letters they had written to each other after their engagement. “We rediscovered our romance,” she said. “We continue to do things together like cleaning and gardening. Nowadays, we also watch a lot of TV together. Will things change after? I don’t know. For now, we are enjoying our time together. We are happy all by ourselves. That’s all that matters.”
Imagine a father and son duo, both victims of bipolar disorder. Imagine the plight of the wife and mother caught between the two. So, when she called up the counsellor after more than a year, the counsellor feared the worst. “I called up to thank you. My husband is so lost in the board game you gifted us so long ago. No violence. No abuse. There is so much peace at home now and all of us are together. He wanted to know from where we got the game. So, I thought of speaking to you.” Ironically, it was The Game of Life that had brought about the transformation.
The TV has been pushed away in many homes. Limited viewing. Definitely no news. Only a few serials that the whole family can watch together. Board games and home-made games are the new favorite. No more adults doing their adult things leaving the children to do theirs. Now the family does family things together. Like the activity-laden custom-made snake and ladder. Or word dominoes (some would call it word antakshari).
Grandma’s version of the musical chair for her two grandchildren requires just one chair. She uses a spoon and plate to create the music. Ever played lagori (seven tiles) in the house? You just need some paper cups and a small ball. You will soon discover that the size of the house has nothing to do with the fun you can have. What matters is that all are in it together. Everyone knows surya namaskar is good for health. It works even better when you have three generations prostrating before the sun at one time, keeping a healthy distance from one another of course.
It was difficult for the teacher, a single parent, to accept that her son was suffering from clinical depression. The counsellor gave her a list of things to observe. The mother always went alone to the counselling sessions. It was as if she wanted to shield the son. Then one day she agreed to visit a psychiatrist. The psychiatrist confirmed the counsellor’s diagnosis. The mother was reluctant to give him the medicines. The counsellor suggested: “Don’t keep telling your son what to do. Don’t ask him questions. You do the talking. Just share what you feel. Accept your emotions. Be honest with him. There is nothing either of you can do about it. But you are happy that you have him.” Many days of conversations followed and continued through the lockdown. A few days after being homebound, the mother saw something the son had written: “My mother is a good person. It’s okay if my father is not there with us.”
As a counsellor, I am amazed when my young friends, 18 to 22 age range, call up at random just to talk. I know some of them were almost lost to the world, caught in drugs, drinking and what not. But now, after days at home they want to talk about spirituality. They want to analyze. They want to introspect. They want to make others happy. And for that they accept that they have to be happy first. They have had enough of TV and the social media. They are bored. For the first time, I realize that boredom is healthy, if it makes you think and look inward.
It is strange to see parents without mobile phones in their hands. Instead, they have the handlebar or the seat of the bicycle their son or daughter is learning to ride. Or a badminton racket. They are scrupulously maintaining the rules of distancing. They are distant from their neighbors, their normal partners. They are now with their new playmates, their children.
In all the years she has been working from home, her husband was a presence she took care of in the mornings and the evenings. Now, I am surprised to see what a hands-on househusband he has become. She is so relaxed. That’s not all. They are at times in the same room with her in-laws. They talk. Believe it or not, they all laugh so much. Together.
At 53, he was the epitome of brand consciousness. Super rich. He bought what he fancied, and that meant only the big names. His cupboards were overflowing with the best he could buy from all over the world. Until the lockdown, the closed shops and the panic buying. “For the first time, I realize that it matters more to have milk at home than all these silly things. I have been such a fool, a hoarder of the worthless.” I laughed. Told him he would go back to who he was as soon the virus allowed. “No, I don’t think so. This is a life lesson. My only regret is I took so long to learn this. And a virus had to teach me.”
Reading a story to your little one? Many are also recording it. So that other parents and children can enjoy it too. There can be no better time for story-swapping! Your child can speak your mother tongue, but can an English-medium student also learn to read and write it? Just ask you resourceful neighborhood parent for flash cards. Earlier, junior could not boil water. Now he has a video that will teach you how to microwave a delicious cake in a jiffy. An IT father developed digital worksheets and shared it with the school principal. Now they have a whole range for different grades. There is a surge in creativity and the wonderful urge to share. Our social intimacy appears to be peaking (and not just to show off) at a time when we are expected to maintain personal distance.
This lockdown has finally made me realize that the radical decision I took about two years ago was so right. After he cleared his eighth grade, we decided to homeschool our son. He was afraid of mathematics to the extent that it was damaging his self-esteem. He also wanted more time to pursue his passion: music.He was taking lessons in tabla, drums and guitar even while in school. So, after he left school, we enrolled him at a music academy for a good four hours in the evening. He now had his open school subjects keeping him busy during the morning and the music in the evening. Then my guilt, my working woman’s guilt, kicked in. I was only getting time with my son when I was ferrying him to and fro the music school. He would be asleep when I left for work. At night after dinner I would be too tired to talk or spend time with him. Even on Sundays, we would just get time together in the evening as he had classes right through the morning. Except when he went off to be with his cousins. Then came the lockdown and now we are so happy. I am getting to spend the entire day with him. There are so many things we do together like cleaning the house, gardening, cooking, watching and discussing news, enjoying movies, and reading books. Above all, I am with him during his music practice sessions. I am so grateful for these days.