This story will shake you up. Even if you are already numbed by what you get to read in the media these days. After all, even the seasoned psychotherapist who shared Sahira’s story had goosebumps while narrating it.

The story is about her, Sahira and him, Nasir. You will not be able to forget her at the end of it. And not want to remember him.
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We do not know what happened to him. But if he were to tell, this is probably how the story would begin in his entitled voice.

​Let us now shift to Sahira’s perspective, as described by the psychotherapist.

“With no footwear and no money, she ran for her life and that of her unborn child. Her parents took her to a hospital, lodged a police complaint and also filed for a divorce.

“Her own family advised Sahira to choose abortion because she was very young and had a whole life ahead of her. She could get married to someone in a few years and settle down. Her family didn’t have enough money to support one more member.

“However, at the age of 19, Sahira decided that she would not remarry but raise the child on her own.

“Her divorce case lasted for over six years. She felt she was being raped again and again in the court room as the lawyers pestered her with questions and made her go through the whole case in agonizing detail.

“During the sixth year of the case, Nasir was caught by the police in another rape case. He was apprehended in his car while he and his friends were returning to Pune with the victim, from the same farmhouse where Sahira was once raped.

“The judge issued a warrant for Nasir’s arrest. Left with no other option, Nasir’s lawyer reached out to Sahira’s lawyer for an out-of-court settlement. Nasir was ready to give complete custody of the child to Sahira and also give her a divorce, if she would let go of all charges and cases against Nasir and also let go of the huge amount owed to her in alimony arrears. Sahira agreed because this would free her daughter for life from having to maintain any contact with Nasir. For Sahira, that mattered the most.

“Sahira had to give up on her dream of becoming a doctor. But she didn’t give up on her dream to be a successful woman, a responsible daughter and a loving mother.

“She has worked mainly with international banks and is currently in a leadership position in a European bank. An alumna of one of India’s leading institutes of management, Sahira continues to pursue her doctorate in organisation management.

“Sahira remains unmarried and stays with her daughter in a beautiful house she owns. Her daughter, an academic topper, has grown up to be a mature and responsible young graduate.”

Do read the complete post by the psychotherapist, Prerna Shah, here.

At the end of it you may want to curse the villain. Or, more positively, follow the victim’s example and celebrate her victory over “fate”. You can, if you badly want to. She is a living example.

You have serious health issues. On first assessment, the doctor gives you less than 100 days to live. More than 20 surgeries and 10,000 days later, who do you thank for letting you be you, not just alive? Yes, your own attitude matters. Then there is your doctor, the medical team, friends, and close family. If you are very lucky, you will also be grateful you had Nancy on your side.

If you have seen the movie, I want to talk and read the books by Arjun Sen, you will know who Nancy is (was, sadly). I had watched the movie before I read his books Raising a Father followed by Unquit Forever: Keep yourself in the game. The latter (the title of which sums up Arjun’s attitude towards life despite a prolonged standoff with death) told me more about Nancy.
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When Arjun met Nurse Nancy for the first time at the hospital, “I heard her scream, ‘Arjuuuun’ way before I saw her.” Then, she “pulled me into a bear hug.”

Then Nancy asked him a question. Did Arjun think of himself as friend and family? She explained: “You wake up with yourself, you are with yourself all day, and you go to bed with yourself. You are your best friend and companion. There is no hiding from that.”

“Arjun, in your journey of living your life, you have to learn to trust me now. I know it takes time to build trust, but in our case, just force yourself to start with 100% trust and then see how I live up to that.” Those are Nancy’s words as quoted in Arjun’s book. She asked Arjun to let her into his life so that she could help him.

Once Arjun wondered how she managed to connect so deeply with every patient. Nancy replied: “You didn’t come in as a patient. You came in as a human being. Don’t you deserve love, kindness and attention? That’s what I do. I fall in love with every patient every time. Unless you love the person, you cannot care. I have heard others say that one has to love what they do. That does not work for me. How can I love my work? I love people and every patient that walks into my life. I fall in love with them. They deserve the love.”

There was a time when Arjun, the consummate marketing man, was considering suicide. Nancy happened to call when he was driving and sensed what he was planning. She said, “Arjun, hear me out clearly. You are a survivor, not a quitter. Your mind will not let you quit. Whatever you are planning, you could fail in it. Do you know what will happen next? You, the branding man, will get defined as the person who failed both in life and death. Is that how you want to be known?” That prompted Arjun to take a U-turn in life and convert the bothersome headwinds into positive tailwinds.

Then, one day, Arjun got the news that Nancy was no more. She had taken her own life. Why? Her husband told Arjun: “Nobody knows why it happened. She finished her shift and left quietly. Her phone was turned off. I guess everyone had Nancy. You, all her other patients, doctors, her friends, and us, her family. But Nancy did not feel she had anyone. She must have been hurting badly, suffering all alone.”

This is how Arjun sums up his connection with Nancy in his book: “She walked into my life, ready to rescue me. But she never made me feel rescued. She made me feel like I was still me, but a better version. Unfortunately, our connection was only about me. She knew everything about me and how to help me get back in life, not just live but run in life. I wish at least one more time I was standing in front of her, with open arms and calling her name, ‘Naannnncyyyyyyyy!!!!’ and inviting her into a big hug.”

Even if you have seen the movie, do read Arjun Sen’s book, Unquit Forever: Keep yourself in the game. It will take you deeper into his life, and the lives of those who made his life a marathon he successfully started and finished—including Nancy. 

Are you fortunate enough to know a Nancy who loves the people under her care beyond the clock and duty? And if you do, do you really, really know her to encourage her to live on, love on?

When the doctor was first describing her cancer, Katie Doble, 32, stopped listening for some time. Because she had a decision to make. Should she be planning her wedding or her funeral? Her boyfriend had proposed to her just ten days earlier.

Katie went on to get married. She also prepared for her funeral but, thankfully, that must wait.
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Her first symptom had appeared in May 2013—"a strange vertical black bar swimming through her field of vision”. It was diagnosed as uveal melanoma, a cancer of the eye. The first line of treatment involved a “radiation-emitting metal disk placed in the back of her left eye”. As feared, that led to her losing vision in her left eye.

On the positive side, her doctor said the chance of her cancer spreading was less than 2 percent. In April 2014, an ultrasound found no signs of metastasis.

Seven months later, just after Katie’s engagement, new scans revealed that her liver now had a dozen lesions. Like most afflicted with the deadly C, Katie was anxious to immediately start the treatment the physician had suggested, the one that would have given her some 16 months to live.
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Fortunately, she had a rare advantage. Her father was a doctor, who was already exploring more promising options in the stage of clinical trials. On his advice, she refused the treatment and entered a trial at Memorial Sloan Kettering Cancer Center, New York. 

Five months into the trial, her tumors had grown. She was moved to a second arm of the trial that added a second medication to the regimen. The side effects of the combination “kicked my ass”. But she braved it. Determined to overthrow cancer as the ruler of her life, she went skydiving. As she floated down, she tasted the salt from her “happy tears”.

She had to exit the trial because the tumors continued to grow even after two months on the combination therapy.

Then she joined a second clinical trial at UCHealth, Colorado in September 2015. That too she had to leave after one treatment on account of gastrointestinal complications.
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Given that it is not easy to access a clinical trial, and the heavy costs involved (estimated at $600 a month in 2015), most cancer patients hardly get to join one. Katie was already a unique case having participated in two. 

In November 2015, she opted for an FDA-approved treatment of radio embolization. Thirty million tiny radioactive beads called microspheres were injected into the blood vessels supplying the tumors in the right lobe of her liver. It worked! The tumors stopped growing and some even shrunk.

Heartened by this, Katie took a break to focus on building a house, “as one does when you’re trying not to die.”

​She had outlived her doctor’s first dire prediction, but the tumors were thriving in the untreated left lobe of her liver. So, she joined a third clinical trial, again at UCHealth. That trial too went on to fail.

In September 2016, they repeated the microsphere treatment, this time for the left lobe. The cancer gradually stopped growing.

One morning in May 2018, she stumbled out of bed struggling for her balance. A brain MRI revealed that the cancer had now spread to her brain. Gamma Knife radiosurgery eliminated the tumor. However, her liver tumors were growing again.
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Going by a study published in 2019, “the four-year survival rate for Stage 4 uveal melanoma patients is only about 2 percent.” By now, Katie had taken part in three clinical trials and also received three additional treatments. Yet three or four tumors persisted. 

In July 2020, Katie started her fourth clinical trial at the University of Pittsburgh Medical Center. Dr Udai Kammula, the doctor leading the trial, had been after uveal melanoma for almost a decade, because it is “so devilishly difficult to fight”.

Dr Kammula injected her with 111 billion new T cells, after first wiping our Katie’s own immune system. A month after the procedure all tumors were gone or shrinking. The one which did not was surgically removed.

​Finally, Katie was cancer free. 

​Today, she works as a recruiter and gives talks to pharmaceutical and biotechnology companies and nonprofit cancer organizations. She lifts weights and rides her exercise bike when she and Nick are not enjoying golfing, biking and hiking.

“Had I made the choice to not get a second opinion, I would be dead,” Katie said. 

How would Katie have fared, if she were in India? Is it possible for a patient in India, handed a grim prognosis, to take a chance with an experimental remedy that is under clinical trial?

Dr Santam Chakraborty, Senior Consultant at Tata Medical Center, Kolkata, co-author of a paper on “Geographic disparities in access to cancer clinical trials in India” is not very optimistic.
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The best person to inform a cancer patient about a clinical trial possibility is their oncologist. However, as India does not have a very integrated healthcare system, the oncologist is most likely to offer trials running in the hospital they are attached to. According to Dr Chakraborty, given the limitations of the clinical trial registry in India, “finding a clinical trial which is appropriate for the patient is a difficult endeavor for the oncologist.”  

In the US and Europe, an efficient, integrated healthcare system makes healthcare records available to all centers. In India, if a patient undergoing treatment in Hospital A wants to undergo a trial on in Hospital B, they will have to undergo a full workup and could be turned away at the end of it for failing to fulfil the eligibility criteria. The patient could have avoided the hassles and the cost of transfer if the data were easily accessible to Hospital B from the records of Hospital A.

There is also the larger problem that in India, as yet, “the clinical trial scenario is not geared towards providing really cutting-edge solutions.” In advanced countries, a new therapy is researched for decades in a laboratory before it becomes eligible for evaluation in a patient.

In India, clinical trials are usually run with products already evaluated in another country. A pharmaceutical company may evince interest if and only if it is sure that there will be a market for the drug in India.
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Clinical trials in India mostly focus on finding new uses of existing treatments or evaluating efficacy of treatments that have been evaluated in the west or finding ways to make the treatment more affordable. This is in stark contrast to the scene, say in the USA, where a novel innovation could be on trial.

“Even if I were aware that a trial very relevant to my patient is being run in an institution like Memorial Sloan Kettering Cancer Center,” Dr Chakraborty said, “I can offer that to my patient here only if the same trial is being conducted at a center in India.” Most early Phase I trials done in India are for “me-too molecules”, meaning medication already established outside.
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It is mandatory for every clinical trial to be registered with Clinical Trials Registry of India (CTRI). “As a patient, I can participate in a trial if I fulfil all the eligibility criteria, provide my consent and my physician is an investigator in the trial,” Dr Chakraborty pointed out. 

Whether in India, the US or elsewhere, there is no telling if every person who enters a trial will be blessed with a positive outcome like Katie was after all her trials. While everyone’s outcome may be unique, Katie has been sharing her experience with all.

“I gave my first talk in 2017, giving an acceptance speech for The Courage Award from the Melanoma Research Foundation. That’s when I realized how much I loved sharing my story. It gives people hope. It now feels like it’s what I’m called to do. It’s my way of paying it forward and saying thank you to all of the people who have helped me along this journey. I don’t want to hoard the wisdom I’ve gained from this horrible experience and expect other people to just figure it out on their own. It’s really, really hard to navigate this. If I can help just one person and change the course of their treatment for the better, then it’s worth it.”

It is never easy for the patient and the caregivers. Who helped Katie pull through it all?

"I've always identified both Nick and my Dad as my caregivers. Nick is my moral support. And my big spoon! He takes care of me physically and emotionally. And my Dad is the one who has helped us navigate this journey and understand the decisions we’ve had to make. I designated them both as my medical powers of attorney because I didn’t want either of them to face difficult decisions alone."

Do Katie and Nick have a prescription for those who are going through such tough times, so that they can cope better? Yes! Communicate and laugh!

"We still manage to laugh our butts off!" Katie added, "one of my lasting side effects from all of my treatments and the abdominal surgery is that it really hurts when I laugh hysterically. So, when I get that keel-over, gut-wrenching laughter, I can’t breathe. And he [Nick] loves it!"

What if Humpty did not have a great fall? Because happy Dumpty was saved in the nick of time by the pail of water Jack and Jill were carrying?

We are playing with rhymes for a reason. The thinking has always been repetition of good old nursery rhymes helps develop focus and vocabulary. Does that rationale extend to all learning by rote?

A report by The British Psychological Society cites research to state that most little children are “insatiably curious”, constantly questioning and exploring (young parents would concur, for sure). If the children were to remain in this state they can outlearn adults, but. It is a very significant but because “by about the age of six, their unbridled curiosity starts to wane” which hampers their ability to keep questioning and solving.
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Now, a new work published in the Journal of Experimental Psychology: General has studied children aged three to six years and “found that simply varying the messages that were embedded in a storybook could make a difference”. 

There were 138 participants in the study in the US and, “to broaden the cultural background of the sample”, another 88 in Turkey.

The children listened to two versions of the same story of Sam following rules and instructions to search a group of islands for treasure. In the first version of the story Sam strictly went by the rules. At the end of it, when a participating child was asked a question, “the potential responses were always limited”.

The second version, the “strategic curiosity” version, lefts things rather uncertain. The children could pick which island to visit and also had to keep an eye on the time. Unlike the “obvious” questions that followed the first version, there were open-ended questions at the end of the second version.

Then came the application part. After the story, the children were introduced to a new game, which featured a virtual aquarium consisting of five fish tanks. Each tank had different hidden creatures, and the children had 15 minutes to find them.

For the group that had heard the “traditional” version of Sam’s story, this meant "following the rules and checking for all your clues". For the other group, it was about "staying curious and paying careful attention to everything around you".

While the two groups found about the same number of sea creatures, there were differences in performance. Those who were tuned to the “traditional” approach “often ran out of time to explore all of the tanks”. The “curious” group “prioritized visiting multiple tanks over deeply exploring individual ones and were more likely to get through them all”. The second group “spent a longer time searching tanks that appeared to contain relatively more creatures, even if it took some time to find those creatures”. This was a clear demonstration of greater “strategic persistence”, the researchers concluded. 

That “strategic persistence” is valuable in the corporate world. So, in the world of grown-up learning and development, should Sam be taught the rules by rote, or be encouraged to question and rethink? Would that sacrifice discipline and progress? Or yield rich rewards?

What do you think, my accomplished friends in the learning domain?

If I am in school, there is no room for questioning either Humpty or Jack. After all, my success depends on getting the answers expectedly right, to up-grade myself. That's what my young seven-year-old student had taught me all those years ago when I attempted to correct her homework. (“This is what my teacher wrote on the board…. Now, who gives me marks? Who gives me punishment if I do not obey?”)
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By the way, I do wonder what you are up above so high. How come the rain does not put off your twinkle? Why don’t you fall if you are diamonds? Hey, are you really stars or high-flying drones?