Thursday, August 25, 2011

Anna's three conditions must be met

So, the government has finally given in. Or have they?

The three conditions that Anna Hazare has set for him to give up his fast - that discussions must start on the State Lok Ayuktas, on the Citizens' Charter and that the lower bureaucracy must be included in the Lok Pal - are the absolute crux of this whole movement that has galvanized the entire nation!

Team Anna has hit the nail on the head. These are the most important parts of the Lok Pal. Honestly, if the Prime Minister is corrupt or if the Higher Judiciary is corrupt, it does not affect the common citizen directly. We may seethe with anger. We may discuss it and post statuses on Facebook and Twitter. But it will not affect our day to day actions.

However the lower bureaucracy is what you and I have to deal with in our daily lives! It is the citizen's charter that will help us get our things done. For example, that a ration card must be given in three days or that a passport must be issued in fifteen days are revolutionary steps that will make the life of the common man so much less frustrating.

So, at the risk of sounding cruel towards Anna's health, I am hoping that the fast is broken only if absolutely fool-proof assurances are given by the government on these three issues.

Saturday, August 20, 2011

I might as well give my 2 cents on Anna

You remember this song:

Its Eer Bir Phatte. In the middle it goes, "Eer kahe chalo lakdi kaat aae, Bir kahe chalo lakdi kaat aae, Phatte kahe chalo lakdi kaat aae, Hum kahen chalo humau lakdi kaat aae..."

So, since everyone is giving their two cents on Anna Hazare and the Jan Lokpal, I thought chalo hamau apne do cents de de!

Ok, so after hearing this topic debated to death on the news channels (mainly NDTV, I find Arnav Goswami making everything a national issue of grave consequence so even a real national issue of grave consequence seems mundane), I agree that people rallying around Anna are not really rallying around his version of the Lok Pal but are rallying together since they are so fed up and angry over the corruption this Congress government has systematically institutionalized. Every government is corrupt. But the Congress takes it to entirely different levels! 

And excuse me, why are they harping about bringing Raja and Kalmadi to book? Why were the 2G and the CWG scams allowed to happen in the first place? The PM keeps blaming the compulsions of leading a coalition for all the ills in the country. Sometimes I feel we need more of a strong PM than an honest one!

Coming back to Anna, I strongly feel they should be more reasonable. Rather than set impractical deadlines and fritter away a golden opportunity, they should come back to the negotiating table and sort things out with the government. The wily government managers are waiting for things to cool down. Public support for the cause may not last long. When people tire of camping at Ramlila Maidan, the numbers will soon dwindle and Anna will be called a loser. At that point, all we will be left with is, as Arvind Kejriwal famously termed it, the 'Jokepal'!

Team Anna should start talking with the government and sort out the contentious issues now. Now is when the heat is on. The government cannot be seen as going soft on corruption. They will have to compromise on some of the issues. Get what we can when we can. Later might be too late.

Thursday, August 18, 2011

My changing attitude towards dialysis

Until a while ago, I never used to like to miss a dialysis session. I would go for at least six nights a week and at one point actually started dialyzing every day. Seven days a week. No break whatsoever. At that time, I was mostly starting on my own and Jayaram would close. On Sundays, when Jayaram did not come, I would do everything on my own. Of late, however, I have been waiting for Jayaram to come and start. I had a couple of scary incidents and so got a little wary of starting.

Honestly, for the past few months I have become a little tired of dialyzing every night. The whole rigmarole of priming the dialyzer and the lines and then starting on your own and then being all alone while dialyzing has got to me. Also, I sleep about 70-80% as well on dialysis than off dialysis. The most important factor, however, is my fluid intake. Believe it or not (and swear you are not going to tell my nephrologist) I used to put on 3-4 kgs of fluid weight every day. Even people with healthy kidneys don't drink that much! But I had a major mental problem.

Recently, my fluid weight gain has dropped to an average of 2.5 kgs per day. I know, that is also quite a lot. But it is at least better than before and headed in the right direction. Not that I am making any conscious effort or that I am unduly worried!

The thing with this is now I can afford to miss a session, especially on Sundays, since my weight gain does not warrant one. So that obviates the need for me to do everything on my own. And I get a full night's sweet, deep sleep.

Saturday, August 13, 2011

The beautiful genome

Have you ever thought, how, when a surgeon opens up a patient on the operating table, (mostly!) he finds everything in the right place? The kidneys are where they are supposed to be, the portal vein is where he expects it to be. If he wants to take a jab at the liver, he will know exactly which area he has to look in.

All this, despite not having opened that patient ever before. Well, he probably would have seen scans but heck, those too are mostly on expected lines!

How is every human so alike? Well, externally humans are very different but inside the body, physically, everything is so similar! Normal spleens are about the same size, shape and texture. Everyone has bean shaped kidneys. Almost everyone has two.

Medical science is entirely based on the fact that humans will have mostly very similar insides which will behave very similarly under similar circumstances.

I often wonder, with amazement, how experienced surgeons know their way inside a human body; how skillfully they stitch together veins and arteries from one place into another; how, during a transplant, everything works with clock-like precision. Put the kidney there and connect up all the veins and arteries and within a jiffy you see urine being produced! And all this, despite the surgeon not ever having seen the insides of that patient before!

I find all this totally incredible!

All thanks to the genome! The genome for a species dictates all this, I guess. Everything is encoded in those tiny little structures! Isn't it amazing that those sequences of alphabets should dictate such complex structures, such complex chemical reactions that are happening every second inside our bodies, we being blissfully unaware all the time!

I know you might think I am growing a little crazy here but stop and think for a moment of how all this magically happens and you will be amazed!

Friday, August 12, 2011

Missed diagnoses

Medicine is not an exact science. A lot of it is subjective. Doctors have to rely a lot on their experience and the results they have had with other patients. Lab test results rarely tell the entire story. It is not a set of mathematical equations that they can follow to get the desired results.

We often blame doctors for missed diagnoses. "Why didn't they detect this earlier?"

It is easy for us to say this in hindsight. But at the time of diagnoses, a multitude of factors go into making a decision. It is not at all easy for doctors. They have to strike a fine balance between making a diagnosis based on the available facts and prescribing too many tests that may help in arriving at a better, more informed decision.

Another major problem is the number of patients doctors in India see. Most doctors that I go to are so busy that I have to often wait for a long time to get to see the doctor. And after all the wait, you get very little time with them. With all this, how much time would they have to read up or research on your particular case?

I have realized these problems and changed my attitude towards doctors. Even though an important diagnosis was missed in my case as well.

Tuesday, August 9, 2011

A tribute to Pujya Panyas Chandrashekharvijayji

Param Pujya Panyas Chandrashekharvijayji

Param Pujya Panyas Chandrashekharvijayji attained kaal-dharma (passed away) yesterday at Ahmedabad. He was a Jain monk, an inspiration and idol to many Jains throughout the country. My entire religious thinking has largely been shaped by his books and periodicals which I have read over the years.

I was introduced to the persona of the Panyasji maharaj by my grandmother, Sarojben, who was an ardent devotee. I was thoroughly impressed by his unflinching loyalty to the agams (the Jain religious scriptures). He strongly believed that they were the ultimate truth and followed the tenets to the letter.

While many fellow sadhus today have given in to using modern amenities, few sadhus and sadhvis like him strictly followed the stringent rules of the Jain monastic order. Till the very end, he did not use vehicles or electricity and lived a frugal life.

He was one of the three famous disciples of one of the greatest stars to ever shine in the Jain firmament, Param Pujya Acharya Bhagvant Shrimadvijay Premsuri Maharaj. The other two disciples who passed away a few years back are Param Pujya Acharya Bhagwant Ramsuri Maharaj and Param Pujya Panyas Bhuvanbhanuvijayji Maharaj. These are all what my grandmother calls, "Chotha aara ni vangi" - basically people who actually belong to previous, purer eons but somehow have been born in this age! Very true indeed!

Chandrashekharvijayji will be remembered most for the three Tapovans he set up. The Tapovans are schools that teach a blend of modern and religious curriculums. The students are true all-rounders and are  encouraged to imbibe values of strong loyalty to the nation, purity of thought and action and care for the environment and the less privileged. His focus was entirely on the younger generation who he believed must be moulded in the right manner to build a stronger, more ethical nation.

His monthly, 'Muktidoot' , was a phenomenal success with thousands of Jains (including I) totally hooked to it. His style of writing and complete dedication to the agams made many Jains swear by his word. His life, like many others before him, was not devoid of controversy. The controversies could not tarnish his image however and till the very end he was highly regarded by all Jain sects.

I had the good fortune of obtaining his darshan twice, both times, coincidentally at the Sabarmati Tapovan.

With his passing, Jains all over have lost the beacon of light, the torchbearer of the sangh and the voice of the agams forever.

Monday, August 8, 2011

What message would I like to give people on dialysis?

Yesterday, the Welfare Association of Kidney Patients, Hyderabad organized a one day picnic to Nagarjunasagar for kidney patients of the city. It was an excellent initiative that aimed to create awareness of kidney disease and the risk factors so that people could avoid it in the first place. The group planned to stop at various villages and towns on the way to Nagarjunasagar and distribute pamphlets and  explain to the general public about this disease and how it can be avoided.

Mamatha, who spearheads this association is on dialysis for the last 12 years. She is a highly energetic lady with great passion for this cause. She called me to accompany the group as well but I could not go due to some other commitments. I plan to go the next time for sure.

Before the flagging off, there was a small gathering where the Commissioner, Information and Public Relations, Govt. of Andhra Pradesh, Mr. Venkatesam, spoke to the gathering. I was asked to speak as well. I was wondering what to say. I ended up making an appeal to the Commissioner to abolish import duties on life saving drugs and to increase the exemption limit under section 80 DDB that allows people with chronic conditions to claim an exemption up to Rs. 50,000 per year. This amount is a bloody joke. I spend more than that in two months on my medical expenses.

Looking back, however, I feel I should have addressed the dialysis patients rather than the Commissioner. I am sure nothing is going to happen on the government front for decades. However, a small message to dialysis patients could have set them thinking about how they can lead normal lives on dialysis.

What I should have said was something on these lines:

There are three things a dialysis patient can do to lead a life as close to normal as possible:

1. Get as much dialysis as your money permits: With dialysis, without doubt, more the better. In fact, co-incidentally, Dr. Ashwin Aiyangar has blogged about this recently. So, let only your financial resources limit the amount of dialysis. The more dialysis you get, the better your blood counts, the less severe your co-morbidities, the more active your life.

2. Exercise: Even if it means just a little bit. But move about. Do as much as your physical condition permits you. Of course, talk to your doctor first. But even a little exercise helps not only your body but your mind as well.

3. Work: If you are able to, work. Even if it is only part time. For one, it takes your mind off the medical problem. It gives you tremendous amount of self-confidence. Your sense of self-worth improves. And, heck, whatever money you make can help you pay your dialysis bills!

Sunday, August 7, 2011

Processions that disrupt traffic

I was on the way back from Hyderabad to Secunderabad. On the way, suddenly I noticed a huge traffic jam ahead of me somewhere in the middle of the Tank Bund road. I could not avoid it since I was already on the Tank Bund road. The traffic was moving at a snail's pace. I was very surprised since it was a Sunday. As the traffic inched its way ahead I noticed a huge group of people wearing saffron clothes with flags and carrying banners of some organization. The group occupied nearly half the width of the road and the entire traffic was held up for at least 45 minutes.

I muttered a curse under my breath. What business had this group, however noble its cause, to hold up traffic in this way? What if someone had an emergency to attend to? What would anyone do in these circumstances?

Then suddenly, I remembered that my own religion organized such processions every year! I was wondering if the objectives behind such processions were really being met. Do people really get impressed by such processions or curse the religion and its followers in the procession?

I have often heard arguments in favor of this procession that go, "All religions do it. If they can do it, so can we!" I usually give up right there.

Maybe what should be done is have such processions in huge grounds - maybe the Exhibition Ground or Parade Grounds or something similar. That way the procession can also be done and people are also not inconvenienced. But, some would argue, that the whole purpose of the procession is to show the people. I am not sure I agree with that.

Wednesday, August 3, 2011

A visit to the post office

I got an email from LIC India one day saying that they sent a cheque to me (pertaining to a policy that my parents had taken for me) quite a while back and it had not been encashed. They wanted to check if I received it or not. As it turns out, my address in their records was an old one and that is why I did not get the cheque.

The email asked me to send the new address if it had changed which I promptly did. I got a response confirming receipt of the new address and that I should contact a certain person with such and such telephone number in case I did not receive the cheque after ten days.

After ten days I contacted the person and asked him about the cheque. He said it had been sent by Registered Post and that I should get it in the next 2-3 days. I waited for 5 days. No sign of the cheque. I called the guy again. He was surprised that I had not yet got it. He asked me to call back the next day and he would enquire about it.

The next day when I reached home, my cook told me that the post man had come home with a registered  post cover and refused to give it to her. He insisted that only I collect it. He left a message asking me to come to the post office to collect it. No mention of which post office. No mention of who to meet and when. Just come to the post office and collect it.

I was lost. I had no idea what to do. The cheque amount was non-insignificant. I had to do something.

I mustered all the courage I could and went to the General Post Office at Rashtrapathi Road in Secunderabad. The building looks quite majestic from outside. Only when you go in do you realize that it is a fit case for the saying, "Paina pataram, lona lotaram"!

There is an Enquiry counter inside. I went up to it and asked the person behind the desk where I could pick up registered post? Without as much as a look back, he said "Go inside". Well, wasn't I already? I figured he meant really deep inside the maze that the office was. There some counters with monstrous lines in the front with an almost hidden entrance to the "inside".

I went through. There were dozens of tables with people behind them animatedly scribbling away on papers with dog ears. Not one computer in sight! I had to ask random people on the way where the Registered Post delivery was made. After listening to contradictory responses and going back and forth "inside" and "outside", I finally met one man, deep inside, that asked me, what I thought was the first relevant question in my adventure.

"Which area do you live in?"

"Balamrai", I responded.

"Oh, vaadu elipoindu", the guy responded, adding that the concerned person left at 11 in the morning. That was a first, I thought to myself. I have heard of truant and lazy government servants. This took the cake. I realized later, however, that I had to basically meet the same postman that delivers letters to my house and that he is usually there in the post office from 8 a.m. to 11 a.m. and I had to come at that time the following day if I had any hope of getting my cheque.

Cut to the following day. I confidently walked to the same room and asked a totally random person in there where I could colect Registered Post for Balamrai. "No. 30", he responded. I asked around where No. 30 was and was directed to a post man sitting on a desk that had a small label that said "30" inside a shelf on the desk. So much for "No. 30"!

I asked him about the cover and he promptly pulled it out and made me sign the Receipt paper. To his credit, he did not ask me for a tip. I was totally shocked!

A few questions still remain unanswered in my mind:

1. How did any random person I asked about where I could collect my cover have an answer? How come no one said I don't know?

2. Why can't they have one section for uncollected registered post with a big sign board that says so where anyone can go and collect their post?

3. Why didn't the postman tell my cook that I had to come to the GPO at R.P. Road between 8 a.m. and 11 a.m.?

4. Why does LIC have to send cheques by registered post when almost the whole world uses private courier companies to deliver cheques?

5. In fact, why can't LIC have a direct credit to bank account option?

6. And finally, why, oh why, did my parents take an LIC policy for me?

Monday, August 1, 2011

My AJKD article now available as a podcast!

My AJKD article, "Taking the Uncharted Path" is now available as a podcast! You can find the podcast here.

Thanks to Dr. Sidharth Sethi for posting about the podcast on his website and also letting me know about it. I had no clue! By the way, thanks also Dr. Sethi for complimenting my voice. And you haven't even heard me sing! Hahahaha!