Money
Happiness
Health
Love
Freedom
Success

But above all, any human being would want someone to show affection irrespective of the kind of person they are. Humans have evolved as they connect with other human beings and has outgrown other homo species just by being together. From that time till now, humans have always had hope.

Hope to live, hope to be remembered, hope to be missed by someone, hope to have made a meaningful difference in someone’s life. Hope that one will not be lonely is no ironical that every living being has its own physical, mental and emotional state that cannot be transferred to the other. We humans have just made a way to communicate what one feels to be inside the flesh and mind of the person that they are. Hope to not become lonely is just to have people who are empathical to what we feel and do everything that they can do to alleviate one’s suffering. Whereas one can never transfer one’s emotions to another no matter what.

I have always been an ambivert with being content with myself and love being in my own world though I have a couple of friends. I like hanging out with people but, I also enjoy being busy with work, having my own company at home not talking to anyone. With this idea at the back of my mind, I thought I would enjoy my own company throughout my life.

Almost 5 months away from the comfort of home in a different city, staying with people I know for a couple of year, I understood that I enjoyed my presence being in the warmth given by my family. With the latter not available, it made me realise that I am not one of those things that I imagined myself to be. A lot of thoughts and plans that I had for myself has been broken that left me in a place of void.

The vacuum has helped me in finding more about my subconscious thoughts and made me more alive and real. It has helped me to unlearn and relearn myself. It is completely normal to be vulnerable to hurt and heal for the space has to be empty for it to be filled.

40 வயதான ஒருவர் அவருடைய விதையில் கட்டி ஒன்று 5 வருடங்களாக இருக்கிறது என்றும் அதில் சமீபகாலமாக வலி இருக்கிறது என்று எங்கள் மருத்துவமனைக்கு சிகிச்சைக்காக வந்தார். தொற்று நோயால் விதை பெரியதாகி வலி ஏற்படக் கூடும். அறுவை சிகிச்சை செய்து நோயின் தன்மையை கண்டறிய முயன்றதில் புற்று நோய் என்று தெரிந்தது. அவரது உடல் நிலையைப் பற்றி கூறியதில் மிகுந்த மனக் கவலையில் ஆழ்ந்துள்ளார்.

“இரு சின்னஞ்சிறிய குழந்தைகளை உடையவன் நான். என் குடும்பம் எனது சம்பாத்தியத்தில் ஓடிக்கொண்டு இருக்கிறது. நான் இல்லையென்றால் என் குடும்பம் என்ன ஆகும்? இதனை சிந்தித்து நான் தூங்குவதேயில்லை. இரவும் பகலும் இதே சிந்தனைகள் என்னை பாதிக்கிறது ” என்று கூறிய அவர், தன்னுடைய குடும்பத்தார் எவரிடமும் தன் நோயைப்பற்றியும் அதன் தாக்கத்தைப் பற்றியும் கூற பயந்துள்ளார். தன் குடும்பத்தின் பொருளீட்டும் பொறுப்பில் தான் உள்ளதால் தனது உடலின் கவலையை விட, தன் வாழ்கையின் கவலையை விட, தன் உயிரின் கவலையை விட தனது குடும்பத்தைப் பற்றிய அதீத சிந்தனை கொண்டு தன் நிம்மதியை இழந்துள்ளார்.

புற்று நோய் பணக்காரர் ஏழை, சொந்தபந்தம் இருப்பவர் இல்லாதவர், ஆண் பெண், சிறியவர் பெரியவர் என அனைவருக்கும் வரக்கூடும்; அந்நோயாளியின் வாழ்க்கையை இருளாக்கிவிடும். கொடிய நோயினால் வறுமை பன்மடங்கு மோசமாகும்; வறுமையினால் நோய்க்கு தகுந்த சிகிச்சை எடுத்துக் கொள்ள முடியாமல் போகும்.
செல்வம் இருப்பவருக்கும் இல்லாதவருக்கும் நோயினால் ஏற்படும் பிரச்சனைகள் வெவ்வேறு பரிமாணங்களை உடையது. புற்றுநோய் கொடியது; வறுமை சேர்ந்தால் அதனினும் கொடியது.

மதிக்கு ஒளிதரும் சூரியனே!

கதியென் றுவரும் விளக்கு களைத்தன்

அறிவுத் தீயினா லேற்றிமன புறட்சிகள்

பறக்க தருமவை மகாசக்தி.

உள்ளத்து கதவுகள் திறந்து

கள்ளம னைத்தும் நீக்கிபல

பள்ளகளை கடக்கும் யுக்தியளித்து

நல்லன வனைத்தும் இருக்கதினமும்

ஓயாத உழைப்பின் உருவமாய்

தேயாத மனதோ டிருந்து

சாயா தூணாய் நாமுருவாவதே-தன்

ஆயுளி னாத்ம பலனென்றெண்ணி-

அறிவுப் பசியினை மூட்டி

பரிவு பாசம் காட்டி

அரிய தாகம் வேண்டுமென்று மதற்

கறிவே உணவும் பசியுமென

உரைத்த ஆசானுக்கு நன்றி.

மருத்துவம் தேவையோ?

கவலைகள் கலைய காரணம் அறிய,
குறிகளைத் தேடும் பயணத்தின் பாதையில்,
மறந்து போகுமோ மனிதம்- அன்பின்
அருமை மறந்து அகத்தை காணா,
மருத்து வம்நல் வாழ்வு அளிக்குமோ?

உளத்தின் கவலை குருடாய், செவிடாய்,
வெளியே தெரிந்து மதுவும் சுருட்டுமுயி
ரொளியை அழித்து உன்னிடம் வந்தாலுடல்,
நலத்தை மட்டும் கண்டால் மனம்,
மீளா குழியில் விழுந்து போகுமே!

சிக்கல்கள் உள்ளது அனைவ ருக்கும்,
பக்கங்கள் பலபேச நேரமில்லை யென்பர்.
அன்பும்,சமத்துவமும், உண்மையும் சிவமானால்
உள்ளமு முடலும் சொர்க்கம் தேடுமோ?
போட்டியும் பொறாமையு மில்லா ஊரிலும்,
வலிக்கு உண்ண மனக்கவலை யுண்டோ?

மாத்தி ரைகள்பல கொடுத்து மனப்,
பசியைத் தீர்க்காமல் வருமுன் காப்பதை,
வாழ்வியல் மாற்றத்தை, விடுத்து முதலாளி,
பசியை தீர்க்கும் மருத்துவம் வீழும்
கடைசி நாளும் நெருங்கி விட்டதோ?

அன்னையின் அன்பு தாய்ப்பா லுமாச்சியின்

தாய் சேயிட முள்ள அக்கறையும்,

சீறான உணவும் அதைவாங்க செல்வமும்,

குடும்ப ஒற்றுமையும், சமுதாய சமத்துவமும்,

மனதில் மனிதமூற்று
முள்ளங்கள் மட்டுமேயுள்ள

உலகில் வாழ்ந்தால், மருத்துவம் தேவையோ?

WHO theme on world breastfeeding week this year is “Empower parents Enable breastfeeding.” The percentage of exclusive breastfeeding in India according to 2018 statistics is less than 55% and only in 41% of babies, breastfeeding started within 1 hour.

What prevents parents from breastfeeding?

Unpaid leave, poor support for breastfeeding at workplace has a negative influence. Globally, a mother’s return to paid work after childbirth is one of the leading reasons for early supplementation with artificial formula and early cessation of breastfeeding. WHO urges the policy makers to make policies that promote family-friendly workplaces such as flexible work hours, a clean private place to breastfeed, public funded paid leave for mothers and fathers. It also emphasises on the need to merge healthcare workers and general public, use media and community platform to provide awareness on breastfeeding.

What can a healthcare worker do to empower parents?

I am working as an intern in a tertiary care hospital in Chennai. During my postings in paediatrics, I saw a neonate, day 4 of life having exaggerated physiological jaundice for which the child is getting photo therapy. The mother was found to have inverted nipple during the postnatal period and correction was taught. But, she had difficulties in providing breastfeeding till day 7 to 8 and child was given expressed breast milk as direct breastfeeding was poor. Though she was taught how to correct her nipple condition, she had to be continuously checked about her breastfeeding technique and repeatedly taught about the correct technique. Even after her problem being solved, she was apprehensive whether she can provide adequate amount of milk that her child needs.

Another child 5 months old had complaints of cough for 2 months and admitted in PICU as the child did not maintain oxygen. The mother who was worried about her child’s health had poor milk secretion. She had to be explained in brief about her child’s condition, how breastfeeding is a crucial step in treating her child and how her emotions can influence breastfeeding. This has helped handle her anguish and at the same time provide the necessary care for the child including breastfeeding.

Empathetic emotional support and guidance for breastfeeding is the only way a healthcare provider can directly influence mothers towards breastfeeding. Mothers had to be cleared of her doubts and they have to be explained if needed in repetition so that the she is confident and feel empowered.

Empowering mothers is the prime step in promoting breastfeeding. What role does a father play in breastfeeding?

Nursing an infant in India predominantly involves the mother and her female relatives. This is mainly attributed to breastfeeding and fathers are not empowered in providing the care for the child. But, there are evidences that, the rate of breastfeeding is higher when fathers support breastfeeding and have responsive relationships with infants. This is the reason WHO emphasized the need for paid public-funded leave for fathers too. Fathers can learn about breastfeeding and provide emotional support, share household task and learn how to parent their kids. As healthcare workers, we should try to involve fathers in breastfeeding counselling and teach them to support breastfeeding mothers.

Empowerment does not stop with parents.

In India, where the family also plays an important role, providing awareness about breastfeeding to the family members and the care-taker of the child is also important.

Breastfeeding is not a choice, it’s a responsibility- A responsibility of the family and community in empowering the future generation towards prosperity.

Everyone in the healthcare field, doctors, nurses, ward boy, housekeeping, ambulance drivers and many others work various shifts even on holidays and festival days. It is full of groans and moans that the constant suffering of the patient creates a chronic stress in the life of the workers. In spite of the hardships, many of them are passionate in their job. Where does passion arise amidst the agony? It is the patient who smiles, who asks about the absurd duty timings and gets shocked, who says thank you from the bottom of their heart saying that they were taken care of so well and who asks why someone hasn’t showed up on some day. The point when a patient shows complete trust towards a stranger in relieving their hardship gives a sense of responsibility and motivation to work. But how does a anyone earn this trust? This is by competence, empathy and seeing a patient as a person instead of a group of complaints and problems. This is by addressing to the emotions of the person that they start recognising the emotions and difficulties faced by the healthcare personnel. Showing empathy is the only way that a health care worker earns the respect that he deserves. It is the primary step that every one of us should do for our voices and sufferings to be heard by the general public.

The super fast technology of the world has its influence in every field. Medical field is now in an era of investigations where history and examination has decreased in importance and significance in treating a person. But, the importance of LMP has proved it to be wrong as I had shared in one of my previous blogs. One of my colleagues has emphasized this fact in his experience. He had seen a woman who had come to him with increased blood pressure and he did not ask her LMP and had prescribed regular anti hypertensive medication. She had an episode of seizure at home that night and had died. This was because she was pregnant and had developed eclampsia. Does this mean that history is more important than investigations in treating a patient? Here comes the battle between humans and machines. I had faced another incident that complicates the battle. I had seen a 52 year old woman with fever, cough and breathlessness in the chest ward. We took a chest x-ray for her and found it to have multiple nodules in both of her lungs. We suspected her to be having bronchopneumonia and had started her on antibiotics. But her symptoms didn’t subside after 1 day of antibiotics. My chief asked me to process forms for CT scan. The CT scan had to be performed in a private imaging centre and the form processing takes time. And I thought the antibiotics will kick in and act in the mean time. Hence I was disinterested in doing a CT scan for her. But the results came as a shock to me. She was diagnosed to have lymphangitis carcinomatosis- a spreading type of lung cancer. If the scan was not done at the earliest, there would have been a delay in diagnosing her grave condition and treating it which adds to the poor prognosis. Hence, in the battle of humans vs machines, patient care is what ultimately wins and both are important for patient care in today’s world.

I am in my paediatric ward rounds now where I saw an 8-month-old child with visual milestones not attained. She only has perception of light but cannot see clearly. When the child’s mother got to know about the poor prognosis, she cried in anguish. Seeing her crying I got tears into my eyes immediately. But I controlled mine and was speaking some comforting words to calm her down. This incident has brought back to my memory all the other incidents where I almost cried. I remembered the elderly woman with giddiness and vertigo who is staying alone and has no one at her home to take care of her, the mother of a child with down’s syndrome when she first understood her child’s condition, and the mother of a 2-year-old child who is now paraplegic with poor vision showing pictures of her when she was active. I had also had tears when I saw the mother of a child who had a chronic disease worried about her future, and an elderly man who got to know that he cannot be the bread winner of the family as his COPD has bound him within his house because of breathlessness. The worse was when I saw a patient with cancer with skeletal metastasis crying in pain. A young gentleman suffering from paraplegia, who didn’t want to be a burden and wanted to commit suicide, broke my heart to pieces. I was almost moved to tears when an elderly woman with oral cancer knew her diagnosis, and cried that she has committed a great blunder by consuming tobacco. The bread winner of a family with a chronic ulcer in the leg cried that he cannot get admitted to the hospital for his ulcer to be treated and this was equally moving. An elderly woman was separated from her family because of her psoriasis and the thought of being abandoned for such a silly reason again broke my heart. And many others have brought tears in my eyes. But why have I not cried in any of these situations? Will crying in front of my patients make me appear weak? Am I deprived of perceiving certain emotions if I become a doctor? Is it my ego that says I am above all these emotions? Is it that my position of care-giver demands that I be projected as a person above the patients? Will the patient and the hospital staff condemn me for showing my emotions? Am I supposed to bear all these thoughts and emotions to myself throughout my life? Are these situations a failure of my profession or my own personal failure? Is it okay to cry at times of helplessness where I cannot ease any of the pain perceived by others?

It was one fine morning morning in my hospital casualty when a young adult female came with complaints of vomiting and abdominal pain. On further questioning she was found to have missed her menstrual cycles and her last menstrual period (LMP) was 6 weeks back. She was given injections for vomiting and sent to an OGcian and general surgeon for further management. Is it her fate or anything else that she went to the general surgeon first. They had ordered for an x-ray abdomen. She has taken it and then went to an OGcian where her urine pregnancy test was doubtful. She then came to us during afternoon and we referred her to labour ward and was found to be pregnant. This fell as a shock to me as I would have not even thought about it and asked her LMP. And that the hidden fetus had an unwanted radiation exposure. How following the protocol and a holistic view in approaching a patient will help way more than improper history and too much investigations is the lesson I learnt that day. It is the unspoken blunders and the mishappenings that teaches us life and also the importance of LMP. Medicine is a field where one should come out of the ‘ego barrier’ and have the blunder-talk that actually reduces the blunders in a doctor’s life.