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Saturday, September 25, 2021

Life's Lessons - Who taught me What? (14)

(continuation of lessons from travels)

 Speaking of air travels, two co-passengers who sat next to me in two different flights taught me remarkable things. I have communicated with one of them and have saved his thoughtful response.

One was an actor in the London theater. We were talking and he said: “You are very relaxed”. I said: “ Yes, what made you say that?”. He said: “I am an actor. I know when I am acting with someone who is new on the stage. They are so nervous that their mouths get dry. Therefore, when they say certain words, I know they are new on the stage because of the way their tongue sticks to the roof of the mouth”. I have used this observation successfully in my practice when I speak with mothers. On many occasions I was able to recognize they were very anxious and that made it possible to help them better.

The other one was an insurance inspector for the Lloyd’s of London. He specialized in investigating fires in airplanes. We were discussing how he investigates fires as to their origin, the spread and possible causes. I shared with him how we investigate origin of symptoms and causes in children. He taught me that it is all based on astute observations followed by systematic logic! Just like Sherlock Homes. We agreed that the process is the same whether we are investigating fire in a physical structure or disease in a human being!

Ninety-nine dollar tour of USA: During my first trip to US, I stayed for five years. At the end of the 4th year (May – June of 1962), I wanted to travel through USA and see the country before I went back to India. At that time, my intention was not to return to USA. My resources were limited. (The monthly salary at the Children’s Hospital of Philadelphia was $50.00 and free boarding and lodging. And, at the University of Chicago, the salary was $120.00, without boarding and lodgings) When I was thinking how to make my dream come true, I heard from Jim Johnson of Binghamton NY(I have mentioned about him earlier), as if he read my mind. He asked what I planned to do for vacation. I said: “what can I do with the money I have?”. Jim must have sensed my frustration. He sent me a check for $200.00 and said that I should travel around the country and enjoy. He also said that I need not return the money because he intended to write it off as unpaid bills in his practice!

It also so happened that I knew one Mrs. Updegraff in Philadelphia. She worked for the Greater Philadelphia Council of Churches. She was a missionary in in a village near Pune in India at Pune and knew Dr. Malathy Jadhav of the Christian Medical College, Vellore. She said that she can give me contacts in several cities where I can stay with families who had grown up children in the adolescent age group. The only condition was that I have to speak about India at the Churches these families attend. I agreed.

In those days there was a special ticket for $ 99 in Greyhound . This allowed one to travel anywhere around the country as long as one does not retrace the steps. In essence, it was a around-the-country travel. I travelled mostly during nights to avoid hotel bills. The contacts given by Mrs. Updegraff was useful in several cities, but not in all. Therefore, in some cities I stayed at the YMCA hotels for  $3.00 for a night. 

During this trip, I saw for myself the size and beauty of the country. During day-travels, I enjoyed the beauties of nature. I experienced the friendship of people in small towns and villages. I found how helpful they were to strangers like me. I became friends with some of the people I stayed with. They taught me about various aspects of life in America.  Mr. K of Portland, Oregon taught me about dairy farming. He owned a dairy farm and even took me with him one early morning when he went to milk his cows. (One of his cows won the competition for the most yield of milk in that county and I still have a photo of that cow!) 

The C family in Klamath Falls, Oregon exposed me to logging in the Oregon area and made me visit Klamath Falls which is one of the most beautiful, mystic and spiritual places on earth. Of the many places I have visited, I will add two more to this list - Kuai Island and Bali. 

 The most enduring friendship was with Jim and Lucy in Colorado Springs. Later I visited them with Ramaa and Bama once. We visited them once more with Bama, Hari and Sheela. By that time, Jim and Lucy had grandchildren. Bama, Hari and Sheela had a wonderful time with them and  experienced life in a cattle ranch and countryside, which included hayrides. Sadly,  Lucy and Jim are no more. But I had communicated with their son until recently.

 I learnt a thing or two about life-long friendship across cultures from these visits. 

Saturday, September 18, 2021

Life's Lessons - Who taught me What? (13)

            This post is a little different. This is not about "who" taught me, but "how" travels taught me some important lessons. That includes travels in general and specific travels.

What did Travels teach me?

Travels taught me many things about life and living.

The most important lessons were about being open-minded and flexible. I learnt that there is no one correct way to deal with daily tasks and life’s issues. There are many ways, each suitable to its place and context. For example, Chinese end their dinners often with soup or salad. The western culture starts dinners with soup. Indians mix soup with their main dish. (Incidentally, the word soup in English, Zuppa in Italian are similar to the word soopah in Sanskrit. This is an example of how travels gave me an interest in linguistics)

It is good to be prudent and plan, but not plan so much that spontaneity is lost. For example, when we (Ramaa and me) were in Turkey, we broke from our group and walked on our own. It so happened that this was near a University Campus. We stopped at a bookstore. A student who was working there wanted to practice his English. He told us many things the tour guide did not cover. More important, he introduced us to a Turkish writer most admired by Turkish people. The author’s name is Irfan Orga. We bought one of his books (Portrait of a Turkish Family) and found it fascinating.

This leads me to another lesson both Ramaa and myself learnt. Whenever we went to a new country, we wanted to experience three things – their food, their language and their music. To get these experiences, we must have an open mind and some amount of adventure. (Ramaa was more adventurous and, I had to keep her under some control for her safety) If we are going to stay within our own comfort zone, how can we understand another culture?  

We used to ask the locals what their “signature” dish (food) is, who their best author is and who their most admired musician is. Yes, we have tasted vegetarian and non-vegetarian food in every country we had visited. We have read at least one book by that country’s famous author in English translation. We often bought one tape or CD of each country’s famous musician. This is cultural education, even though that is not enough to give us a deep understanding of any culture. Ideally, we should immerse ourselves  in that culture by living among the locals for a few months. 

 I would like to share this habit, this lesson we learnt with youngsters. This will help open their minds to develop respect and tolerance to other people’s points of view and ways of doing things.

Travel with Visu: The very first travel experience without my family members was with Visu. It is one of the most memorable. I was in high school at that time. My brother made it possible, as usual. We had a marvelous time. We stayed in modest hotels and ate cheap but hot meals. Visu taught me how to find good places to eat, how to negotiate price and how not to panic, if things do not go as planned. Once we missed a train – almost. Visu’s comment: “So what? We take the next train going our way!”

The most remarkable memory was our visit to Ramana Ashram and the darshan of Ramana Maharishi. What an impression it left! I did not know at that time he was suffering from some tumor of the bone and had surgery on his arm “without anesthesia”. I learnt about that several years later. But I remember that he passed away a few weeks after we had the darshan. The peace in his presence and the glow of his body are still fresh in memory. They still influence me during my meditation times. The other lesson was: “ Ramana was also a human being. No one can escape illness and death. If a soul as serene and divine as Ramana can get cancer, what other human being can escape disease?”

The first trip to USA was a memorable one. That was the first time I travelled by plane. It was not jet age yet. I flew by TWA, “Super-constellation” and it took 3 days from Bombay to New York! It was hop - step - and - jump with several stops for refueling. It was monsoon season and naturally it was pouring rain at Mumbai. But I was so excited about the future, the present moment became exciting.

I learnt for the first time how to eat using knives and fork and how to open a milk carton. There was no one to teach, except the one in the next seat.

Saturday, September 11, 2021

Life's Lessons - Who taught me What? (12)

 Friends, again I am writing two posts this week. The first one is the continuation of the series on Life's lessons. I was "moved" to write the second one during my meditative moments. 

Books that influenced me most

“Bhagavat Gita” is clearly the first on the list. I have read the original in Sanskrit. I have read three major interpretations, one by Bal Gangadar Tilak, one by Vinoba Bhave and one by Kanchi Periyaval. The translation by Kannadasan in Tamizh, is a gem for its language and unaltered meaning of the original.

The two most important lessons I have always carried in my thoughts are: 1. Sloka 43 from Section 2. Our concern should be to carry out our duty (dharma) without looking for the rewards. I can also say I have tried to apply it in real life as much as possible. I did not do so once; that was when I saw clearly why this lesson is very important. 2. Sloka 63 in the final chapter where Lord Krishna tells Arjuna “I have shared with you the deepest of knowledge (about this Cosmos). Think about what I have said and act as you think is best”. He did not say “Do as I command”. What a way to teach?

The second most important lesson came from Sir William Osler, considered the Hippocrates of modern medicine. He says: “When you want to learn about a subject, go to the most original writing on that subject. Then, read the most recent review on that subject”. He was talking only about medical subjects. But I have used this idea for several decades not only in reading medical literature but when learning about any new topic, to immense pleasure and profit.

For example, this habit led me to read one of the earliest descriptions of tetanus in an Egyptian Papyrus manuscript (Edwin Smith Surgical Papyrus. I read it when I was at the University of Chicago). I can say with reasonable confidence that I have read the original descriptions of most of the diseases such as Mumps (Hippocrates), Chorea (Sydenham). Mongolism (now known as Down Syndrome) and the so-called Salaam Epilepsy. I have read the original descriptions of all the rheumatic diseases, particularly the one which established that connective tissue and blood vessels are part of all the organs and therefore connective tissue diseases are multi-system diseases.

This habit of reading the originals solidifies description of diseases in our memory. We learn why the original author thought this was important and what did he/she see unique which made him (her) describe it. Every time you read about the condition in modern literature, you just add new facts to that old memory unit like a “coat-hangar” and, also can visualize gaps in knowledge.

As I mentioned, I have used William Osler's advice in subjects other than medicine. For example,  searching for the source of the metaphor of two birds on a tree in the Mundaka Upanishad led me to a treasure house of wisdom in Asya Vamasya Sukta in Rg Veda. That led me to read the entire Sukta in Rg Veda 1: 164. That led me also to the source of the famous quote:  “The truth is one; learned men call it by different names”. This is also in the Asya Vamasya Sukta.

It is impossible for me to describe the value of this one lesson from Sir William Osler and how much this practice has enriched my intellectual life.

On Becoming a Person is a book by Carl Rogers. This pioneer in psychology taught me about how to listen and what the fundamentals of helping professions are. I have written about this topic in my Handbook of Clinical Skills.  I have tried to apply those principles in my role as a physician, as many times as possible.

Soon after I came to USA in 1958, when I was trying to adjust to the cultural shock, the book that helped me was “A Mirror for Man by Clyde Kluckhohn. This is a book on cultural anthropology which made me understand how to appreciate cultural differences. The primary lesson was that one should observe other cultures to learn and NOT to judge. One should not label cultural behaviors as “good” and “bad”. But one should understand what it is for, how and when it originated and what the advantages and disadvantages of those practices are. That way, we can adopt them if they are beneficial and reject them if they are no more valid under current circumstances (place and time) or not suitable for our needs.

This book has a chapter on how americans think and act. This was very helpful for me to adopt and behave appropriately in the new settings. It also influenced my tolerance for other ways of doing things. This book was written almost 50 years back. Obviously, the book is outdated and behavior of people has changed.  But  many of those observations made by Kluckhohn  are still true.  

This book influenced my sensitivity to cultural factors in my medical practice. This made me understand my own culture also better. 

What is in a word?

 Friends, again I am writing two posts this week. The first one is the continuation of the series on Life's lessons. I was "moved" to write the second one during my meditative moments. 

“War on poverty”

“War on drugs”

“War on terrorism”

Words hide passions

Wars show passions

We are praying for Peace,

Why are we worshipping “wars”?


Saturday, September 4, 2021

Life's Lessons - Who taught me What? (11)

 Parents and grandparents who taught me

One of the earliest experiences was with a mother who was taking care of her son with a colostomy. She knew exactly how to clean it, dress it and what ointment to use etc. But she always had arguments with the nurses – rather, the nurses were always fighting with her. During discussions with her, she taught me an important lesson. She said “ Your nurses may know a lot about colostomy in general . But I know colostomy in my son better than they know. I live with him and I know how to take care of colostomy in my son”.  Once the nurses conceded that fact and were willing to listen and care for the boy the way she wanted it done, there were no more problems.

This became a lesson for me in medical practice in general. I may and indeed do know more about a disease than the parent. But the parent knows more about that disease in her child better than I know.

Another lesson was taught by several parents on different occasions in different ways. Some families fell apart when one child was diagnosed with a chronic disease. Some families coped well and were resilient. Resilient families taught me that their strengths were in one or more of the following  areas: supportive relationship in the family, someone outside they can depend on for help, faith in some tradition or religion, trust in one person who can help guide them and someone with a sense of humor in the family.

One other feature of these parents who coped well is their desire to help other families with similar problems. They were not dwelling on their own bad luck all the time. They took care of their own children with the disease and found time to help other families. Those are the parents who started the American Juvenile Arthritis Organization which is still doing excellent work supporting families of children with arthritis.

One other experience taught me about humility and the power of faith. One five-year girl with severe lupus became comatose due to her disease affecting the brain. Almost every organ in her body was affected by the disease. We had administered every medicine available at that time. She remained in coma for three weeks. Throughout those three weeks her grandfather and grandmother took turns to be on her side 24/7. They used to tell me that they were praying all the time, sometimes holding the girl’s hand. That girl woke up one day and has been disease-free when I saw her last time in her teens. You can make whatever conclusion you want, but the grandparents, particularly the grandfather, believed that they “prayed” that girl out of coma.

There are many more stories of this kind, each one with an important life’s lesson.