When friends call......

Some  time ago I had written about how difficult most of us find to console friends in times of tragedy. But now my views are leavened with having been on the receiving end too.
Last month tables were turned and it was I who lay in a hospital bed.

 So what can I tell you about how to console friends in their times of travail.

The first, do call or write. The very fact that you are in their minds and prayers is very reassuring

When you write recall incidents in the past of happier times together and urge them to get well soon for happier times to come

It is true that when you call, emotions often take over despite your best efforts. But you need to control the urge to commiserate or cry. Rather focus on the serious cheerful. For example once a friend called and said " I want you to get well soon so that I can fight with you about Obama and the state of the country" or another "Keep it up Anil! It's always great to be alive, (and to have you with us) no matter how difficult it is to stay involved!!" "All I can say I am so happy to see this to know you are on your way to getting back to your old life! Hope you will be out of hospital/re-hab real soon now. Lots of love and good wishes from all of us,"

All these messages and calls are a reminder that you are still loved and missed and that you have a life, a trifle altered, still awaiting you ahead.

Your words will provide "Comfort on difficult days, smiles when sadness intrudes, rainbows to follow the clouds, laughter to kiss your lips, sunsets to warm your heart, hugs when spirits sag, beauty for your eyes to see, friendships to brighten your being, faith so that you can believe, confidence for when you doubt, courage to know yourself, patience to accept the truth,  and Love to complete your life"

And finally , if you can, simply sit by their side - quietly , gently- simply sit. No words are necessary, your very presence says it all. That will be the most soul satisfying moments of them all.

Going home

Going home

It had been a month. And boy,what a month it had been! From a near unanimous prognosis of a few days left on the death bed to walking home after thirty days of pain! The very thought of going back to some semblance of my former life cheered me immensely.

And it had all started with a swelling of my feet-an indicator of edema increase. Mine had, it seems, gone beyond limits. So I was rushed to the hospital and then followed some of the most painful days of my life. But now I was going home and that was all that mattered...

But in a sense you cannot really go home- the world has changed,your environment is no longer the same, and the people you knew before you went away too have pursued their own lives. And don't forget you have changed too- after all the turmoil has to have left a mark on you too.

The key is to recognize the changes and to learn to adjust to ..one of the hardest tasks was wearing shoes and getting into the car, walking everywhere but with a walker, ensuring that all the medicines were at hand, and that oxygen boost was available, reorganizing the house with a special bed, shower chair, and bedside toilet, and getting a wheelchair for those long journeys to cinemas and restaurants ( one can dream cant one?). Nothing was a great hardship but only if one planned and organized for it. Life could be managed, I found,if one put ones mind to it.them. I certainly found that in my case. I found myself speaking much less and thinking and reflecting more..appreciating the little kindnesses and courtesies..curiosity about my surroundings slowly reemerging...writing albeit slowly becoming once again a joy.

Yes it seemed I had almost touched the pearly gates but had been to my great surprise denied admission at least at this time....so now it was upto me to make the best of the extension of life granted me.

What had I learnt from this journey...

The great love and sacrifice of people around me,principally my family. Never would I take them or their love for granted.The affection of my friends, the kindness of strangers and the wonders of science - the dialyser was one of those life saving machines. I learnt patience and becoming careful in my words, even a trifle timid. I learnt the joy of watching the daily sunrise, hearing the conversations of those around me, and watching my grandson dance!

 

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The hidden obama

The hidden side of Obama

Joseph Dubois

The White House is not supposed to be a place for brokenness. Sheer, shattered, brokenness. But that’s what we experienced on the weekend of December 14, 2012.

I was sitting at my desk around midday on Friday the 14th when I saw the images flash on CNN: A school. A gunman. Children fleeing, crying.

It’s sad that we’ve grown so accustomed to these types of scenes that my first thought was I hope there are no deaths, just injuries. I thought, Maybe it’s your run-of-the-mill scare.

And then the news from Sandy Hook Elementary School, a small school in the tiny hamlet of Newtown, Connecticut, began pouring in. The public details were horrific enough: Twenty children murdered. Six staff. Parents searching a gymnasium for signs of their kids.

But the private facts we received in the White House from the FBI were even worse.

How the gunman treated the children like criminals, lining them up to shoot them down. How so many bullets penetrated them that many were left unrecognizable. How the killer went from one classroom to another and would have gone farther if his rifle would’ve let him.

That news began a weekend of prayer and numbness, which I awoke from on Saturday only to receive the word that the president would like me to accompany him to Newtown. He wanted to meet with the families of the victims and then offer words of comfort to the country at an interfaith memorial service.

I left early to help the advance team—the hardworking folks who handle logistics for every event—set things up, and I arrived at the local high school where the meetings and memorial service would take place. We prepared seven or eight classrooms for the families of the slain children and teachers, two or three families to a classroom, placing water and tissues and snacks in each one. Honestly, we didn’t know how to prepare; it was the best we could think of.

The families came in and gathered together, room by room. Many struggled to offer a weak smile when we whispered, “The president will be here soon.” A few were visibly angry—so understandable that it barely needs to be said—and were looking for someone, anyone, to blame. Mostly they sat in silence.

I went downstairs to greet President Obama when he arrived, and I provided an overview of the situation. “Two families per classroom . . . The first is . . . and their child was . . . The second is . . . and their child was . . . We’ll tell you the rest as you go.”

The president took a deep breath and steeled himself, and went into the first classroom. And what happened next I’ll never forget.

Person after person received an engulfing hug from our commander in chief. He’d say, “Tell me about your son. . . . Tell me about your daughter,” and then hold pictures of the lost beloved as their parents described favorite foods, television shows, and the sound of their laughter. For the younger siblings of those who had passed away—many of them two, three, or four years old, too young to understand it all—the president would grab them and toss them, laughing, up into the air, and then hand them a box of White House M&M’s, which were always kept close at hand. In each room, I saw his eyes water, but he did not break.

And then the entire scene would repeat—for hours. Over and over and over again, through well over a hundred relatives of the fallen, each one equally broken, wrecked by the loss. After each classroom, we would go back into those fluorescent hallways and walk through the names of the coming families, and then the president would dive back in, like a soldier returning to a tour of duty in a worthy but wearing war. We spent what felt like a lifetime in those classrooms, and every single person received the same tender treatment. The same hugs. The same looks, directly in their eyes. The same sincere offer of support and prayer.

The staff did the preparation work, but the comfort and healing were all on President Obama. I remember worrying about the toll it was taking on him. And of course, even a president’s comfort was woefully inadequate for these families in the face of this particularly unspeakable loss. But it became some small measure of love, on a weekend when evil reigned.

And the funny thing is—President Obama has never spoken about these meetings. Yes, he addressed the shooting in Newtown and gun violence in general in a subsequent speech, but he did not speak of those private gatherings. In fact, he was nearly silent on Air Force One as we rode back to Washington, and has said very little about his time with these families since. It must have been one of the defining moments of his presidency, quiet hours in solemn classrooms, extending as much healing as was in his power to extend. But he kept it to himself—never seeking to teach a lesson based on those mournful conversations, or opening them up to public view.

Jesus teaches us that some things—the holiest things, the most painful and important and cherished things—we are to do in secret. Not for public consumption and display, but as acts of service to others, and worship to God. For then, “your Father, who sees what is done in secret, will reward you,” perhaps not now, but certainly in eternity. We learned many lessons in Newtown that day; this is one I’ve kept closely at heart.

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Falling out of love.....with obama

Falling out of love...with Obama

Lately the true believers have started seeing the stars dimming when they talk about Obama...five years of attacks by the republicans without an adequately forceful defence seems to have taken its toll.....

And as in any love affair, disenchantment starts setting in as the poetry of the campaign turns to the prose of governance. Every misstep is magnified, every error seems to be end of the world. In this period objectivity tends to get lost and people forget all that has been achieved already.

The facts are this president has delivered more sweeping, progressive change in 36 months than the previous two Democratic administrations did in 12 years. "When you look at what will last in history," historian Doris Kearns Goodwin tells Rolling Stone, "Obama has more notches on the presidential belt."

As president, he has rewritten America's social contract to make health care accessible for all citizens. He has brought 100,000 troops home from war and forged a once-unthinkable consensus around the endgame for the Bush administration's $3 trillion blunder in Iraq and Afghanistan. He has secured sweeping financial reforms that elevate the rights of consumers over Wall Street bankers and give regulators powerful new tools to prevent another collapse. And most important of all, he has achieved all of this while moving boldly to ward off another Great Depression and put the country back on a halting path to recovery.

Along the way, Obama delivered record tax cuts to the middle class and slashed nearly $200 billion in corporate welfare — reinvesting that money to make college more accessible and Medicare more solvent. He single-handedly prevented the collapse of the Big Three automakers — saving more than 1 million jobs — and brought Big Tobacco, at last, under the yoke of federal regulation. Even in the face of congressional intransigence on climate change, he has fought to constrain carbon pollution by executive fiat and to invest $200 billion in clean energy — an initiative bigger than John F. Kennedy's moonshot and one that's on track to double America's capacity to generate renewable energy by the end of Obama's first term.

On the social front, he has improved pay parity for women and hate-crime protections for gays and lesbians. He repealed the policy of "dont ask, dont tell."He has brought a measure of sanity to the drug war, reducing the sentencing disparity for crack cocaine while granting states wide latitude to experiment with marijuana laws. And he has installed two young, female justices on the Supreme Court, creating what Brinkley calls "an Obama imprint on the court for generations."

The historic progress that Obama has made is especially evident in eight key areas especially if you remember where the U.S was in 2008 before he took over: In 2008, just two years ago, the country faced a fiscal crisis and a second great depression, we were mired in two wars abroad , we were losing 750000 jobs per month,  Dow was at 6000, there were no investments in infrastructure or green technology, the American auto industry faced bankruptcy.And what has Obama managed to do in just three years:

1 | Averting a Depression: his economic team has helped prevent the collapse of the US into the second great depression and the world economy
2 | Sparking Recovery: US economy has shifted from a tailspin to some measure of stabilization and some prospect of job growth and Dow stands at over 15,000
3 | Saving Detroit: GM is now the largest and most profitable car company in the world
4 | Reforming Health Care: Universal health insurance (with promised deficit reduction!) is now law of the land providing coverage to over 20 million of our fellow citizens, covering pre existing conditions, allowing students to stay on their parents plans - a goal sought by Democrats for decades.
5 | Cutting Corporate Welfare
6 | Restoring America's Reputation:Equal pay for women has been passed into law.
7 | Protecting Consumers: The race to the top in education spending has created reform in a large number of states from the bottom up,.The size of Peace Corps has been doubled, Pell grants increased substantially and a major fillip given to Volunteerism. A new Consumer protection agency has been created.
8 | Launching a Clean-Energy MoonShot:Major investments have been made in green technology laying the foundation for the future.A stimulus package has helped undergird infrastructure and will probably do more to advance non-carbon energy than anything that might have emerged from Copenhagen..

It is my hope that in time the true believers will recognize these achievements and that stars will return to their eyes once again!



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Women of nazi germany

Hitler's Furies: German Women in the Nazi Killing Fields

The conventional image of women in Nazi Germany is well known. In what was a very masculine world, women generally appear either as hysterical, weeping Hitler fanatics or as hapless rape victims, reaping the Soviet whirlwind. Some readers, however – those familiar with the execrable concentration camp guards Irma Grese and Ilse Koch or perhaps with Bernhard Schlink’s novel The Reader – might recognise a third stereotype: that of the woman as perpetrator.

Hitler’s Furies, a new book by the American academic Wendy Lower, brings this latter image to a non-specialist audience. Distilling many years of research into the Holocaust, Lower focuses her account on the experiences of a dozen or so subjects – not including Grese and Koch – ranging from provincial schoolteachers and Red Cross nurses to army secretaries and SS officers’ molls. Despite coming from all regions of Germany and all walks of life, what they had in common was that they ended up in the Nazi-occupied east, where they became witnesses, accessories or even perpetrators in the Holocaust.

Lower is scrupulously fair to her subjects, providing a potted biography of each, explaining their social and political background and examining the various motives – ambition, love, a lust for adventure – that propelled them to the “killing fields”. This objectivity is admirable, particularly as most of the women swiftly conformed to Nazi norms of behaviour, at least in turning a blind eye to the suffering around them. One woman, a Red Cross nurse, organised “shopping trips” to hunt for bargains in the local Jewish ghetto, while another, a secretary, calmly typed up lists of Jews to be “liquidated”, then witnessed their subsequent deportation.

Most shocking of all are the accounts of the women who killed. One of Lower’s subjects, a secretary-turned-SS-mistress, had the “nasty habit”, as one eyewitness put it, of killing Jewish children in the ghetto, whom she would lure with the promise of sweets before shooting them in the mouth with a pistol. Lower presents another chilling example: that of an SS officer’s wife in occupied Poland who discovered a group of six Jewish children who had escaped from a death-camp transport. A mother, she took them home, fed and cared for them, then led them out into the forest and shot each one in the back of the head.

Despite these horrors, Lower’s book resists the temptation to wallow in emotive rhetoric; nor is it drily academic. She writes engagingly, wears her considerable erudition lightly and has opted to stick with a broad narrative account, comparing and contrasting but never allowing her analysis to outweigh the fundamental humanity of the stories. The book’s power lies in its restraint.

Neither can Hitler’s Furies be imagined as some sort of Woman’s Hour rereading of the Holocaust. There is no special pleading for the subjects and the gender studies aspect of the book is kept well within bounds. Indeed, in analysing the women’s progress from nurses and secretaries to accomplices and perpetrators, Lower is at times eager to emphasise that the forces that drove and shaped them were in some ways the same forces experienced by Germany’s men – the seductive appeal of Nazism, the heady lawlessness of the occupied eastern territories and the “new morality” of t Germany. It’s worth remembering here that many of those women who committed crimes could not resort to the time-worn excuse that they were “following orders”. They were not. They were merely reacting and adapting to their surroundings.

Consequently, Lower stresses that her subjects were not just marginal psychopaths; rather, they might be seen as perfect embodiments of the Nazi regime, products of the hideous, murderous times in which they lived. A gender-specific explanation is offered only tentatively: that the women simply got caught up in a heady vortex of power and anti-Semitic violence – the Ostrausch, or “intoxication of the east” – which was fuelled by their intimate relationships with the SS men around them.

In the final chapter, Lower relates the fates of her subjects after the war, detailing the efforts made – or more often not made – to bring them to justice. Of the women she has studied, only one was tried and found guilty; the others benefited from a combination of a biased judiciary, a perceived lack of evidence and entrenched cultural prejudices about female innocence. Only the German Democratic Republic, Lower argues, was rigorous in pursuing wartime female perpetrators. Elsewhere, they quite literally got away with murder.

My life in rehab

My life in rehab

A few weeks ago I found myself testing the US medical system-- again. It had been seven years since I underwent quadruple bypass surgery at the best heart center in the US. Unfortunately that experience had left me with an ejection fraction of 15% barely adequate to pump the heart. During the past seven years, three doctors had managed to skillfully redesign my life to a relative health. But now I was back again having fallen off the strict regime which had upset the chemical balance of my body.

After the hospital stay it was decided that I needed dialysis to rid my body of all the toxins that were slowly damaging my body.  You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function. When your kidneys fail, dialysis keeps your body in balance by: removing waste, salt and extra water to prevent them from building up in the body, keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate, and helping to control blood pressure.

Chronic kidney disease and GFR - glomerular filtration rate is the best test to measure your level of kidney function and determine your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test, your age, body size and gender. The earlier kidney disease is detected, the better the chance of slowing or stopping its progression. One in 10 American adults, more than 20 million, have some level of CKD.

Actually some kinds of acute kidney failure do get better after treatment. In some cases of acute kidney failure, dialysis may only be needed for a short time until the kidneys recover. Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, o r even at home.

I chose a rehab nursing home for the early days of my dialysis. And it was another learning experience. The dialysis machine is really a very simple machine which takes blood through one tube and returns it to your body through another. The machine itself does all the work of cleaning the blood and removing the toxins from the body. So you go in twice or thrice a week, are tied to one of these machines ,and after three hours you emerge with considerably cleaner blood. The hardest part is lying on a bed for three hours!

The collingwood facility I went to was clean, efficient and well run. There were a variety of patients there


....a CEO painfully learning to recognize what day of the week it was, A high school teacher determined to walk again, a grandmother surrounded constantly by her children and grandchildren, a lonely old man who cried at night..yes it was a varied mix of humanity...while management was mostly white, specialists were mostly Indian, daytime nurses were the local black, but night time nurses were tall strapping women from Africa- Somalia, Nigeria, Eritrea...an interesting mix indeed..

I learnt a lot....from how to walk, how to urinate lying down, getting up from comfortable sofas, and sleeping on beds surrounded by bars, being woken by a floating cast of nurses at all times of night and day and constant pricking by needles drawing blood....

But after ten days I was ready to go home!


After ten days I was ready to go home...


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It was a day in my life........

A few weeks ago I found myself testing the US medical system-- again. It had been seven years since I underwent quadruple bypass surgery at the best heart center in the US. Unfortunately that experience had left me with an ejection fraction of 15% barely adequate to pump the heart. During the past seven years, three doctors had managed to skillfully redesign my life to a relative health. But now I was back again having fallen off the strict regime which had upset the chemical balance of my body.

One of the prime culprits was a new drug called Lyrica. NowI love my doctor-he is kind, considerate and so far his judgements (I have had him now for 25 years) and advice have been sound. But....once in a while his judgement slips. Unfortunately it happened last week...He had prescribed Lyrica, a brand new drug, a month ago to alleviate my phn pain a result of a bout of shingles the prievous year. But he had not taken into account it's possible side effects! Apparently lyrica had built up in my body raising both the creatinine and bun levels beyond the danger levels. Alarmed at the new levels he now recommended a right heart  catherization and an iv drip. Except that I had become so weak as a result of lyrica, I felt that the procedure may be danger to my life. So I refused the procedure then, only to reap the fruits of my delaying and leading to the emergency trip to the hospital! 

The new hospital system-- and it's old habits. I entered the hospital and soon enough found myself engulfed with various experts.

The perils of specialization and coordination: The  tale of three experts. -- during my seven days scores of experts visited my bedside but three standout each of whom predicted my demise with different degrees of subtlety. One prognosed that the only solution to my condition was a heart transplant. But a few years earlier, John Hopkins, after a detailed assesment had declined to place me on the list because of old age of 70. Another suggested an LVD but in the present condition it was not possible. A third prognosed that dialysis was only a temporary fix --in short I should get my affairs in order ( and this in presence of my daughter who was understandably distraught). Another suggested I focus on Gita . In short all of them saw but a limited lifespan left for me....fortunately my old cardiologist was there to provide a common sense path forward.

The hospital had now a new set of gadgets:

There was a 3 lb heart monitor

There was more paperwork- more computers but less efficiency

There was a new bed which moved every few seconds- modern but uncomfortable.

Among these shiny gadgets old fashioned commode stood out in discomfort and oddity

Lessons old and new

Doctors don't know everything --As Jerome Groopman wrote on average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong Ð with catastrophic consequences.

Nurses are grossly under appreciated. Constant attention by a good nurse may be just as important as a major operation by a surgeon.  ~Dag Hammarskjold . Nurses dispense comfort, compassion, and caring without even a prescription.

Your family is everything. During the entire period my family stood like a rock beside me-my daughter took leave to spend nights massaging my back, my son flew back from Vietnam to reinforce her ministrations and my wife was an ever present presence in the room. Without them it is unlikely that I would be writing this blog!

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