A Harrowing Experience with our Medical Establishments

I will remember the entire former part of 2024 as an extremely busy episode for me. While it was partly caused due to professional commitments, the biggest contributor was my mom's health related issues. During the nearly 3 months she spent with us in Bangalore, we must have been in and out of various hospitals and clinics as many as 30 times. Probably more. This involved general health checkups, dental procedure, cataract surgery and gall bladder removal, all in the midst of an unrelenting professional routine. It left me completely drained.

But what I want to write about here is not the prolonged episode concerning my mom's case, but the brief one that followed it, concerning my wife.

All the necessary treatments and examinations had been done. My mom visibly looked better than when she had joined us in March. I was exhausted, but ready to heave sigh of relief, satisfaction, and even feel slightly proud of myself for having level-headedly handled the process. That's also when I was saying words full of praises about how professional the Narayana health system is: it's expensive, a bit too elaborate. But it instils trust in the heart of the patients and their caregivers.

That's when, one day, Shilpi, my wife, started getting high fever and vomiting accompanied with severe headache. Her BP readings were worryingly low. Our relative, who is a doctor, prescribed some antibiotics and other medicines, but also suggested that we shouldn't wait too long before we visited the hospital, if the BP readings didn't improve.

Our regular place to go in all health-related cases is the Narayana Clinic on Neeladri Road, Electronics City. It was a weekend and Narayana Clinic was closed. By Saturday afternoon, Shilpi's fever showed no signs of abetting, and she was almost screaming and delirious because of headache. It was a panic situation. And we headed off to Cauvery Hospital, a corporate hospital of significant scale and repute. We were taken in the emergency ward.

They put Shilpi on drip and started tracking her vitals. They also were pushing some drugs through IV, likely to bring down her fever and headache. There was a ward doctor handling the case. I still think all this was quite regular and the reasonable course of treatment in the given situation.

While they were still exploring the further course of treatment, we thought it right to mention a particular condition Shilpi had been suffering from for the last couple of months. Her prolactin levels had been found to be higher than normal a month or two before, and she was under medication for that. We shared this piece of information with the doctor in all good faith, assuming that more information is always better than less. However, this piece of information seemed to throw the whole diagnosis and treatment into a completely different direction. Suddenly, all symptoms started indicating a somewhat serious medical condition called prolactinoma - a tumour in the pituitary gland. An immediate MRI was suggested. Against meek and helpless protests from me, within an hour or so, Shilpi was undergoing head MRI scan! I will not easily forget those silent desolate hours I spent all by myself outside the radiology room wondering 'What just happened?'.

We came back home by around 11 pm. Shilpi's fever and headache had come down for now, most likely because of the medicines. The night went by uneventfully. We had our appointment with the hospital's neurologist the next day. So, we visited the hospital the next morning, collected our MRI reports and saw the neurologist. She said that there was nothing worrisome found in the scan. However, she thought, and sounded so confident, that it was migraine. She prescribed some migraine medicines. Great!

As for actions on our side, we were not yet done. Another symptom Shilpi was suffering in the day or two was some difficulty in passing urine. Next day, Monday, we visited our regular family doctor in Narayana Clinic. On hearing the entire story, our doctor ruled out migraine. Because of the urine retention, he suggested undergoing ultrasound scan of stomach. A blood test was also prescribed. Or were these suggested by the neurologist? I realise now that I am losing track of some of the details. However, I do remember the highlights.

The US scan report showed swelling in gall bladder. And some issues with the liver. The doctor said that these add up to a clear diagnosis of urosepsis -- that starts with a urinary tract infection which affects the kidneys, and eventually sends the body's immune system on an overdrive whereby it starts attacking the body itself, another serious medical condition which could turn potentially fatal. The doctor said that we should watch for symptoms like difficulty in breathing and tightness around chest. These would indicate that the condition is worsening. Otherwise, if things went well, the current course of antibiotics (suggested right in the beginning by our doctor relative) was adequate.

That night -- or rather the following early morning around 4 am -- Shilpi woke up saying she was feeling tightness around her chest and some difficulty in breathing. That was a meltdown moment for me! I panicked completely and didn't know what to do. I froze. We didn't do anything. Just slept away the remaining hours of the night.

The next day, we visited the doctor again. I think, by now the blood reports were in. So, the new diagnosis was dengue! We were sent back home with some medicines to help her urine retention and very little instructions. Rest. Check your platelet count every other day. We did that for the next couple of days. The platelet counts held up through the next few days eventually starting to rise. Shilpi had started feeling better, though suffering from acute weakness for a few days. Though, dengue was itself a serious enough medical condition, thankfully, it didn't take us all the way down this time. The worst was behind us!

An ordinary fever/headache to prolactinoma to migraine to urosepsis to dengue! It was a long circuitous route through series of misdiagnoses. But it still left our pockets lighter by thousands of rupees due to an MRI scan which, now I feel, was completely unnecessary. I would say that it was forced on us at a moment of panic and helplessness. And let's not even talk about the extreme anxiety all this caused us.

I don't want to name or shame anyone, especially the doctors involved.  I don't think that there is any question to be raised on the competence of the doctors involved. But I would like to ask them if all this was done right. Is this how our modern medical system is supposed to help patients? Is the extreme and protracted episode of anxiety that we tolerated unavoidable? Why so many misdiagnoses? Retrospectively, we can say many things. But aren't doctors supposed to help us reduce our suffering, instead of merely theorising about them retrospectively, and that too sitting on piles of prohibitively expensive tests?

It was a harrowing experience. I have tremendous respect for the medical profession and doctors. I have seen many times in my life how doctors have gone well beyond their call of duty and acted like angels in moments of suffering, being epitomes of integrity and capability. Yet, this expensive and ineffective process is clearly not a success, and I want to call it out without malice to anyone. I hope, members of the medical community will take heed of my humble appeal. I don't want to make allegations without having adequate proofs. But all this smells heavily of corruption too. Somehow, incentives all all medical establishments are stacked up in favour of pushing patients through expensive treatments. Doctors, though by themselves not corrupt, are probably under pressure from their employers to push for inefficient and unnecessarily expensive examinations and treatments. Anecdotal evidences are in plenty. They all can't be false!

I have nothing to say. It's saddening!

Excesses of Feminism

Why is a feminist publicly correcting me that a word I use -- I swear -- without an intent to be patronising or sexist, but which feminists have (arbitrarily) decided to tag as patronising or sexist, not considered patronising and insulting? You can't argue on logical grounds for a minute why such a rule exists. Yet, you consider it your duty and right to act as a police who enforces this rule on public. Why?

On the one hand, they want us to use gender neutral pronouns (they, zhe) or both versions of pronouns (e.g. he/she). On the other hand, they start using the male version of the word as gender neutral and deprecate the female version of the word as sexist. If both male and female versions of pronouns should be used, why should we deprecate the female version of a noun as sexist?! This is inconsistent, arbitrary and illogical tailormade to psyche logical people out of their wits! The message is clear: You can't use your logical reasoning if you want to sound politically correct. You are at our mercy, because we will set rules at will and you will follow them. Fall in line and endure insults or get called out!

These days, we come across increasingly large number of people who consider themselves the guardians of arbitrary codes of conduct and speech set into force by some feminist intellectuals. In the process, they act like they may correct others anytime on things they consider against their taste. Like many other things, such codes of speech are things people have to follow, not so much because they see any sense in them, but because of the fear of being called out and bullied by the militant factions of feminism.

By all means, let's protect women's rights. They are still raped and abused. Let's stop it. They are discriminated against. Let's stop it. They are killed in their mother's womb, prevented from going to school or taking up a profession. These need to change. And we should all actively fight against these ills.

But stop bullying well-meaning people in their day-to-day functioning by enforcing arbitrary and inconsistent codes of speech which do nothing beyond giving you a false sense of power. In the process, you are pissing off well-meaning and genuinely good people who would be happy allies if you didn't daily insult their common sense. In the long run, you are losing friends and earning enemies. This is going to come back and bite everyone.

Belligerently Virtuous

 

I have spent years and decades (in fact, much of my life) being rather secretive about my ethical stands. Reasons?

• I wanted not scare people off.
• I wanted to come across as modest and approachable.
• I didn't want to be dismissed and persecuted as being prude.
• I didn't want to invite criticism that I am showing off my virtues.
• I didn't want to be misunderstood. For example, in multiple cases, my riding a bicycle to work, or not splurging on clothes has been openly interpreted as my miserliness or even poverty. I don't see anything wrong with being a poor man. But I have problems with something I am doing out of my choice being interpreted as something being done due to circumstances.
• In this world of 'cancel culture', there's a fear that those who choose to feel threatened and offended by you, will someday call out a small perceived slip by you as a weapon to shoot you down. A person who has been open about his good deeds in the past is more vulnerable to cancellation, because on top of whatever charges are levelled against him at the moment, he lays himself open to charges of being a hypocrite owing to his earlier opposite image.

Over time, I have realised that the above line of thought was useless and caused much time in getting wasted? Wasted in what?

• In caring about opinions which don't matter held by people who matter even less.
• In not allowing, to be positively influenced by your actions, many who are open enough to feel inspired by anything good you do, rather than feeling threatened by you.

In summary, I do what I do because I think it's right to do it, not because I want others to praise me or even take to my ways. Having said that, getting praised or becoming a positive influence is acceptable, even desirable. It makes complete sense that, if you do something good with good intentions, you be open about it. And know that in doing so you are not being vain. In fact, those who say so are up to nothing good themselves than pulling down someone behaving well. This world indulges in unbridled voyeurism in lusting over images expressly intended to show off and make others feel deficient on account of money, physical beauty, exclusive attainment of sexual love and so on. And in this, they do not bat their moral eyelid. These buggers have no right to judge you if you are doing something good with your talent and intentions and are generous enough to share it with others.

In the Picture

This Thursday, I chose to travel by public transport bus to Airbus Takeoff. While their high official did a lot of talking about sustainability during the session, I did my little part to help sustainability. I took a bus (and enjoyed the ride) to and from the venue. I carried my own water bottle and refused to pick up the plastic packaged water bottle. A gentleman at the conference even tried to pick me on why I carry a plastic bottle and not a steel bottle.

Concern for Inclusion or a Marketing Ploy

 In discussions about professional products and services, there often is vehement shaming of any opinion that seems to require the user to up his ante and try to learn, understand and perceive something which he currently doesn't. Accessibility, inclusion and customer focus are used as weapons to counter any demand on the cunsumer's skilling up. We see ourselves falling for this ploy pretty quickly. To do so is very easy, convenient and most importantly safe (because talking about accessibility, inclusion and customer focus is socially acceptable behaviour). However, one must also be mindful when the concern is genuine and when it's driven by the deeper desire to keep people in the shackles of stupidity. If your business and your profits, and your personal wealth, depends on your customers' weakness, you have no right to banter about you concern for their limitation. You basically are interested in perpetuating the power you hold on them by keeping them stupid and unskilled so that you can keep using these to increase your own wealth.

I hope consumers of any product and service are mindful of this phenomenon. Beware! When the seller is talking about accessibility, inclusion and customer focus, it may be motivated by a pure selfish concern: to perpetuate their market by deepening your dependence on their offering.

Example:

MOOCs have been selling the idea hard that human attention span is 7 minutes or something, and that any form that puts a demand on the learner's attention for anything more is, by definition, not going to work. This is probably true for a lowest common denominator of learner population but is untrue in general. However, this aggressive repetition has ridded many of our learners from the little guilt for their waning attention. As a result, now, many of them don't even try to pay attention for anything longer than a few minutes thinking it's natural and conveniently pass on the blame of their wavering attention to the unengaging (read unentertaining) performance of the instructor or the inappropriate nature of the longer format of classroom lectures.

I don't want to dismiss the success of MOOCs as a purely evil thing. But a good portion of it can be attributed to the above idea which has been sold really hard by using the lip-service of influential pedagogues.

An unfortunate collateral damage of this phenomenon is the ability of the students to hold their attention for a longer time, a mental ability of great importance in a wide range of situations (e.g. engaging deep conversations, profound literature, classical music) where paying attention and patience leads to a growth, fulfilment and enjoyment unmatchable through instant gratification.

Humans and Operating Systems

 Multitasking is the act of switching between two or more tasks, both of which are in the middle of executing. If one task is waiting, say for some input from the environment, the operating system will switch to executing another for the time being, thus ensuring that the computing resources are utilised judiciously, and progress happens.

Human adults are often needed to multitask. When the currently executing task stalls or waits for some reason and you can't do much about it except wait, a human often experiences emotions that an OS can't. There's impatience. Theirs anxiety. If the result of this task failing are bad or disastrous, these emotions are particularly strong.

A human may have to switch away from this stalled task since there are other tasks running and waiting for your attention. They may meet a sad fate if they don't get your attention while you can give it to them. Switching to other waiting tasks is but the most logical thing to do, because that's what an operating system would do. But this is also one of the hardest skills to learn because humans are not operating systems.

Beauty of Mind and Beauty of Matter

It's been a constant grouse for me why it's easier for physically attractive people to get attention much more than for people who are mentally capable. For example, it's not uncommon for fashion models to have millions of followers on Instagram. Comparatively, an artist should consider himself fortunate if he can garner even a few thousand followers.

In fact, the attitude that the world seems to have for intellectuals (in which I include those who make their living using their mental capability; this would include teachers, scientists, creative professionals like artists, writers, film and theatre directors and even bureaucrats to some extent) is more than just lack of interest. Instead, I see a certain degree of animosity and intolerance too. The world around us as we see it is the product of the the thoughts and work of intellectuals. So, no one can simply ignore the existence of intellectual beings. However people seem to prefer having nothing to do with this aspect of their being, thus trying to restrict their relation to intellect as a transactional thing. Where intellectuals must be dealt with at a social level, they are boxed into stereotypes of being geeks, nerds, studious, scholars etc. amounting to grumpy, mean, serious, sever, belligerent to being socially inept and insufferable to some extent.

This animosity and unfair bias against intellectuals -- often known as anti-intellectualism -- placed vis-a-vis the enormous appetite that the world has for anything glamour has appeared very unfortunate to me to the extent of causing me great and enduring pain.

Here, I try to make peace with this predicament by trying to explain it based on psychology, to the I extent that I understand it.

So, I would like to distinguish virtues in terms of being associated with mind or matter. There are human qualities that cause immediate sensual pleasure. A beautiful body, apart from the neutral aesthetic angle, causes sexual titillation. Cooking done well leads to pleasurable eating. A beautiful painting or sketch leads to a visual treat for the viewer. A piece of music is nice to the ears whether one understands music or not. All these, I would like to call the experiences of the matter. Experiencing these involves no training or preparation.

A level above these involves aspirations, arguably a thing of the mind, with which we are born. Aspirations to look good, to be rich and influential, to be accepted and respected in our social surroundings -- these aspirations lead us to see beauty in things which otherwise may not be having any apparent beauty. For example, being rich draws looks of admiration because people aspire to be rich. Possessions -- cars, gadgets, house, properly jewellery, dresses -- receive compliments and admiring looks from those who wish to have these for themselves. Of course, as a rejoinder, let me add that it would not be completely correct to say that the above things of possession have no inherent beauty of their own: а house can be really pretty and grand; a car may be majestic, sleek, fast and powerful; a gadget may be sleek, a piece of jewellery or garment can be really fine. Yet, I would say that a large majority of humans aren't so concerned about how inherently beautiful these objects are -- at least not until they find them well within their financial reach -- but what it entails to possess them.

Collectively, the above two forms of admirations, I would like to categorise as those of the matter. They would evoke reactions from almost anyone, with or without any special training, education, talent or intelligence.

The other form of beauty is the beauty of mind. This form of beauty, in order to be admired, demands us to get into the semantics -- the structure and the kinetics -- of the object in question.

To sense this form of beauty one certainly needs to get into a state where he concerns himself as much with the process that creates the object of beauty as with the object itself. The process that created a piece of beauty is an arbitrarily deep thing. For example, to be able is sing a particular song, the singer must go through a prolonged and rigorous training in music. The poet must feel something extraordinary or something ordinary extraordinarily that he expresses through the song. The music composer, the orchestra and the singer must internalize the details of the song -- both the technical and the emotion to put together a performance powerful enough to grab the notice of the most insolent of hearts. While the song itself has the beauty of the matter, the process that creates it is unboundedly more beautiful. But it is accessible to the person only with his mind's eye open. 

Unfortunately, staying in a state where the mind's eye is open is not effortless in most cases. In fact, most of us spend only a small part of our conscious life in that wakeful state. For most part, we are in an unconscious state, a mist of insolence and apathy surrounding us. I suspect that for most unfortunate people, this wakeful state happens for a disappearingly small period of time. I am unprepared to believe that there are people who never experience this wakefulness. You may consider it my form of faith that says that each one of us is blessed with that spark of divinity that can be stoked into a blazing fire with the right kind of nurturing. But anyway, what's important here is that statistically most people have their mind's eyes closed. Hence, appreciation for the beauty of the mind is so difficult to find. Places like Facebook or Instagram are where most of us spend the moments when we are in no condition or mood to perceive anything that's not out on the surface or doesn't assert itself loudly.

Sometimes creators of the beauty of mind, in their frustration of not being able to garner are kind of popularity that those with the beauty of the matter do, try to assert themselves in all sorts of ways. Unfortunately, this hardly ever ends well. In most cases, they are judged as belligerent, that is, pushing their supremacy on others. One question is: is indeed this belligerence there? Hard to say if it's right to interpret this behaviour as belligerence. It's definitely born out of anger and frustration, and has an element of violence in it. But belligerence?Belligerence amounts to an act of aggression in an attempt to force someone to to do something without his consent. What is an overassertive creator of beauty of mind trying to force people to do by making a noise about his creation? It's hard to point out. It's often construed as an attempt to force people to acknowledge the superiority of such a person. This mayn't be the case though. Such a claim, if at all there (which I doubt it is) as vacuously true and is in no need of validation. If someone is wilfully denying this, it's clearly a mean act. For most creators, their so called belligerence is really an act of retaliation against this meanness. But interestingly, to begin with, the denial of the above acknowledgement doesn't originate from meanness, but from intellectual incapacity. When intellect is slumbering, where is the question of it seeing below the surface?

The other, even more unfortunate, way the creative mind asserts its presence to the intellectually asleep majority is by commodifying itself. 'Become so good that the brilliance of your goodness pierces through the thickest of the wall of intellectual slumber', that's the maxim. This commodification is the unfortunate mechanism that drives the commercial world. It legitimises consumerism which is the advanced state of intellectual slumber; and it legitimises the alienation caused by the non-interest in the deeply beautiful thing in favour of that whose beauty is shallow and of the material. It also normalises the claim that there's no fundamental difference between the beauty of the mind and that of the matter.

Before I close, I would like to return to the infinite potential of the experience involving the beauty of the mind. There is really no limit to what you are allowed to see and experience behind an act of creativity. In fact, it's completely legal to perceive things that even the creator may not have perceived. Experiencing the beauty of mind is an act of creation.

On a completely tangential note, this may provide at least a partial resolution to the following conundrum: 'Does a copy (probably produced mechanically) have the same beauty as the original creation? Beauty of matter: yes! Beauty of mind. no! Beauty of mind can't be copied. It can't be manufactured. Process of creation happens only once -- in the mind of the creator, in the mind of the experiencer. In fact, beauty of mind is not a thing, but a process. Ephemeral. Unique. Unreplicatable.

Final word: Beauty of mind is not meant to be popular in the manner the beauty of matter is. It is sacred, and trying to push it through the wall of the widely prevailing intellectual slumber may sometimes work, but often will break it, defile it, turning it into the beauty of matter.

Dividing the Prize of Good Work

Can organisations consider transferring a part of the salary of their employees to their partners, family members, or anyone at home, who makes it possible for the employees to put in his or her hard work?

The world has run long enough with the assumption that an employer pays its employees their salary, and it's the responsibility of the employee to share the benefits with his/her family members. Clearly, had this been a sufficient mechanism for all benefits to trickle down equitably, the whole gender discrimination issue wouldn't have arisen. The fact is that the person who has a direct access to the finances has an upper hand in the outside world in various ways. This advantage plays out very distinctly over a long period.

Personally, having been a family man for a decade and a half, it's quite clear to me that neither of us -- my wife and I -- would have been able to flourish in our professional craft without the other stepping up to help at every step. Unfortunately, this invaluable help gets a fairly sad compensation as a mention in the thesis acknowledgement or as a 'thank you' in an award ceremony, however sincerely and emotionally spelt. We need to make the compensation more explicit.

There could be objections to the above idea that a spouse's devotion or a parent's love are invaluable and thinking of compensating them in financial terms is like devaluing them. I get that, and I don't want to be dismissive about it outright. However, undeniably, the current system has led to a long-term drift and needs some correction.

Also, this idea wouldn't directly correct many other issues, for example, the fact that some people will never get an opportunity to demonstrate their capabilities in certain fields of endeavour due to this arrangement of division of labour. But, if we as a society take the task of estimating the financial value of handling a home and family, the issue of one feeling unrewarded and unacknowledged for his/her effort would be reduced to some extent, hopefully. It is likely that, in turn, everyone -- regardless of gender -- would feel motivated to contribute to domestic duties in the same way as to professional ones.

There's a trend to turn our workplaces into gender equitable spaces. This is a very good thing and should continue and strengthen by all means. But a dual force should also be created wherein men feel more encouraged to participate in managing home and family. It's definitely done in some of the developed economies, and it works. For example, some of the European countries like Sweden give paternity leave equal to the maternity leave, and that too a lot of it. This shows that the society there acknowledges the importance of nursing and raising a child, invests on it as a society and encourages men and women to participate equally in it.

A couple of points to tie up a few loose ends. Firstly, though I am thinking and writing about this subject around Women's Day, the matter is not about upliftment of women, or gender fairness. It's about fairness in general, which is gender/caste/race/class neutral virtue. This includes the interests of parents, caretakers and others who stand guard at home while a person goes out into the professional battlefield to earn bread and accolades. In the same vein, this thought has nothing to do with feminism, which is a sexist term in my opinion. Thinking like an ethical human being is an age-old idea, though put to use to a miserably insufficient extent. If feminism has done anything to help anyone do that, there're also evidence that it has brought up a generation of women (and men) who have misplaced notions of being knowledgeable about this issue and use it only to further strengthen their own privileges.

If our society considers itself a developed one, it should develop mechanisms of estimating the (economic) value of all contributions to the society; and, if possible, create channels through which credits and rewards flow to the people and places where they are due. I know, this may be a bit out of the way the world works. But to get important results, we should consider making fundamental/radical changes.