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Act Three

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How do I keep alive?
Everyday smile and revive?

How do the pale shreds of my broken heart
Feed the rest of my decimated parts?

How am I able to see the light?
How do I keep up the fight?

How do I muffle the animal-like shrieks that
arise from the dark well of my chest all day long?
How do I carry on?

How does the Earth like a whirling-dervish go round and round?
Can it not hear my heart-rending sound?

How does the Sun go on beaming round the clock?
Does it not feel the massive shock?

How does Time trundle on?
While Saagar is forever gone?

How does the air in cycles turn to breath?
In and out, in and out, in and out to death?

This must not be me.
It must be Act Three.

The playwright’s script,
Dictating entry and exit.

The stage-set and the screenplay,
The pause and what actors do or say.
This must be the way.
I must be one amongst many in the play.

-SM.

(Resource: Spot the Signs)

It’s everywhere.

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A few decades ago, cigarettes were everywhere. It was normal for men and women to smoke. Physicians were known to recommend smoking. The advertising machinery glorified it.

Today, Electro-Magnetic Fields (EMFs) are everywhere. They wrap us all in multiple layers of invisible weaves of radiations arising from cell-phones, baby monitors, cordless phones, bluetooths, wi-fi routers, smart meters and microwave ovens. There is very little information out there about the effect these gadgets have on our bodies and minds.

According to Dr Mercola’s research these EMFs cause a significant oxidative stress on our cells leading to the release of free radicals which in turn cause serious mitochondrial damage. Mitochondria are “powerhouses” of each cell, breaking down fuel molecules and creating the energy the cells need to perform their functions. Children are at greater risk of such damage than adults. Damaged mitochondria have been held responsible for anxiety, depression, autism, Alzhiemer’s disease, rhythm disorders of the heart and infertility. Dr Mercola also gives practical suggestions on how to minimise the damage.

In 2008, a Danish study involving more than 13,000 mothers revealed some sobering potential effects. Children born of mothers who used cell-phones during pregnancy as compared with children born of mothers who did not, experienced a :

  • 49 % increase in behavioral problems
  • 35 % increase in hyperactivity
  • 34 % increase in peer-related problems
  • 25 % increase in emotional issues

These findings indicate a huge impact on public health and need for further research. Mobile phones are now essential to our lives. Our days begin and end with them. Some people have it right beside them even when they sleep. Lack of one is considered odd. Not being able to locate one’s phone can induce a state of panic. ‘Low battery’ is a highly undesirable state. There is an official term for fear of being without a phone, NoMoPhobia (No Mobile Phobia). I think our generation was the last one to have reached adulthood without cell-phones. Now, they are  everywhere. 

Jo is a dear friend and mother to a 9 year old who is on the Autistic spectrum. Here she shares what it’s like to advocate for her son and how hard it is to ensure that he receives appropriate care. Thanks Jo.

PS: Incidentally all antipsychotic medications are known to cause severe mitochondrial damage too.

Every day my love is new.

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All those years ago, when we were kids, we attended medical school together. The Batch of 1983 had its 3rd re-union at Cochin, the capital of Kerala in South India over the last 3 days. I travelled from snow-bound Wiltshire to lush green tropics. Many of my classmates came together from all over the globe. Some brought their families. Others brought videos of their kids doing this and that. I brought memories. We shared stories of our teachers and colleagues from our time as adolescents and young doctors at our alma mater. We felt close to each other, reminiscing our naivety, vulnerability and innocence. Nostalgia of our ‘good old days’ of simplicity, like silk threads knitted us close.

We went sari shopping. My friend chose a pale blue sari with a gold border. Her 15 year old daughter commented, “it’s as bland as playing tennis without a net.” It was exactly the kind of thing Saagar would say. He would also take great pleasure in imitating the way I say, “So pretty. No?”. Aaaaaaaaargh!!!

Looking back:

2014: Saagar went.
2015: Longing
2016: Longing
2017: Longing

If I told my plight to a river, it would stop flowing. If I told it to a tree it would shed all its leaves. I burn in this fire of longing, again and again, every day. I have become a boat of compassion filled with the gold of nothing, riding the waves in search of my beloved. I weather the tides of sorrow and happiness while my longing lives in me. I find my beloved in my longing. There is no destination no more.

An ancient parable goes like this: Once a forest caught fire and all the birds and animals of that forest started to leave. There was a bright little parrot who decided to stay. The tree that housed it said, ”You have wings. Go. Fly away.”
“I ate your fruit, I soiled your leaves, I played from branch to branch. You burn and I fly away? You love but once.”
The utterly foolish parrot goes and plunges herself in a nearby lake, comes back and flaps her wings over the blazing forest fire. Two drops of water fall. She goes back into the lake and come back with another couple of drops of water and sprinkles them over the humungous fire. The other fleeing birds and animals start scoffing and laughing at her.
“What do you think you are doing?”, they say.
The parrot turns around and says “I am doing what I can.”
Just then the Gods pass by and see this bird. They take the form of an eagle and watch her closely. They are incredible moved to see her do what needed to be done, be in the here and now and her passionate endeavours to quench the fire in and around her. The Gods wept and the clouds burst into a heavy down pour of milk.

Everyday my love is new.
I wish you the same.

“Whatever happens in your life, no matter how troubling things might seem, do not enter the neighbourhood of despair. Even when all doors remain closed, God will open-up a new path only for you. Be thankful when all is well. A Sufi is thankful not only for what he has been given but also for all that has been denied.” – From ‘Forty rules of love’ by Elif Shafak.

Kisa Gautami

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In ancient India, there lived a woman. She was happily married to a rich merchant and was the proud mother of a bubbly one year old. After a brief illness, her only son died. Her grief was unbearable. Wailing and weeping, she took her child’s lifeless remains from door to door pleading with the townspeople to bring her beautiful child back to life. No one could help her. She was destroyed.

Someone suggested she take her infant to the Buddha. She did. Through her tears and sobs she narrated her tragic story and begged Him to infuse life back into her bundle of joy. The Buddha listened with compassion and said, “Kisa Gautami, there is only one way. Bring me 5 mustard seeds from a household where no deaths have occurred.”

Her eyes lit up with hope. She hurriedly gathered up her bundle and once again, went knocking on each and every door in town. To her utter disappointment, every family had experienced death in one form or another. She realised the lesson that the Buddha had wanted her to learn. Suffering is a part of life and death is inevitable. Kisa Gautami’s eyes were now open. In the light of this knowledge, she could handle her grief. She went on to become an ardent follower of the teachings of Buddha.

Like Kisa Gautami, I have found myself at the feet of the Buddha. His teachings have brought light and lightness to my being. Along the way other divine souls have helped in unique ways.

This is the festive season for most people. Planning meals, choosing stocking fillers, selecting wrapping paper, posting greeting cards and preparing to welcome the New Year. Yay! It’s all happening. But a Saagar-shaped piece is missing. I feel for all the families who will have that vacant chair at their table this year. I hold them close to my heart. As time goes by, it does not get easier. This excerpt on the subject of ‘Pain’ from ‘The Prophet’ speaks to me. I hope it helps you too. I wish you as peaceful a time as possible.

“And a woman spoke, saying, “Tell us of Pain.”
And he said: Your pain is the breaking of the shell that encloses your understanding.
Even as the stone of the fruit must break, that its heart may stand in the sun, so must you know pain.
And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy;
And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.
And you would watch with serenity through the winters of your grief.
Much of your pain is self-chosen.
It is the bitter potion by which the physician within you heals your sick self.
Therefore trust the physician, and drink his remedy in silence and tranquillity:
For his hand, though heavy and hard, is guided by the tender hand of the Unseen,
And the cup he brings, though it burn your lips, has been fashioned of the clay which the
Potter has moistened with His own sacred tears.”
― Kahlil Gibran, The Prophet

 

Confidentiality versus Life

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Three years back I joined a club no one wants to be a member of. I became a parent who lost their beautiful child to suicide. He was 20. I didn’t think it was possible. I trusted his doctors to take good care of him. I trusted they would tell me if there was a real risk of him dying, given I am his mother and was his prime carer. I thought they had the expertise to identify and address ‘crisis’ when they saw it. Suicide was not in the script. It was not supposed to happen. I turn the fact of his sudden traumatic death over and over in my head and it makes no sense.

There are hundreds of distraught and bewildered members of this club. Common themes emerge from their stories. The commonest one is:

“They knew our child wanted to end his/her life but they didn’t tell us anything about it.”

Who are they?
Decision makers – Medics. Universities.

Why?
Because he/she is over 18, hence, technically an adult.
Their ‘confidentiality’ is paramount.

Is it?
Is it more important than helping them stay alive?

The Hippocratic oath states:
“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”

According to experts[1], these are the essential components of an effective suicide prevention safety plan:

  1. Discussing the reasons for living
  2. Safe environment
  3. Identify distress triggers
  4. Removing ways to harm yourself
  5. Activities to calm/lift mood or distract
  6. Contacts for general support
  7. Specific suicide prevention support
  8. Professional support
  9. Emergency contact details
  10. Personal commitment to follow safety plan

Most of the above cannot be implemented without the help of carers and families if the person in question is seriously unwell. This has been recognised by the Department of Health, Royal Colleges of Psychiatrists, GPs and Nursing along with The British Association of Social Workers and The British Psychological Society. Together they published a consensus statement entitled[2] “Information Sharing and Suicide Prevention” in 2014, the same year that my son, Saagar Naresh[3] passed away. It clearly states that practitioners should disclose information to an appropriate person or authority if this is necessary to protect a child or young person from risk of death or serious harm.

“If the purpose of the disclosure is to prevent a person who lacks capacity from serious harm, there is an expectation that practitioners will disclose relevant confidential information, if it is considered to be in the person’s best interest to do so.”

This is still not being practised. The world of medicine is a conservative and defensive one. Until the regulatory bodies, NHS Trusts and the Government come forward to reassure practitioners that their decision to share information appropriately will be supported by them, nothing will change.

While the world carries on, innocent youngsters die from lack of support and understanding from the very people who are best placed to help them. PAPYRUS, a UK charity dedicated to prevention of young suicides[4] demands that information be appropriately shared with carers and families by all who take care of vulnerable young people at risk of suicide.

Confidentiality versus Life. It’s a no-brainer.

References:

[1] https://www.healthcareconferencesuk.co.uk/news/newsfiles/alys-cole-king_1219.pdf

[2] https://www.bl.uk/britishlibrary/~/media/bl/global/social-welfare/pdfs/non-secure/i/n/f/information-sharing-and-suicide-prevention-consensus-statement.pdf

[3] www.kidsaregifts.org

[4] PAPYRUS (https://www.papyrus-uk.org/)