Day 687

search

“Is it wrong that I secretly enjoy this bit very much?” asked a deeply religious young lady as she was going off to sleep as a result of having received some anaesthetic medications from me this morning.

The turmoil and the innocence of her question made me think about how much of our life is governed by what’s right and what’s wrong. On the one hand it in an important judgement to make and on the other it can be completely stifling if we take it too far. It can make us judge others and ourselves rather harshly. After all, the past and the present is witness that many thousands of innocent people having been rightfully and ruthlessly killed and ruined in the name of a ‘loving, merciful and forgiving’ God and ‘democracy and liberty’.

Being ‘right’ often does nothing more than instil a sense of false superiority, designed to control the feelings and behaviour of others and confine them and society to very narrow boundaries. People who believe they are ‘good’ and ‘right’ constantly look down upon others who may be different.

According to a story from Hindu mythology, Lord Vishnu had 2 wives – Laxmi, the goddess of fortune, and Alaxmi, the goddess of misfortune. Both of them believed they were the most beautiful. So, they asked Vishnu, “Which one of us is the most beautiful?”
Vishnu said to Laxmi, “When you arrive, you are the most beautiful.” And he told Alaxmi, “When you leave, you are the most beautiful.”
What is the correct answer? Who is really beautiful?

“Existence knows no right or wrong. The beauty of existence lies in doing what is appropriate, rather than relying on morals and ethics.The life process seems to be so chaotic and unbearable for you that you are trying to bring some silly sense of order by establishing your own principles, your own morality, your own ethics. If you bring your own silly sense of order to life, you will completely miss the magnificent order of the existence. There is no need to be orderly. Existence is in perfect order.” – Jaggi Vasudev.

images

Day 681

About 5 months after Saagar’s passing, one of my close friends sent me a subtle message suggesting that I should be careful about what I write in my blog as a few of my work colleagues read it regularly and if I appear to be too fragile or vulnerable, it might have a negative impact on my professional life. I understood her concern. The medical profession is not known for its understanding and compassion for mental frailty in colleagues.

Dr Wendy Potts was a GP in Derbyshire who blogged about living with Bipolar Disorder on a regular basis. One of her patients read the blog and complained to her Practise. The doctor was suspended. A few weeks later she ended her own life.

Firstly, I don’t understand the basis of the complaint. Would patients complain if their GP had diabetes or cancer?

Secondly, I don’t understand the basis for suspension from work. If the doctor’s performance was not questionable, then there is no ground for that.

Ref : https://www.theguardian.com/uk-news/2016/aug/26/gp-found-dead-after-being-suspended-over-bipolar-disorder-blog?cmp=oth_b-aplnews_d-2

This is one of many examples of poor treatment of medical colleagues with mental health issues. I think we are a long way from seeing parity between physical and mental illnesses as the ones who are supposed to put that into practise are themselves caught in the stigma associated with mental illness.

(PS: apologies for not being able to insert the link to the article in a better way. The ‘link’ icon on my page doesn’t seem to work anymore. Any ideas? )

 

Day 652

Of all developed nations, Japan has one of highest suicide rates, third only to Hungary and South Korea. In the year that Saagar died, 25,000 people died of suicide in Japan, making it 70 people per day! Shockingly, this number is more than 3 times that in the UK. Male to female ratio is nearly 2:1 in Japan as compared to 4:1 in the UK.

Why is it so?

Japan’s long tradition of “honourable suicide” makes it a noble thing to do. It is perceived as people taking responsibility for themselves.

“Isolation is the number one precursor for depression and suicide,” says Wataru Nishida, a psychologist at Tokyo’s Temple University. This is particularly applies to elderly people. Many lone deaths of elderly people are never fully investigated by the police. The almost universal practice of cremating bodies here also means that any evidence is quickly destroyed. This also means that suicide is underreported.

The Oxford English Dictionary has recently added the word hikikomori . In Japanese this term describes a type of acute social withdrawal in which a person does not leave their home or room for a period of at least 6 months. In 2010, roughly 700,000 people were living as hikikomori in Japan. Their average age was 31 years. A recent survey of young Japanese people’s attitudes to relationships and sex by the Japan Family Planning Association, it found that 20% of men aged 25-29 had little or no interest in having a sexual relationship. Technology may be making things worse, increasing young people’s isolation.

_68545751_200907_messy_room6

Japan is a very rule-orientated society where young people have no way of expressing their anxiety or frustration. There is an acute shortage of psychiatrists. Treatment is essentially by medication as professional psychological support of good quality is not easily available.

Until the late 1990s, depression was not widely recognised in Japan as an illness. An advertising campaign run by a pharmaceutical company called it ‘a cold of the soul’ which helped raise awareness but is now blamed for employees faking depressive illness to take time off work.

This cartoon by Torisugari is his ‘manga therapy’ according to his psychiatrist but it does help improve the broader understanding of the condition.

_90430606_image-1-976

{“The world that had supported me up until now is breaking up and falling away! I can’t even stand up any more!” says the character, Watashi (whose name means “I” in Japanese).}

 

The suicide figures have started to fall over the past 3 years but the absolute numbers still remain alarmingly high.

 

Day 650

A brain surgeon, Paul Kalanithi got diagnosed with terminal lung cancer at the age of 36. Suddenly he found himself on the other side of the table. He wrote a ‘rattling, heartbreaking, beautiful’ book about his life as a doctor and then as a patient before he died. It is called “When breath becomes air’. In it he tactfully dissects the walls that exist between doctors and patients. Having found myself on either side of the table – first as a physician and then as the mother of a severely ill child, I can completely relate with this excerpt below.

“The reason doctors don’t give patients specific prognoses is not merely because they cannot. Certainly, if a patient’s expectations are way out of the bounds of probability – someone expecting to live to 130, say, or someone thinking his benign skin spots are signs of imminent death – doctors are entrusted to bring that person’s expectations into the realm of reasonable possibility. What patients seek is not scientific knowledge that doctors hide but existential authenticity each person must find his or her own. Getting too deeply into statistics is like trying to quench a thirst with salty water. The angst of facing mortality has no remedy in probability.”

“I had to face my mortality and try to understand what made my life worth living and I needed Emma’s (my doctor’s) help to do so. Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death to rebuild my own life – or perhaps find a new one.”

I cannot imagine what one’s options would be when diagnosed with a severe/ terminal mental illness. Saagar was unable to access his own life as he knew it and perhaps chose to find a new one.

Day 640

 

dahlarexf1_1692375c

In 1960 Roald Dahl’s son Theo developed hydrocephalus (fluid collection in the brain) following a road accident. He needed repeated surgeries to drain the fluid through a thin tube (shunt) away from his brain. The problem was that the shunts repeatedly got blocked.

Dahl knew Stanley Wade, an expert in precision hydraulic engineering from their shared hobby of flying model aircrafts. In 1960 a team formed by Wade, neurosurgeon Kenneth Till and Dahl invented a new valve with a negligible risk of blockage. By the time the device was perfected, Theo had healed to the point at which it was not necessary for him. However, several thousand other children around the world benefited from the WDT valve before medical technology progressed beyond it.

His daughter Olivia died of measles at the age of seven in 1962. Her death destroyed him. Many years later he spoke of his lack of fear of death, “If Olivia can do it, so can I.”

Roald Dahl believed in taking practical steps to improve the lives of those around him. He generously gave his time and money to help seriously ill children and their families, including many he never met. Roald Dahl’s Marvellous Children’s Charity helps to make life better for seriously ill children and young people in the UK.

The charity believes that every child has the right to a more marvellous life, no matter how ill they are, or short their life may be. They focus upon helping those who have the biggest needs, and who aren’t being fully supported by anybody else. This might be because they have a serious rare condition, be living in poverty, or not have any family at all.

2016 marks 100 years since the birth of Roald Dahl, an extraordinary storyteller, a pilot, a spy, an inventor and most of all, a father.

imgres

Day 631

Kamikaze” is a word that has become synonymous with all that is crazy, fanatical and self-destructive. It literally means ‘divine wind’. Kamikaze aircraft were essentially pilot-guided explosive missiles, purpose-built or converted from conventional aircraft. In the second world war young Japanese pilots would attempt to crash their aircraft into enemy ships in what was called a ‘body attack’.

“Dear mother, my one regret is I could not do more for you before I die. But to die as a fighter for the emperor is an honour. Please do not feel sad.” A lot of letters had been written in this vein. They appear to confirm the view that a whole generation of Japanese men had been brainwashed into self-abnegation and blind obedience to the Emperor.

Young school girls bid farewell to the departing kamikaze pilots with cherry blossom branches:

Chiran_high_school_girls_wave_kamikaze_pilot

0e0df84b-fe4f-4af5-beb6-ef91be53d5bf

‘Honour’ is an abstract concept entailing a perceived quality of worthiness and respectability that affects both the social standing and the self-evaluation of an individual or an organisation such as a family, school or nation. Young minds can be moulded into believing that dying is a good idea. It has been happening for many years and continues to carry on through many generations in various parts of the world for one reason or another.

 

Day 619

photo

An entire family of doctors, some of them psychiatrists, with 2 young men in the family who live with a mental illness, all get together every year and talk about everything except the illness. They often speak on the phone to each other about all kinds of things but never about the illness. There just isn’t the space for that specific topic. This happens with ‘educated’ families.

A highly qualified mental health professional who specialises in children and adolescents is someone I have known for years and is very close to our family. When Saagar was ill, I wrote an e-mail asking for help but there wasn’t as much as a phone-call to find out what the problem was. In this age of Facetime, Skype, Viber, Whatsapp and what not, the means of communication couldn’t have been a barrier.

What are the barriers? Is mere talking about it too uncomfortable? Is it too much responsibility to take on? Is it too difficult to accept that the problem exists in such close proxomity? Is it too scary? Is it shameful?

I just googled ‘Stigma’ and this came up on top:

“stigma
ˈstɪɡmə/
noun

  1. a mark of disgrace associated with a particular circumstance, quality, or person.

“the stigma of mental disorder”
synonyms:        shame, disgrace, dishonour; More

  1. (in Christian tradition) marks corresponding to those left on Christ’s body by the Crucifixion, said to have been impressed by divine favour on the bodies of St Francis of Assisi and others.”

This is the society we live in. It is ours to keep or change. EP, my 81 years old friend is also a doctor. She lost her son to a mental illness in 1993 and has been working tirelessly for the last 23 years on the medical community to address this problem of stigma. She doesn’t use the internet but her beautifully hand written letter says:

“Not to give up is the first task. To support each other is the next priority.”