grieving

Day 738

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“How are you?”
“Exhausted!”

This is the answer I get more often than not. It seems like a wave of tiredness is sweeping across town. 20% of road accidents have fatigue as a contributing factor (Source: Dept of Transport). 15% of Britons suffer from fatigue lasting at least 6 months (Source: Fatigue Science for Human Health). 5.6 hours per week of productive work is lost through fatigue (Source: Journal of Occupational and Environmental Medicine, Vol 49).

Apparently this is not a new phenomenon. Over the centuries, it has been attributed to the misalignment of the planets, ungodliness and even a subconscious desire to die. According to Freud, a very strong part of us longs for a state of permanent physical and mental rest.

Lack of good quality sleep, sensory overload, inappropriate diet, low physical activity, disregulation of the Suprachiasmatic nucleus (responsible for maintaining the circadian rhythm), hormonal imbalance (low dopamine and/or low serotonin levels as in Parkinson’s Disease and depression) are the usual culprits. Inflammation is emerging as a common pathway linking all the above. But it is not the complete answer as fatigue is seen to persist even after the inflammatory markers have normalised.

Fatigue sits perfectly in the mind-body spectrum of conditions. It is not surprising that it is poorly understood and has been the subject of very little serious research. This article by Harrington offers some answers: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479364/

Many ‘boosting remedies’ and ‘re-energising potions’ line the shelves of pharmacies – Iron, Vitamin B and C, Flavinols, hormones, pro-biotics and and other magic supplements. Dehydration , even mild is said to induce tiredness. So, aqua is a simple remedy.

While the search for an optimal solution is on, we struggle on, waiting patiently.

Day 737

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“I wish it need not have happened in my time,” said Frodo.
‘So do I,’ said Gandolf, ’and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given to us.’

Tolkein wrote this roughly 80 years ago but it is ageless.

‘It must be really hard talking about Saagar in public meetings. Is it?’
The answer is ‘Yes. It is. Very hard.’
But I have decided to do it with the strong intention of creating awareness, breaking the stigma and making sure that through the lessons learnt from the poor management of his illness, other lives can be saved. I have decided to put this intention out to the universe with the promise that I will do everything I can. It is my belief that the universe is responding and will respond to support this true intention.

I can’t get how he died out of my heart and head,  even tough it happened in 1 second. I sometimes forget to honour who Saagar was and how he lived. He lived for 20 years, 5 monthS and ten days! One of the comments his Head Master made about him was, ‘he spoke to me the same way he spoke to a student 3 years younger than him.’ He treated everyone with respect and light heartedness. He found every opportunity to laugh and make others laugh. He brought out the best in people. I need to learn from him to enjoy my life and relationships, to enrich my life and that of others through every interaction. I must decide to do that too.

Day 736

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In the NHS, staff morale is at an all time low.

Non-UK staff have been insulted by the Secretary of State and Prime Minister and made to feel that their work is not appreciated and their presence neither wanted nor likely to be tolerated in the not too distant future. Considering that at least one-third of the NHS staff has its origins outside of the UK, this does not bode well for the future.

Our medical students are threatened with financial handcuffs to tie them to the NHS for four years as if they hadn’t already paid tuition fees and won’t be going on to pay punitive taxes for the rest of their careers. Junior doctors are being subjected to an unnecessary new contract which is unsafe and unfair, that they voted against and that discriminates against women, less than full time workers and those who wish to improve themselves as doctors by undertaking research or further training.

The salaries have been falling since 2003. Meanwhile, hovering in the background, there have been two years of national negotiations about a potential new and toxic consultant contract. The press continues to make doctors look lazy and loaded. Fewer school kids are applying for places in medical schools than ever before. More junior doctors are looking for jobs abroad than ever before.

The UK environment for doctors is not attractive.

 

Day 735

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Today, I woke up determined to have a ‘normal’ day.
Fed the cats. Helped Si make a breakfast smoothie. Got ready. Gulped the thick fruity drink down and headed for the train station. On the way, I received a text from a junior doctor who thanked me for sharing this blog with her as she thought it was full of very valuable insights. From her own experiences, she knew how reluctant society was to talk about mental illness. She is seriously considering specialising in Psychiatry.

At work I had a capable young trainee working with me. Aside from anaesthesia we talked about the gentrification of Brixton that had gone too far and how doing admin is far more tiring than looking after patients. Then I caught up with some admin.

‘Grassroots’ in Brighton sent an e-mail thanking me for contributing to their World Suicide Prevention Day celebrations : https://youtu.be/aclR9grDt1Q

One of Saagar’s school friends sent me a ‘friend request’ on face book! Yay!!! 🙂

Went to the gym after work. There was a beautiful, slim, tall blonde lady training at the same time as me. I overheard her saying that she did not like to look at herself in the mirror. I couldn’t think of one reason why that might be the case.  Wonder what her story was! After finishing the session had a heart to heart with my trainer who shared his difficult time looking after his father in a hospice for 3 months before he passed away.  We both had tears in our eyes and we gave each other a warm healing hug before saying bye. While having a shower I realised that if I stood absolutely still under the warm shower, it felt like being inside a warm duvet.

On the way home, I slept with my mouth open on the train. Luckily didn’t miss my station or swallow a fly. Got a phone call from R’s Mum. She has not had a good week. R’s inquest is coming up next month and she really wants to talk to me about it. So, we set a date for next week.

Got home and lit a candle for Saagar. Sat down with a cup of tea and heard a knock on the door. There was a lady from Greenpeace. After talking to her for 5 minutes at the door I invited her in. For the next half an hour we had a great conversation. I didn’t mind missing the ‘Archers’. We spoke about many topics close to my heart – air quality on London, lack of proper usage of solar energy in India, people forming strong bonds with technology while loosing their deep connection with nature, writing, campaigning and so on. I am now a proud member of Greenpeace!

Now I am about to cook dinner for Si as he is working late…again.

So, I suppose I did have a ‘normal’ day.

Day 734

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The tradition of fasting to death is called ‘Santhara’. It is glorified in Jainism, an ancient religion of India that teaches a life of renunciation. It usually applies to elderly people who feel they have entered the final phase of life with no meaningful purpose left to fulfil.

Early this month a beautiful 13 years old girl, Aradhna, from a Jain family died two days after fasting for 68 days. She lived only on boiled water for nearly 10 weeks. (http://timesofindia.indiatimes.com/city/hyderabad/13-year-old-Jain-girl-dies-after-observing-68-day-fast-to-bring-good-luck-to-family/articleshow/54750457.cms)

According to the media, her father, a jeweller was in financial difficulty and he consulted some senior Jain monks who came up with the idea of her fasting to get the family out of that situation.

According to her father, it was her wish. She had fasted for 8 days in 2014, for 34 days last year and it ‘suited’ her. She was keen to go further this year. As 68 is an auspicious number in that faith, she wanted to fast for that many days. It was entirely voluntary. The family merely supported her wish.

According to both, the completion of the fast was marked by huge celebrations attended by 600 people. So was her funeral procession. She was anointed as a ‘divine soul’.

According to the hospital, she was brought dead from home. The family’s defense is that she was slowly recovering after breaking the fast gently with fluids and semi-solids but then she suffered a heart attack.

They certainly didn’t know of a condition called ‘Refeeding Syndrome’. When undernourished patients are re-fed there is an increased requirement for phosphate as the body switches back to carbohydrate metabolism, which can be made worse by a background of relative phosphate shortage in starvation. Phosphate levels in the blood begin to fall and mainly affect the heart and brain. So, it is more than likely that her ‘heart attack’ was because of prolonged fasting  followed by unmonitored and inappropriate refeeding. (http://www.gosh.nhs.uk/health-professionals/clinical-guidelines/re-feeding)

Was this a suicide? A murder? Pure ignorance? Superstition? Religious blindness? Lack of common sense? Huge violation of children’s rights?The journey of her soul? Karma? All of the above? What values over-ride the basic instinct of parents to feed their off-springs?

It seems so wrong!