Day 952

A surgeon’s wife writes

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The Dark side of Doctoring is an insightful blog written by a surgeon.
The common themes that push doctors into dark despair are:

1.Loss of control.
2. Loss of support. 6am. Repeat.
3. Loss of meaning.

One would think that those who look after other people would know how to look after themselves and their colleagues. Not so at all.

Thank you Dr Eric Levi.

 

Day 951

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Who? The young. 

1 in 6 people is an adolescent. More than 3000 adolescents die every day from largely preventable causes, according to a new report from WHO and partners. That amounts to 1.2 million deaths per year.  Many key risk factors for future adult disease start or are consolidated in adolescence. Adolescent mental health and well-being are often overlooked.

In 2015, more than two-thirds of these deaths occurred in low- and middle-income countries in Africa and South-East Asia. Road traffic injuries, lower respiratory infections, and suicide are the biggest causes of death among adolescents.

Most of these deaths can be prevented with good health services, education and social support. But in many cases, adolescents who suffer from mental health disorders, substance use, or poor nutrition cannot obtain critical prevention and care services – either because the services do not exist, or because they do not know about them.

“Adolescents have been entirely absent from national health plans for decades,” says Dr Flavia Bustreo, Assistant Director-General, WHO. “Relatively small investments focused on adolescents now will not only result in healthy and empowered adults who thrive and contribute positively to their communities, but it will also result in healthier future generations, yielding enormous returns.”

Suicide and accidental death from self-harm were the third cause of adolescent mortality in 2015, resulting in an estimated 67 000 deaths. Self-harm largely occurs among older adolescents, and globally it is the second leading cause of death for older adolescent girls. It is the leading or second cause of adolescent death in Europe and South-East Asia.

“Improving the way health systems serve adolescents is just one part of improving their health,” says Dr Anthony Costello, Director, Child and Adolescent Health, WHO. “Parents, families, and communities are extremely important, as they have the greatest potential to positively influence adolescent behaviour and health.”

At long last, the world is waking up and so is the World Health Organisation.

Podcast:
In conversation with Meera S and Dr George at Business FM, Malaysia:

Doctor in the house: Adolescent Health

Day 944

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The Great Master

All I manage to read these days are short stories. Partly due to my abbreviated attention span and partly because the time has come when I ‘should’ start wearing reading glasses but I don’t. I get by, by increasing the font size and by reading for short periods of time. Also by squinting a lot.

‘The First Forty nine stories’ is a collection by the Nobel prize winner, Earnest Hemingway. In the preface he says, “In going where you have to go and doing what you have to do and seeing what you have to see, you dull and blunt the instrument you write with. But I would rather have it bent and dull and know I had put it on the grindstone again and hammer it into shape and out a whetstone to it, and know that I had something to write about, than to have it bright and shining and nothing to say, or smooth and well-oiled in the closet, but unused.”

After devouring the collection, I read up about him and was saddened to find that he suffered with depression and died of suicide. Here’s an example of the sensitivity and vulnerability of his characters and the simplicity of his story telling style. It’s called ‘Cat in the rain’.

https://soundcloud.com/user-474898075/new-recording-2

 

Day 941

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Karma – Good or bad, to each his own.

Valmiki started his life as a thief — looting to feed his family. He felt that he was protecting them and doing his duty. He was about to steal from Saint Narada who questioned him on his stealing ways.

Saint Narada: Why do you steal?
Valmiki: It’s my duty to protect my family. I only know how to steal and kill.
Saint Narada: By killing and robbing others you are acquiring lot of bad karma. Go and ask your family members whether they can take any part of your karma.
(Valmiki goes to his family)
Valmiki: Can any of you take part of my karma that I have incurred for you, due to my stealing habits.
Valmiki’s Mother: I didn’t know anything about the bad things you were involved in. Therefore, in no way can I be part of it.
Valmiki’s wife: I didn’t know anything about the bad things you were involved in. Therefore, in no way can I be part of it.
Valmiki’s children: We didn’t know anything about the bad things you were involved in. Therefore, in no way can we be part of it.
Valmiki (to Saint Narada): Nobody is willing to share any part of my bad karma. What’s the salvation for me then?
Saint Narada: Chant ‘Rama’, all day and all night.
Valmiki chanted ‘Mara’ as he misheard the saint. He chanted for many years. An anthill formed over him. People heard only the sound. When he came out of his meditation, he wrote the famous epic Ramayana.

Day 939

Me? Lonely? Naah!

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Joe put an advert in his local paper which read: “Senior citizen, 89, seeks employment in Paignton area. 20 hours plus per week. Still able to clean, light gardening, DIY and anything. I have references. Old soldier, airborne forces. Save me from dying of boredom!” He said he had lived alone since his wife, Cassandra, died two years ago and had been lonely. “When you live on your own there is no one to speak to. Since she died I’ve moved into a flat and it’s a big block. Once you walk into that flat it’s like solitary confinement,” he said. He is due to start work at a cafe in the town after the owners of the family-run business spotted his request.

Film-maker Sue Bourne says it’s a major public health issue. Her BBC documentary is called “Age of Loneliness”. It tells the stories of 14 people, young and old. “A silent epidemic that’s starting to kill us. But we don’t want to talk about it. No-one really wants to admit they are lonely.”

Si is away for a week. It’s only tolerable because I know I will see him at the end of the week. I tell myself it’s ok but it’s not easy. I miss him. I have something planned with friends for every other evening of the week so that I have something to look forward to. Something to keep me distracted. I can’t imagine how it must feel to loose a spouse or a partner you love and have been with for decades.

Source:
View: An online magazine that talks about issues that matter.
Editor: Brian Pelan

http://viewdigital.org/2016/11/03/need-talk-suicide-prevention/

 

Day 925

Vulnerability. Not weakness.

Stories are data with a soul. Researcher and storyteller Brene’ Brown has taken the time to take a deep hard look at shame and vulnerability.

She believes that ‘connection’ is neurobiologically why we are here.

Shame is fear of disconnection or not feeling like you are worthy of connection. For example, not good enough, not pretty enough, not strong enough, not rich enough and so on. All experiences of excruciating vulnerability.

After 6 years of researching ‘Shame’ she took a closer at a sub-group of individuals with ‘Worthiness’, people with a strong sense of love and belonging who believe they are worthy of love and belonging. She called them  ‘Wholehearted’. This group had a few remarkable  traits:

  1. Courage – to be imperfect
  2. Compassion – ability to be kind to themselves and others
  3. Connection – ability to give up the idea of perfection

They fully embraced their vulnerability. They believed that vulnerability makes them beautiful. They were willing to reach out their hand first, to invest in a relationship that may or may not work out. It was not comfortable but they did it anyway.
Vulnerability is also the birthplace of tenderness, belonging, love and joy.

What makes us vulnerable?
The simplest things like asking for help, waiting for the doc to call back, initiating sex, loosing a job, asking someone out on a date and many more.

Why do we struggle with vulnerability?
The uncertainty is too uncomfortable. So we numb it.

At present, we are most highly addicted, medicated and obese populace ever.
We can’t selectively numb feelings.
When we numb vulnerability we also numb joy and connection.

The ways in which we deal with our discomfort with vulnerability are:

  1. We make everything uncertain, certain, eg- religion.
  2. We Blame- a way to discharge pain and discomfort.
  3. We Perfect – most dangerously our children.
  4. We pretend – like what we are doing doesn’t have an effect on people.

We need to let ourselves be seen.
To love with our whole hearts even if we are unsure.
To practice Gratitude despite the uncertainty because our vulnerability means we are alive.
Lean into joy and believe – I am enough.
That enables us to be kinder and gentler to the people around us and to ourselves.

Ref:

Book :
Daring Greatly by Dr Brene Browm
TED talk by Dr Brene Brown on Power of Vulnerability:

Day 912

Everything was fun.

As soon as he could walk with support, leaving home in the buggy for a walk in the evening meant, him pushing the buggy, taking it for a walk. Looking into the mirror, playing hide and seek with himself was fun. Kicking a cotton sheet off him with his frantically moving arms and legs was fun. Wearing big sunglasses and shoes was fun. Playing with toys and words was fun. Crawling, walking, running was fun. Dabbling in different kinds of music was fun. The ‘bandana’ phase was fun. Playing and listening to any kind of percussion was fun.

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Going round and round while sitting in one of my mother’s big cooking pots with a convex bottom was fun. On his second birthday, we found him in the balcony with a pot of yogurt, officiously feeding himself and our dog, Caesar, with alternate spoonfuls of the honeyed white stuff. As he grew older, pulling faces was fun. Smurfs and Mighty Morphin Power Rangers was fun. The little toy in the occasional Happy Meal at McDonalds was fun. Z-Ball was fun.

Being back here in my parent’s house brings back heart-warming memories of his childhood. He was such good fun!

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Day 885

Megan Clark is 19. She came out of anonymity to speak in support of the statement made by the judge on her rape case. Judge Lindsey Kushner, while sentencing the rapist, advised young women that they risk rape if they get drunk. It is well known that drinking seriously impairs judgement. Drunk young women make themselves very vulnerable. They are less likely to be able to defend themselves, remember the events correctly or be believed.

The judge’s statement was interpreted by some as ‘victim-blaming’.

I think it’s common sense. I have great admiration for this young girl for coming forward and speaking from her experience. It must have taken courage.
In no way does it absolve the attackers of  what they did.
It’s about taking care of ourselves. The lessons are there if we are willing to learn. It’s much better to learn from other people’s mistakes.

In an ideal world no one would steal, rape or cheat. In the real world they do. That is why we lock our doors, install burglar alarms and have heavily protected bank accounts.
Freedom comes with responsibility.

There is mountains of evidence to say that there is a significant increase in mental illness in women who have been physically or sexually assaulted in childhood and adult life. The harmful effects of abuse can continue to contribute to psychiatric illness for many years.

Ref:

http://www.telegraph.co.uk/news/2017/03/28/rape-victim-says-judge-warned-women-drinking-heavily-right/
http://www.sciencedirect.com/science/article/pii/S0140673688916005

Day 869

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Once upon a time her life revolved around music. Her days and nights were spent either listening or humming or singing or watching thinking about songs. All her time was infused with music. Her friends would sometimes have to shut her up. She was addicted. Music was her friend in good times and bad. It was a constant and reliable companion. It never let her down. They had a steady relationship.

One day her world turned upside down, inside out and back to front. She couldn’t make any sense of anything anymore. Music didn’t help. It fell by the wayside. Their friendship disappeared. She couldn’t cope with rhythms, notes or lyrics. Melodies brought forth floods of tears. Harmonies took her to painful places. She stayed away. She fiercely guarded her heart strings from melting. She preferred silence. Deep, dense, safe silence.

Serendipity stepped in. A musical friend who knew of her old connection invited her along for an evening of informal singing in a friendly group. She reluctantly agreed. The thought of revisiting Music had fleetingly crossed her mind on New Year’s eve. Her parents and friends had been gently pointing her in that direction. Her love of music was alive but its expression immediately exposed her fragility. Could she risk it?

She decided to go along even though she was filled with self doubt. Would she be able to hold a tune? Would she get the timing right? Would she run out of breath before the end of a line? Would her voice sound okay? After a long estrangement, would Music be her friend again?

On the morning, she meditated, prepared herself physically and mentally, determined to face Music and re-establish their friendship.
She did it.
It wasn’t as difficult as she thought it would be. She went with the flow. Her throat welled up a few times. Her eyes got heavy with moisture. Every now and then she completely lost herself, disappeared. She came away smiling, feeling lighter. She reinstated a new, joyful connection with her old friend, who had been waiting for her all this while.

“Without music, life would be a mistake.” – Friedrich Nietzsche

Ref: Neuroscience of singing: http://upliftconnect.com/neuroscience-of-singing/

Day 866

Having a couple of daylight hours still left after work is a luxury. This evening I was lucky. I walked aimlessly along the Southbank and ‘The F-word’ exhibition caught my eye. F for Forgiveness. Bold posters with simple, human messages from ordinary people from all over the world, telling stories that transform, offering a dynamic and challenging exploration of forgiveness through real life situations.

There is nothing ordinary about forgiveness. Forgiving others. Forgiving myself. I constantly struggle with it.

One mother said “When I was told that my son had been killed in action, the first words that came out of my mouth were ’Do not take revenge in the name of my son.’ It was a totally instinctive response.”

When Saagar passed away, one of the strongest feelings that came up for me was – no one should have to loose anyone they love to suicide. That was the driving force that kept me alive and goaded me on but forgiveness is a subtle and powerful thing that happens at another level. I am very conscious of the fact that it is something I really need to address but keep putting it off while it keeps gnawing away at me. Perhaps, it is not entirely by co-incidence that I chanced upon this exhibition.

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Ref: http://theforgivenessproject.com/