"is anxiety a curse"

She was admitted after a cervical disc herniation which lead to a neck surgery.She was paralyzed. Her arm and legs were off,no movement,no feelings.She was left mostly with emotions.She was anxious,she was crying.That was all very understandable as who would not be if ever in similar situation.

Then good things started to happen.Her arms started to move,her breathing got better and she was able to talk on a volume compensated wean.

The dilemma was her continuous struggle to feel out of control.She was having anxiety all the time so much so that it was compromising her medical care.Luckily help was available right there in hospital.

I have read a quote "a free and relaxed mind is always in meditation".I have also read that "there is nothing that wastes the body like worry, and one who has any faith in God should be ashamed to worry about anything whatsoever".

To some, anxiety is a curse,no amount of relaxation technique and or chemicals make it completely go away.

To others, a little bit of anxiety is a motivation to do well in all. Those are the one who know that keep watching your back all the time may lead you to trip and a fall.

"it is important where you put your energy"

There is a lot of change in health care,always new policies and procedure.This is a norm these days.
Who make those policies on a daily basis.
People compliant about politics and make a big deal about this and that.
Patient care,communication,customer service,cost management,all intertwined in modern medicine.
Results are read as a scale number zero to ten.Nothing stays same,look at yourself.

Where are we going?
Medicine is an art and science,not a business.
It is important where you put your energy.
There is nothing wrong in politics as long as you are not caught in politics.
Be a human,treat life and death as part of a process and die well as you die once.

"he was looking at me"

He was young and maintained to be alive by artificial means with a breath and a pulse.The rise of medical enterprise has made this possible.We thrive to keep pushing an earthly body till it get totally disintegrated either by dysfunction of organs and implanted devices or invasion by organisms.

He was brought in after a tragic accident from which he suffered multiple injuries. He was wrapped in bandages from head to legs with open areas at his eyes,mouth and neck.His wide open eyes were staring straight like looking at you.He was looking,each member of his family was convinced about that.

Sadly that was not the case.We tried to explain but it was hard for them to bear the burden of unwanted truth.He was brain dead that was the reality.

To some he was looking at them and what he was seeing,no one knew.It was like looking in dark,to see only dark.
To others he was seeing.That was their own self-limiting sight which made them blind of a reality they don't want to see.

As I saw him looking at me,I said hello,I will take care of you.I knew he can't see but I did it as a respect to his looking.

"dna of happiness"

A tear in an eye at the birth of a child.A smile on a face at the sight of a lover.
Happy moments,quest for happiness.A journey we all want.

She had trouble with her lungs,bladder and bowels so much so that her diseases start to define her as who she was.She was not happy,she was complaining,nothing seemed to working.No amount of reassurance brought her peace.

There were questions :"why she was not happy about anything".
Our answers were ,"one day at a time","body is not a machine","healing takes time".She was struggling to be happy so do we to make her happy.

What is so desirable about happiness that everyone wants it,to be happy,is it a feeling of have it all.

Some may decode DNA of happiness in love,money,material or success.To them it is a feeling of have it all.It is the proximity to a feeling of in control which makes them happy.

Others find happiness in contentment in what they have as that is all.They are the flag carriers of happy band of people who truly invite happiness in their lives knowingly that love conquer,contentment rule.

"one step forward two steps backward"

He was doing better but not yet out of woods.Life had brought its ceremonial dance of recovery,one step forward two steps backward.

One day he was on fast track to recovery then next day an emerging problem was taking away all gains as he developed fever.After few days he was feeling better then he got diarrhea.His mother got concerned about her son's recovery.She was counting steps,one step forward two steps backward.His recovery was unpredictable at that time.This happens all the times in intensive care,people take time to get better.

As his condition improved and days turn into weeks,his mother was cautiously optimistic.He was then two steps forward with occasional one step backward.

Some people develop synchrony with their ceremonial dance of recovery by acceptance while in the rhythm of chaos.Others invite impatience as their dance partner only to be miserable while recovery happen beyond their understanding in an ungrateful way.

Only a few encounter one step forward two steps backward with grace.Those are the one who keep dancing while music of uncertainty is on.They are the true survivors.

"if i only"

She was suffering from emphysema that had gone from bad to worse.Smoking cigarette was her thing,no quiting as we talked.

Her lungs were failing to exhale carbon dioxide which lead her to hospitalized.

As she started to get better and ready to be discharged,the importance of smoking cessation was reiterated.I saw a smile on her face,one of those when you think to have a winning argument,and she said,I may still get sick even if I don't smoke because of emphysema.The answer was yes.

She looked triumphed.

Then I smiled,it was a sober moment as I told her,"you will be the only person then to feel bad about yourself lying in a hospital bed telling yourself if I only had not smoked I may have better chances".

There was no wining as she looked sad.I hoped a message sink in before it get too late.

In life there are no guarantees as we have sayings like bad things happen to good people.The one thing make good people good is they have done the right thing when they are required.When bad things happen at least they are not to blame themselves.they don't have to fight if I only thoughts.

In grand scheme of things that is the strongest ally one can have.That is not to fight against oneself.

"it takes a lot of gut to follow your heart"

I have heard that before.

She was frail,recovering from a heart attack.She looked comfortable and her expressions were like a smiling face.She got married thrice,and always found a new love,she revealed herself.

She was on a roll that day as she continued,our heart speak a simple language from day one of our being in this world.That language never change but we grow up as we believe and start giving meanings to our heart's straight talk.

We never like straight answers especially if those come from our heart,she kept talking to me.That is the cause of all unhappiness and depression.

She gave me something to contemplate that day onwards.

To some matters of heart are beyond common sense and laws of probability.

Others dive in deep to have lines of communication with their own heart.They are the authors of ultimate love stories by following their heart. Those are the people who are guided through life's cake and chaos,like a marriage vow: in health and sickness be there as one.

"building a castle on soft sand"

I spoke with her family,she was not getting better.They were accepting the fact that their mom will die at some point in her hospital stay.

In the coming days she started to show some signs of stability but her prognosis remain poor.Her kidneys were failing with minimal output,lungs were venting on borrowed breaths.Though she appeared comfortable and lively.

The same family who once accepted the fact of life then start building a castle on soft sand.I saw a yawning of hope in the march of death.

This is life we all struggle to live,I heard from a colleague.

To some it is easy to see what is so obviously there and coming,that's the job of professionals.

Others who watch a slow death of a loved one live and die daily while waiting for the ultimate to flatten their castle on soft sand.

“many are called, but few are chosen”

I stopped reading the article until I read this "Many are called, but few are chosen.” I wondered,may be how it worked then and every day now.

He was admitted to hospital with a range of medical issues.Those conditions of encephalopathy,hypoxia and failure to thrive lead to final discussion with his family to decide as he would have wished in a situation like that.The decision was made for comfort measures only with withdrawal of medications not fit for the goal of passing away in peace with dignity:no pain,no suffering.

He got very comfortable,so much so that his survival day after day lead the most interesting question asked by his family,why he was not dying?

I answered them,he is a fighter.

Today as I was reading this "Many are called, but few are chosen",I got my answer.

"to step on magic carpet with anticipation"

Sometimes I struggle between what I want and what I get.I guess we all do struggle this way all our lives.

The other day there was a case of a young woman with a neuromuscular disease that had progressed to respiratory failure and dependence on ventilator.I wanted her to get better,come off ventilator,eat as she used to a few months ago.I was wishful and I had struggles.My conflict of mind and heart knocking on doors of my soul.I asked for be guided and I was lead to do my best.

Another case of an older man with end stage emphysema on high flow oxygen depriving him from eating,sleeping,talking.He was afraid of dying as if he ever fall asleep.He appeared to me like a warrior dying of his own fear of enemy.I wanted him to come out of his fear and breath life.I was wishful and I had struggles,conflict of mind and heart knocking on doors of my soul.I asked for be guided and I was lead to do my best.

We all do have our magic movements in our lives,you may see in the eyes of a lover or in the heart of a seeker.The mystery of universe revolves only if we keep asking and searching,the mystery resolve once we become part of it.

To some magic carpet and magic moments happen only in stories.
To others,magic happen on demand,they only have to do is to step on magic carpet with anticipation,"ask and you shall receive".

So I stood on my prayer rug then knelled and bowed my head asking for guidance in anticipation,"ask and you shall receive".

"walking in a temple,living in a prayer"

He was a physician,I met him after his admission for respiratory failure due to a progressive neuromuscular disease.He told me that he was a good one and he had diagnosed his own disease at least five years prior to his physician had diagnosed.
There was no treatment so he remained quite and kept his secret until now.

He was the most understanding patient I have ever met,he told me that he was not afraid of dying.He continued by saying that all his life he served his patient with humility,knowing that medicine has cure for a few diseases and most of time it is symptom management.He believed in honouring human life,the most sacred human attribute as a physician.

The other day when his condition got too unstable,I saw waves after waves of people visiting him.I came to know those people were his patients of all those years when he was walking in a temple,living in a prayer,his calling as a physician.

"a fallen Christmas tree on a side walk"

We are almost there, Thanksgiving is coming soon and then the festive commercial holiday season of Christmas. I was talking to him about future, hope and living for another day to have one more day to live..

He was depressed as being the youngest in his family of six siblings, he was the only one alive. He was well accomplished in his life and now at the cross road of time, he was alone. He told me,he never found time to get marry and have a family. His life was always on the go to end up like this, he said with sadness.

Then he asked me, have I ever seen a Christmas tree after Christmas day on a side walk to be picked up. People discard those festive trees after giving life with decorative ornaments,lights and laughs. He told me that he felt like that tree on the side walk of life.

He died in the winter of that year surrounded by his doctor and nurses.

As another Christmas season is in air it will remind me about him when I will see a fallen Christmas tree on a side walk.

But I also want to remember that when trees surrender leaves in winter,they regain it in spring,that is the cycle of life.

"life offer choices and chances"

He was admitted after suffering a heart attack then having a pneumonia.While he was recovering from a failing heart,he told me that his wife died after a protracted illness while he was in hospital.He regretted that he was not there when she had her last services.I saw tears in his eyes as he showed me his broken heart.

He was talking about his love,how he missed her,why that happened to him.He cried for his unsaid goodbyes.

He said,If only if he had a choice,he had taken that.But he had none as he was told then that his chance of surviving that heart attack was dismal.

Now he was alive,recovering and soon to be discharged home.

Life offer choices and chances in its majestic scheme of events.Lucky are those who have choices in life.Some may say that luck is a matter of chance not ones choice.

To some his survival from a massive heart attack was a celebration of luck,a matter of chance in hundreds.To others,his life here after will be a matter of choice he has to make,an opportunity he got by chance.

a patient care agenda: an organic solution

I have learned from holistic care gurus that organic foods and natural cures have no side effects.It sound like a cliche as nature has its own way of doing things, effects which we may not understand and probably not call as side effects as the effects may be rather not so dramatic or upfront.

Recently attending a primary care innovations conference from a leading medical school,it dawn upon me that as a physician group we are either too smart or no-so-smart. I wonder as we are being pushed to become administrators by using business models in our patient care.

Are we missing something really basic in our delivery of health care.This is the question, how to keep patient care simple?

The speakers with very effective power point presentations were conveying data.I saw spaghetti models,fish bone graphs and a slew of informative slides. The words of wisdom were focused on improving health care.It sounded like I can hear the foot steps of a reformed coordinated care model at our door steps.The idea of involvement of teams from office receptionists to physician assistants,nurse practitioners,social workers and physicians is simply wonderful.Another idea of patients being followed by phone calls,power of electronic medical records and creating a dialog among multidisciplinary teams is super wonderful.The one thing was beyond my understanding was that where were the patients as it was so focused on them with savings cost.

As patients focused care models being developed I think physicians are more and more pushed into a management model rather than a workable, passionate and compassionate model.I did go to medical school to serve humanity,I love this profession and the responsibility with privilege comes with being called a doctor.I just love it.I remember going to doctors office with my parents in a different part of world without any manged care.I know my parents loved and respected their doctors,I certainly did. I wonder what is so new when we talk about patient focused models, communications, coordinated care and home visits by a physician caring a bag and stethoscope.I have seen all that but what happened in last decade or so that we the physicians and our patients start speaking different languages,we now need to improve our communication.

I heard in the conference,one speaker saying that "patients get confused that why doctors ask so many questions while patient expectation is to get answers".The real challenge is to incorporate patients in their own care.This is going to be challenging as we know patients come from different back grounds,cultures,regions with different myths,expectations and realities.Each individual patient is a story in its own way,which we call as their history; present,past,social,family.

I think engaging patients in their care with developmental tools to enhance broad based partnership between health care and patient is one of the more rewarding and sustaining cost effective solution in our health care reform.One way of doing so lies in our education system by introducing a curriculum like being a patient what to do and what to expect with resources and simplified do's and don't.The value of preventive medicine in our school systems like drug addiction issues to safe sex education already exist.

Our future generation of texters and tweeters are certainly going to be more deprived of humanly face to face contact with a healing touch as our search for a coordinated electronic care is evolving.I certainly did not go to medical school to avoid an eye contact with a patient in my office to pay attention to properly clicking his symptoms on his electronic medical record.Something need to change but we need to keep humanity as our common destiny.

The concept of caring for a patient as a whole probably need to have a second look from a different eye to see and a different mind to vision.It may come from a patient or from a physician as middle man business concepts are taking away the real spirit of our practice of medicine.As we are stepping forward in our search for a patient driven agenda,an organic solution may be in spinning back to past.This may be a road to future success.

"love is too big to fail"

She was twenty five years young with a progressive neuromuscular disease,bed bound on artificial means of survival.I was told she like to watch television.

I saw she was living a life with her eyes staring at the television screen.
I saw dreams of some other day in the eyes of those who loved her and professionals who provided care.

I saw her world was confined with her limitations of body,mind and survival needs.
I also saw expansion of others world in love,compassion and acceptance.

Our lives on the planet earth sometimes take us to distenations of extreme compromise to raise us to the final gates of infinite humanity.The common destiny of us all beyond what we have taught of otherwise.

As I took care of her,I saw her family's involvement in those having similar condition.That was their life mission to stay together as a family to be there as life goes on.

"No questions asked,you can come back to your family anytime as together we stand",I was told.

I saw what I heard before,love is too big to fail.

"wearing nothing but a smile"

Her biggest attribute,according to her family was to wear make up all the times.

She was brought in to hospital with second stroke.Her brain was affected in ways of functioning:communication,perception and control.She was not the same person as she was a week ago.That was the statement by her family.She always wanted to look good.

The days were turning up into weeks.As we were dealing with her on a day to day basis her new attribute appeared as a smiling face.She still looked wonderful wearing nothing but a smile.

After all that happened to her,there she was with a drooling asymmetric face with a smile.

The prognosis was that she will never be the same by the stroke or some may say by the stroke of her luck. She may never need a mirror.

I wondered as whether that was an irony or natures balancing act,by taking away something in pairs and giving back in singles.

"our design as a human being"

Are we designed to have a Foley's catheter,a tracheostomy tube,a gastrostomy tube?

The question was actually a statement by many of us,we think out loud at times like that.

He was suffering for years from a host of illnesses of mind and body.He survived his siblings without knowing that.He remained in hospital being taken care of his body needs;skin care,infection prevention,nutrition support.

In his case,the quantity of life had way surpassed the quality issue.To be honest the quality was not that bigger issue from the beginning.The subject of cost at the end of life care,the emotional attachment of doing unselfish good,job security to have chronic patients,all can be applicable here.

To some,our design as a human being is well accommodating,to have tubes put into our bodies.This gives us a survival edge.
To others,no amount of intervention even putting our mouth on their mouth bring them back to us.This is life.

"tomorrow's headline"

He walked in the operation room to never walk again.He said,if he was smart enough he would had walked away from hospital that day.

Life,as usual threw a lemon but that was not making a lemonade moment,so I did not said a word.

He was diagnosed and treated for abdominal aneurysm.After surgery,his life changed from being on two feet to being paralysed hip down.

I saw his daily struggle for each and every drug,prescription,intervention we recommended.He always asked question,always refused in the beginning and always agreed in the end.As time went by I felt for him,who would not do what he was doing by going through what he had gone through.A tragedy of life;never to walk again.

Sometimes tomorrow's headline can be avoided but in his case a news became a tragedy.

To some,our disclosure in terms of risks versus benefit of an intervention is just a talk,nothing happens.To others,the worse possibility happens like winning a tragedy lottery.

"from your mouth to God's ear"

She was admitted with a fall which led to a broken neck.She required mechanical ventilation to keep her alive.Days of her life changed as she started to learn doing things differently with her disability.

One day she told me that she was never religious but wonder how can she become a religious person now.She was regretful of the lost time as she was turning eighty.As we talked about God and religion,she asked,where was God when she had a fall.Then she questioned,why that happened to her,what good has done to her by God by allowing her to fall.

As days turn into weeks and she was getting better,we did talked about power of prayers as it is;from your mouth to God's ear.

To some,a fall is a fall even though some fall raise them from a mortal to an eternal life of knowing.
To others,God's ways are His ways,we may or may not understand: "we have no knowledge but that which Thou hast taught us;surely Thou art the Knowing.the Wise".

"what is worse than pain"

Pain scares everyone but she was not one of those scared by pain.I had seen that.She had gone through many procedures for large open draining wounds but pain had not touched her as it did to us by just looking at her wounds.We always wondered why she was not in pain,and the best part of us always cried,she should be in pain.

One day as we did her wound care,she looked uncomfortable making noises.I asked her about pain on the scale of one to ten.She looked at me and said,pain is bearable but what I have is worst than pain,I am extremely nauseous.

To some,the notion of no gain without pain do not go too far.They may need to have luck on their side to have it all.

To others,what is worse than pain,it may be nausea.

"recycled emotions"

She came to us after a bad fall,she broke many bones.She had no complaint of pain, nor she ever reported any during our ward rounds,nursing care and rehabilitation sessions.

She was tough.She told me that she is just not into pills.One day,she looked quite uncomfortable so I talked to her about my concerns and how we can help in terms of her pain management.She agreed to disagree by saying that she is just sore,it does not hurt.

The next day during rounds I found her crying,I asked her about her pain and offered her help,she declined by saying she was not in pain.Then she continued by saying, the day was reminding her of husband's death twenty three years ago and she still feel so much pain,it hurts.

To some,physical pain is the ultimate cry for help.To others,recycled emotions bring back so much pain that even time cannot heal.

"beyond self righteousness"

I knew her since we joined our residency program,she was different from other residents.She was upfront,talkative and had a habit of smoking.

Now she was there with a terminal lung cancer.I was sitting next to her bed,her husband was sitting next to her.We were talking about memories of old good times.

I think this is the way people talk when they are going through bad times.All we did was talking and talked about those times when nothing was impossible,death and disease was not a possibility.Certainly not for us.

She told me about many things including how firm she was with patients who use to smoke.How much she struggled to quit smoking,and how she felt when she tried to convince patients to quit when she herself was struggling with it.She finally did.

To some,she was a hypocrite.To others,her act to save others with the same poison which was killing her was beyond self righteousness.

"self controlled experiences"

He had been in and out of hospital so many times that we all lost the count.Every time he went home he was back in hospital with something new.

He had real issues of heart and lung diseases,and he was told about being on a bonus life many years ago by his doctors.

As I knew him over his stay in hospital,I felt for him.His desires were simple like get better,go home,take care of his bills and house.The problem was his lack of understanding of his life reserves.His lungs,heart,kidneys and joints were not the same as before.

One day he told me that he want to do things in life just make him better.

To some their self controlled experiences of living a life make them miss the living with limitations and adjustments.Others do necessary adjustments to live with diseases as a part of human experience.

I found life's self controlled experiences are life limiting.Those struggle of living,as we know, takes away life from living and who wants to live a dead life.

"paradoxical hope'

She was dying young as I saw her during our daily morning rounds.She had a failing liver with all hallmarks of it.Her abdomen was distended,her skin and eyes were yellow and her face was pale.The only question came to my mind was,"what she has done to herself".

The sad part was that she was dying young just before the age of medical renaissance.
The age of stem cell now moving towards an age when organs can be build in near future.I thought that with a heavy heart.

As a day turn into a next day over those few days I saw her desire to be alive,she had a spirit of fighter though her chance was dismal.One day I sat down with her during her more lucid movements and told her that. She looked at me and said,"if I manage to be alive I am with my loving family here but if I die I will be with my loving family there".

Surely over next few days as her mind was getting more encephalopathic,she was more and more talking about meeting those who had gone before her.

To some paradoxical hope of remaining in the presence of their loved ones is a concept we ponder as we move on in our own lives. To others it dose not make sense to ask for the same whether alive or dead.

I think paradoxical hope is a mean to come to terms in whatever outcome we get and be in peace .

"wisdom of ages"

He was a successful businessman.He got older and sick.His problems included a complicated pneumonia,failing heart and an anxious mind.As he started to improve he got more anxious about his business.He knew it all,he had plans for next hundred years.

One day I asked him about his plans after his full recovery.He told me how other people are missing and messing things in his business.He would have done this way,others were doing things that way.I saw that he was not happy,he was worrying about everything;decisions,contracts,payroll,bills.

To some their aging experience teach them to delegate responsibilities and trust people.Others fight to regain their control as they have done all of their lives.The struggle of managing stuff keep them away from experiencing a chance,probably the last chance,to sit back,relax and let go of what is not so important.

I think the real adventure start with losing the control and being cool while watching others taking care of your stuff in their own style.That is the wisdom of ages:faith,discipline,unity.

"no wi fi required"

We all age with time.Our timing measure success,luck,rise or fall,you name it.I was talking to a grieving widow.She was in her sixties and whose husband passed away recently.The multitude of medical issues made it clear to us that it will take time to heal wounds inflicted by time and disease.
Her wounds included those of mind,soul,feelings and loss.

I was ill,when he died,I was in hospital.She told us when we had our ward rounds.
I don't know what happened to him,I was not there for him.I miss him so much. She said with tears rolling down on her face.

I looked at her and held her hand,during that moment I wanted to be honest and compassionate,not always an easy one.
I said,I am sorry for your loss,he is not in this world but what can we do to make this world as beautiful as your love for your late husband.

She looked at me,and said,Have you had lost a loved one.

As I looked at her eyes,she saw my teary eyes.She smiled,"I am a teacher with two masters degrees,I know all".

To some personal stories need a paper,pen and audience,others tell stories in tears with eye to eye contact as no wi fi required.

"When wives become mothers and husbands become fathers"

He was kept alive on a ventilator for respiratory failure for years.He was also suffering from dementia with no voluntary function.I met him and felt heart broken for his wife,who was visiting him,rain or shine,every day.She was changing his clothes,talking to him and talking to us on his behalf.I saw that she was keeping cartoon channels on TV for him.One day I asked her about him,as I knew him then only as a name with a medical history.I had no knowledge about him as a person,I wanted to know his voice,his opinion,his wants,his passions.

How was he when he was him,I asked.
He was a loving person.I love him,she replied and then start flipping TV to a cartoon channel.

All her routines;washing,cleaning,nurturing look like of a mother,protecting her precious bundle of joy.I could see a wife in love,I saw her hoping against a situation with no hope.

As I watched her caring for her husband,as months turning into years,I wondered how chronic diseases take toll on loved ones.I saw an interesting reality as I noticed when wives become mothers and husbands become fathers.

"quote"

"Faith is the power to stand up to the madness and chaos of the physical world while holding the position that nothing external has any authority over what heaven has in mind for you"

Caroline Myss

"I love being in love"

He was a writer and he was in bed.What a combination,he had all the time in world to observe and pen down his thoughts.His muse was the hospital environment so to say that.

All day while recovering from his hip surgery,besides physical therapy he was thinking and working on his novel.One day he asked me,what do I want,a loving heart or a forgiving heart.I knew what I want but that was not the point.

He smiled as he saw my reluctance and said,he will take a forgiving heart over a loving heart in a split second.

I wondered,what was so great about forgiveness that even love cannot compete.I did not ask that question.

Now I am reading his novel with a proclamation that a loving heart is a forgiving heart.

I love being in love!

"cactus in paradise"

From the time he was diagnosed,he never felt well.Every day was a struggle.

He was a naval personnel whose life was marred with exposure to asbestos.He developed mesothelioma as a consequence.The invasion of tumor progressed like a conquering army destroying every fiber of his being in its way.

One day during examination, I noticed his chest with a growth which eventually became something like a cactus.I saw that with open eyes,though I wanted to close them.

He did not suffered much as he died soon.I think back with a feeling of sadness.

How our experiences in life affect our psyche so much so that I prayed for his moving on in peace.I did struggle for that prayer.

I hope may there be no cactus in paradise.

"he was stuck in present"

There was no one out there to take care of him,I was told that he was hospitalized for years.His medical conditions warranted a level of care which could only be provided in a hospital setting.I saw him day in day out,starring at roof,drooling,connected to oxygen,feed by tube.That was his life.No word,no past,no future.He was stuck in present.

Sometimes It takes a life to give a life.In that situation,It felt like all that was taking life out of life.

The sad part was that he looked to me as being suffering without knowing.I knew that he had dementia.That not knowing was his blessing,I did not agreed.I felt his pain of not knowing.

I wonder what ones suffering does to other being may be the truest life lesson we are supposed to learn.
In our knowing and feeling of others suffering,the notion may not be to get down but to rise and stand up for those who cannot stand for themselves.
The weakest stand up may be feeling sad for a sufferer but the highest calling can be holding hands and pulling up the fallen ones.

I stood up for him as I remembered that humanity is our common destiny.

"obituary of a dream"

There can be an obituary of a dream,I agreed.But what I was reading was titled as an obituary of a love.How can love die,I am asking this question.

They were a so to speak a perfect couple,they met each other on a cruise while both vacationing though separately in their sixties.They fall in love and got married.The fairy tale stories are never ending though their story ended with a heath issue.He suffered a heart attack,sudden without any prior history.He underwent bypass surgery,complicated with a stroke,then pneumonia,ventilator support and later did not recovered.

Over days of care and keeping her informed,I learned as if their match was made in heaven,it appeared they were soul mates too.She adored him so much that I wondered how life sometime takes a life time to reveal.Why now was the question,like this ,to just take it away.

She told me that she will post an obituary,and I was reading that.

To some,love strike with a cupid only to pierce their heart to bleed,leaving behind memories to talk about without a celebration.

Too late,to end so soon,love is mysterious in its own way.That was her closing line.

"nature groom's us to grow up and grow out"

The purpose of life is to live with experiences.Some may say that life is a live in experience.Nature does groom us to grow up and grow out.The struggles of life brings questions like why good things happen to bad people and why bad things happen to good people.Why young die and old live,the disasters of wars, tsunamis, floods, earthquakes,famine.While lives of thousands change forever,lives of billions remain unchanged.There are joys,sorrows,issues of global warming, corruption,job security, traffic jams,births,marriage,divorce,disease.Every one live in experiences,some may say that we live in a recycle of experiences.

He was young and he wanted to be a basket ball star.All his heroes were game players.When I met him,we develop instant connection.He talked about every single game,he did not miss a single game.He told me that he was pretty fast in court.I saw his college video I agreed, man he was electric.

He was admitted to hospital after a gun shot.The bullet lodged at his spine.He survived but became paralysed waist down.He will never walk again.He told me once that life has played game with him.

Over years I saw him growing up and growing out.He got involved in life,with life,for life.He enjoyed game and talking about it.I wondered how person of his age got wisdom of ages for survival.He made us look tall,while he remained bed bound.

To some,when life experiences bring a challenge of survival they take it with a choice.Nature then groom them to grow up and grow out.Others struggle in their lives to experience more until they become ready.

"readiness to accept"

He was in hospital for almost a year,before that he was still ill.

When I met him ,he was a nonverbal,emaciated,contracted man.Only way to know about his ways of life was through his involved wife. She claimed that he was a good man.

I know that bad things can happen to good men and I know that there is a reason behind this,though our capacity to reason has its own limitations.Over all he was a good man stuck in a body with a stroke of fate.

Over time of his illness,his lungs start to failing then he became dependent on a ventilator.He got pneumonia,and develop sepsis.A decision was made to keep him comfortable via opiates and anxiolytics.We all were ready to accept the ultimate outcome,day after day,as those pass by in moments of anguish and struggle between life and death,we saw a life which does not want to leave a body.

He got better !!

His wife had tears of joy,she said,he always does this to her.Lord has answered her payers.she was ready for that for years.

I wonder,how much our readiness is enough to accept situations as they are,without a tear,without questioning and without doubting ourselves.

To some, they find readiness to accept with ultimate demise of hope in time.Others find their way to cope,as being human,in prayers.

"meeting strangers at the last station"

In our line of duty we meet total strangers,some of those become routine acquaintances,others become friends.

Even those who we serve as a face,touch our lives in a unique way,they guide us at our own crossroad of life's experience.We talk if they can then we know who they are.

The short coming of a medical record is the division of a patient's life into a format which includes present compliant,history and examination.The time constraint of modern day medicine practice create lack of a personal touch.

I am honoured to know so many patients who in the beginning were total strangers,who then became friends.They left at their time of departure,but meeting those strangers at the last station make me think,the fundamental question:how much success in this world is the real success.

To some,the last station in their journey is a hospital bed with a Tracheotomy,Gastrostomy and a Foley's catheter.I wonder what would they have done differently if the foresight of their limitations at last station had been thought through before hand.Our basic needs to breath,to eat,to void can make us so incapacitated that at times no amount of name and fame can bring those back.

Life is a journey and the purpose of life is to live with experiences without missing the sight of departure at the last station.Good byes can be so long.
This can be our own story in making,a foresight of what is important now and what future will hold.

"flowers are forever"

i saw her arriving in the ward on a stretcher with a bouquet of purple flowers neatly tucked in to her sides.
It looked nice but the overall picture was not so rosy.The multitude of health issues were there to deal with besides her age.She was 80 years younger who made you wondered how she managed out so far.

Overtime I knew about her,her pains,her life,passions and hobbies.One of her hobby was to send flowers to people in their good times and not so good times.I learned that flowers are natures gift,a way of decorating our lives with color,fragrance and delicacy.

I saw that every few days she was receiving a nice bouquet and her room was becoming a wonderland of exotic flowers.Flowers say it all even without a message card,she told me that. If I have to live again I will live as a flower she continued.

That was my last conversation with her.She left behind tons of flowers,all reminded us of her presence,even though she was not there.

Yes,I remember her words:flowers say it all even without a message card.

To some of us she touched our lives with a different perspective;flowers are forever as is her memory.

"wish you were here"

Life is not easy to live.The pain of hanging on is sometimes more severe than hanging in there.


I have heard enough stories of people losing their spouses at home.Sometimes expected though at other times suddenly in their sleep in their own bed just next to them.People live with a scar of unfulfilled love when that happen,sudden death,no warning ,no sign.

He was dying in hospital with cancer,a progressive,erosive tumor causing pain and suffering.His wife was there all the time,as were we.He was asked to have any thing and every thing what ever he would liked.He asked for a beer and his wife got it.I remember that afternoon,he had a beer,we browsed through his photo-album of world wide cruises,pictures of waves,wind,rain and shine.

He looked at me with a smile,rather strangely and said,I am glad I met you at this time.I can't thank you enough.

I felt tears in our eyes,no words,no voice heard though our silence said it all.He was dying,he knew that.

To some experiencing death with a dying spouse is as devastating as to others a death without goodbye,sudden unplanned.

How it happen,why it happen remain beyond mind and reason,though a desire of "wish you were here" stays on with those left behind.

"story of my life"

She was young and had issues of mind and body.I saw that she was bleeding from her forearm,as I walked into examination room.

I was told that she did cut herself.She had a history of that.Her whole arm looked like a scratch board with prior cutting scars.The bleeding from new cut stopped within minutes as I applied dressing.

So you will be getting a scar,don't do that,I told her.
She replied,I don't care,this is the story of my life.

To some living with a scary story give them a role in life,though a short one.Others recreate their story by healing their scars.

I do'nt know her story as there was no story teller.The only question I ponder is how to find those healers amongst ourselves who might cure scars.

"to give God a second chance"

He was young with no serious health issues,though taking care of him as a patient was not an easy job.

He was admitted with a complaint of severe chest pain piercing through front of his chest,all the way back to his spine.In ordinary situations,just this compliant can be a daring diagnosis.Though not in the case I was dealing with,as all of his tests came back negative.We all felt so relieved and happy as he was not a stranger patient,he was one of us.

I spoke with him afterwards,as what was going on.His test were all good but why he had this pain.He blamed all that to stresses in his life.I suggested that he should rest, keep faith and pray.

He responded that he lost faith since his younger brother died as a young man.I felt sad but still I said it,"give faith a second chance".He looked at me in a way that I still wonder what was that about. I felt a struggle deep down in myself as I told him "to give God a second chance".

I don't know how those words came to me,though I wish he may find faith,as he had it once upon a time.

Some may say that you can't lose something if it was your's before,certainly it include faith.

"quote"

"All that we are is the result of what we have thought. If a man speaks or acts with an evil thought, pain follows him. If a man speaks or acts with a pure thought, happiness follows him, like a shadow that never leaves him".

"miracles do happen"

He had suffered a massive stroke that was the reality and their life froze to a point where nothing was moving.

She sat by his side,everyday,talking to him and reading, though he was unresponsive. A bible by her side, many pages tabbed "so I can go exactly where I want to in a second". The prognosis was grim and she was so calm. Though lying so sick in the bed, a massive stroke having robbed his reason and presence, the aura of the strong and handsome man who was her husband could not be hidden. "He spoke to me today", she said so hopeful. 'Did he really?' we all wondered, medically seeming an impossibility.

So often loved ones see and hear what they want to. 'Maybe', we concluded, because this is what we all wanted to be the truth and, of course; miracles do happen.

"is knowing that is enough"

Her eyes were bright but full of fear.She was suffering from pain and anxiety along with diagnoses of multiple organ cancers.There was the struggle of a lifetime,to be alive with a decent quality of life.

One day she told me that she does not want to die and she will fight for her life.I knew that she knew the truth. I saw a losing battle but I could not say that.Her life was her own struggle knowing that there may not be a tomorrow.

The days of our life are counted on a calendar,likewise her years had been counted.We all walk around carrying a ticking clock without knowing that at some point our battery will ran out.She knew that her clock was dying.

To some,death is the departure from pain and suffering.Others fight to be alive to endure pain of living.

What is so great about life that we all cling to it as there will be no death. I wonder,is knowing that is enough.

"second best thing in life"

She was not young anymore,age always is a relative time-meter anyway.Her problems were different.She had acute and chronic medical issues ranging from respiratory failure with a tracheotomy,a feeding tube,generalized muscle weakness and developmental delay.

She did surprise her medical team by getting better with a speed only she could maintain.Once she came off ventilator,she start talking,a nonstop talk about her fiance,though none existed to our knowledge.

We did not confronted her,no one knew the truth behind her veil of mind.We were just happy for her.Her passion was obvious,she was on a speedy recovery and she was in love.

If our breath is the first best thing in life,some may ask what is the second best thing in life.I say,being in love.

To some,as we know, it may even take a breath away.

"love was in air"

Everyone of us have a story.Though everyone of us may not have a title of our stories.Truly just being alive is a story,as simple as that.

He was admitted with respiratory failure on a ventilator.He had a failing heart and a losing brain.He could not talk,breath,recognize.His life was dependent on machines and medicines.He was alive,as some of us said,because his time was not yet up.

His story was rather untold until I saw him while she came to visit him.In her presence,he started mouthing words,he was smiling,his heart rate went high and he needed medication.Everyone saw what happened but no one knew how it happened.

To some,life,love and soul mate remain fascinating aspects of stories of life.To other,how he felt what we did not, remain beyond reason and understanding.I felt though love was in air and he breath in as life.

"a persistent hugging state"

He was getting better day by day.He was funny and was in love.All of us were happy for his long awaited recovery until one night his heart rate got out of control.Matters of heart,as we know, are always serious weather in romance or in medicine.His heart stopped,the circulation of blood stopped and then with resuscitation he was revived. A life saved in front of us.

The cost was high.His brain got severely affected by lack of oxygen during moments when heart had stopped.Again in romance or in medicine heart rules brain follows.

Over days to follow his recovery,it was saddening.He was on a ventilator and he had developed contracted arms and legs.He was mouthing words,unable to recognize,unable to see,unable to voice love to his loved ones.

Life with its mysteries bring stuff which we interpret according to our desires.

To some, his tightly contracted arms againgst his chest were a persistent hugging state while others saw an incapacited man with a terrible outcome in modern day life saving endeavor.

Quote

"The consciousness of loving and being loved brings a warmth and richness to life that nothing else can bring"

Oscar Wilde