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So much love...!!!

It seemed that he had gone into a persistent vegetative state after a routine surgery. There was no identified toxic/metabolic/anatomic/structural/infectious/rheumatologic cause identified from results of a slew of extensive and sophisticated tests based on every possible near/far fetched hypothesis that could be tossed in the diagnostic process. His brain looked structurally normal with normal electric activity.But he continued to just stare blankly into the recesses of his room, like.... all hope of purposeful life had been sucked out of his existence, as heart continued to pound, blood flowed, lungs bellowed. But... to what end? What caused his neurons to be so benumbed... no one knew. I felt like I wanted to enter into his hippocampi /medial frontal area and tickle and see how they responded .

Only one thing stuck in the story : he had lost his wife to an acute illness a few months before.

I shivered at the thought when I heard the detailed story for the first time. I found it hard to picturize in my mind the fact that this man had slept beside the dead body of his wife for three days without alerting anyone of her death . They called him crazy and schizotypal, but  he had been a 'normal' guy before her death plunged him into craziness.

There was incredible sadness when one entered his room after hearing this story. Like he was one with his wife at last, and we were no one to intrude in to this seeming oneness of two persons. I knew then that he would die soon. I had seen my grandfather shrink into this absurdity of purposelessness without my grandmother had passed. All their lives they had been so passive-aggressive to each other, but in the death of another, the unmanifested love had played out like a gutting opera tristis a la Ivan Illych gradually stenosing all life.

I asked Psych- "Could this be catatonia?"  They said, " NO, please rule out an organic cause." 

I thought, "yeah, sure!!! "

I felt like asking, " could the diagnosis be Sadness? "


They would have called me crazy, I know.


Disclaimer: The details of the above mentioned situation are a figment of imagination only.

The Ritual by Abraham Varghese

Am so amused by some of the reactions in the comment section of this video.

The busyness of being busy

I have always struggled with when lack of novelty threatens sustaining interest in activity. I remember Louis Aledort's comment at MBA's Hematology CME, when I first attended this in Mumbai. Somehow his comments stood above Mammen Chandy's ode to Lorenzo's Oil. They stuck in my impressionable mind. He had alluded then that the redeeming moments during boredom ridden midlife/after-midlife crises are often an interesting patient, a serendipitous catch, a renal bruit you picked, an opening snap that others overlooked, an anion gap you chose to investigate that turned out to be the real thing, that reinforced your way of thinking. That maybe you should just do your thing, give 2 hoots to what people say, write, recommend. Because you are the one who is doing things in circumstances which surround you.

 It is important to ask yourself a question, to rejuvenate the juices or the physical exam skills, to sharpen your skill of diagnostication,to invent a way. You could be very good in adhering to guidelines and doing things systematically. But boredom/ lack of engagement will elicit an error in you if callousness or lack of conscientiousness towards the culture of safety does not.

I think it is important to be busy. But it is also important to decide what you wish to be busy with.