caregivers Posts

“Keep Sharp” by Dr Sanjay Gupta

Dr SanjayGupta’s new book, Keep Sharp, is an absorbing read about how to keep oneself fit and healthy, especially our brains. He shares the widely held belief that grey matter stops developing in early adulthood. But now new theories say that that is no longer true. The brain can remain sharp if encouraged to do so by adopting better lifestyle behaviour such as regular exercise, eating home cooked food ( preferably slow cooked and less reliance on takeaways), meditating, reading more, less of digital consumption and definitely hydrating more with regular water than sugar-based drinks. His concern stems from the growing number of people who are diagnosed with dementia, a condition for which no known cure exists as of now, but cannot be ruled out in the near future given the rate at which medical science is advancing. Dr Gupta, who has travelled widely as a reporter with the CNN and continues to practice as a brain surgeon recognises the urgent need to appeal to people while they are healthy to take charge of their lives. He is very keen that folks wrought a change in their life now with the hope that it will mean a better old age. He also focuses on caregivers or as they are defined as now, ” invisible second patients” and the need to understand the stress that they imbibe. Caregiver burnout is very real and hence, self-care is critical. Perhaps it’s design in the book is unintentional but the message that comes across is that devastating impact of caregiving is akin to being in a war zone. But he states often enough in the book that “I’ve noted that the people who live better– and longer — are the ones who hold on to hope.”

I like the way he has likened caregivers to “invisible second patients”. Apparently it is parlance commonly used in the medical fraternity. It has not been coined by him. But at least he has made it visible to the lay reader and I think by doing so, it has been a phenomenal act upon his part. It is almost cathartic for a medical professional to recognise how stressful caregiving can be.

Having been a caregiver myself for many years, it’s heartening to read an experienced doctor confirm many of the practices that one has unwittingly woven as regular practice into one’s life. For example, eating a balanced diet, preferring slow cooked homefood to commercial food, no snacking, water vs juices/sodas, daily exercise, reading etc. Perhaps it happened by witnessing the slow degeneration of a healthy individual. A large part of the cargiving is taken up by creating the right meals and exercise. So basic. As he constantly emphasises in his book that these are some aspects of one’s cargiving that should be non-negotiable. Everyone is busy but not busy enough to fit in some self-care on a daily basis. It helps in the long run as he can affirm from the patients he meets or the autopsies he has conducted and reviewed the state of brains.

Dr Gupta has created as 12-week brain training programme that may sound easy or tough depending on the nature of one’s current lifestyle. But it is doable. Worth exploring.

Read it.

3 February 2021

Of books tackling medical science

Of late there have been a deluge of books making exploring medical science accessible to the lay reader too. This recognition of making technical knowledge available to the public in manageable morsels is a remarkable feat.

Maylis de Kerangal’s  Mend the Living is a novel about a young man who goes into an irreversible coma after a car accident. His organs, including the heart, are to be harvested. Mend the Living is primarily about the heart being transplanted. It is a haunting book for sharing different perspectives of all those affected by the death of Simon Limbeau. It is not only his immediate family — his parents, younger sister and girlfriend, but also the medical personnel responsible for Simon and the patients who would be receiving his organs. It is an extraordinarily mesmerising story, almost poetic in its narration, which has been translated fluidly from French into English by Jessica Moore. Here is a fabulous interview of the author by the translator published in Bomb magazine who insists “I have a strong conviction: I consider the translator as a writer, an author. I always have the feeling of being a translator myself, translating French into another language, which is the French of my books. All this nomadism of texts, the movement from one language to another, I find it so stimulating and rich. I don’t want to say at all that books’ themes, subjects, and stories don’t interest me, but for me what comes first is how a book provokes an experience of the world via language. So all these foreign languages remind me of the fact that I feel like a translator myself, and that translators, in a way, are the authors of these books.” Mend the Living, a work of fiction, won the Wellcome Book Prize 2017 — a surprising choice given that most often it is awarded to non-fiction.

Poorna Bell’s memoir Chase the Rainbow  is a tribute to her husband who committed suicide. He was a journalist who was able to mask effectively his acute depression and heroin addiction from everyone including his bride! It was only some years after her wedding did Poorna discover the truth by which time they had not only lost their home but were deep in debt. Mental health issues plague many but it is rarely discussed openly for the social stigma attached to it. Slowly there is a perceptible shift in this discourse too as more and more people are sharing their experiences of grappling with mental health issues or with their loved ones. This is critical since the caregivers too need support. It always helps to share information and challenging moments with caregivers in a similar situation without being judged — something those on the outside inevitably do.

Another fashionable trend in narrative non-fiction is to write histories of a significant medical occurrence. In this case Speaking Tiger Books has published the doctors-cum-writers team Kalpish Ratna’s competently told The Secret Life of Zika Virus . 


Bloomsbury has published a former consumption patient and scientist Kathryn Loughreed’s packed-with-information account Catching Breath: The Making and Unmaking of Tuberculosis  

Many, many more have been published. Many are readable. Many are not. It is a fine balancing act between an overdose of specialist information and storytelling. The fact is ever since access to information using digital tools became so accessible there been a noticeable explosion of science-based texts in publishing worldwide and it is not a bad thing at all!

An article worth reading is by Dr Siddhartha Mukherjee in NYT “The Rules of the Doctor’s Heart“, published on 24 October 2017. It is about his experience as a senior resident at a hospital in Boston in the Cardiac Care Unit, a quasi I.C.U. where some of the most acutely ill patients were hospitalized. One of his patients was a fifty-two-year-old doctor and scientist who had been admitted to await a heart transplant. It is an incredible essay!

Maylis de Kerangal  Mend the Living ( Translated by Jessica Moore) Maclehose Press, 2017. Distributed by Hachette India 

Poorna Bell Chase the Rainbow Simon and Schuster India 

Kalpish Ratna The Secret Life of Zika Virus Speaking Tiger Books 

Kathryn Loughreed Catching Breath: The Making and Unmaking of Tuberculosis Bloomsbury 

6 Oct 2017 , updated on 30 Oct 2017 

Anne-Marie Slaughter “Unfinished Business”

unfinishedbizSheryl Sandberg and I agree on many things. We both encourage women to speak up and take their place at the table; we both want to see many structural changes in the workplace. To some extent the difference between us is largely a matter of which side of the equation to emphasize — a difference that, on my side, at least, is a function of relative age. I would have written a very similar book to Lean In at forty-three, Sandberg’s age when she published her book. My kids were very young and I had never met a work-life challenge that I could not surmount by working harder or hiring people to help out. By fifty-three, when I wrote my article, I found myself in a different place, one that gave me insight into the circumstances and choices facing the many women who have found that for whatever reason, leaning in simply isn’t an option. 

Anne-Marie Slaughter’s Unfinished Business was published in 2015. It is a book based upon her extremely popular article published in the Atlantic in 2012, “Why Women Still Can’t Have it All” (July/Aug 2012, http://www.theatlantic.com/magazine/archive/2012/07/why-women-still-cant-have-it-all/309020/ ). It went viral. Three years later this book was published and another article in the Atlantic. This time by her husband, Prof. Andrew Moravcsik called, “Why I Put My Wife’s Career First” ( Oct 2015, http://www.theatlantic.com/magazine/archive/2015/10/why-i-put-my-wifes-career-first/403240/ ). She also did a TED talk in 2013, ‘Can we all “have it all”?’   ( https://www.ted.com/talks/anne_marie_slaughter_can_we_all_have_it_all?language=en ).

Of late there have been many conversations about women, feminism, the work and home balance etc. Many puritanical feminists firmly believe that men should do their share of household chores and chipping in with parenting etc. Many women are made to feel wretched for not being professional enough at work if they mention their children and family responsibilities as being of concern too. Many women are denied opportunities to grow professionally for being mothers and having a family. Being a single woman or preferably a woman without children raises the chances of professional growth exponentially. But seriously, is it important to lean in so much that either work or family suffers? Why cannot it all be seen as a slow dance that evolves and grows?

Anne-Marie Slaughter’s Unfinished Business is the feminist bible for now.  Another text may come along and replace it very soon given with what speed content is being uploaded on the internet. But for now this book works wonderfully well. Its arguments about striking the balance, importance of family and institutional support for working women, essential to have male role models like her husband who opted to look after the children without any hassles and of keeping egos at bay. Many marriages fall apart since it is so deeply ingrained in society that the man should be earning more than the wife and if roles are reversed, even when the husband is supportive, societal pressure can get to be so much that it puts undue stress on the relationship.

Personally I feel that many of the institutional structures are based on a very fixed linear notion of how time operates, inevitably a patriarchal construct. Whereas most women work on “stolen time” especially when there are children involved and they are the primary caregivers. Alas, it is this masculine interpretation of time as being linear that dominates our daily function. Motherhood is a slow, nurturing process and sometimes it is the mother’s presence that is required more than the father’s — an argument that may not go well with too many traditional feminists. Similarly with work responsibilities and one’s career. But it is true. Feminism is not simply about being empowered by acquiring more masculine characteristics to prove that irrespective of being born a woman, you can do everything on an equal if not a better footing than a man. Modern day feminism is about being an empowered woman who has the ability to voice her opinion, make her choices and stand by them. Women negotiate and make choices on a daily basis in whichever space they inhabit. This is why Unfinished Business is relevant for everyone.

Read it.

Anne-Marie Slaughter Unfinished Business Oneworld Publisher, London, 2015. Pb. pp. 330. Rs 499

24 February 2016

 

Being MortalIf we shift as we age towards appreciating everyday pleasures and relationships rather than towards achieving, having, and getting, and if we find this more fulfilling, then why do we take so long to do it? Why do we wait until we’re told? The common view was that these lessons are hard to learn. Living is a kind of skill. The calm and wisdom of old age are achieved over time.  ( p.95)

…Three Plagues of nursing home existence: boredom, loneliness, and helplessness. (p.116)

Reading award-winning writer and practicing general surgeon Atul Gawande’s Being Mortal was such a cherished reading experience. His basic premise is that the conversation with people who are severely ill, with slim chances of recovery is one of the most difficult tasks a medical practitioner has. His insights into caregiving, an analysis of the US healthcare system, assisted living and an understanding of the Indian family social structure offering support similar to hospice care abroad are sharp. For instance something that is often noticed in practice, but rarely uttered is how many daughters look after their ageing parents. Yet the mantra in society, at least in India is, a son is important to have since he will care for you in your old age. Whereas Atul Gawande points out quite rightly too, “your chances of avoiding the nursing homes are directly related to the number of children you have, and, …having at least one daughter seems to be crucial to the amount of help you will receive.” I marked the book extensively and scribbled comments since it resonated with me. Having been a caregiver for my ailing grandfather, familiar with the excruciating conversations about enemas, maintained a funeral notebook where he had detailed the arrangements and been responsible for telling my surviving grandparents that their spouse had died, Being Mortal is a godsend. Atul Gawande’s perceptive observations about caregiving, mortality, longevity, quality of life as opposed to honouring the Hippocratic oath echo conversations heard often amongst caregivers. There is much, much more to read and discover in this book. Read it. Buy it.

Atul Gawande Being Mortal: Medicine and What Matters in the End Hamish Hamilton, an imprint of Penguin Books, New Delhi, 2014. Hb. pp. 282. Rs. 599 

12 Nov 2014 

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