My Heart is Beating!

My heart is beating!!!

Me: Hi Mr. Jackson,  how are you feeling?

Mr. Jackson: I am fine. ( In a feeble voice)

Mr. Jackson was waiting in the holding for his CABG ( Coronary artery bypass graft).

He was very anxious and scared but was facing it like a brave heart. 

 (One of the perks of rotating with Anesthesiology is while I get to learn about wonderful anesthetics and life saving ventilation techniques, I also get to watch the great surgeries which is often not feasible with other rotations.)

Speaking of Braveheart, I recently watched the sacrifice scene from the movie Apocalypto, during my recent visit to the historical places like Uxmal, Chichinitza, Tulum and many more in Mexico. I felt so queasy after watching the butcher cut through the victim's chest , pull out the heart and squeeze it, followed by many more cruel acts.

Learning about the ancient Mayan history and human sacrifices over and over again from every guide at every tourist spot was making me sick to my stomach and I was unable to enjoy the scenes, because my over imaginative mind was visualizing the scenes, as they were being described.

Surprisingly, when I saw Mr. Jackson's chest being cut open, his heart being emptied into the machines and then paralysed, it didn't bother me at all. I kept watching the whole surgery in awe, without any hesitation. I knew that the expert surgeon with amazing finesse in his hands, a real Braveheart, was saving Mr. Jackson's life. Indeed, in my eyes, the surgeon was the superhero.

It was the similar beating heart, similar goriness but one was taking a life and the other was giving a life. Both the butcher ( a villain in my eyes) and the Braveheart surgeon ( a superhero in my eyes) were courageous enough to cut open someone's chest but one was ruthless and the other was very careful and protective.

The same courage and power  which could take someone's life,  when positive could prolong someone's life.

I feel so thankful to be born in an era where morals and ethics are so much valued. Where strong and powerful people assure safety of the individuals. It's a pity that we still have some people who like terrorizing other people. The recent blast at the Port Authority was very disturbing, moreso because my spouse gets off at Port authority everyday around that time for his office commute. Thankfully, when the blast happened, we were in Mexico for vacation. However, even the thoughts give me goosebumps.

History is very important. Especially when it is a sad one. So that, we can make sure , it never gets repeated. So that, we can understand the pain associated with the destruction caused by wars, nuclear attacks, massacre, bomb blast, air crashes or unpleasant rituals and can make sure that it never gets repeated.

I wish that the kindness could be instilled in to every beating heart. Empathy and love could be transfused into everyone's veins. And, perspective could be implanted in everyone's body.

It would be so wonderful if every heart that beats, beats for beating the cruelty and inculcating love.

My heart is beating!!! 

Jaya Sonkar

©All rights reserved. Jaya Sonkar 2017

Everything has a purpose!

Everything has a purpose! 

'This Thanksgiving, I want to take the time to thank all my friends, family and mentors, who served a great purpose in bringing me to where I am.'

If I wasn't born, I wouldn't know how beautiful life could be
If I didn't see deaths, I wouldn't find a deeper meaning of life

If I wasn't a patient, I wouldn't know what pain would mean
If I wasn't a doctor, I wouldn't know how fulfilling , healing others could be

If I wasn't rushed, I wouldn't know how relaxing, sitting in the sun and having a drink could be.
If I was never idle, I wouldn't know how accomplishing , tough work could feel.

If I didn't make a mistake, I wouldn't know how to fix it
If I didn't do things right, I wouldn't know how gratifying it could be.

If I wasn't a child to my loving parents, I wouldn't know what pure fun means
If I wasn't a mother to my beloved daughter, I wouldn't know what pure love means

If I didn't have my beautiful sister, who held my hands and was always kind
I wouldn't be so calm and reassured that she would be my spine, if I ever break mine.

If I didn't have an adventurous spouse, I wouldn't have explored the adventures.
If it weren't for his dedicated efforts, I wouldn't have enjoyed the tea on the tree house with birds.

If I didn't fall in the muddy puddle, from that bike, with my childhood friend 
We wouldn't have so much to laugh about, everytime we chatted

If I didn't have a failure, I wouldn't know what would success mean
If I didn't get success, the power of optimism and diligence would have gone unseen

If I didn't have that friend, who gave me courage and made me feel empowered
I wouldn't know how great a deed of uplifting others could be

If I didn't have the kind mentors and guides, who backed and encouraged me,
I wouldn't have understood how fulfilling teaching others could be.

If I didn't have those lovely friends and helpful neighbors,
I wouldn't be able to feel at home in a foreign land.

If I didn't get the kindness from others,
 how would have I paid it forward ...

If I didn't have that colleague, whose ego kept him blinded from reality 
I wouldn't know how wise the phrase, 'picking your battles' and 'letting go' could be

If I didn't have those wonderful colleagues, who backed me up in tough times,
I wouldn't know how wonderful having true supporters could be

If the clouds weren't there,
How would we miss the sunshine

If the sun didn't shine too bright,
How would we miss the rains

If the rains werent there,
How would we see a rainbow

If the winters were not there,
How would we see the snow

And if it wasn't for this Thanksgiving,  how  would I find a right time

To thank everyone who helped me brighten up my life.

A big thanks to all my near and dear ones!

- Jaya Sonkar

Post script:

As a child , I was made to say this prayer that is quoted below , everyday. I understand it's depth now.

"Thank you God for world so sweet
Thank you God for food we eat
Thank you God for birds that sing
Thank you God for everything."

Amen!

©All rights reserved. Jaya Sonkar 2017

The Human Touch!

A few days ago, I watched a Ted Talk about, "Present, Not Perfect" by Elaine Meyer. She explained very beautifully how one of her patients wanted someone just to be there to hold her hands and reassure her. How that patient didn't want a perfect doctor but wanted a nice someone to be there for her. Humans are blessed with emotions which can work miracles for the sufferers.

One of my most memorable patients was a very sweet old lady in her mid-80s who succumbed to a massive MI. I will name her Mrs. Jones in my story.  Her husband, Mr. Jones, was almost a 100 yrs old. He had never imagined that he will see her go. He was confident that he would die before her. But life took a turn and left him alone once again. 

When Mrs. Jones came to the hospital, she was somehow aware that she would not be able to make it. What did she want at that time? When Mr. Jones lost Mrs. Jones, what did he really want from us? They both wanted a human touch. They needed someone to hold their hands and listen to them, someone to give a rub on their shoulder, and perhaps a hug.

They were coming from a long journey which was at its last mile. They probably wanted to tell us about what they saw, what they learned, what they experienced and what were they concerned about at the end of the journey.

When Mr. Jones got the message that Mrs. Jones passed, his legs started wobbling, his heart sank and so did he. We held him and slowly lowered him to the chair. Tears ran down his eyes. It was 15 minutes of silence. Somehow, no words came to my mind. All I did was hold his hands and sit next to him. I couldn't break the silence. 

Mrs. Martha, one of the nurses gently interrupted and asked the family if they had any questions for me.The husband and other family members had no questions. The nurse then gently asked them to move aside so she could cover Mrs. Jones and get her ready for her final farewell.

Soon after everyone left, Mrs. Martha came to me and said, "Doc, it's 3 a.m. in the morning. You've been working hard all day and all night. Go, get some rest."

 I was lost in my own thoughts. I looked at her and asked her," Mrs. Martha, how do you deal with many such tragedies day in and day out."

 She smiled and kindly whispered, "You are very nice... I try. People in the hospital think that we have an attitude in this unit. But we have a heart too. We have to toughen up. But we are there for our patients. These two hands have held many patients' hands and helped them bid adieu to this world. Oftentimes, people pity when some patients are alone that those patients are going to die alone. Doctor... nobody dies alone here. We are there for all those patients."

Following week, when I went to the clinic, one of the attendings, Dr. Cool, was casually mentioning about what he wants after death, where he wanted to be buried and which car should be used to transfer his body. My eyes were awestruck. People plan for living and he was planning for what happens after his death. Another attending, Dr. Nice, who was observed my expressions, said, 'Don't be surprised, my friend. You are young. You plan for how you want to live. At our age, we know we will die sooner or later, so we all try to prepare ourselves for that.' 

Just a month later, I met another patient who lost her spouse in the morning and developed a heart attack herself soon after. When I went to see her, she was all tears and said, 'My husband is calling me. I want to go to him. But I am scared.' Fortunately, she had many family members to comfort her. All she needed from me was reassurance and a human touch.

When we are born, all fortunate ones get the warmth from our parents. It's said old age is a second childhood. The same warmth is needed again but not everyone is fortunate enough to get it.

What we can do on our end is be nice to anyone who is suffering. Give them a human touch. Show them that we care and are not mere machines who follow protocols.

Just as I was engrossed in my thoughts, I noticed one of our fellow doctors, Dr. Fluffano, who was very proud of his very special position, yelling at his colleague for a chair. In his mind, every chair had a rightful owner. I was surprised to see that. Then he yelled at another doctor for something else. Then Dr. Fluffano came to me and tried to yell at me for something that he assumed had happened, but was not true. At first, I was unhappy at his reaction. Then I thought that there must be a reason behind his unpleasant behavior with his colleagues which was earning him hatred from one and all. Could this be purely his ego, or could this be the power of his new position blinding him or could he be going through some problem which no one understood nor gave him a human touch?  

Instead of feeling angry, I started feeling sad for him and decided to help him understand the impact of his actions and where would they lead him. So, I helped him with some kind words. Hopefully, it will lead him to self-realization.

What really separates humans from other animals is intelligence and emotions. An act of kindness and a human touch can make a huge difference in any kind of outcome. It is not limited to patients. It is universal. Everyone needs someone who cares, someone who is there, someone who is present even if not perfect. It is always worth offering kindness to people and be present for them. 

Let's do one act of kindness every day. Let's be present for someone. Let's not make anyone miserable. Let's make efforts to add a human touch in the care we deliver. Would you like to join?

Disclaimer: The facts, identities, and incidents have been modified. Any resemblance to anyone living or dead is purely coincidental.

-Jaya Sonkar, M.D., M.P.H.

©All rights reserved. Jaya Sonkar 2017

Just Chill, Chill ! CODE CHILL!!! There may or may not be a second drill!

Disclaimer: The names of the patient, diagnosis and facts have been modified for the story. 

Just Chill, Chill ! CODE CHILL!!! There may or may not be a second drill!

Smiles!!! Hugs!!! Laughter!!! Happiness all around!

Yes, once in a while we do get happy endings. Miracles do happen. And when they happen for good, there is a vibrant energy all around which can make the toughest people shed a tear, give a warm hug and bid adieu with a big smile. 

This is what was happening when Mr Richard was leaving the Critical Care Unit. All the healthcare staff including myself gave him and his wife, who had been by his side all this while, our best wishes and warm farewell at the time of his discharge from the hospital.

Just a couple of weeks ago :

CODE BLUE Emergency Room Bed X! CODE BLUE Emergency Room Bed X!

I ran to the ER. That was the first time I saw Mr Richard. A young man of big built, health conscious individual lying dead on the bed with ongoing CPR . 'I feel the pulse', shouted the nurse. Mr Richard was still unresponsive. He was intubated and transferred to my Unit. Code Chill activated. All lines placed. Mr Richard chilling out with the central line, arterial line, esophageal probe, NG tube and tons of stuff. 

Mr Richard was lying unresponsive on the bed, sedated, paralyzed, on a zillion drips. Was he feeling anything or was he just chilling out while his family was all tears. Next day we started weaning him off Code Chill. He started showing some movements. We got hopeful. Over a couple of days, Mr Richard woke up, very agitated, still needing support for breathing. He recovered slowly and steadily, got rid of all the lines and tubes, got a life saving device, and finally got ready for discharge.

It was a miracle happening in front of our eyes. The entire team was very patient with his agitations while he transformed into a smiling and pleasant gentleman again. He was like the baby of the whole Unit. Everybody was looking forward to a great outcome on him. His survival filled everyone with a unique positive energy. 

As a small child, I used to wonder that when we keep food in the fridge it lasts longer. If we keep human beings in fridge, would they live longer. Well, in the fridge they wouldn't survive the cold.

However, our brain has better chance of survival and decreased risk of anoxic brain injury under the effect of hypothermia protocol after cardiac arrest.

When Mr Richard started talking, he barely remembered anything. All he remembered was that he was driving back from work and was on his way to pick someone. The next thing he remembered was when he regained consciousness on the hospital bed. He had a low speed motor vehicle accident which left him unscratched. His heart probably stopped and he probably tried to control his vehicle by slowing it down and moving it to the curbside. 

It's scary to imagine that anything can happen to anyone. Life is so unpredictable. Who knows who has what underlying pathology that may surprise one and all in weirdest and scariest ways.

There are admissions to ICU almost everyday. Makes one wonder that its someone's turn everyday. When uncertainty and unpredictability prevails, we should certainly make goodness and kindness predictable and prevalent too. Who knows, the person your are talking to, might be having his/her last interaction with you OR... vice versa!

Very few people are able to survive what he survived. Very few people are able to retain their brain functionality, the way Mr Richard did. Very few people get a second chance like him. 

Yes, he got a second chance! Not everyone does. Don't wait for your second chance. 

Jaya Sonkar, MD, MPH

©All rights reserved. Jaya Sonkar 2017

Open your eyes!

Open your eyes!

Me: Hi Susanna! Is Mrs Whitney here?
Susanna: No Doc! She is not here yet.
Me: Ok, Please let me know when she arrives.

I came to the call room. Somebody knocked at the door.
A colleague: This is my call room. I moved the table and chair from other room to this room. Its not nice.
Me: Hey, I wasn't aware of that. If it means that much to you, you can have it. All yours.
I vacated the room and went back to the patient floors.

Phone rings! Unit clerk speaks: One patient just arrived on the floor. Is that the one you are looking for?

Yes! That was my patient. Mrs Whitney. A soberly dressed woman in her middle age, wearing sunglasses, with a serene expression on her face.

Me: Hi Mrs Whitney, How are you doing? What brought you in today?
Mrs Whitney: I have been having this weird chest pain for the past week which is annoying.

Mrs Whitney and I talked for sometime to get more details around her problems. I needed to review her home medications. She opened her bag nicely and took out all the medications from the bag without difficulty, handed me the medications one by one. Then she politely asked me to put them back in her bag which she left open for me. She kept her sunglasses on all the time, while attempting to look at me. I put all her medications in her bag once I was done looking at them. Then she closed her bag and turned her face to front.

Me: I like your sunglasses. How are your eyes?
 I saw a little tear trickling down her cheek which she tried to hide and wipe away quickly as if something went in her eye.
Mrs Whitney: I am blind.

There was a pause.

Mrs Whitney: 5 years ago, I went for photocoagulation for some eye complication from diabetes. There was another complication and I lost my 1 eye. My other eye still perceives some light. In the past I could see everything.

Me: Are you able to manage your tasks. How do you take your medications? Is there someone to help you at home?
Mrs Whitney: Yes, I have my kids and my spouse. They help me. They put the medicines for me with big inscriptions. I am able to recognize them by feeling them and perceiving different cloud patterns using my better eye.

Me: Mrs Whitney. You are a very fine person and a strong woman. I am very happy to see how you carry yourself and be as independent as you can. I will help you out with your other problems and will keep you posted once your results are back.

Mrs Whitney: Thank you!

As I walked out of the door, I closed my eyes for a few seconds. I was scared to imagine how it would feel if the eyes would shut down permanently. I remembered doing this in the past when my mom was legally blind before she got her cataract surgery. She still painted beautifully with her mind's eyes. Thank God! my mom sees good now. Touchwood! I opened my eyes, went back to my desk and placed orders for Mrs Whitney.

The thought kept bothering me.
I don't know how Mrs Whitney bravely accepted her fate. May she get the best in her future.

Life can change so much over time. This woman who could see in the past, can not see anymore. Which means she cannot do so many things now. Her life would be filled with darkness. She would not be able to enjoy light, nature, colors, people, things mundane or spiritual! She would not be able to drive around independently.

Life has so many uncertainties. At one moment you can be at the peak of the mountain, the other moment you can fall off the hill.
One should do one's best to make use of every moment in living one's life to the fullest. We must indulge in doing meaningful things and help others. There is no room for hostility, enmity, quarrels, egoism, competition or power play when there are so many peaceful, beautiful and meaningful things to do and enjoy.

Everyone is unique and everyone is a winner in one way or the other. The real power is not in being bossy to others but is in controlling one's own mind and ability to let one's inner angel win over one's inner devil. The real victory is to rise in one's own eyes through good deeds and leave a good mark in someone else's heart. The real possession is not possession of wealth or material but is of the inner peace...'Inner peace' which brings eternal joy, which is beyond any kind of power or praise.

As I continue with my journey in pursuit of inner peace and happiness, I also wish everyone else, success in attaining real power through inner peace and joy.
Open your eyes! Enjoy your 5 senses, while you have them... coz' you never know! Bon Voyage!

-Jaya Sonkar

Disclaimer: The names of the patient and the facts have been modified to put it in the form of story. Any resemblance of any other character in the story to anyone living or dead is coincidental.

Thanks for reading!

©All rights reserved. Jaya Sonkar 2017

When Love, Love, Love will Sail!

When Love, Love, Love will Sail !!!

Life is love, Love is life!

The sun and the moon
The night and the day
The light and the dark
The love and the hate

Reward and punishment
Success and failure
Comfort and fear
A smile and a tear

Life is a package
Full of wonders
Sometimes it is smooth
Sometimes it's a thunder

It is sleet, it is snow
It's a cloud, it's a rainbow
It is real, it's a shadow
It's a cliff, it's a meadow

Should I leave, should I stay
Should I fight, should I pray
Should I relish, should I resist
Should I give up, should I persist

Should I demand, should I submit
Should I accuse, should I admit
Should I believe, should I doubt
Should I bury, should I scout

Should I move on, should I look back
Should I release, should I stack
What is right, what is wrong
Am I weak, am I strong ...

Many years have gone
A thousand more to come...

Should I sow, should I reap
Should I shred, should I weave
Should I sing, should I scream
Should I live, should I dream

Should I hide, should I seek
Should I hurt, should I heal...
Should I love, should I hate
Should I quit, should I wait

For the moonlight, for the sunshine
For my soul, for my life...
I give and still love to give
I live and still love to live

Every moment is unique
Every feeling is mystique
Every charm is real
And reality is bleak

I have faith, I believe,
It will happen one day
My faith will not dwindle...

When the stars will twinkle
When the moon will shine
When the sun will be cool
And the rainbow will sublime

When the snow will be warm
When the fire will be frail
When my soul will be free
When the freedom will prevail

Then love, love, love will sail !!!

Happy Valentine's Day !

-Jaya Sonkar

©All rights reserved. Jaya Sonkar 2017

Losing a limb!

Losing a Limb!

'So Mr Henry! Did you think about it?'

Mr henry: Let me ask you something! Are we playing beauty and the beast here...'Wait, let me get this right , I am the beauty here and you all are the beasts.

You all might be good to me but I am scared of you all. I don't think, I am ready for it yet. May be I will get a heart attack before I get to that...'

Mr Henry is an old man who has lived his life the way he wanted. He has multiple co-morbidities including immunodeficiency, Diabetes, peripheral artery disease and many more problems. He recently is struggling with one of his legs which is dying, and before it spreads further, the leg needs to be amputated.

When I first met Mr Henry, he appeared to be a difficult patient, who barely answered the questions, didn't agree to the tests and management, was offensive and angry all the time. We had multiple specialties working on him to plan the best treatment modality for him. Unfortunately, the best solution that we came up with horrified Mr Henry. We gave him the solution to get rid of his leg and he gave us 'No' for an answer.

When I went back to see him again, I found a little child within him. He pointed out his feet as if it was his baby. He gently touched his feet and said , 'it has a little rough skin around it and feels very cold. Can you give me a cream and a soft blanket to cover it. May be it will get better with care.
Can anyone here clean up my feet and remove the dead skin. Then my feet will look good.' As he was speaking, I saw his scared eyes brimming with water.

I was quiet. So was he. After a momentary pause... he said, 'that wont help, right? ... May be , my failing heart will die before my leg dies. May be my leg wont die... Can I come back if it worsens. will you still take care of it?'

I nodded at him with a smile, patted his back and came out of the room.

Just before coming out of the room , I noticed that Mr Henry had a new pair of shoes lying next to his bed, which were stealing his attention while he was talking ... he probably wanted to dance with his daughter on her wedding, wearing these shoes. The poor old man was struggling with keeping himself and his leg alive.

I recently bought a pair of beautiful shoes for myself and had been waiting to put on them next time I went out. What if....I don't even want to say it!

We always judge people with their behavior but we often forget to realize the situation they are in and the forces that are driving their behavior. Every body including me was frustrated with Mr Henry for his offensive demeanor and non compliant and uncooperative attitude. I was unable to understand Mr Henry until I put my own feet in his shoes. May be I would have been the same if I was him. May be I would be terrorized too. May be I would be double minded too. May be I would have returned from the OR too.

My mentor always used to tell his diabetic patients, every part of the body is important, so take good care of it. You lose a toe and you will realize how important it was for you... i just realized the depth of it.

Whatever may have been, I know for sure that I would have needed warmth and patience from my caretakers. He deserved a patient ear and a smile , like any other patient.........and thats what I gave my beautiful patient through my beastly appearance of a doctor ...

'Wish you well, Mr henry'.

(Disclaimer:
The name and facts have been modified in the story.)

-Jaya Sonkar

©All rights reserved. Jaya Sonkar 2017