Wednesday, May 29, 2019

Meet People Where They Are!

Meet People Where They Are!

As I was enjoying listening to the wise men and women at the Annual Geriatric Conference, something penetrated deep into my mind.

It was the phrase, 'We meet people where they are.' It was said in the context of a research grant where it was advised to link the value of the research to the values that the donor had. But the context was not exclusive. This applies universally! The best way to engage with children is to be like one and meet them where they are.

A few months ago, I met a very sweet and homely woman in the park who brought her children to the park to play. We looked at each other and smiled. We greeted each other and introduced our kids to each other. Her warm demeanor made me feel very comfortable. 

I am a quiet person and generally don't have much to talk about if it is not medicine or work-related. Fortunately for me, she was a great communicator and had an enormous treasure of things to tell. She spoke and I listened. I enjoyed listening to her speak about different foods, recipes, different clothes, tailoring techniques, and community parties. She was very kind to invite me to the various religious and community events which I would have loved to attend if my schedule permitted.

Initiating and facilitating conversations that are engaging can be challenging. Meeting people where they are and linking your ideas to their interests may be easier. I found myself being good at that. I enjoy food, appreciate fine clothing and of course am all ears when it comes to parenting techniques. I could relate to the things that she talked and we had a long engaging conversation and became good friends.

I had several other such experiences in the past. They all started coming to me one by one.  Along with the pleasant memories, some unpleasant interactions struck my mind too.

Coming from an emotional background, care and affection is embedded in my DNA. And that is how I look at things. I was able to get along with people who were sensitive to other people's emotions but wasn't very comfortable with the ones who weren't. In life, we have to interact with all sorts of people. And every personality has a value. They all play a role in making the survival of humans possible.

To be able to come to terms with people, we need to understand their deep values and talk to them in terms of those values. Just like the wise researcher said, to submit a grant for a cause that is aimed at improving well being among people, it should also be tied to expected favorable and cost-effective outcomes for the people. This will not only promote understanding among each other but will also lead to a collaborative approach in making a positive difference.

In summary, whether it is to get anybody's buy-in for any cause or it is to make a pleasant conversation with someone, we need to find where they live and then we go there and we meet them where they are. And some of them may come to you and meet you where you are!

Jaya Sonkar M.D., M.P.H.
5/29/19

©All rights reserved. Jaya Sonkar 2019

Wednesday, January 9, 2019

New Year& Resolution For All!

New Year's Resolution!


I will not be upset,

I will not be mad

I will not let anyone

Make me sad

There can't ever be enough

Of what one has had

I will expect things

Both good and bad


I will love myself 

As I love others

I will be kind to myself 

As I am to others

I will continue to work hard 

To achieve my goals

I will still wear several hats

And play those roles


I will believe in goodness

I will believe in fortune

I will believe in struggle

And earn my silver spoon

I will help people in need

But not be taken for granted

I will not let any seed

To be wrongly planted


I live in my body

That is my precious place

I live in my mind

Not in outer space

I will keep them pure

I will keep them clean

I will keep them pretty

And lush green


I will keep my conscience clean

And have a pure face

I will not let anything

To dampen the grace

My morals will not be shaken 

My kindness will not be taken

The goodness will prevail

As I will sail, As I will sail


Jaya Sonkar

1/9/19

©All rights reserved. Jaya Sonkar 2019

Sunday, January 6, 2019

Happy New Year!

Every year is born new and every year gets old.
Every year has its life story to be told
Some stories are good and some stories are not
Some memories are good and some memories not
Some experiences teach us a few, and some a lot
What really matters? It is a food for thought
The new year is here again, to be embraced
There are new joys to be shared and new challenges faced.
Let's be ready to open yet another door
And be ready to explore
And challenge ourselves more and more
And see what life has for us in store
Wishing everyone health, wellness, success and more
HAPPY 2019, Let's soar, Let's SOAR!!!

- Jaya Sonkar
6/1/19

©All rights reserved. Jaya Sonkar 2019

Friday, November 2, 2018

Be true to yourself!

Moment of truth

It will be forgiven, It will be forgotten
By all but self

Be your own Santa, Be your own Elf
Be your own God and let yourself tell
The right and the wrong
To your very self
Because in the end
It is no one else
It is just yourself
It is just yourself

You will be forgiven, you will be forgotten
By all but self
By all but self

When you look in the mirror
Do you bring a smile to yourself 
When you are without a peer
Are you happy with just yourself
Are you able to sleep sound
Are you able to eat well
Is your conscience clean
Is your mind swell

Tell yourself the truth
Before you go to bed
Because in the end
It is no one else
It is just yourself
It is just yourself

It's time to check your own soul
It's time to check your own self
You will be forgiven, you will be forgotten
By all but yourself
By all but yourself

Jaya Sonkar
11.2.18

©All rights reserved. Jaya Sonkar 2018

Friday, September 28, 2018

Medicine is unique!

https://www.tedmed.com/talks/show?id=528918
Great talk by Dr. Pamela Wible!
After a long day of work, a simple question like how are you, how was your day, is there anything I can help you with or a simple gesture like a warm hug, a pat on the shoulder, the touch of the hands is much more comforting and valuable than anything else. A million-dollar cannot buy one the comfort that these small things can.
Medicine is not about writing a note to submit to the insurance company for billing nor is it about saving the notes as a defense against a potential lawsuit. Medicine is not a matter of the bottom line. There is a difference between a factory and a hospital. What works for Mc Donalds and Burger King may not work for Medicine. Perhaps, its time for the insurance companies to realize that Capitation would not necessarily lead to high standards of healthcare. Instead, it can lead to multiple readmissions and closing of the hospitals. Perhaps capitation is decapitating Medicine itself and the treatments have become mere reflex actions based on algorithms instead of involving critical thinking. If the human body was as simple as machines, it would work perfectly. Fortunately, human beings are not machines, they are very complex human beings. Perhaps we need something else. Perhaps its time to bring the human touch back into the world of Medicine.
Doctors are not and should not be treated like assembly line workers for the sake of humanity. There should be some respect for the super amazing human body and its caretakes should be treated differently and somewhat uniquely.
Medicine is a very unique profession. It indeed bares all the nerves in the process of becoming a doctor. We see the full cycle of life: birth and death in a day. There was a time when the word 'death' was so scary to me that I wouldn't even allow my ears to hear it. Now I see it and don't blink.
One of the recent wellness talks revealed that doctors are the strongest personalities when they start but the system and personal or professional struggle beats them down to a level that they find ending their lives as the easiest solution.
Doctors use every single neuron in their brain for critical thinking, they use every single myocyte for running around day and night to make their patients rest comfortably on their beds, they force their eyes open for their patients to get a sound sleep. They miss their meals to make sure that their patients eat well. Doctors work very hard. After all the hard work, they don't deserve a tragedy in the end. They deserve a happy ending.
It is very hard to understand the struggle unless one is in the same profession, that's why it is even more important to share these Talks. To all those who have a spouse, a relative, a friend, a neighbor or even an acquaintance as a doctor, please be very kind to them, especially when they are post-call. Please do not forget to ask them how was their day, maybe give them that warm hug. Who knows they might just have declared someone dead.
Dr. Pamela Wible has done a beautiful job in spreading awareness. I just felt like sharing her work forward. My heart goes out to all those who have lost their lives. They deserved to live and save lives.
-Jaya Sonkar M.D., M.P.H.
9-28-18
©All rights reserved. Jaya Sonkar 2018

Wednesday, March 21, 2018

Let the sunrise of happiness begin!A three by three table of happenings and a step towards happiness!

A three by three table of happenings! - A step towards happiness

Act matters more than the outcome. Intent matters more than the act. And perception matters more than the intent.

Let’s take a small materialistic example,


Positive Intention
Negative Intention
Unintended act
Positive Perception
Happy   :)
Happy :)
Happy :)
Negative Perception
Sad :(
Sad :(
Sad :(
Proportionate Percerption
Happy :)
Sad :(
Undetermined :|

Person A wanted to gift beautiful clothes that person A really liked, to persons X and Y. Person B bought beautiful clothes for two friends but those friends left, so s/he thought of giving it to person X and Y, so that the clothes could get utilized. Person C also bought the beautiful clothes for persons X and Y with an intention that that clothes are beautiful but persons X and Y will look fat in those clothes.

Person X has a very positive outlook. Person X was happy when s/he got the clothes from Person A, Person B or Person C regardless of the intent behind them. Person X thought that the clothes were very beautiful and if s/he worked out a little, s/he could fit in the clothes. If person X wouldn’t be able to reduce weight, person X would give the clothes away to someone else who would fit in those clothes. Person X would still be happy.

Person Y has a negative perception. Regardless of the intent of the gift giver, person Y thought that because the gift didn’t suit him/her, person A, B and C are all bad and they made person Y sad.

Person X who had a positive outlook doesn’t necessarily was ignorant of the intentions but person X chose to think positive. Even if person X found out the true underlying intentions, person X continued to stay happy. The example above is a very silly example. But there are big things in life that happen. Acts with much higher level of consequences can happen. Circumstances and situations are the best test to identify people who are true and who are not.Its not our job to punish them or reward them. But it is our job to learn from the experience and move a step closer to the reality. Sometimes, incidences in life help us in coming closer to reality. We should embrace such incidences as they teach us to set realistic expectations and not the desired expectations. Person X understood things and got close to reality without actually getting harmed. And person X didn’t let any act affect his/her happiness.

On the other hand, even if Person Y found out or understood the positive and negative intentions behind the act, person Y chose to base his/her feelings on the net result. Person Y is unhappy even with person with the good intentions because person Y fails to understand how could person A be so thoughtless and how could person B be such a utilitarian without being cognizant of other’s feelings. Person Y chose to move away from reality by setting unrealistic expectations and ignoring the truth.

There could be a person Z, who chose to be happy if the intent was good and feel sad if the intent was bad without worrying about the outcome. The loophole is that person Z will need to judge the intent and be judgemental. It’s said, ‘Those who understand, will not judge and those who judge will not understand.’
Person Z may sound reasonable and practical but who will be the judge for judging the judgement of person Z. How would person Z know if the judgement was real or not.

The above example is just to illustrate a small example. It doesn’t apply to unlawful acts. Criminal acts,acts of lying, or immoral acts are more complicated and beyond the scope of the current discussion. In general, unless extremely devastating conditions occur, which have another tangent, most of the happenings in life are mere acts. It’s our mind that can turn it into good or bad leading to happiness or sadness respectively. That being said, it doesn’t mean that one should turn a blind eye towards the reality. Instead, we should improve our understanding and come closer to reality.

If we are unhappy with someone, it is possible that someone is unhappy with us. While we think that our reason is legitimate, someone else might think that their reasoning is legitimate too. People who seem to be good to us can be bad to others and who seem to be bad to us can be good to others. It relative.

The gist is that our happiness depends on ourselves. The world cannot change, the people cannot change but we can change how we perceive things and learn to stay calm and happy. Life is too short. We are a tiny finite speck in the infinite timeline. Whatever seems as big as a mountain will go away with time anyway because eventually we will go away and with us all our experiences and feelings will go away. Then what is the point in carrying the big mountain with us when all it would do is make us feel burdened all the time. Why shouldn’t we remove that big virtual mountain and feel light and rise, rise above the cobweb of complexed feelings into the clear sky. Why not simplify things. Why not have a positive outlook and see the glass half full. Seeing the glass half full doesnt mean that we don’t know it is half empty. Its just about being thankful for having it half full. Why not smile and generate endorphins and stay happy and healthy! Why shouldn’t we reduce the 3 by 3 table into 1 by 1 table of positive perception and happiness.

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

©All rights reserved. Jaya Sonkar 2018



Tuesday, February 13, 2018

A toast to a good life, because we are a long time dead!

A toast to a good life, because we are a long time dead!

Oftentimes, while discharging elderly debilitated patients to a subacute rehab, I wondered what kind of experience do patients get there. I went to the rehabilitation center today where many elderly patients were living in a nice blend of a hotel and healthcare facilities. It harbored multiple family activity rooms, physiotherapy room instead of a gym, a humongous bathroom with giant bathtub instead of a pool or a jacuzzi, a big cafeteria with diabetic, renal, cardiac, puree and clear liquid diets instead of delicacies and a dedicated smoking area. A soothing music  and fruit flavored water everywhere made the patients and visitors feel welcomed.

A very nice Geriatrician gave me a tour of the facility and introduced me to the world of Geriatrics. After a brief introduction and discussion of the real problems of old age , complexities of diseases, multi-organ failures and goals of care, I started rounding on the patients. I met Mrs. Walker, an 80 yr old pt who had a hip fracture from a fall and was recovering at the rehab center after her surgery. She looked content with the care and was waiting to get better to be able to return home. I saw several other similar patients, spoke with them and their families. Most of them were content with the care and didn't want any aggressive care. They were all a little scared too regarding whether they would be able to go home or would they worsen and return to the hospital.

When it was time to finish the rounds and go home, I walked through the passage towards the elevator when a very old frail lady on the wheelchair caught my attention as she was extending her hand towards me. I reflexly extended my hand towards her to comfort her, when she held my hand nicely and warmly and tightly and she wouldn't want to let it go. It felt very cute. It felt very cute just like it feels when a baby holds the hand. She was trying to say something, but was unable to express. She was demented and had multiple strokes in the past which had hindered her communication skills remarkably.

I don't know who she was, how she was in her young life, was she nice to people, was she mean to people. To me, at that moment, she was as pure and innocent as she could be. 

We all start our lives so pure and most of us end or will end our lives so pure. So what happens in the middle. Some people understand the meaning of life earlier, some later and some never. Some people live their lives to the fullest, live happily, some make mistakes and repent, some don't learn from their mistakes and some try to create mistakes in other's lives.

Based on the experience with terminally ill patients and very old patients who retained their mental status till the end, everyone had one thing in common. Everyone who was content , whether rich or poor, light or dark, short or tall, fat or small, they all had true love in their lives. True love could be with anyone, parent, sibling, spouse or friend or any person who gives you a deep understanding. It's a feeling of loving someone more than yourself. The love with material makes the process of dying harder. The true immaterial love makes it easier.

In our productive life, we should focus on finding and giving love and kindness. Bringing a smile on a face of someone in pain, wiping a tear from a crying face, feeding the hungry, and healing the sick gives a deep satisfaction. These good deeds become our immense treasure as we grow old.The materialistic pleasure stays here while the soul flies away on parting from the material body. Acts of kindness and love make the soul lighter and lighter. And the lighter it is, the easier it flies.

In our productive years of life, we must gather richness of kindness and love and keep our heart lighter and brighter. Ego, jealousy, power play and treachery would make the soul heavier and heavier.  We should aim not for ruling the mini kingdoms but for dissolving such mini kingdoms that create knots in the smoothness of nature. We should aim at making someone's life better and not miserable.

People who understand this earlier are able to live a better and fuller lives. Those who focus on materialistic pleasure, sadism, and power play end up miserable  in their own minds. I have seen elderly who have been miserable repenting on the bad things they did and wasted their lives. I have also seen elderly who made a very good use of their lives, learned their lessons and completed their journey feeling fulfilled that made them happy and content which in turn made their transition from the material phase to the immaterial phase very easy.

The nice old demented lady was still holding my hand. I tried to understand what she was saying. She was hungry and wanted to be taken to the cafeteria for food. She kept holding my hand as if I was her mom and she was my little girl. I assured her that we will take care of her. A nurse just walked up saying that she was going to take the patient to the cafeteria. I continued to hold her hands for a few steps towards the cafeteria while looking into her eyes and patting her back just like I do for my daughter when I drop her at the school. I then pulled out my hands from hers slowly and let her go the rest of the way with her nurse  The warm touch of her hands didn't just touch my hands, it touched something within and it gave me a very deep good gratifying sensation in my heart.

Let's try to stay as pure as we can while we have all our senses and mind and feel the depth of the gratification that results from that purity.
Let's raise a toast to a good life, because we are a long time dead! Let's raise a toast to a good soul, because it is forever living!

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

©All rights reserved. Jaya Sonkar 2018