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

Where there is a will, Respect it!

Life really goes a full circle. We are born as babies, then we grow up and walk. We walk through the entire life and then we are babies again, just this time bigger and wrinkled.

This is a story of 2 dads who I happened to take care at the same time. I will call them Mr Leon and Mr Stevens. (I will use fake names and will alter the illnesses to protect their privacy)

Mr Leon is a dad of a 42 yrs old daughter Myra who also has a 10 month old infant. He had an oropharyngeal cancer and history of stroke that changed his life overnight. Stroke left half of his body paralyzed. Moreover, he had a contagious infection that could be very harmful for the people taking care of him. Despite this, the daughter took care of him religiously. Having lived like this for a couple of years with numerous hospital and Nursing Home stays, Mr Leon was at the end of his patience and was desperate to reach to an end of his sufferings.

Mr Stevens is a dad of a 45 yrs old daughter. He was up and about until 4 weeks back. He was afflicted with Parkinson’s disease and Alzheimer’s disease which were progressing gradually until 4 weeks back when his condition deteriorated markedly, to an extent that he became bedbound. Mr Stevens is 4 weeks into this condition and is hopeful that he might get better.

Both of them were awake, alert and oriented but could not speak clearly. It was very hard to understand what their meaningful mumbles meant. Both of them were unable to eat on their own, Mr Leon being slightly worse than Mr Stevens. Both of them needed a nasogastric tube for feeds. Mr Stevens willfully cooperated and got his NG tube and hence his treatment. Mr Leon didn’t …

Seldom do we see a bed ridden patient like Mr Leon with all organs functioning. Mr Leon’s heart, liver and kidneys were all in good condition. But his hemiplegia and history of oropharyngeal cancer left him debilitated with inability to eat, move or speak clearly. Over a period of time, he became very frail and weak. He was depressed and tired of his prolonged sufferings. He couldn’t get a PEG tube because of suspected perforation and infection. He needed an NG tube at the minimum.

The daughter loved her dad. She was all in tears. She had been taking care of her dad and her infant diligently for many years and was finding it very hard to let go of her dad. She wanted to keep him alive and comfortable. She respected her father’s wish and with a heavy heart, agreed to DNR/DNI. But she still wanted to keep going with the basic measures to keep him alive.

Mr Leon’s love for his daughter didn’t let him say ‘no’ in her presence and would agree to all sorts of physical exam, blood draws and medical treatments. One morning her daughter was able to talk him into agreeing for NG tube as well.

I went to his room, smiled at him and asked him ,’how are you Mr Leon? Now where is that beautiful smile. He attempted to smile. After explaining him the procedure , I started preparing to insert the tube. He looked reluctant. I asked him if it is okay for me to put the tube. He said “No” in his frail mumbles. Then he said. I don’t want this. I am a man of merit. I’d rather be dead than have another tube. I have had enough. It was very hard to decipher his mumbles. But he used all his strength and made gestures with his entire frail body to make me understand what he was saying. It almost made me feel like a butcher with that NG tube in my hand. I kept it on the side and patted his shoulder. I told him, “Mr Leon, I am with you. I will not do anything to you that you would not like. I will talk to your daughter.“

My other patient , Mr Stevens willfully swallowed the tube but Mr Leon was uneasy even at the sight of it.

Both daughters wanted best for their dads. Mr Stevens and his daughters goals were aligned. They had just been 4 weeks into this situation and were very hopeful to come out of it. It was optimal to do every possible thing for them because the patient wanted it too. He wanted to live and be able to return to his previous functional level!

On the other hand, Mr Leon was tired of several years of suffering and didn’t want to lead a miserable life any more. He had lost all hope and wanted to go. But his daughter could not let him go. She was respecting some of his wishes but was trying to compel him to agree to other measures to have a few more days with him. She did not realize that she was just prolonging the suffering for her father. Convincing him for more procedures were hurting his self esteem and causing him more physical pain. His love for his daughter forced him to say yes but deep down he wanted to be left alone.

It is very important for us to remember that patient comes first. No matter how much we love someone, true love is loving what our loved ones want, respecting their wishes and honoring their decisions.

Everybody likes independence. No body likes being compelled into doing something they don’t like. And that’s exactly what the terminally ill patients want. The best thing we can do to them is agree with them and tell them that we are with them in whatever decisions they make. At the end of life, extra few days don’t matter. The quality of time spent does. Spending some time with them, diverting their mind from illness, cracking a joke when eyes are in tears, remembering good times together and telling each other how much they love matters more. I remember when I told one of my terminally ill patients that his daughter called in to say that she loves him a lot and is on her way, brought a smile on his face despite his excruciating pain.

Mr Stevens is still struggling to get his life back while Mr Leon finally got hospice at home.  It is still a happy ending because both of them are getting what they want and not what they are forced into. May God comfort both of them!

-Jaya Sonkar MD MPH

©All rights reserved. Jaya Sonkar 2016

Is there a life after dealth?

As I put Riya to sleep tonight and watch her in her sleep, my eyes dont want to close. Just feel like watching her all night to keep me going through another 2 weeks of night shifts.

Night float can be challenging at times when you get paged back to back with mutiple sick patients that keep you running between all floors, but at the same time its a great learning experience.

Recently, I met this patient at night, who had an emergency surgery after which he was in coma for a couple of weeks. He came with another similar acute issue. (Disclaimer: I am changing the name of the patient and the diagnosis as well as other facts to safeguard his privacy).

A very interesting young patient in his late 40s, Mr Cooper, went through a lot lately. He told me about a lot of his life experiences. As I finished speaking with him and was ready to move out, he stopped me and said, "Can I tell you something if you promise not to call me a freak."
I promised him. Then he said, "I havent mentioned this experience to anyone because of its unusual nature." 
I assured him that I will be all ears and will be supportive.

Mr Cooper said, 'A few months back I was brought in the hospital for this emergency surgery. Then something strange happened, I could watch myself being operated. I was trying to wake myself up but couldnt. Then I saw the doctors cut me near my knee to take something out to repair something in my chest. I couldnt believe that despite all this, I didn't feel any pain. I was so disconnected with my own body. I could see everything from the top of the room that was happening to me as a mere spectator. Then I got really worried realizing that I might be dead. I started crying and shouted at myself to wake up. Then I got drifted away to a place where I saw a lot of heat and heard a lot of hue and cry and saw them calling at me. I ran away from there. Then I saw this very beautiful bright white light, very soothing to eyes. I went ahead and saw my mom. She ran and picked me up in her arms. Suddenly i felt i was small like a child and was playing in my mom's lap. Then I came back to see myself. I wanted to reenter my body. I wanted to live. I had so many things to finish , so many promises to keep. I could not let myself die.

Two weeks after my surgery, I woke up. When I woke up, I still remembered a lot and I still do. Out of curiosity, I checked my knee to see if they really cut me open at the knee or was it a dream. To my surprise I did see a healing wound. Later I found out that everything I saw actually happened.

Ever since my life has changed. I used to be so afraid of dying but not any more. I live my life in a much better day. I am more compassionate to people wnd am more goal oriented. I know what I want and how long it should take me to do everything I want to in this lifetime. Its a strange feeling of calm within...."

There was a brief silence in the room after he finished. I was lost in my thoughts while he was in his. Then we both smiled at each other.

I said, "Mr Cooper, thank you for sharing this experience. While the complexities of this paranormal experience you've had is beyond the capacity of my little mind, I feel obliged to tell you that I have heard similar experiences from my other patients too and they were all sane minds. I am very happy that this experience brought positive changes to your life. May you live long and achieve all goals of your life."

I walked out lost in my own thoughts. Lately, I lost one of my dear aunt. Its not easy to cope with the loss of our loved ones. I feel the pain that my parents are going through. Fear of losing loved ones often gets to me. At such times, the thought of life after death is really comforting. And who knows it might actually be true. The thought of having a chance to live with all our loved ones at a very soothing place indefinitely is so relieving. Then why not be comfortable and just believe it blindly.

Beep beep. Beep beep, goes my pager and there I return to earth from my heaven. Orders placed!
There goes the phone tring tring. And guess this time it's Dr Charming and Dr Handsome, "Hey jaya, is everything ok. Do you need any help with the admission?" 
"I am fine Dr Charming? I will be done placing orders for this one soon. Is there another admission pending?"
Beep Beep , goes my pager again.
Dr Charming," what admission? The next admission is mine." Dr Handsome, " let me know if you need help with pages. We just made hot coffee. We'll bring it to you."

As much as I enjoy taking care of my patients at nights with the 2 most wonderful seniors I have ever had, Dr Handsome and Dr Charming (as they called themselves and indeed true) when most of the people are cozy at home with their families, I cant explain how much i missed putting Riya to sleep.

Today I dont want to sleep. I want to fill my eyes with my baby's pictures which I can see everytime I blink during the nights.

Lots of love and blessings to my most precious treasure, my priciest possession, my darling baby Riya.

Jaya Sonkar MD

©All rights reserved. Jaya Sonkar 2016

Little Riya and Rosgulla factory

Once upon a time, in the city of Rojapur, there lived a little girl named Riya. She owned a Rosgulla factory. Her Rosgullas were very famous for their big size, softness and sweetness. Everybody wanted Riya’s Rosgullas. Wherever she went, everybody would just say, “We love Rosgullas, Riya’s sweet rosy cheek Rosgullas”. Riya was very good at running the factory. She would always take care that the supply meets demand. She would take special care in gathering good quality raw material for rosgulla production. The raw material vendor, Mommy & Company was very happy as Riya paid lots of smileys to the company in return. It was a steal deal for Mommy & co.

One day a naughty monkey came from a nearby town and told Riya, “Dear, you work so much for the Rosgullas. You deserve some rest. I will take care of the factory for you.” Riya thought that the monkey was right. She had worked very hard to establish the factory and now it’s time for her to relax. So she decided to take some time off.

Riya thought that the monkey will be as good as her in running the factory. How little did she know that the monkey’s intentions were not good. He was sent by an old witch, from the nearby town of Thinfield, who wanted to sabotage Riya’s rosgulla factory. Ever since Riya’s Rosgullas came into vogue, her cake factory became less and less popular. The witch used to attract kids with her cakes and then tricked them into becoming her slaves.

The monkey sent Riya to Sleepville and stopped making rosgullas. The factory workers were being laid off due to lack of work and poor economy. Since Riya was off to Sleepville for her vacation, there weren’t enough smileys to pay the workers. This caused riots and unrest in the nearby town of Stomachville, where the workers resided.

CEO of Mommy & Co., who was friends with Riya, also became worried. The raw material was going waste and the company didn’t get enough smileys for living. One day the CEO decided to go to Stomachville and meet the factory workers.  She asked the workers if it was possible for any of them to go to Riya and tell her what was happening. The workers told her that the monkey was very shrewd. He sent Riya to Sleepville where only selected members, who had a Dream Van, could enter. However, there was a Cheek Postal service that could carry the message for them if they paid her a large box of Riya’s Rosgullas. The CEO reflected for a while and then made a plan. She told the workers that her company will supply the raw material to the workers in the Stomachville, who can then sneak the material in the factory to make rosgullas. They would then send these Rosgullas to Riya in Sleepville via Cheek postal service with a lovely note to return to Rojapur. The workers liked CEO’s idea and did as planned.

Soon they made a large box full of Rosgullas and sent them to Sleepville. When Riya read the note, she became very sad. She left Sleepville immediately and took the next Good Morning train to Rojapur via Thinfield. She punished the monkey and the old witch. Then she reached Rojapur and hugged the CEO. She also distributed lots of smileys to Mommy & Co. and the workers in Stomachville. Everyone in  the city was very happy to have Riya and her Rosgullas back and they all lived happily everafter.

Jaya Sonkar

©All rights reserved. Jaya Sonkar 2015

A tribute to my parents!

Dear mom and dad,

How I want to express my gratitude

For the eternal treasure of fond memories

For endless love that you’ve showered on me

But I can’t thank enough.

As I am growing older,

Moving from one place to another,

Going through different phases of life

Stepping into different roles,

I realize what a paradise I had for my childhood.

How I cherished the selfless love,

The moral values you taught and I learned,

Value of truthfulness and honesty,

Loyalty and modesty,

Genuineness and integrity,

Acknowledgement and empathy

Oh!  I can’t thank enough

I remember the nights that you stayed awake

To put me to sleep and bake a cake

And make a pretty dress for my birthday

The nights when you took me to fair

Despite the heavy work day

The nights when you played hide and seek

And when I got tired, lulled me to sleep

The days when you taught me and prepared me for the world

Supported me at each step and pushed me forward

I remember the day

When you soiled your hands to find my pretty earring

And cleaned it and placed it on a rose

I felt so blessed!

Oh! I can’t love enough

Those loving eyes and patient ears

Those lessons you taught had wisdom of years

That soft touch and warm embrace

That solemn, kind and pleasant face

Oh! I can’t respect enough

You never counted the sacrifices you made

The gifts and values that you gave

You always made me feel so precious and deserving

Just silently gave, never expected anything

I haven’t seen anyone loved so much

I am so fortunate to feel your gentle touch

You have the qualities rare to find

The pious soul and beautiful mind

Oh! I can’t feel grateful enough

You spent your youth to nurture me

When I grew up, you set me free

But still stand as my backbone

You still are the tree that gives shade

Oh! I can’t cherish enough

My little secrets are now our special memories

That only lives with you and me

There is a special bond we share

Which grows each day, no matter I go anywhere.

Oh! I can’t feel sad enough

For being so far from you

I wish I could be near all the time

How I miss being in your arms

Away from evil and selfish harms

Away from the liars

And away from the fakers

Oh! I can’t miss enough

Dear mom and dad,

I will be a mother soon

And I’ll have my own little moon

My own little sunshine

My precious boon

I want to pass on the same sweetness

Bless me with the same strength and goodness

So I can raise a sweet new soul

With the same love or even more

So I can give her same trust and strength

That you gave me when I was young

So I can give her a good life ahead

And set my bird free, once she is fed

So I can help her spread her rays

And keep your incense alive always

Your loving daughter,

Dr. Jaya Sonkar

May 17, 2012

©All rights reserved. Jaya Sonkar 2012

Tummy Talks!!! (Little rhyme for our expected daughter, Riya)

In the little, warm and dark room

With faint light and faint noise

A little angel is cuddled up

In her calm and cool poise

She sleeps soundly on a soft bed

Within the cocoon of gentle love

And mommy wonders, where lies her head

While looking at the stars above

She made her first gentle move

After a few quiet days

A little tough to interpret

And respond to what she says

Soon she learned to speak through kicks

While mommy learned to understand

What her little one strives to speak

Before she enters foreign land

When 4 months old, she gently said

‘Mom, there seems to be an earthquake’

I said, ‘No dear, it’s just a retch

To spill out the hot chocolate shake’

When 5 months old, she gently asked

‘Mom, am I on a thrill ride’

I said, ‘No dear, it’s just a jerk

Caused by a little stiff joint’

When 6 months old, she happily said

‘Mom, it is one of the smoothest days’

I said, ‘Yes dear, it is, indeed,

As sun scatters its brightest rays’

When 7 months old, she meekly asked

‘Mom, is there an acid rain?

I said, ‘No dear, it just feels sour

It will soon pass, won’t happen again’

She said, ‘I see some strange lines

Wherever my little bones reach

Is this some kind of worrisome sign

Or is it just to put me at ease

I find it hard to move around

The space is small even to cuddle

It feels like I am an astronaut

Snugly fit in a space shuttle’

I sighed and thought and then smiled

And said, 'Dear, you are right, indeed,

The lines are there to add more room

For you to sleep, play and feed'

One fine day, she sweetly said,

'Mom, can you take me out to play'

I said, 'Sure dear, me and your dad

Will take you to Wildwoods and Cape May'

Happy she was, to feel the warmth

And see her little bed, full of toys

That mom and dad had gathered with love

To welcome their little bundle of joy

When 8 months old, she softly asked

'Mom, I hear loud breathing sounds

Are you running a marathon?

With your heart, my heart pounds'

I said, 'No dear, it’s just a tiff

That mommy’s lungs and body have

Soon they’ll be good kids

And mommy will pat their back'

She asked, ‘How would it be when I

Step into this world mundane

Would you be happy and content?

Or would you be in a lot of pain'

I said, ‘Oh dear, what should I say

You are such a sweet blessing

The joy we have been waiting for

That dampens all the suffering'

Now at 9 months, she often asks

'Mom, how is the world around

Is it full of awe and wonder,

Bright lights and soothing sounds'

I said, ‘My dear, the world is awesome

There are always changing seasons

The leaves, the snow, the cherry blossoms

There is much to do and lots to learn

Where sun rises and birds fly

Where wind blows and clouds rain

Where flowers bloom under blue sky

And farms are full of sugarcane

All is pretty, all is pleasant

But there is something you should know

No matter where you’re born or trained

You get the fruit of what you sow'

At this, she said, 'that sounds fair

It is a balance of nice and vice.

I am prepared to come out there

And ready to throw my nice dice'

I said, 'My dear, that is so sweet

Your dad and I just can’t wait

To welcome our little sugary tweet

Blessed with lots of goodness traits'!!!

Dr. Jaya Sonkar

©All rights reserved. Jaya Sonkar 2012