Bon Voyage!

Bon Voyage!

A very sweet elderly lady departed.

She was a very sweet lady with very advanced disease. She had only her niece to take care of her who tried her best to help out.
At her 2nd and last visit, she could manage only a phone call and she could not get any labs or imaging and follow ups and consults. I tried to educate her only to realize that poor lady had so many limitations. She was dependent on others for her care.
Sometimes, life situations tie the hands.
May she rest in peace.

I remember her first visit. The gangrene that she had wasn't looking good but she didn't want aggressive care. She was planning to move to assisted living.

Having seen so many patients through their journey, what I have come to realize is that the best companion in the life is self. We meet several people in our journey but we board and depart alone.

On the other hand, no one is alone because everyone boards and everyone departs.

We should make the most use of the time while we are here.

We keep worrying about gathering and planning a lifetime without realizing that the life experiences are worth much more.

Everything else will stay back on this earth. Even the body and mind and skills stay back. The life departs without anything but experiences and learning.

Welcome to the world of Medicine! These experiences are very soulful and teach a lot.

We just need to keep grasping these learning nuggets, stay happy and healthy and live each moment because each moment that goes will never come back. 

We should always strive to make a significant and positive difference in people's lives.

And these people are humans.
All good work done makes us feel lighter and brighter.

The lighter we are, the easier to depart. After all, while likes to carry a lot of baggage lifetimes after lifetimes!

Dr. Jaya Sonkar MD MPH

5/30/2023

©All rights reserved . Copyright 2023

Abhi To Main Jawan Hoon

Abhi to main jawaan hoon!

(I am still young.)

"Hello Doctor": comes a very sweet sound when I entered the exam room.

A very beautiful lady in her late 70s was sitting elegantly on the exam chair. She was very well-maintained and her body language was as nimble as of a little girl. She was full of life and grace. She was hurting in her joints.

She felt like she still had so much work to do but her joints and muscle strength were limiting her.

She was very well aware of her health but I could see the spirit in her eyes that she could still do so much to make a difference.

I introduced myself to her and we worked on making her feel better and more mobile and help her complete her goals.

This reminds me of a gentleman who was in mid 80s and he was worried bout the way the arm muscles were lax and he was losing his strength and was unable to do the yard work so well. He was fully functional with intact executive functions and very tech savvy that was impressive.

He had a very good sense of humor and in his mind he was still young and could move mountains. He wanted to do a lot more in the years to come. He had an autoimmune disease that manifested very late in his life.

Seeing geriatric population is very insightful. I have realized that the age is in the heart and it is what you feel it is. 

Dedicating this song to all my very sweet, energetic , motivated elderly patients.

Dr. Jaya Sonkar MD MPH 

5/21/2023

©All rights reserved . Copyright 2023

https://www.spreaker.com/episode/53952399

The gem of the patients! Lets fill our treasure boxes with pleasantness!

Disclaimer: The names of the characters have been modified. Ms. Brittany: "Doctor, two months ago, I was driving. And now, I can't even sit up. I had breast cancer several years ago. I survived that, and had all kinds of surgeries, but never knew that someone can have so much of pain and yet be alive. My eye is hurting as if it will burn away. My back is hurting as it will burn away. I believe Jesus is there and he resides in me and he will help me." I held Ms. Brittany's hand and tried to comfort her with the fomentation that she was struggling with and adjusted her posture to make her comfortable. Me: Ms, Brittany, please continue to have this faith and have strong willpower. I have seen patients improve. We will try our best to ease your suffering with the help of medications. Please continue with physical therapy. Long Pause while she looked me in the eye and attempted to speak more and tried to hide her tears... Ms. Brittany: Thank you, doctor, for your positive words.  Ms. Brittany was an active and independent woman leading her life. She had a stroke that took her left half away.  Me: Ms. Brittany. Have you been seeing a neurologist?  Ms. Brittany: No doctor, And I don't think I can see one. I think it will be a while before I can drive again. Me: Would you have anyone who can help you? Ms. Brittany: I won't know until I ask. I guess, my family will. But everyone works, except me. Me: Dear Ms. Brittany, you have worked hard all your life. It's your turn to get care. Ms. Brittany: I guess, you are right, doctor.  You see, I lost my husband a year ago. Now, I am glad for him. He is in a much better place. I never knew someone could be in so much pain and yet be alive. It would have been traumatizing for him to see me this way. I am glad he went before he saw me in this condition." Me: I am sorry to hear about your loss Ms Brittany. I can only imagine the pain and sadness that you must be going through. I will say that I agree he is at a good place and I hope things get better for you. Nothing lasts forever. This, too, shall pass and things will hopefully get better. Ms. Brittany looked into my eye and said, "Thank you, doctor, for your positive words." ms. Brittany must be a very kind soul. I have seen people get delirious and unpleasant when in so much pain and suffering. She had maintained her kindness and was not complaining much despite being in so much pain. It was saddening to see her lying on the bed like that. I did whatever I could to give her some comfort and came out. Life is so unpredictable. Would she have ever imagined the morning that this will be the last morning when she can walk out of the house? The only thing that was giving her some relief was that her beloved husband did not suffer this way and also did not suffer from the pain of watching her suffer. Just the same day, I met another very pleasant patient, Ms Stacy, she was independent and was enjoying cooking her meal in her house. She was worried about her posture that she was bending forward and this was getting worse. She had severe spinal stenosis and she did not want to go through any surgical intervention.  She mentioned that she lost her spouse 3 yrs ago. She got married to him at the age of 13 yrs and they never dated anyone else. They created a big family. She was proudly mentioning that her grandson-in-law was an Indian just like me and then she told me stories about India that she heard from her grandson-in-law who she was very fond of. She was very satisfied with her life and just wanted to maintain her independence until she was alive. Both the patients were in their 80s and 90s A few days ago, I saw another patient, Ms Katie in her 80s, for whom, mobility and being pain-free were very important. She responded great to the knee injections and was mobile again. She gave me a very precious hug and called me her daughter.  As we age, what is important. Almost everyone wanted independence and mobility. No matter how much one is loved or not, no matter how much wealth or knowledge the person has, no matter how big a family someone had, in the end, your own hands and feet and brain matter, and people don't really want to stay in their body if the body limits them. The body in itself is limiting. We are not able to see, hear, or feel a lot of things. We are limited in our knowledge and reach. We are part of mother earth and are protected in her womb and we never take off. We stay in her womb from birth to death. Until a few days ago, I could say that the memories of good times stay and all the life experiences result in fond memories that stay forever. Only to realize that memory fades away too.  I saw a very sweet elderly man, Mr. Alan today, whose wife lost her memory to the point that she didn't recognize him and could not tell a difference between him and another man. He was shattered that the love of his life couldn't even recognize him. He was trying to hide his tears when e said that they were planning to move to assisted living and place his wife in memory care while he lived near her as he didn't have the physical capacity to take care of her and was very sad of losing the cohabiting with his wife of several decades. He was very thankful that he was able to use his shoulder again and manage quite a bit but his wife's memory loss was the most painful thing for him. It will hurt only until he has his own memory. Memory fades away too and so does the mind. It's not just the body but the memories get lost too. What remains then? Nothing? Or is there still some learning that we carry forever. And who is this We or I? In the end, it is a lone journey of social animals. Even if you love someone from the core of the heart, that someone will not wait for you to be ready to say goodbye. When the time comes, that someone will go or that someone will not accompany you when you go. It's a "bhedchaal" i.e. walking behind the sheep and cattle in the direction where they go. It just seems right to continue the life cycle and learn and earn and create a family and enjoy the time. But what is the purpose? No idea! I just know that holding Ms. Brittany's hand and comforting her and placing her in a comfortable position, wiping her tears, listening to the stories from Ms. Stacy, being hugged by Ms. Katie, and comforting Mr. Alan made me feel really good. That gave me a feeling of pleasantness and I was able to close my eyes for the night peacefully and calmly. One day someone asked me why I like to go out to the Assisted Living facility. It is for this vast knowledge that I gain from the gem of the patients who have collected wisdom for almost a century and who have lived the history, is why I don't mind driving 100 miles. Yes, that does make me think of my elderly parents with whom I would like to spend more time and take care of them, and also think of all the other elderly people who have ever seen me as their daughter. My heart goes out to them and I pray that everyone ages beautifully and keeps collecting wisdom points of pleasantness in their treasure box. We are all following their footsteps from the day we were born and we will continue to follow till the end. Let's fill our treasure boxes with pleasantness!

 Jaya Sonkar MD MPH 5/4/2023

 ©All rights reserved. Jaya Sonkar  2023 

 A song dedicated to all the elderly love birds! Please click on the link below to listen. Stay tuned! https://www.spreaker.com/episode/53747096

Are you too proud of being too good?

Are you too proud of being too good?

"Neki Kar Dariya Mein Daal"

Its a very good mantra to stay happy

Love without attachment

Live without limitations

Express without fear

Be good and do good without expectation of any reciprocation

Are you too proud of being too good? 

It is really good to be good, be helpful to others, and be thoughtful and empathetic,..... as long as there is no expectation attached.

Am I good?

I am just a human. It's for others to decide if they perceive me as good or not.

Do I have expectations?

If I am a human and haven't evolved to the level of God, Yes I do have expectations. But, I have learned to manage them and I don't like to allow anyone else to make me sad by not doing what I wanted them to do. Because, if I wanted them to do what they didn't want to do for me, then I am not good anymore. 

Should I become altruistic?

Not if I have worldly responsibilities. I took on this life for a purpose and fulfilling that task is my utmost duty. Once I complete that, only then do I earn the right to be altruistic, in which case I can give the 5 elements back which can be altruistically brought to use by recycling and provide to other lives. 

I once was a victim of believing that I was too good only to realize later that that goodness might have been a torture of the other. And then the reform started. 

Now if I am good and I have expectations, I let myself know that I am a human and am working my way up the spiritual ladder and haven't reached there yet.

If I am good to someone and that goodness actually brings joy to the other without me having any expectation from the other to reciprocate, then I actually feel proud of myself of making good use of the body my life has gotten for this period of time. 

If one is good to someone and if one does something for the other because it gives one joy, then that act is very good. However, It must be kept in mind, that the goodness may not be perceived as goodness by the other, especially if that person is expected to reciprocate because that reciprocation may be difficult for the other person due to different circumstances and also that reciprocation may not be joyful to that person.

When you do something with an expectation, then that is a transaction. Oftentimes people say, "I did so much for the other but that other did not do this for me". 

The question is was it discussed beforehand that a reciprocation or a return was expected or was it implied? If yes, then yes that is a breach of an unsaid contract. But if it was not discussed or if there was no clarification of such an understanding, then it is not right to blame the other person for not being good in return.

It is also not uncommon to come across this phrase, "I did so much and am the reason behind his or her success but that person was so thankless." Everyone is indebted to something or the other, to someone or the other from the moment born. Parents, siblings, teachers, friends, circumstances, employers, peers,  strangers, enemies, everyone plays a role in carving an individual. So certainly, one has a tremendous role in the journey of a lot of people and one owes a lot to others for making their journey and learning possible. 

Gratitude is not taken, it is given. It is up to the recipient whether or not to feel grateful. If the other person doesn't feel it from within, then the person should rethink the expectation. 

To stay happy, one should only do what one is capable of offering without an expectation of any return. Anything that imposes a task of reciprocation on the other where the other is not nearly as joyful as the one who does the act of kindness, brings pain to the other. And that doesn't necessarily mean that that other person is not good. It just means that the other person's circumstances and feelings do not give them the same joy in reciprocating.

This act of goodness is separate from a business where everything is transactional and a return is expected.

If one truly aspires to walk on the path of goodness, one should ask oneself the following questions:

If I do this, will I expect anything in return?

If I do this, will I be upset if I do not get a return?

If I do this, will it be an effort that will prevent me from being happy?

If I do this and expect something in return, will I be uncomfortable asking for a return or will it be unfair on my part on asking the other to do something in return?

If the answer is Yes to any of the above, then one should not do that thing until one is ready from within to do that and act selflessly as a joy.

Of course, getting a reciprocation or recognition or acknowledgment brings joy but one should not depend on others to bring joy to one. The joy should come from within .

The goal is finding inner joy and being in control. Do what brings joy from within and not let our joy depend on others' actions.

And we must always remember, a positive energy from one to the other will either become kinetic positive energy and be paid forward if not returned or it will become a potential energy which may become kinetic sometime in the future.  And it is said, "What goes around comes around."

Jaya Sonkar MD MPH

4/23/23

©All rights reserved. Jaya Sonkar  2023

My first day at Jaipuria!

It was a pleasant morning. My mom hugged me and wished me well. I went to the bus stop with my dad, my elder brother, and my sister and waited for the bus excitedly. This was my destination. I had always wanted to go to Jaipuria. 

Yes, going to Jaipuria was my dream which came true.

A year ago, I used to go to another elementary school and I always saw my brother and sister going together to Jaipuria. I wanted to join them as soon as I grew old enough.

I was told, growing older wasn't enough and that we needed to pass a very tough entrance test. They ask over 40 questions in 5 minutes and there are several rounds of it. They tested Hindi, English, Math, Memory, etiquette, social skills, etc

My parents taught me well, especially my mom. I remember doing grammar for 10th standard with my mom before the entrance test and yes I topped it with a good lead. 

It was published. My relatives from far off came to congratulate me. One of my mamaji gave me INR 100 which was a lot at that time.

I felt really good. All the recognition was a bonus. For me, my dream of going to Jaipuria with my bhaiya and didi was the biggest which got fulfilled.

I still remember Mrs. Lila Chnadra waving from the window to my parents and she gave me a very warm welcome on the bus. She used to be my bhaiya's teacher and had seen me before.

During the lunch break, my brother came and took me to the canteen and bought me 2 samosas. I was mesmerized by how nice and big this school was as compared to my previous kids' school and how yummy the samosa was. He then gently escorted me back to my class. He was 5 yrs elder than me so I walked with air that such a senior person is my brother :)

Still remember buying stickers and pens from stationary and those fun stationary shop and canteen visits with friends.

The teachers were motivating. Starting from Mrs. Indraramakrishnan, and Mrs. Aloma Das, to Ms. N Kapoor, Ms. Gauri Bhushan, Mrs. Usha Sinha, Mrs. Indu Sharma, Mrs. Bhagoliwal, Mr. Shepherd, Mr. Menon, Mrs. Lal, Mrs. Arora and other honorable teachers, our music and art department, activities, and a lot more.

Certainly, the best in Kanpur. Once in the school, there was no other way but to go higher.

And thereon, it was a journey till the end of the 12th standard. Amazing teachers, great peers and friends, and a steep learning curve. 

At that time, during the matches, we used to cheer our sports team as,

'Wherever we go, people wanna know, Who we are, So we say,

We are the Jaipurians, are mighty mighty Jaiprurians."

All I have to say is that this slogan is so true!!!

Proud to be a Jaipurian!!!

Dr. Jaya Sonkar MD MPH

3/29/2023

©All rights reserved. Jaya Sonkar  2023

It's all about perspective

It's all about perspective!

Everything is relative.

Good or bad

Near or Far

Slow or fast

Future or past

It's all about perspective!

A plane is the fastest among most of the vehicles

When we fly, it doesn't feel fast. In fact, sometimes it feels slow. You see a light that's far off and it moves very slowly towards that.

Is it really moving slowly?

Well, objectively, if we go by the speed, it is going fast. But the speed with which it is approaching that light doesn't feel much. That's because the proportion of distance that it covers is probably not a large proportion.

Similarly, when we are engaged and really enjoy what we are doing or if we are busy, time goes so fast as if a day passed just with a wink of an eye.

But if we are sad, in pain or just unhappy, the time feels very long. 

Someone might feel that the town which is a 100 miles away, is far. The other person drives a 100 miles each way to and back from work. Some other person drives 500 miles a day and some even more. 

What's near to one could be far to the other.

We have an understanding of good and bad, right and wrong and a general notion of good is something that doesn't harm or brings joy.

However, there is an interesting twist to it.

What's good to one might be bad to the other.

Someone might say that giving candy to a child is good and it brings cheer. The other would say it can rot the teeth. 

Someone may say, it's good to reward. The others may say it's better to punish. Another might say rewards may make it too easy. Yet another could say punishment can demotivate people.

Everyone can choose to see the glass half full or half empty . The volume of the glass won't change. The perspective can make a remarkable difference and can result in very different outcomes.

If we really enjoy what we are doing and count the things that we want to do and spin it to always land on a positive perspective,  life is really short and very precious and full of tremendous joy.

Now, you may like this article or you may not.

In the end, it's all about perspective!

Jaya Sonkar MD MPH

3/10/2023

©All rights reserved. Jaya Sonkar  2023

Holy Holi!

Holi ka tyohaar

Rangon ki Bharmar

Toliyan zordar

Koi na bair, sirf Pyar

Holi khushiyan ka tyohaar

Khushiyan ka tyohaar

Bacche pichkari chalaye

Maayein gujhiya banayein

Ghar aaangan sajayein

Papa sangat Ghar le aayein

Mil ke Holi manayein

Holi rang sajayein

Hiranyakahsyap ya prahlad

Har yug mein inke Pratap

Har dharma mein inke avtaar

Bhakti koi bhi Karein aap

Ya padhein koi bhi kitaab

Satya, ahinsa, prem ke hi path

Holi bhulaye Sab santaap

Mil ke Holi manayein sabhi aaj!

Holi hai!

Jaya Sonkar MD MPH

3.10.2023

©All rights reserved. Jaya Sonkar  2023