life of management

It's not just wondering about the diseases of individual patients, nor is it just paying heed to tendencies of groups, epidemics, mentality and educational levels of patients... it's not just following the government rules, or adjusting with current political trend... answering to media, local over enthusiastic political activists eager to make issue of anything to gain some political benefit, managing a team of workers elder to me by decades, paying attention to jobs of newcomers, their friendships and rivalries with each others, answering to taluka and district offices... managing economy of scanty drugs, the sanitation of operation theatre and the instruments... managing the government funds, salaries of workers, and government schemes... being a medical officer is being more a manager than a doctor...

It's hard to keep in touch with your medical knowledge, to handle everything according to standard norms, the conditions being slightly strange or not as mentioned in books... x ray machine is here though not properly trained technician, doctor is here—me of course, though not proper health facilities like even basic drugs... patients are uneducated, politically alert villagers wanting me to diagnose and treat every disease with the x ray machine and whichever drugs I have. PHC is a referral service, they say, but they don't provide any means to convince the people to move to higher centers if they show signs of  malignancies, heart diseases or diseases not treatable at PHC level... People look at the referral chit as a proof of the doctor's incompetence, or ignorance—overall lack of interest in their health condition. Many are not willing to invest that much time and energy for their own health or health of their relatives...

I'm out of my big lovely standard books, in real world, among real patients—posing conditions similar to those described in my beloved books but in highly different circumstances, learning to deal with people with very different viewpoints than that of me—very different from one another, to convince them, to handle their differences and sometimes to make use of them, to handle unforeseen circumstances. Maybe this extended part of medical education is worth a year....

It requires strength

"I'm no more a romantic person living in some dreamland or a perfectionist craving for best or an innocent sweet child, honest, always true to her morals... I know it's nearly impossible for life to be perfect, dreams might be just fantasies, not always meant to be achieved; morals are just luxuries only lucky fulfilled and superhuman can afford, or they're rules of some mad obsessed ne'er-do-wells, or are some chants in fairytales—never working in real life. There's no true love, there's no passion; devotion is a meaningless word... selfishness being the first predictor of success, luck being the second. Loving others without expectation is killing your own soul. Trusting someone is risking yourself, promises being stepped down as cheap talks... or bluffs... cheaters are winners, believers are fools—born to be flop. I'm not describing some nightmare, or experience of some negativistic person with some personality disorder... this is real life, alas, not a fiction...."

It's very easy to be cynic in this world, series of experiences pushing us to pessimism... but thankfully it's not all desert. It requires strength—a lot of strength to see the meadows, the rivers, the waterfalls and the jungles... True love is here—able to surpass all fictions, pure care isn't mythological, here is comfort, here is trust... faith is here to make us relaxed. It's not harmful to rest in dreamland when we know what is real... It's not harmful to attempt mending the future while living in present. Number of efforts may not lead us to success, but they're bound to increase its chances—if done in correct direction. We're not passive limp non-living objects moving only with forces from outside, neither are we reptilian brained animals thinking only of me myself and my present tense... we can gain knowledge, can plan the future, can think strategically while still protecting our morals... we can get joy by doing something for our loved ones; we're humans, we're born to celebrate our humanness. 

Luck... Fortune... Life

We never like to admit it, though we can't deny it; inevitable, uncertain, unpredictable and random but for sure in every aspect of our lives 'luck' does play a central role. A collection of unpredictable things, an array of random events, life is composed of a host of life changing phenomena happening without any direct cause just because of nature's tendency of random fluctuations... It's a tendency of us humans to seek out and attribute causes, to make predictions, to expect some outcomes and to get disappointed when things don't happen as we want, or to get ecstatic  on getting unexpected boosts to expect the same victory next time.

"Fortune favors the brave," "man makes his own luck," "luck may help sometimes, work always helps," I used to be a fan of such quotes, until I realized that they're just weak efforts of humans to encourage efforts in extremely hopelessly uncertain and unpredictable environment. Fortune isn't some conscious thing to favor the brave, only the rash decision makers fortunate enough to get positive results are remembered as braves the history being amnesic to the failures. Sometimes good thoughtful decisions come out with bad outcomes, the outcomes have many things along with our actions to depend on, it's an injustice to blame only the decisions when things go wrong and an over admiration to attribute all success to the decisions and actions when we get success. Even if we consider the parts other than us while planning for some action, we can't guarantee accomplishment as there's something we can't guess in proper, that something being luck or random fluctuations of it. Winning one lottery doesn't guarantee another win,  it can be proved that 'hot hand' in games is mere a mirage... your viva may depend upon the answers given by the candidate before you, in written exams things like mood of the examiner, or the quality of your first answer can affect the results more than actual quality of your overall performance. Being good doesn't promise a good outcome, helping everyone including the wrong ones may throw you in crisis or may make you an idol, being moral in immoral situations may make you a star or leader or may throw you in trashes...

Are we just puppets? If everything depends on luck, what's the role of making efforts? Does it have any role... We can't control luck. We are puppets in some sense, the consequences of our actions depending at least in part on something we can't control. But we're not lifeless dolls tied with some invisible strings getting moved by some invisible hands moving on random... we're capable of making actions, and planning them before making; we're capable of thinking and learning to think, of understanding the situations our capacities and incapacities, of estimating the odds of success impartially while restricting our tendencies of favoring our own decisions or those of doubting them more than needed if we're anxious, of deciding whether to take the risks, and of controlling our emotional responses when we fail or when we succeed.  We're capable of resisting temptations and learning to wait, to have more patience, to sacrifice immediate joys to get more enjoyment in future, or to accept minor losses in order to avoid major ones in future... We're born with certain levels of optimism, but we're capable of increasing it if we lack it or of decreasing it if we're born with optimism that is delusional. We can learn to direct our limited resources to things which really matter, we can learn to be rational while still being a dreamer.... Aren't we lucky that we're alive enough?

Why violence

Horror movies with ugly ghosts, screams and shouts, or brainless violent movies with dance of cruelty, injustice and blood... we are lucky to be able to choose whether to see them, but there are humans whose life is nothing but a live regular experience of such incidents. People fight, they beat others, verbally and physically abuse others, do injustice to the innocent, behave like some angry reckless beasts that too in their own homes. Every day starts (if there is a day) with extreme fear and uncertainty about the existence, every now and then there's possibility of severe violence...

When survival is a big challenge, thinking about growth and progress is out of question. misery rules lives over there. There are bad even vulgar words; there are moans, groans, cries; there are tears and pathological villainous laughter, there are wounds, bleeding, slashes, abrasions, hematomas, and even fractures... loss of organs or organ functions....

With all hopes wiped out, life over there is synonymous with a blend of stress and pain. Before recovery can progress to healing, another assault follows. Sickness, illness or  decreased working capacity are treated with doses of threats, abuses and physical violence... and they're not some wandering ghosts or renowned criminals, for most of the times they wander in outer world as normal humans. I really can't understand in terms of traditional evolution the existence of mother beaters, wife beaters and child abusers. Do they really gain something by hurting their own kin, by transforming their own homes into live hells?

Many times they are males, sometimes addicted to one or more psychoactive drugs with those drugs seizing their controls over their own brains... sometimes they're hale and hearty, conscious, maybe without any drug flowing in their bloodstreams and they just happen to love violence; some may be very intelligent, using planning and high tech techniques of offering distress to take revenge of innumerable small offenses done against them, such as cooking something they don't like... maybe they're psychopaths, maybe they're frustrated failures attempting to get rid of the frustration by doing something injurious to the innocent.........

What's wrong with their world... who's at fault? What makes the crops of psychopaths so common? Lower socioeconomic status with scarcity of resources, scant facilities and excess of problems is said to be associated with high levels of improper aggression. And such aggression does nothing but worsens the situation. Why do people to fall into vicious cycle of scant resources to aggression to destruction of the resources, rather than using the available resources judiciously economically and effectively for helping themselves and others? Why do they choose to hurt others when in fact comforting, helping and loving others can be a great source of solace and relaxation?

Actually more than the actual socioeconomic status, person's own rating about his socioeconomic status is more strongly associated with such improper behavior. In other words, unsatisfied souls tend to be more improperly aggressive. Their aggression is the major obstacle in progress, and the major cause of distress to themselves, their closed ones and to the whole world...    

I don't know how rational it is to think to alter them... I don't know whether there is some rational way to do so... It's like a huge forest in fire, I don't know from where to start and how. For now I'm trying to keep my sensitivity alive, perhaps by chance someday the destiny might offer a chance to make some difference, it won't be a good thing to miss it mere due to indifference.

                                                                 

Frustrating Stimulating

Stimulus is the prerequisite of any action, it's the soul of efforts, fighting spirit, the thing making us strong enough to sustain and keep working even in highest adversities... some sort of stimulus is mandatory to sustain the urge to stay alive. Adversity on the other hand can be defined as lack of stimuli for growth, it's the scarcity of positive things, positive feelings, a threat to existence... The quantity and quality of adversities we face may be the results of our actions or may be purely matters of chance or maybe a combination of both... but they do come; the bad thing ends and the worse follows; surprises come one after another to the extent that you may stop getting surprised... typhoons come, tsunamis happen, earthquakes occur in your delicate mind and push you backwards sometimes far behind the starting line and you've to strive to reach to the starting line leave apart reaching the finishing line.

It requires a highly developed and strong frontal cortex for animals to think of the future and to keep on pressing the lever even if the food reward doesn't come for one time, two times, tens and hundreds of times... but what that poor frontal cortex shall do if thousands of presses are fruitless, and instead you start getting shocks..... I think frustration is a natural phenomenon if the situation is too frustrating. Frustration doesn't come alone; depression, aggression, decreased cognition are all it's companions. It's a vicious cycle, and it goes on affecting each and every part of our lives, making us a person we hardly would have imagined when we were not frustrated. Firstly we lose our voice and then our desire to have our own voice... the pen is there, so is the paper, but the collection of words is often soulless.

It requires intact cognition, lots of energy and high spirits to search meaning in meaningless tasks... it requires extreme confidence, passion and devotion to search traces of hopes in hopeless conditions. Sadly to frustrated tired brains even life saving tasks seem to be meaningless, slightly joyous tasks seem to be extremely mundane. Dullness, boredom, hopelessness, meaninglessness and also sadness... life gets soaked in such dark shades, we become adapted to them and eventually forget the sense of brightness. We come to a point where life can become extremely unproductive, highly dependent on the very scarce sources of stimulation it has... With all joys disappeared from it, the life can become synonymous to painful suffering.

But pain isn't a neutral thing... it's a stimulus. Frustration sensitizes us to all the little positive things we have in our lives, they all when combined are enough to make us to get up and start again with a different approach. It is painful of course, but pain is I feel a foundation of some sort of creative thinking... though this thinking is totally different from the creative thinking due to joy, it can be very productive. Even the act of imagining of how life would have been if things were slightly different is very soothing. Frustration is better than having no emotions at all, it doesn't feel good and thus can act as a stimulus to do something to get out of the situation... If compared to writing frustration isn't the end of the story, it's not a full stop nor is it a comma, it's writing the same sentences with a different tone and maybe with a different meaning... who knows if tomorrow something blissful happens and the next paragraph contains a tinge of smiling heaven in it.  

It is and that's what matters

"It's like a big zero, meaningless, blank, painful, pitiful, extremely hopeless, hopelessly useless, cruel, demanding, demeaning...," sometimes life comes to a point where all efforts seem to be fruitless, we get bombarded with one disaster after another, we get one proof after another of our miserable ineptness, when we lose the sense of direction as if we're trapped in some irremovable fog, noises become so loud that we can't hear our own voice; all we hear are demands, orders and expectations from others especially from our loved ones who somehow seem to have forgotten to love unconditionally; in the bottom of our hearts we're forced to carry an ocean of endless emptiness studed with dying desires, comatose mutilated dreams and above all with an incurable sense of agonizing loneliness... it's the time when we're forced to find out the cause to sustain life or to bear it, to choose whether to continue or to quit... "Why me," is another pathological thought that consumes much energy to get repressed.

This painful feeling grows with age and by the time a kid reaches young adulthood it already has become overwhelming... Some are lucky that they never get these bouts of madness, some succeed in getting rid of it and living a 'normal' life, and in fulfilling all the expectations while still carrying that ocean of emptiness buried somewhere in depths of their minds... some quit, and the remaining ones make their names as synonyms of madness... prove either to be extremely productive or to be completely useless, all their fate depending upon where they direct their search for themselves.

Madness isn't that worthless I feel; it does worth a try or maybe many. Life is slippery, we can't hold it; no matter how stagnant we feel it is, it's always on the move. We're not stationary things, we're humans, time is bound to change us, so are the situations, our feelings and experiences. What we have today there's no guarantee that we'll possess tomorrow... and this includes along with our talents our adversities, pains, failures, all the noxious stimuli evoking fears tears and cravings, our madness, desire to do something, to love, dreams of creating something, of making some difference, our energy, our youth...

Things change with time, just for example- once upon a time I used to write comedy, now comedy seems to have divorced to my pen; it just doesn't come, every sentence comes with a tinge of tears. I wish I would have written some more at that time..... I may write it now if I try hard, but some things are just irreversible. I can be curious, but I can't be a kid. Time affects every single aspect of our lives. To avoid this 'I wish I would have' feeling in future, we must move today.... Our desire of doing something, the endless craving, the sense of not feeling satisfied with the current situation, in other words 'the madness' is only the chance we've been given by the destiny, we shall not lose it by feeling overwhelmed... what if all of a sudden we get some frontal lobe lesion and like Phineas Gage get converted into creatures those can be called in words of his friends as 'no longer us'... we shall not ignore what we have and waste it in crying for what we haven't.

Instead of feeling sad due to the expectations from our loved ones, or feeling that our love is unrequited, we shall think of exploiting our desire to take care of them.. who knows tomorrow some pathology or trauma might happen to our brains and we may lose completely the sense of heavenly pleasure we get for caring them. This uncertainty applies to every field of our life, and this makes the current moment crucial.

It (the current moment) may be like a big zero, meaningless, blank, painful, pitiful, extremely hopeless, hopelessly useless, cruel, demanding, demeaning whatever... but it is and that's what matters, and we must make something from it before it passes away.

discard labels... be humans

I hate boundaries, I always have... Restrictions suffocate me, so do some unexplainable rules. Division of humankind on basis of states, countries, continents and even casts, religions and races make me uncomfortable. Maybe I'm immature, maybe completely mad, but I really can't digest the concept of nationalism, can't understand what on Earth people try to achieve by fighting for boundaries, ruling other nations, or by killing for religions casts and some strange beliefs... and even by saluting to some flags. Can't there be a constitution bigger than the constitutions of each and every state and each and every nation, a constitution of humankind? Can't there be a big flag representative of the whole of the humankind rather than that of a tiny fraction of it? Can't there be a sacred book sacred to people of all religions? Can't we remember the fact that we're humans before we get labeled as members of some tiny community? Is it mandatory to waste resources such as money time and manpower and to sacrifice lives for fighting for little causes like what little immature kids do? Is it mandatory to look at our near and distant neighbors as our competitors, and to set our goals as to overpower them and to make them to lose, especially when we know that there are real problems out there those we need to tackle as humans? Can't we be partners instead of being rivals and work as a team using our differences to compensate for the weaknesses of each other to reach to a common goal of making human life better?

It sounds good to focus on a tiny part of a system and to feel dedicated to it, as it sounds easy to improve the tiny part than improving the whole system... but it'll be a foolishness to ignore the fact that the tiny part is a part of the whole system, and any damage to any other part of the system is bound to cause at least some harm to the part we feel we're dedicated to. Even if we happen to live in an isolated community on an isolated island, still there are things like pollution global warming and altering balance of the ecosystem which can affect us directly or indirectly... and most of us aren't that isolated. A citizen or member of some community is a bigger word than just an individual, but it's much tinier than the word human as we all are members of humankind.

It seems hard to think of equality when things aren't really equal; there are differences in geographic conditions, educational awareness, health and hygiene, availability of resources, faiths and belief systems, extent of social pathologies like money mindedness and corruption... and many more; but we're always free to grow, to introspect and overcome our weaknesses; and instead of looking at others as obstacles in our path or as potential threats to our existence or as something we've to overtake, we are free to look at them as other part of our world and learn from them and seek help from them to overcome our shortcomings while simultaneously helping them to overcome theirs. We're always free to choose to be helping humans instead of acting as area or dominance driven quadrupeds. I think that cooperation rather than competition is the key to success, satisfaction, and evolution; but it requires more strength patience and dedication, and an entirely different mindset... and fortunately all of these are achievable by practice.