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Updates
2018-07-16T11:28:56

ANOTHER STEP IN AN EXCITING JOURNEY!! It has been an exciting journey as a surgeon spanning over 21 years.... from an unsure, rebellious senior resident to a muted mature version... Director, Surgical Oncology- Breast Cancer.The journey has been anything but easy but I look back with lot of pride. I chose to take up surgery for my post graduation, a decision certainly emerging from the heart. To step into a male dominated world could only be a prompt from the heart. The brain would have screamed, “Harakiri”! I soon found that out as my immediate senior with my being in residency for a week declared with impunity, ”You will never make a surgeon”!I was discouraged but was not one to give up. I was labelled ‘The Rebel’! I carry that tag still. I am never one to back away from voicing my opinion, which may be uncomfortable but many a times the truth. I will agree that one art that I am yet to master from my male counterparts is their innate ability to be at their diplomatic best in the worst of situations. I have been promoted to Director, Surgical Oncology! I must have done something right to get here but I have been fortunate in several ways as well. The good fortune of having an amazing mentor in Dr Harit Chaturvedi and his confidence in my abilities, a supportive family and the ‘bug’ in my head which keeps pushing me to do more, have got me here.For me, this is an opportunity to lead, to mentor and to leave a legacy.It is also time now to shift gears from not just treatment of breast cancer but to prevention and early detection. I have taken baby steps in that direction but there are miles and miles to go before I sleep.... and the rebel in me is still alive and kicking. All that I can say is that the landing punches are just that much softer!
2018-06-30T02:09:25

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Bliss Foundation launches its unique ‘Touch Feel and Do’ Workshop to create breast and cervical cancer awareness! All things, big and small, begin with an idea. Touch Feel and Do workshop was conceived as we sat across a table. It started with the questions Are we doing enough? Are we doing right? Do the ladies we talk to understand what we are trying to tell them? Do they know what to look for? What should alert them? And then the realisation dawned, that when we talked to them, they absorbed a few things here and there. They surely could not piece it together. We had do something different to create a lasting impression....while the thoughts flew back and forth, the idea of a dummy with all possible presentations of breast cancer came up. The dummy was acquired by the tireless efforts of Reva and what started as a thought began to take shape.We wanted the ladies to touch the dummy breasts, to feel what cancer may be like and to do it on their own selves. A pre lecture questionnaire followed by the lecture, a post lecture questionnaire and then a Touch Feel demo completed the workshop The results quite amazing... from ignorance to empowerment in a matter of an hour and a half- the duration of the workshop. We are on a roll after the stupendous success of yesterday’s program where the Touch Feel and Do Workshop was formally launched with the blessings of BK Sister Shivani. We have done 10 and with more doctors and volunteers joining us, we hope to complete 30 this year. With the kind of love and support we are receiving, there is no stopping us now! A big hug to the Crusaders who made this happen- Nidhi Agarwal, Reva Kumar, Meenu Madan, Dr Swasti, Dr Neerja Gupta, Dr Mallika Agarwal, Dr Smriti Neha, Ms Payal, Vijayaji, Ruby, Saloni, Anju, Kalpana, Shivani, Smita, and the young Turks Navya, Ansh and all the volunteers .....you have every reason to be proud of yourself!💖 Jaadoo ki jhappi for the unsung heroes who work selflessly for the cause- Karuna, Esther, Deepta, Rituparna, Archanaji and Mrs Solanki. You help us dream bigger!💖 A big thank you to all those who attended the program and believed in us!
2018-06-25T17:42:31

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LETTING GO During my years in medical school, it was always tough to lay your hands on the best books available. They were outrageously expensive for a middle class student like me. My dad would still want me to have the best. He would put aside his needs and my mother would spend less on the essentials so that I could have expensive reference books in medicine and surgery. I devoured on Harrison’s Principles of Internal Medicine and Schwartz’s Surgical textbook. They were hard to reproduce in the exams but were succinct in their explanations of the various diseases that plagued the amazing human body. The last I read from these books is more than 20 years. They occupied a corner on my bookshelf and gathered dust. They would catch the corner of my eye, occasionally and I would clear the dust as a sweeping sense of nostalgia overcame me. With my daughter’s books jostling for space, I decided to make space for her while the house was being painted. I brought these old books down, turned a few pages with a lump catching my throat. I realised, there time was past.All the information I ever wanted was just a click of a button away. A lot has changed since the time they were the only prized possessions I ever had. They had to go... the new had to make space for the old. Their life had come one full circle!
2018-06-09T02:52:12

RISING TO THE OCCASION Yesterday, this beautiful young lady of 33 walked into my room. I could see she had had chemotherapy as a smart bandana adorned her bald head. She was accompanied by her mother and her husband. Her dazzling smile and her confidence as she took me through the journey of nursing a 6 month old baby, of discovering a lump which was labelled benign at first, of the lump growing in a month and she, of her own volition going for a biopsy and discovering she had breast cancer, shook me! She had visited 3 or 4 hospitals for various reasons and is on the verge of completing chemotherapy. She had come to meet me to discuss the surgical options and the implications. She told me that she was scared of needles and pain but her composed demeanour conveyed something else. I could see, I was having the privilege of interacting with a woman of utmost strength, resilience, poise and maturity way beyond her years. Her smile never left her face. Her mother contributed positively in equal measure but the sadness in her eyes of seeing her little girl suffer did not escape my notice. She required to have an injection to up her white cell count. She went to the nurse in the treatment room for the same and showed her a prescription for the same on her mobile, from a different hub of the same centre as ours. She refused without thinking what she could have done to help her-a cardinal mistake! The nurse was following a process, which said no medication without prescription, which was fine. What she did not do, was figure out a method to solve the problem. She could have got a print out, on our institute’s letter head and cross checked with the prescribing doctor and administered the medication. What happened next was no surprise. The mother was outraged. She had accompanied her daughter across half of Delhi for a consult and this Nay from the sister, truly rocked her frail boat. She truly took the nurse to task for being unhelpful and uncaring. The situation was brought to my notice.The matter was sorted out, a printout of the prescription was taken and the injection was done. However, the bitter taste in the mouth remained! I know for a certainty, that the only people who go to hospital, happily, are doctors and the staff at work. The ailing come, as they don’t have an option. They entrust us with the job of sending them back, cured or relieved of their ailment. We, as caregivers, should never forget to look beyond and see the footprints that they have left behind, as they walk the difficult path to meet us. There is a story, sometimes, most heart rending, that we need to know- a story that should only raise our level of empathy. Each one of us has to walk that extra mile, go beyond our call of duty to ensure that we do our best for the person sitting across the table, entrusting us with making some of the toughest decisions of their lives. We, as professionals, have to really rise to the occasion, every single time!
2018-06-03T04:59:19

Never too old to make choices Last week, I met this lovely lady, pushing 80 years. I’m reluctant to call her old for her lively demeanour would put the chronologically young to shame. How I met her was because she had been diagnosed with breast cancer. Fortunately for her, she had early breast cancer. This is a delight for a breast surgeon like me, who is used to seeing advanced breast cancer. After going through the investigations, it was decided that she should have surgery. I started discussing the surgical options and just as I would do with all my patients amenable to all the options, I discussed breast conservation surgery, mastectomy ( surgical removal of the breast)and mastectomy with reconstruction. She was quick in making her decision and said she wanted to have a breast conservation surgery. I liked her firmness but her daughter was not so sure. When the time came for her to be admitted, the daughter came up to me and said that she and her brother thought it would be better if she went ahead with mastectomy. It was surely concern for their mother. They wanted her to be disease free and also thought that at her age, it did not matter if she lost her breast. At the same time, they were not sure that breast conservation and mastectomy yielded the same results. I spoke to her again and said that her mother had made a choice, which was scientifically tenable .Ten years ago, my warped mind might have encouraged her to go for mastectomy. Now I know, choice has nothing to do with age.The instances when husbands, brothers, parents, relatives and anyone else( read neighbors!) influencing surgical decisions have been too many and every time, my heart has gone out, especially, to the young ladies who have had no say in the choices imposed on them.Losing a breast is a self esteem, body image issue- the loss and its impact is borne only by the one who loses it.The lovely dame stood by her choice and it was executed. Choices are not about being right or wrong. Choices are about the freedom to make a decision and stick by it. The comfort of having made one’s choice is a confidence booster and can bring about unexpected results. I do know that, for a fact!
2018-05-28T01:54:07

Today I complete 22 years of marriage and I thought this an opportune time to look back at my life with satisfaction. My marriage was arranged by my parents through mutual friends. My husband is an engineer and the one time we met before the process began, he had decided and I was still unsure. I was trying to peer into the crystal ball, hoping to figure out how this arrangement would work for me. I was training to be a surgeon, not a choice many sensible women at that time made. The questions kept me awake- would he understand the demands of my profession, the late hours, the middle-of-the-night zipping to hospital to deal with an emergency etc? Would he understand my need to study further, maybe go abroad and work hard to give myself a full fledged career? His being an engineer did not help the cause at all. And then I stopped thinking and gave in to the wishes of my parents. When I look back at those 22 years gone by, I have plenty to be grateful for. For a woman to pursue a full fledged career is never easy anywhere in the world.What you make of it has plenty to do with the support you have. The support I had was truly unconditional. I completed my post graduation after marriage. My in-laws wanted me to carry on, unhindered, with my studies.FRCS soon followed with my parents chipping in to look after my little daughter. I went for a year long fellowship to London, leaving my daughter behind with my husband and mother in law. And did I stop? And did he stop me from pursuing my dreams? Not once! We are all imperfect in our own ways but valuing people for their strengths is what sustains relationships. His presence in my life has been the star and I can only wish him the very best that life has on offer!!
2018-05-21T17:26:24

Yesterday I visited my niece and was on the phone talking to my patients, sorting things for them. When I finished, she asked me, ‘Isn’t your profession stressful?’ I was quick to say NO. The conviction in my tone has taken many years to come. I recall my early days as an oncologist and in particular, this vivacious young lady who had a relatively advanced colorectal cancer with involvement of her ovaries. She had undergone surgery elsewhere, 4 weeks prior to coming to our unit. Her abdominal wound lay open and was pouring out fecal matter and abrasive intestinal juices, consuming her skin.I could not come to terms with the unfairness of the situation, then. Why was this young lady with the most sparkling, hopeful eyes dealing with this horror? I wanted to pull her out of this mess and diligently did my best to improve her nutrition, take care of her wound and her medication. She and I would talk a lot- her dreams, her aspirations, her twins, her loving husband, her family...we became good friends! Her surgery was planned and executed well. She was recovering well and she wanted to be home to celebrate her twins’ birthday. I assured her she would. And then that day arrived, when she walked. She walked for the first time after 8 weeks. I was thrilled and went home thinking she would be out of the ICU the next day. I was going up to the hospital the next day when I got a call that she had had a cardiac arrest. I thought I had heard wrong. I ran up to the ICU and before I reached, she was gone. Pulmonary embolism had taken her away. I was distraught and I cried, rather howled, like I had lost one of my own.An elderly physician put an arm on my shoulder and said, ’ This is certainly not the last time you will have to deal with this. Don’t get attached to the outcome of what you do. Do your best but remain detached from the outcome’. Those words have stuck and I have grown since. My focus is entirely on what I can do for the person who sits across the table and entrusts his or her life to me. I do my best to understand the problem, execute treatment, handhold them and try and do whatever I can to make the experience as seamless as possible. Cancer outcomes are never a 100%. You do lose some at the end of the day but if I have contributed to making their life easier through their suffering, I have done something worthwhile. While it is easy to be overwhelmed by these difficult situations, I need to remain detached from them so that I can do more for those who need help. I have come a long way since, but it is not as if I am not affected by what happens to my patients, anymore. It is just that I have taken better charge of the emotional me and replaced it, not entirely, with the professional me!
2018-05-12T01:57:54

I am a big fan of Angelina Jolie. So what is the big deal about it? Half of the human race is possibly her fan..her looks and her acting prowess has had the world swooning. I am her fan for a different reason. I haven’t followed her movies, her drop dead gorgeous looks or her personal life but I admire her for her courage. Some years ago, this remarkable lady announced to the world that she is having both her breasts removed. She knew that she was carrying a genetic mutation which made her susceptible to breast and ovarian cancer. Her family history was strong for both breast and ovarian cancer and once she tested positive for the mutation, she knew she carried a 60-80% risk of developing either of these cancers. She was faced with the prospect of prophylactic breast and ovarian surgeries. I can only imagine the sleepless nights, the battle within-to do or not to do, several rounds of long discussions with her doctors, family and friends, the impact on her career which relied heavily on glamour, her children... and so much more. And then she made that decision to have both her breasts removed and subsequently her ovaries. She shocked the world but at the same time catapulted herself to that realm of courage and fortitude that rarely people of her standing dare to tread. I joined her fan club and her story of courage became the benchmark for women caught in a similar situation. Why I recalled this story was when I encountered my own Angelina Jolie. This young lady of 35 had a very strong family history of breast, ovarian and colon cancer on her maternal side.Her husband was gutted when she was diagnosed with breast cancer. I advised her for a genetic consult while planning for her surgery. The genetic consultant had barely advised her gene testing and was discussing the possible implications, when she said that she had made up her mind. She very calmly told the consultant that irrespective of what the test says she was going ahead with bilateral prophylactic mastectomies and bilateral ovarian surgeries in the same sitting. She came to be and conveyed the same to me. It shook me inwardly and took me a while to gain my composure as her husband stood by her, rock solid in his support of her decision. ‘COURAGE’ as a word probably does not do justice to the tenacity with which one arrives at this supremely difficult decision. I have done these surgeries before and this one was certainly not the last. Such decisions are rationalised within the multidisciplinary board, the molecular oncologists, the psychologists, the family and most importantly, the patients!! While I see more of these Angeina Jolie clones, I will always hope and pray that these amazing ladies’ decision translates into long, meaningful and inspiring lives!
2018-05-02T16:10:34

I was brought up in a middle class Malayalee family, extremely open minded about education ( like all Malayalees) but as close minded about display of any form of affection. I used to envy my north Indian friends when their parents would hug and kiss them, completely oblivious to being watched. It came naturally to them. By just watching this momentary expression of affection, I used to be suffused by an inexplicable feeling of warmth and also experience a certain positivity percolating into the environment. This seemingly innocuous expression of many positive emotions... love, kindness, a blessing, a prayer, gratitude, healing... came to be extolled as ‘Jaadoo ki Jhappi’ in Munnabhai MBBS. While I always believed in the magic of Jaadoo ki jhappi, it is my patients whose firm belief in its power to heal, that made my belief stronger. I don’t know when, but it has come to be a usual occurrence for my patients to walk up to me and almost ‘demand’ their Jaadoo ki jhappi. The awkwardness of my childhood has given way to the concerted belief that it does good to both the giver and the recipient. And that brings me to my dear Champion, Mrs C who spends time between Australia and India. She is having her regular checks post breast cancer treatment in Australia.She was here last week and waited for a couple of hours in the Outpatients for her Jaadoo ki Jhappi.And I was only too happy to oblige. If she believed it was healing for her, it was for me too! Isn’t it true, the more you give, the more you get?
2018-04-22T05:38:29

Breast cancer can catch anyone by surprise. Why I say that is because the usual history is a lump felt in the breast over a few weeks to a month or two or more. Apparently innocent as it caused no pain or upset the rhythm of life. It was just there! I identify with this extremely unpleasant feeling of being caught out or cornered or ganged up against, when this innocuous lump is declared cancer, almost everyday. How could a lump which was just there till yesterday change life indelibly? The grief that accompanies the diagnosis is unfathomable in most. The denial that follows and the unfairness of the situation is quite hard hitting. I, as a Clinician, after so many years of being witness to this familiar response, still find it hard to say something sensible to console, especially if the affected is young. It is almost as if I am on their side, a part of their family, going through this heart- wrenching sequence. When I am at a loss, the best I do, is hold their hands and say everything will be alright. I want it that way and no other way, as every doctor would. And it works! I liken the situation to being in quicksand. If you struggle too much with the situation, you get pulled in, the brain gets clouded and wrong decisions are made. If you reach out to a helping hand, gently ease yourself out with coaxing and cajoling coming from your loved ones, you make it! How one handles the situation has a large part to play in what the final outcome would be. We do not choose situations in life and some situations do catch you unawares. What you can choose, is your response to the situation- accepting it, making light of it, taking it in your stride and going through treatment with the desire to heal and bounce back, is usually what winners do!!
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