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2018-08-02T16:02:32

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WHEN THE CHIPS ARE DOWN.... There are times when one feels trapped, not knowing which way to turn. All spaces close in on you as if to smother you. That is the kind of feeling which had crept into this young patient from Kenya. She had undergone two botched up surgeries on her leg for a tumour, which had now, returned with a vengeance. She is to have more surgery but her spirits are dwindling. She is away from home and only has her twin brother for company. The money is drying up quickly and she, an accomplished dancer, is confined mostly to the bed or the wheel chair as the leg fails to take her weight. Today, she was particularly distraught and her tears flowed freely. Our physiotherapist came to me and asked if we could cheer her up by bringing her to the Breast Support Group meeting, where a troupe of youngsters was coming to get our Champions to perform Zumba. I thought it was a great idea and she was carefully shifted on a wheelchair to the building next door where the program was to be held. And right in front of our eyes began the transformation. The girl could not stop clapping and moving to the beat on the chair while her brother kept pace beautifully with the trained Zumba troupe. The 25 odd Champions, doctors and support staff all got going, only stopping to catch their breath or a sip of water.This little girl got caught in a whirlwind of foot tapping music and an all pervading gush of positive energy. She laughed and spoke to the Champions and believed everyone when they said she would be fine. She left with the promise that when she recovers from surgery and is back on her feet, she will come back for a Theme party and she would lead the dance! So when the chips are down.... DANCE!!
2018-07-27T16:06:52

REFLECTING WITH GRATITUDE Today is Gurupoornima and I am blessed to have had amazing teachers in my life...heartfelt gratitude to all those who held my hand and taught me to walk, to those who saw me trip and fall but let me pick up myself, to those who pushed me so that I would not get used to the comfort of an easy ride, to those who laughed at me so that I could learn to laugh at myself, to those who ridiculed me so that I could start believing in myself! I am grateful to my patients-my awesome teachers-who have taught me how transient life is and how to make life bigger and better every single day. They remind me how minuscule I am in the larger scheme of things and how acceptance is the easiest way to avoid disappointment.May you all live happy, healthy and meaningful lives. Loads of respect to all my Teachers!!!🙏🏻🙏🏻
2018-07-21T18:36:57

THE ART OF SELFLESSNESS OF PURPOSE Three weeks ago, a thin built lady from a remote village in UP walked in with her sister and her nephew, who lived in Delhi. While they poured her story of being diagnosed with breast cancer, I could sense an underlying anger. The sister burst forth with the information that her elder sister’s husband is a farmer and had thrown her out on knowing the diagnosis. He refused to get her treated and had said that she was as good as dead to him. The sister was vehement and was certain that she would get her elder sister treated. That is exactly what she did. I operated upon the lady. On receiving the pathology report, I shared with her that her sister would require both chemotherapy and radiation. The patient’s husband also came for that consult and asked me if he could take his wife home before she started chemotherapy, to which I said he could. Hardly had they left the room, that the younger sister returned to my room, furious. She said, ‘ How did you even suggest that he could take her back home? He will not spare her. How could you undo the effort that I am putting in, to treat her?’ I was stumped!She went on to say that she would look after her and make sure she had her complete treatment. She told me that she was a person of modest means with a one room flat but she would arrange accommodation for her sister and get one of her nieces to look after her while she underwent treatment. There was that intense look of determination in her eyes when she said, ’ Doctor, no way am I going to let her go- I take her full responsibility!’ How many times do you come across such unsung heroes in your life? This young lady is a hero, championing the cause of her older sister who has no voice. Her sister has a husband who has only used her but refuses to stand by her as she readies herself for her biggest battle, yet. She has found an unlikely knight in shining armour in her younger sister, who, I am sure will brave the storms lying in store for her. It is not the money in your pocket that makes the world go round but it is the desire and the will to help that makes the world go round. I love the spunk of this lady and have loads to learn from her. Selflessness of purpose is what makes her so inspiring and restores my faith in humanity!!
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!
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