Dr K

Dr K has been my parents’ GP since they started living in Ottawa fifteen years ago.  I had never met him but had heard my mom and my dad mention his name often.  Listening to their stories I was always envious since this doctor appeared to be the stuff of legends and I was deprived of any contact with him; in the United States I am certain that meeting such a doctor is a near impossibility.
Over the years I had heard of his role as a guide.  My father had come to rely on his judgment and his expertise.  The one instance I remember very clearly is the one where my dad was going through some strange vertiginous and balance related issues.  It was frightening because we couldn’t tell what this was.  Was it another frightening symptom of the illnesses he already had, was it something new? So they went to see Dr K.  He asked several questions, lay my dad on the stretcher and essentially just tilted him this way and that.  It was apparently a matter of realigning something in the inner ear in order to fix its balance function.  When my dad was off the stretcher his problem was gone.  There was no guessing, no running of a million tests, each yielding no relevant information toward a recommended diagnosis.
I had heard from my mom that when Dr K first met my dad and learnt his name he told them that his dad’s name was Aaron which is really close to my dad’s name – Arun.  Over the years I heard stories of just how many times he had said that my dad reminded him of his own dad who he had lost several years ago.  Their office visits to his clinic included long conversations and a mutual delving into each other’s backgrounds and history.  
Dr K is well-traveled and has been to India several times.  He has been to Bihar, he knows about Laloo Yadav.  He is very involved with the Doctors Without Borders organization and spends many months of the year out of the country treating people who are much removed from care of any sort.  He spends a lot of time in the northern polar regions of Canada as well, treating the native population.
As we mourn the passing of my dad I didn’t want my mom’s health to start suffering from neglect, if nothing else.  She had recently cancelled her annual check up appointment with him because she was spending most of her time in the hospital with my dad.   Yesterday mom agreed to go and see Dr K.  I drove her there and even accompanied her to the examination room.  When he came in he greeted me with a hug, no introductions were necessary and then he focused his whole attention on my mom.  He hugged her and then he pulled his chair really close to hers and held both her hands as he looked straight into her eyes, not saying a word.  The tears started rolling down her eyes and mine and when she spoke she told him how much his care and his affection had meant to my dad, my mom, over the last fifteen years.  She told him how my dad always wanted to consult with Dr K even when he knew that his ailment required more specific care than that which a GP could provide.
They held hands and kept reminiscing for a long time, he remembered every conversation and every session they had ever had.  He occasionally turned to me to tell me how my dad had such presence, such an impact on all the people whose lives he touched.  He told me my dad inspired instant admiration and reminded him so much of his own dad and that he had felt a lot of affection for mine.
We had assumed he would have known of the cause of death since hospitals in Canada keep the GP informed of all developments.  But word hadn’t reached him yet.  The last information he had was that my dad was in critical care due to renal failure.  He learnt of his passing when my mom checked in at the reception and told the receptionist.  So we told him that renal failure wasn’t the cause.   It was PJP bacteria/fungus that goes after people whose immune systems either don’t function because of an autoimmune disorder or are suppressed by anti-rejection drugs given to people who have had an organ transplant.  My dad had had two organs transplanted and his immune system was severely compromised.
The PJP destroys the lungs with a severe pneumonia.  My dad’s lungs were full of fluids.   He couldn’t breathe.  When doctor’s asked him how he felt he would tell them he felt like a fish removed from water.  
I told Dr K that my brother had overheard a conversation that his medical team were having in the ICU and they weren’t aware that my brother was listening.  One of the doctors had compared the chest X-Ray to the whiteness of a pillow case. Dr K uttered the words “white out” when he heard this.  I could hear the tears in his voice as he said these words and then turned around to grab a Kleenex.
He explained to me that a normal chest X-Ray would look black on the film.  Like an idiot I said you would also see ribs.  He said, “I don’t see ribs…ah I see…that’s interesting…if you are a doctor you don’t see the ribs…you see the black or the obliteration of the black (air) with the white that represents the absence of air and the presence of fluids or anything else…”  With this exchange it hit him that this was the worst case scenario.  He told my mom that she should have called him, that he didn’t have the magic that would have fixed him this time but he would have known what was going on and we wouldn’t have spent so many days wondering and clueless.
He finally got around to completing my mom’s check up.  He recommended diabetic counseling for her.  I urged him to recommend this counseling as soon as possible but he said that this was not the right time because she couldn’t learn or retain new information at the moment, through grief.  He recommended it for three months from now and I saw him type in a note full of compassion on his computer screen as he emailed the staff responsible for setting this up.
He hugged us warmly as we left his office.  I left feeling more comforted than I had felt in the preceding 48 hours.

Is a title really necessary?

I watched the Fourth of July fireworks on Lake Cazenovia this year.  Each spectacular display filled me with a trepidation that belied my awestruck smile, the smile the camera captured.  I had a sense of being in the wrong place at a wrong time.  My presence was required elsewhere but life always unfolds in a less than ideal fashion.

We are scattered across town, across borders and under various roofs tonight.  I am not sure anyone is sleeping well.   I am trying to express myself on a tiny phone screen at this strange hour of the night with words that are inadequate and restrictive.
My memory is long.  I remember always being eager to sling a thermos full of something refreshing, cross bodied across my tiny, four or five year old frame, slipping my hand in daddy’s warm hands and getting on the steamer that crossed the Ganges and took us to our ancestral home, ferrying us between Mahendru Ghat and Pahleja Ghat.  The steamer served deliciously unforgettable potato cutlets.  Whenever he asked if I wanted to accompany him on a trip my answer was a resounding yes.

Over the years, I remember the times I disappointed him after every math exam and the times where I surprised him with an academic performance that was better than what he expected.  After a particularly harrowing exam result in college I had mustered up enough courage to hop on a three wheeler and go straight to his office in the middle of the afternoon to ask for money for a course where I promised him I wouldn’t disappoint.  I was full of apprehension as I worked up the nerve to ask and floored when he gave me the funds without raising any objections.  I think I kept my promise that time.

There was the trip to Chandigarh.  The aloo paratha with butter that we shared was the stuff epicurean dreams are made of but what stands out even more is a hope he expressed  – that I would always be skipping to the music in my head, confident and stress free.

He had a vision for me.  It entailed a very detailed and impressively executed plan for setting me free to find and define myself in this world.  He did his part with perfect choreography.  I am still trying to live up to my end of the bargain.  I have stumbled, I have slacked off and I have never taken a single step past the “work-in-progress” mould.  There is some defective switch, circuit or gear within, something eager to bestow a lemon status on me,  I can promise to keep trying and I am certain he believes I’ll get there.

I was driving for seven hours alone in the car with my thoughts and recollections. The news in the morning had been delivered with an unmistakable note of panic and distress in mom’s voice and I had to drop everything and get on the road.  I needed to be in the right place this time.

Seven hours alone in a car gives one a lot of time to reminisce and makes for some blurry-visioned steering.  The tears this time reminded me of the tears we had shed together on a bench in the Prince George’s Plaza Mall in Bowie, MD on the eve of daddy’s departure to India, leaving me behind.  I was young and naively fearless but he had faith I would flourish, even through the tears that wouldn’t stop for either one of us.

The illness that reared its ugly head in 1987 was already a year old at the time and it just made him more determined to clear a thorn free path for our future.

I look back on my first 2015 trip to Ottawa in May.  The snow had melted and the snowdrifts of Syracuse and Watertown no longer threatened our passage to Canada.  I was excited about my trip and I remember telling my hubby and daughter that I couldn’t wait to have some “juicy” conversations with dad. There is nothing more engaging than the panoramic vistas that emerge and unfold when we converse with my dad – religion, socio-economic systems, botany, philosophy, his philosophy and how he has honed or tweaked it over time, his career, his childhood, his independence from a very young age – I can listen to every story forever.

Sadly, in May he barely spoke.  He was easily tired, depressed at how difficult it had become to move and he was also irritable.  I was torn between compassion and my own selfish need for enlightenment through conversation.

My expectations were dashed and I was guilt ridden for having these expectations and saddened at how much of a prisoner his brilliant mind had become to his body.  I was sad to see how broken both my parents looked and felt and how helpless or useless I was with offering succor.

I called several times since May.  I always wanted to hear him say he was doing better but I learnt to be happy when he said he wasn’t worse.  When I called him on Father’s Day Sunday he didn’t indicate any worsening in his condition but on Monday mom told me he had to be rushed to emergency care for difficulty in breathing.

He has been in the hospital since that day.  He has had better days and bad days as his team of specialists try to work through the puzzle that his system has become after undergoing a liver transplant, severe pneumonia, years of dialysis leading up to a kidney transplant and the rather rapid loss in mobility within the last year.  The doctors are still guessing that he has a severe lung infection and are treating him with antibiotics.  He is on oxygen and has trouble conversing.  The monitor starts showing lower oxygen saturation levels when he talks but today he felt it necessary to talk to me about his will.  It wasn’t a welcome topic for me, this wasn’t the conversation I yearned for or relished.  I listened and am still stuck on the part where he got ready-eyed again as he told me that he had always added to and never depleted anything.  I am snagged on that sentence and that particular tonal inflection because such a thought would never even have occurred to me and I cannot imagine why he would want to stress that.  

He is my hero, always has been.  This world, my world, is worth living because of him.  

On July 3rd he was feeling good, ready for rehab, ready to come home and to start penning his experiences.  I am hoping tomorrow will be the first in a very long succession of such brighter days.

What Changes?

There was that feeling again. The one that suggested she was losing herself. She was another year older and had convinced herself in this past year that such a feeling was absurd.

How could it not be when the person sensing the loss and the person getting lost somewhere were one and the same?

What people meant when they expressed such a sentiment was no longer clear. So, she felt a need for better words to express this sense of loss, this sense that challenged a long held view of her sentient years, that something within us all remained ageless and changeless.

Imprisoned eyes, the truest representatives of this changeless state, were held captive within a cage of flesh and bones. They observed and interpreted a shifting mosaic of impressions, rearranging them one way or another to fit some unfathomable pattern that would make the most sense; eyes remained the same while views changed.

She had lost her favorite views. A dark and solid wall had appeared where something shone, shimmered and beckoned before.

It’s an old day

Blank pages are easy to come by.  You can grab one from the printer or turn over a new leaf in the notebook.  Life, is not like a piece of paper or  even like an entire notebook.  If you think it is then you are harboring a delusion.  Sure, you can crumple up a messed up day and discard it, you will still have something else to scribble or doodle on tomorrow.  Your ballpoint pen will last a few months and your pencil is yet to be whittled down to the nub.  It is a disposable world and paper is still not scarce.

Fresh starts are cheap and you are easily lulled into a false sense of invincibility and a misplaced belief in infinite second chances and disappearing footprints.  In reality fresh starts do not exist and you do not walk away from anything.  What appears to be a fresh start is a consequence disguised as an opportunity in a lifelong construction project that can never outrun time.

You can build a spiral staircase for no other reason than a fascination with spirals or staircases or the golden ratio but when you learn that your fascination left you with stairs that have no purpose or destination, you are stuck with a folly that you then adapt or build around or let linger as a monument to un-reason. You can end up with doors that open up to walls or windows without views as you change or the world around you changes.  But any perspective demonstrates the consequential nature of all events, even the ones that appear mutually exclusive.  No actions get discarded.

We change everything around us for better or for worse even while just being.

Can’t See the Hour Hand Move

Something is changing in infinitesimally subtle ways.  I would prefer the subtlety to be even more pronounced than it already is, such that I can’t even anchor it in written thought.  Anchoring adds complacence.

I am more taken by pauses that last even a fraction of a second than I used to be with constant, interminable action.  
The barely noticeable pause between string crossings while playing a violin passage makes all the difference to the sound quality, this realization enabled me to take a baby step forward in my playing.  I find that something similar is at work when I don’t rush to complete the sentences of a person with whom I may be conversing and when I let them bring their thought to its own natural conclusion.  This feels more rewarding than being heard or needing to appear like someone who might already have been through the thinking and the thought that is being expressed.
I am still traveling through a seemingly endless tunnel of arrogance where my careless, thoughtless, hurtful, indifferent, caustic and angry words are capable of wounding an intended target but I am quicker with the introspection and resultant remorse or contrition.  There is some light at the end of this dark tunnel.
There are other things, other clues hinting at the changes afoot (unintended pun looms) even in how I no longer twist my foot out of laced up sneakers or jam my feet in them without bothering to undo the laces first, all in an effort to maximize efficiency.   Now I undo the laces first – spread the two flaps apart – then extricate my feet with ease.  Since tying the laces can be done on autopilot, without assigning extra brain cells to the task, it is almost like the pause between string crossings; a centering space.
That’s all I choose to anchor for now.  Onward through the tunnel and into the light of unexplored and calm spaces.

Reading and Walking

Part of this new 2015 chapter in health and fitness should be about eliminating multitasking, I think. And while reading The New Yorker from cover to cover in the process of getting to an 11,000 steps daily goal on the treadmill might qualify as dual tasking it will have to remain. These days it is impossible for me to just sit somewhere and read. It is similarly impossible for me to simply be on the treadmill, staring at the display and getting really good at multiplying by 9 (1 g of fat = 9 calories). So I’ve decided that the two activities belong together.

I used to read on the bus while traveling to work in NYC. Now I don’t travel anywhere and The New Yorkers were piling up. I am finally getting to read each one, having found the perfect complementary task.

But here’s the thing about the articles in this magazine – you can’t just read something and move on. What you read within these pages resonates well beyond the final page turned. Reading Nick Paumgarten’s article about Conde Nast’s move from midtown to downtown had a deep association for me since I have always worked for their competitors in and around the same neighborhood and I get nostalgic about the same sights and sounds and can identify with beautiful Nick Paumgarten phrases like “accretion of intent”.

In the next engaging article you read about Yitang Zhang an unheralded mathematician who bridged the prime gap. The article starts by Alec Wilkinson’s admission that math has always been somewhat beyond him. But despite this admission he is able to interview Zhang and explain what Zhang managed to do, so that most people reading the article could get some sense of Zhang, the magic and mystery of prime numbers and the unhurried and focused way in which this mathematician approaches every problem. I was amazed that I didn’t tune an article about prime numbers out after reading the first paragraph! Imagine there are prime number fetishists! 2 and 3 are neighborhood primes, 41 and 43 are twin primes, prime numbers that are 4 numbers apart are cousin primes and the ones that are 6 numbers apart are “sexy” primes! Who knew? Not I. I’ll never forget this one 700666007 – a beastly palindromic prime! Also that any prime number that contains 666 is a beastly prime. How fascinating!

The last article that I got to read before reaching my steps goal was about food safety in the US. It is always surprising to me that no matter what phase of life one is in, there is always something in this magazine that complements your thoughts and actions. What you read then amplifies your concerns (which can be bad) or helps you realize that there is some merit to your choices. In this case, the more I read about food safety in the US, the more I realized how unsafe food in our supermarkets can be.

I am a newly minted vegetarian. I have been meat free for 30 days now. I decided to stop eating meat because I was appalled at not just the conditions within and without the farm but the very concept of factory farms; their raison d’être. I felt good about my decision. Now, reading about Salmonella Heidelberg and E Coli contamination and the reluctance of FDA/ FSIS to call E Coli an “adulterant”, makes me feel even better about my decision.

The article talks about how FDA and FSIS have evolved since inception. How FDA was supposed to oversee everything except meat and poultry and FSIS was supposed to oversee meat and poultry except catfish, for some reason, catfish belongs to FDA. There are no clear distinctions anymore about the roles of these two watchguards over our health and well-being. They say this is where these agencies are now, having grown in this manner. Why would they be allowed to grow in this manner? When responsible parents raise their kids don’t they try to ensure that their kids grow right, with straight teeth, straight backs – no scoliosis, an education, immunity etc. Why does the government allow its agencies to grow helter-skelter?

It made me think of the time I was in Portugal for a business trip, all those years ago, and noticed how the buildings looked old and moldy, so many things looked like they were falling apart. I was new to America then and my eyes were younger, willing to believe, and quite in awe of the newness, the shine, the lack of unkempt sights. Photoshop didn’t exist back then, but in retrospect I feel as though what I saw in the US then was a photo-shopped or airbrushed reality.

When you read about FEMA screw ups, FDA and FSIS screw ups, special interests lurking everywhere, you wonder if things are, in reality, falling apart like the moldy buildings in any country that isn’t an airbrushed United States.

I think this passage from the article is the scariest thing about food safety one can come across:

“When another court ruled in favor of the F.S.I.S. decision to declare E. coli an adulterant, the ruling included a passage to prevent the F.S.I.S. from applying the same label to other bacteria: “Courts have held that other pathogens, such as salmonella, are not adulterants.” In response to that decision, in 1996 the F.S.I.S. enacted a series of new rules to curb pathogens like salmonella. For whole chickens, the salmonella “performance standard” was set at twenty per cent, meaning that one in every five bird carcasses could be contaminated. That standard has since been lowered to 7.5 per cent, but the performance standard for salmonella in ground chicken is much higher—44.6 per cent—and for ground turkey it is 49.9 per cent. “Which means that almost half of all your ground chicken that goes off the line can actually test positive for salmonella,” Urvashi Rangan, the director of food safety at Consumer Reports, told me.

Some products, such as cut-up chicken parts, have no performance standard at all. A hundred per cent of the product in supermarkets may be contaminated without running afoul of federal limits. Rangan told me that she was stunned when she discovered this, just recently: “We’ve asked the U.S.D.A. point blank, ‘So does that mean there aren’t standards for lamb chops and pork ribs?’ And they said, ‘Yeah, we don’t have standards for those.’ ”

Can one still look at the meat aisles the same way in one’s supermarket?

I had to hop off the treadmill just before the “Fiction” in this issue, that comes tomorrow.

I can’t think of another publication out there that could fascinate and engage a reader in this manner.

Observations

His dad makes himself comfortable,
Facing a space heater,
a blanket draped over his slight frame.
He leans back, head tilted upward,
Facing the ceiling,
as he lightly closes his eyes

Mine makes himself comfortable on a lazyboy or a chaise,
He curls his spine downward and faces the floor, head facing down,
as he lightly closes his eyes

His mom looks nervous and is torn between sensing a darkening future
And denying the present.

Mine looks nervous and is torn
between sensing a darkening future
And believing there is yet another
victory waiting to be snatched.

I see my own face in the mirror and imagine a rougher terrain, ridges and folds and vanished lips, that would stare back at me from the mirror one day, suddenly, making me wonder why I ever believed aging would be gradual.

I wonder if I would look up or face down when I lightly close my eyes while contemplating my inner child’s crumbling, creaking prison.

What happened today?

“Woke up, fell out of bed,
Dragged a comb across my head
Found my way downstairs and drank a cup, ”

Did all of the above but didn’t feel I was late for anything nor did I need to make a bus in seconds flat. Those days are long gone. But I did read the news again this morning. Nothing had changed.

Distant wars were still being fought, people were still killing people with guns while guns continued to appear where they didn’t belong, we were still trying to interrogate Ms Zellweger about her face and no one had managed to do anything about the interest rates on student loans.

I lost myself in spreadsheets and background entertainment wondering what piece of the grand puzzle I was

It was a good day

Good days are the ones where I hit all the notes and don’t slack off or miss a beat. So as you can tell, the violin practice went well. I also managed to drink enough water, exercise, cook butternut squash and draw and paint a bit. I like such days.

Day 2 of being vegetarian – done! 64 days to go because they say it takes 66 days to build a habit.

Darling I don’t know why I go to extremes…

Today was day 1 of being vegetarian. It didn’t feel too difficult but that’s a meaningless thing to say on Day 1, I am well aware. So I won’t say much more about that.

I do realize that as a vegetarian I would need to spend more time cooking. I just finished reading something that said that vegetarians need to get into the habit of reserving two hours of each day for food preparation and cooking. As a lazy non-vegetarian I had come to rely on the hubby or on thaw and nuke alternatives. But hubby doesn’t have any vegetarian cooking in his repertoire and I am trying to stay away from thawing and nuking.
(I wish mom lived around here…sigh).

So what’s a newly minted vegetarian with limited cooking skills and interest to do? I can replace a meal or two with a green smoothie and I can make myself some rice, dal, khichdi, aloo gobhi and chole without getting too stressed out but what about the times when I am bored and sick of these things? I can research recipes, talk to friends and get cooking but I’ll run out of hours in the day, won’t I? We still have the nutritional needs of two carnivores to think about, my work hours, my exercise hours, my violin practice, reading, writing, drawing, relaxing.

No matter how hard I try to set things right it seems I am always my own worst enemy, or the enemy of a healthy balance!

(Cue Billy Joel – “Darling I don’t know why I go to extremes, too high or too low, there ain’t no in-betweens…)

I suppose the only way to do it would be to start the day earlier and end it in time to get the adequate number of hours of REM and non-REM sleep. It would also require a ramping up of selfishness – putting my needs before others – more than I already do.

Who knew that contemplating one small change would trigger the need for adjustments in so many other areas. The only analogy I can think of is the one that a Pilates instructor once used for going into a forward bend or returning to a standing position from it – think of yourself as a puppet with the string attached to the top of your head and raise yourself up (or bend forward) one vertebra at a time until you are straight (or folded), as if each vertebra drags the one adjacent. It’s as if the intent toward vegetarianism will bring everything else behind it in line, one at a time.

Let’s see what January 2nd brings.

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