Sunday, January 23, 2011

How Networkers Cross the Street And Other Secrets of a Happy Life

Like many things in India, crossing the street requires more courage and determination than one expects to have to come up with for such an everyday event. Street-crossing styles range from the terrified to the brazen, from conciliatory to let's-make-a-deal. It takes all kinds to make a world, but my favorite street crosser is The Networker.

She starts by making eye contact. There she is, standing confidently on the edge of the road, with no intention of wading in until she has someone's surprised attention. "Hello there!" her expression says. "You're a pedestrian at times, aren't you? You've been in this position too, right? You know you have." She never stops looking at the driver she has selected and before he knows it, he has stopped, almost against his will, and is smiling back at her as she moves out in front of his car.

I like her style because she's on to something fundamental. She knows there's more to life than crossing the street. And while she does want to get across (she's got appointments, she's got a schedule, she's got things to do), she also wants to change the world - one intersection at a time. She wants the guy who lets her go to feel good about doing it; so good that he will do it again for someone else. And again for someone else. And again. And again. Till it's a habit.

And when she's the driver herself, she remembers the pedestrian she once was and will be again and she startles those waiting patiently by the side of the road by stopping and waving them across. She watches their surprised and wary expressions, smiles encouragingly as they hesitate and then broadly as she sees them get the idea, sees them realize that she is really stopping for them and that they can take their time as they step out onto those mean streets that suddenly seem less menacing and more like friendly avenues which are as much theirs as hers.

I like her style because she knows that everything, even something as simple as crossing the street, is about relationships, about trust, about knowing that the other person could be me, and very soon will be me, and that how we treat the driver whose help we need, how we treat the pedestrian who needs us, will determine how the world will evolve - not only for us but for our children and for our children's children.

I like her style because she is being the change she wants to see in the world.

Friday, January 21, 2011

The Practice of Medicine

I'm not a doctor or a nurse, but I have patients. It's amazing what you can learn to do. I take temperatures, check blood pressure, administer chest physio, nebulize, adjust medications, give enemas. I can even insert a feeding tube.

A few days ago, Masiji's blood pressure shot up to 150 over 110. I cured her.

Of course I called Dr Sebastian for advice, but the cure came from me. And it was that simple. A little time; a little attention; a little touch.

Masiji is a person who needs excitement and variety in her life. She likes drama and she thrives on attention. And it struck me as I was checking her blood pressure the evening of the day it shot up, that as a widow living far from her own children, nobody touches her now. Although she lives with us and even shares a bed with her sister, she has almost no physical contact with anyone. 

Being unwell automatically means touch. My hand on her wrist as I check her pulse.  On her shoulder as I help her out of her sweater so I can put the bp cuff on her arm. Fixing the stethascope under the cuff, my hand now beneath her elbow to hold it steady. It struck me.

And so, though Sebastian told me I should check her BP once each day, I decided to do it twice - morning and evening. I added the little detail of bringing a notebook so I could write down the result. As far as possible, I stuck to the same time each day - to show her I was taking this seriously. Every day I would explain again the difference between the systolic and diastolic readings and why we were more concerned with the second number than the first. Every day, we discussed her medications, discussed the need for exercise and stress reduction and how she really should lose some weight. Every day.

And it was while I was doing all this that I realized how much of medicine is not the interventions - the medicines, procedures, surgeries and tests - but the human contact, the questions, the listening, the concern, the attention, the touch.

When I accompanied Vikram to Delhi for his six-week checkup (almost flying colors! almost complete recovery!) I was struck by the contrast between the two doctors we met. One spoke almost exclusively to me, in English, focused on the test reports and the brain scan rather than on Vikram and didn't lay a hand on him. The other spoke in Hindi, asked V a lot of questions, listened carefully to his answers and, in a startling - these days - divergence, actually physically examined him.  Vikram came out of the first session feeling anxious and confused; out of the second relaxed and hopeful.

How much of good medicine is about listening, about genuine concern, about touch?

It's not easy. Patients, by nature, are plaintive and querulous. Their concerns are the only ones that matter and they have no idea of all the other things the doctor or nurse is thinking about. To them, their headache, their coughing, their pain is the only thing in the world. But good doctors enter into their world and help them to find the road out.

Yesterday, when I went into Masiji's room to check her blood pressure, she waved me away. "Not today," she said. "I know it will be too high."

"Why is that, Masiji? What happened?"

Turned out she and Mummy had had an argument. An inconsequential fight over nothing in particular, though she needed to tell me every single detail. My job, clearly, was to listen. No advice, no pointing out any inconsistencies. Just to listen.

When she was finished talking, I took her blood pressure. 140 over 70. She was cured.

Wednesday, January 12, 2011

Kartik Learns To Talk

A few days ago I met Nisha on the road. Nisha is Gia's Mom, whose story I shared back in October. Gia has a little brother named Kartik, and I told his story a few weeks later.

Gia was worried about Kartik because at the age of two and a half, he still wasn't talking. We got him into Karuna Vihar for an assessment and the diagnosis was simply that he needed more stimulation, more time with other children, more communication. The prescription? Two hours every day at Latika Vihar, our inclusive children's center.

When I met Nisha, Kartik had been coming to Latika for about six weeks. So I wasn't expecting much. These things take time.

But Nisha leaped off the bike, her face alight, and said "He's started talking! He says Mama, Didi, chai, and roti now. What did you do? It's like magic."

What did we do? Time to go to Latika Vihar and find out.

I found Kartik being looked after by Pooja, our special educator. In spite of having seven other children to care for, she managed to stay aware of what he was doing and what he might need.

When Kartik first arrived, she told me, he would sit quietly on his own, only truly secure when Gia was in sight. Gradually, with her help, he ventured further out to see what other children were doing, eventually deciding it was more fun to play the way the other kids did.

Parallel play is an important step in a child's development. Kids are totally absorbed in their own thing, but still like the idea of another child nearby.  Kartik was right on time - almost three, he was doing just what he should have been doing.

But Pooja knew he would need help moving towards a more interactive style of play, a style where turn-taking, sharing and communication became more important.

So she helped him test the waters and guided him as he took the first steps toward being with other children.

At first, he was hesitant - needing her almost constant presence:

Gradually, he gained confidence, learning that he could still be safe, even without her right beside him:

But the real breakthrough came when Kartik realized that other children could be trusted too:

and that the sweetness of a friend's support is what will take you through even the most difficult challenges:

Kartik still has a way to go, but his resilience, Nisha and Gia's devotion and Pooja's skill will get him through.

As for me, I just can't stop thinking about luck and narrow escapes. How many more Kartiks are there out there? How can we reach them? When it is so simple to help them find their voices, how can we allow ourselves to fail?

Saturday, January 8, 2011

That Lady Who Brings The Chai

You know her. She's the one who serves the tea in your friend's house, or in the office where you work or the office where you are visiting.

She keeps her head down and seldom makes eye contact, though she might smile shyly if you happen to notice her in an encouraging way.

You probably won't, though. No offense. I'm no different.

When I first came to India at the age of 23, the whole idea of servants creeped me out. I was a self-help American girl and though I had once been a waitress myself, I couldn't bear the idea of anyone waiting on ME. Toast? Thanks so much! I'll make it myself. Tea? Thank you, no really.  I'm fine. I'll get my own later.

Over time, I got used to the idea. Learned how to reach out for the cup while continuing to listen attentively to the other people in the room. Later, I could even go right on talking while picking it up, continuing with my important train of thought as if that lady with the tray wasn't even there.

Because she wasn't.

She was in her world; I was in mine. This went on for years. Then slowly, the walls began to come down. My friend Gloria - in her gentle, inimitable fashion - showed me another way, a way which acknowledged the humanity of the person holding the tray without stooping to condescension or pity. My friend and house guest Angie - with her fiercely democratic and egalitarian presence - taught me how much more fun it could be to engage with the person holding the tray.

And then it was off to the races.

Because now, every person serving tea - whether in my home or in some dreary government office - has suddenly leapt to life. There they stand, holding the tray, yet full of a hectic, inspired life the depths of which I cannot begin to fathom.

She's all dressed up. She's got a dream for her son - the bright one, the one who can imitate anyone. She loves the deeper shades of red. She's wearing pearls this afternoon.

She brings the tea in on a tray, but she's thinking about her village. She's remembering the bus journey that brought her here. She's calculating the days until her sister's son's wedding. She's hoping it will rain so her crops back home will flourish.

She's alive. She is not just that woman holding the tray. She's got a life, and a story and a dream of a common language. We owe it to her to look into her eyes and acknowledge her existence.

Thursday, January 6, 2011

New Year Resolutions

I love resolutions – reflecting on them, making them, keeping them, discarding them: the circle of life!

This year, mine include more hand-written letters, more time with my mother-in-law and her sister (both live with us) more long walks and more baked potatoes.

Less worrying, less time on the computer, less judging, less cholesterol. Fewer late nights, more early mornings.

More cake, more photography, more prayer, more music.

What about you?

Tuesday, January 4, 2011

New Year Images: Let Them Go

On New Year's Day, I went to visit one of our neighbours. Mrs Agrawal is a good woman: funny, down-to-earth, warm and generous. I brought her some "Mexican Wedding Cakes" - a special Christmas cookie which melts in your mouth and has no eggs. She was thrilled.

We sat in the sun on her verandah and caught up with each other's lives. Though we live right across the road, we seldom have the chance to chat. She told me about her daughter's operation; I told her about Moy Moy's pneumonia.

Then out of the blue, she asked me what another of our neighbors had against me. I knew what it was, but I pretended not to. For months I had watched the other neighbor's husband dump their trash on the vacant lot next to our house. Finally I asked him why they didn't spend the 30 rupees a month to have their garbage collected and disposed of properly. Since that day, no one in that family would even look at me, let alone speak.

"Why?" I asked Mrs Agrawal. "What do you mean?"

"She says you have trunk loads of money coming in for Karuna Vihar and it all goes in your pocket."

I smiled and said there are all kinds of people in this world and changed the subject.

But the accusation stayed with me all day. It came at an odd moment in my life. Due to a cash flow problem, we have literally been living hand to mouth in the Foundation. I have been frantically fund-raising just to meet the payroll and several senior staff have gone without their salaries a few times. Our normal 10% raises are six months overdue. Moy's health issues have been draining, I have given money I don't really have to several people who were also in health crises and, in fact, I can't remember when cash has ever been quite so tight as it is right now.

So being accused of siphoning money meant for the Foundation hit me hard. It was absurd and funny, but it was also painful.

Yet the only option is to try and understand, to step out of the aggrieved innocent's role and become instead the compassionate observer, the one who realizes that this has nothing to do with me and everything to do with her. This is a huge challenge for me - my "image" is important to me and I find it next to impossible not to defend it against detractors.

But being in public life - even in my own tiny sphere - means that this sort of thing will always happen. Small people will always exist and they will always be ready to pull others down. The challenge is to go on doing one's work sincerely and with honor and integrity and with no concern for what "people" might say.

The Tibetan prayer flags are the image I hold on to: fasten your life to the rope of integrity and honor and let everything else flutter by on the prevailing winds.

Image? Let it go.