Delhi State Cancer Institute Dilshad Garden

Since it was now obvious that the disease had come back as had been confirmed by the biopsy report received from the Apollo hospital, there was nothing but to go for the treatment whatever it was worth. Accordingly, we began looking for the best available option. The best in Delhi was of course All India Institute of Medical Sciences, having the best faculty and arguably the most modern equipment and laboratories. The only problem was that it  was a government hospital.There would be queues and crowds. More over there would be no admission during administration of chemotherapy. What I heard was that after getting the dose of chemotherapy the patient would have to go home.The other hospitals on the list of hospitals approved under the Central  Government Health Scheme were the Max hospital in Saket and the Dharmshila Cancer Hospital  in Vasundhara Enclave.The Max hospital at Saket was far away and the reports about the Dharmshila   hospital were not sanguine. Dr. Anil Agrawal had suggested that the Delhi government hospital, namely, the Delhi State Cancer Institute was a good one and that I could use its facilities which ,according to Dr. Agrawal, were very modern and up to date. Patients are grouped as "Private" and "General" patients.Private patients have to pay much more than the patients in the General category.In return the queue for them would be shorter and the rooms , if admitted , would be more commodious with a separate bathroom attached to each.
Twenty thousand rupees were required to be deposited in advance.The tariff for a day was five  thousand and one hundred rupees. The room was very commodious, air-conditioned and a toilet-cum-bathroom attached to it. A TV set and a refrigerator were thrown in for good measure. Of course, the administration of drugs was done by nurses and brothers (i.e. male nurses).They were available all the twenty four hours and were courteous and well behaved, Administration of drugs and other relevant fluids took several hours. The process was over by one a.m.
What caused a bit of irritation was the process of discharge, which seemed interminable. Repeated inquiries would elicit   the stock reply that the file was under submission. Anyway, around one p.m. did we finally get the green signal that we could leave. Later, we came to know that almost all decisions are taken at the level of the Director of the hospital-Dr. Grover
A meeting with Dr. Grover does not happen easily.I could meet him only by invoking my old associations.I requested one of my earlier  bosses--one Madam Kiran Dhingra, who was from the UT cadre to intervene. And she did.The staff of the Principal Secretary of the Health department Government of NCT Delhi arranged a meeting with Dr. Grover. Dr. Grover is a suave gentleman , experienced and worldly wise and has a total control over the Institute.When we three---Col. Saklani, Ankit and I met  him, we did not come out displeased.
The dose of chemo did have its side effects and I  had to undergo them. 

Transfusion and after .....part 2

The first day at the Shanti Gopal hospital was really bad.They did not have the blood and wanted us to get them the blood from some other hospital or a blood bank.For that they first wanted the patient to get admitted.He would then be examined by their doctors and then a request would be made to the concerned hospital or the blood bank.After the blood in question has been procured by our people,the same would be brought to S.G. hospital where it would be matched and brought to the room temperature.Finally, after completing all these requirements the transfusion would begin. Normally it takes between four and six hours but on that day it took seven full hours.It was torture of a different kind but then I had to undergo it. The good thing was that at long last I was able to go home that day itself,my residence being just a kilometer away.
This procedure had to be repeated many times ,every time the search for the required blood group would begin and following the procedure set out by the hospital the transfusion would start.Some day it would take five hours and some day it could go on for seven hours.Of course, every time they would first insert a canula.Inserting a canula in the veins of a person gone weak is itself a difficult task and if the nurse or the ward assistant happens to be inexperienced then the mere insertion  itself becomes a painful experience for the patient .And this was  the case at the S.G. hospital. Anyway, I got the requisite number of units transfused to get my haemoglobin level to more than nine.Getting this level was necessary
, otherwise the doctors at the cancer hospital would not administer  chemotherapy to me.  This process  was not completed in one week or one fortnight but took several weeks. Actually, chemotherapy is done in cycles--   one cycle comprising two doses separated by an interval of eleven days. However, every time before a dose is given, a blood test of the patient is done to ascertain whether the parameters are all right. Normally, they are concerned about three things,viz. haemoglobin count, total leucocite count ant platelet count.If any of these is not within the limits acceptable to the cancer hospital authorities the dose of chemotherapy is not administered.A kidney function test and a lever function test are also done and if any of the parameters such as blood urea number or the creatinine level is not within acceptable limits the next dose of chemo therapy is not given.The patient has to get' all these parameters back to acceptable ranges  before he can get the next dose of chemotherapy administered to him.You will read in the next post(s)  how chemotherapy was administered to me and in how many doses and  cycles.

Transfusion and after

Those of you who might have been following this blog must be wondering why there has been no entry after April 2012.Has the blogger been well?Or has he succumbed to his illness,dreadful as it is?
Yes, it has been a very difficult period for me. I needed a lot of blood for transfusion in my body because the haemoglobin count had fallen much below the safe levels.It was between 5 and 6 as against 13 and 17 required for a healthy male.Surprisingly, it was 13 in September2011.
My blood group which is O-negative is not easily available and it was needed  on an urgent basis. But human kindness is not dead. My daughter mentioned the fact that her father needed blood immediately and her office circulated the request amongst all its staff members and among all its associate offices.The result was that my need for blood became known to more people than , perhaps, was necessary. Anyway, people became aware and even volunteered to donate. Liplka, my daughter began receiving phonecalls and messages from different parts of the country.
My residential colony,on its part made an appeal on the public address system to residents to come forward to donate blood as a member of the society I.e. me needed blood.My wife started getting phone calls from the residents asking her to indicate the place where the callers could go to donate blood.Yes humanity is still alive. Many people came to the hospitals where An kit, my son -in-law had made arrangement for collection.Incidentally, only a few were able to make a donation of blood, as in a number of cases the blood group was O-positive and many other volunteers were themselves anaemic and therefore ineligible.The transfusion began at the Ashanti Gopal hospital. Continued in part...2.

Anemia

For the last several weeks I was experiencing a strange kind of lassitude. I was feeling  a total lack of strength in my body. I would be badly tired when I came home after driving from the residence to the temple and back In the mornings, when I finished my morning chores in the bathroom, I would be completely exhausted and felt like hitting the bed. Unfortunately, I could not do that as I had to perform the morning prayers, which normally took about fifteen minutes. I would, somehow complete the task trying to finish it sooner and then go to bed and lie down there.After taking a rest for about ten minutes, I would restart reading the newspaper for about an hour or so.In the meantime, I would be given a glassful of green tea with some biscuits and dry roasted grams.I would read the newspaper and simultaneously eat biscuits and grams and would feel slightly better. Between one o'clock and two o'clock I would take my lunch and would feel almost normal for the rest of the day. Gradually, the condition deteriorated and I began feeling very weak and exhausted. Finally, I measured my blood pressure with a digital machine I had kept at home.It was low--diastolic being somewhat in forties and systolic between one hundred nine and  one hundred forty. What was alarming ,however, was the heart rate. It was one hundred eight. I mentioned this to my surgeon Dr. Anil Agrawal, who suggested that I should get in touch with a cardiologist. Dr. Ranjith Nath of RML hospital casting the first glance at me blurted out instantaneously that I was anemic. He however, suggested some blood tests and also a 2D Echo. I got the tests done and was shocked to see the report of haemogram .My haemoglobin count was 5.9, much below   the normal count which should be between 13 and 16 for men. The echo report was all right and Dr. Nath had no hesitation in recommending  a blood transfusion. Dr. Anil Agrawal advised that I should also undergo an endoscopic examination of  UGI i.e. upper gastro intestine part of my body. This,I got done at the famous Apollo Hospital in Sarita Vihar. Against my expectation, the endoscopic examination was rather painful.They took a  few tissues for histopathological examination and said that the report i.e. the biopsy report would be available after five days and the same should be collected from Gate no. 4 of the hospital in due course.
My son Aishwarya collected the report on the 6th evening. As I was eager to find out the result I telephoned to him  during his journey back home to ask him  and he, in somewhat anxious voice said that the disease had come back.

Assembly Elections 2012

Assembly elections2012 had a few lessons for all of us.There were lessons for political parties of course. But there were lessons for the psephologists--both professional and amateur variety and   for the individual citizens  as well.It was almost a foregone conclusion that in Uttar Pradesh, the Samajvadi Party led by Mulayam Singh will emerge as the single largest party but that it will get such a huge majority was not in the wildest thoughts of even the most optimistic supporter of that party. That it got such a big majority of seats dashed the hopes of the Congress party which had been dreaming of at least sharing the power in the state if not outright ruling it by insisting on having its own chief minister should the Samajvadi Party fall short of a majority and need the support of the Congress Party to form a government. Of course the biggest loser was the Bahujan Samaj Party which lost its government.The Bhartiya Janata Party which had hoped that it would share the power if BSP needed some help after the elections were over was also disappointed.Samajvadi Party got so many seats that it now needs no one's help in forming the government.
What are the lessons for the individual citizens?The lessons are:that your caste matters more than the well-being of the state and the nation;that law and order matter much less for the citizens; that muslims may not be traitors but they certainly are not patriots as is exemplified by their en mass voting for the Samajvadi Party knowing it full well that the party represented something that is anti-modern. Last time the Party went openly against computers and the English language and although they have promised laptops and tablets to students this time, their middle age mindset could not have undergone a sea change  in just five years. Election victory of Samajvadi Party,therefore, was likely to push the state backwards. This fact was known to everybody including muslims. Still the fact that they chose to elect this party goes to prove that imminent backwardness to which the state would be pushed to does not matter to them.The second aspect is the goonda raj to which the state of Uttar Pradesh was subjected  when this party ruled last time.Today,even when the government of the party has not  been sworn in, media are filled with the reports of the alleged excesses by the workers of the Samajvadi Party. A young boy has reportedly been killed  and  dozens of huts of the dalits have been gutted. If this is the 'agaaz' what the 'anzaam' is going to be is anybody's guess. The Samajvadi Party had promised that there would be no return of the 'goonda raj' that the state had witnessed last time but omens appear to be bad.There have been a few incidents since the victory of the SP was announced. Akhilesh Yadav, the son of Mulayam Singh blames the officialdom for these incidents stating in a press conference that officials want to discredit their party's government as they fear their transfers which would be effected immediately after the new government assumes office. But we all know what the truth is.Criminals who form the rank and file of the Samajvadi Party are not going to mend their ways easily. And they are definitely going to demand their pound of flesh for their support to the party. It will be interesting to see how the party leadership tackles this thorny issue.
The results of the Punjab assembly  elections were unexpected. The Shirimani Akali Dal and Bharatiya Janata Party combine pulled out what could , for want of a better word  be called a miracle. During the past forty-six years,no party or coalition had been returned by the electorate to power a second time. So the election results this time were nothing short of a miracle. How the ruling combine managed this will  always be shrouded in mystery. What I can guess are the three factors: the first was that the image of the Congress party had received a battering at all-India level and anti-incumbency in Punjab was not adequate to undo the damage caused to the Congress party by its all India image.The second was the absence of emphasis on the panthic aspects by the Akalis in this year's campaign They had given more seats to Hindus this time. This created an assuring secular atmosphere in the state causing more Hindus to come out and vote .The third and the most important factor was that this time, for a change, the ruling alliance could really boast of having done something for the development of the state and its people.The Akali-BJP combine won with a larger majority this time than it had done last time.
Uttarakhand, Manipur and Goa are the smaller states. Goa was, of course, bound to give a verdict in favour of Manohar Parrikar, what with the naked dance of corruption in that state and a few ministers getting caught on criminal charges. Manipur did not have a viable option and hence it returned the Congress party to power.The most pathetic results were in the Uttarakhand. This was the only state which did not give a categorical verdict. No party could get an absolute majority in the assembly.Of the 70 seats that the assembly has,32 were bagged by the Congress,31 by the BJP, 3 by  the BSP, one by the Uttarakhand Kranti Dal and three by the Independents. Thus the Congress needed support of four more MLAs to get an absolute majority and the BJP needed that of   five MLAs.If the BJP had won one more seat that would be at the expense of the Congress and the equation would be:  the BJP 32, the Congress 31 and the rest as they were.This would have been possible,had the BJP chief minister B.C. Khanduri won from Kotdwar.  Khanduri was made the CM just a couple of months ago because Ramesh Pokhariyal 'Nishank' whom Khanduri replaced, was considered as a corrupt man.The irony is that Nishank has won, while Khanduri has lost. Khanduri lost because he contested from a Rajput dominant constituency. Garhwal being notorious for its 'kha' 'ba' politics, Khanduri had little chance of winning. Some say that Khanduri's defeat was a result of sabotage. Whatever it may be, the consequence is that a Congress government with Vijay Bahuguna as the chief minister has been installed  in Dehradun. Vijay Bahuguna does not have the support of the majority of Congress MLAs but he has the blessings of the High Command i.e. Sonia Gandhi the Congress President of India.It appears that a majority of Congress MLAs wanted Harish Rawat to be the chief minister if a sitting MLA was not to be the chief minister .Harish Rawat is now sulking and is reported to have resigned as a minister from the Union Council of Ministers.The big question is: will Bahuguna be able to win a vote of confidence? Or for how long can he continue as the chief minister of Uttarakhand?  

The General's Age

Just a couple of days before he filed a writ petition in the Supreme Court under Article 32 of the Constitution, General V.K. Singh the COAS, is reported to have said that he had not thought of moving the court till that time. I think that was a totally misleading statement.General Singh must have been contemplating this move for a long time.He must have planned his move meticulously because he had earlier submitted a statutory appeal to the government. He is not a green horn that he did not know what fate his statutory appeal would meet.In ninety nine percent cases the statutory appeal filed by officers of the defence forces  personnel is rejected. Mostly the appeal is against the supersession of the officials. The G&A branch of the Ministry acknowledges the appeal and sends it to the concerned force i.e.the army or the navy or the air force for comments.The force in almost all cases re-iterates the position  and the Ministry generally agrees with that. In some cases the reference returns to the Ministry after the chief has seen it i.e. he has agreed that the supersession is justified. It is unlikely that the Chief  of the Army Staff did not know this fact. Then why did he submit a statutory appeal?              He submitted it because he knew that if he went to the Supreme Court without  first exhausting this channel, the Court would throw out the case without even bothering to go into its merits.
.People are criticizing A.K.Antony the Defence Minister that he has not evinced enough sensitivity to this important issue. Yes, Antony is like that.He just can not think for himself but is guided entirely by his personal staff. If this means disregarding the views of even the Defence Secretary, so be it. His earlier stint in the Union Cabinet as the Minister of Food and Civil Supplies was anything but remarkable.Officers of the Defence Ministry by now know very well what calibre their Minister has and also why he is there.
The question is what happens to the General if the Court chooses to dismisse his petition? Will the government sack him?This is the first time that an army general has thus embarrassed the government. So would he go unpunished? I don't think this government would punish him directly but he may be denied any post- retirement sinecure appointment. The situation will become more piquant if the General succeeds in his endeavour,i.e. he gets a favourable verdict from the Supreme Court in the next four months i.e. before the 31st May 2012 when he would superannuate.He will then insist that he be allowed to continue as the Chief till May2013. Then each day that he is in the office, he will be a thorny prick to the government in general and to the Defence Minister in particular.Will  the Minister be asked to tender his resignation then?Perhaps not, as Mr. Antony is the Defence Minister of the country not because the PM wants him to be the Defence Minister but because someone else more powerful than the PM wants him so. Who is bothered about the demoralisation of the armed forces that Antony's continuation in the office entails?.I wish Iwould prove wrong but I have a feeling that if there is an external aggression on the country today, its defences would crumble just as a bridge made by corrupt contractors and venal engineers crumbles.
If General Singh succeeds in his efforts and continues till 2013, the loser will be not only Lt. Gen. Bikram Singh who is likely to become the COAS (if General Singh  retires now i.e. in 2012), but also the Government of the country. There will be a complete trust deficit between the Government and the General for a period of one year. Officers who would have got their promotions as a consequence of General Singh's superannuation in 2012 will now have to wait for one more year. Some of them, including Lt. General Bikram Singh would even retire as the age at which the officers in the armed forces retire is linked to their rank--,the higher the rank, the farther the date of superannuation.So there will be quite a lot of heartburn if General Singh gets one more year as COAS. 

Terror of a Purana

It is customary among some of the Hindus to organize a recitation of the Garuda Purana within  the thirteenth day of the death of a member of the family. In fact the Hindu scriptures also enjoin this. It is part of the rituals that are required to be performed by the family of the departed.The Puranas are the texts comprising tales and adventures of some divine personages or the rishis. Thus we have Vishnu Purana, Shiv Purana, the Bhagwat Purana ( the story of Krishna),   Narad Purana etc. All these puranas tell the story of the divine personages i.e.Vishnu, Shiv, Krishna, Narad etc..The Garuda Purana is a little different in that it is not the story of the adventures of  Garuda, who, according to the Hindu sacred books, is the vehicle of Vishnu and is a bird-- a hawk with supernatural divine powers.But the Garuda Purana does not describe the adventures of this bird.It is but a dialogue between him and his lord viz. Lord Vishnu.
In the book Lord Vishnu tells Garuda what happens to a person after he gets out of his mortal body.Sixteen chapters of the book describe in detail how the person is transmuted first in a being with dimensions of a hand and then with dimensionsof a thumb.The description of what he undergoes is a tale of unqualified terror.The reader is taken through  paths paved with all kinds thorns, burning coal, boiling oil and incessant beatings. A normal middle class man who attaches far more value to the written word in general and the word of a scripture in particular, is bound to be filled with extreme terror when he is told what fate he is going to meet in the nether world.There is a detailed description of various kinds of sins and the punishment each of these sins entails There is a strong emphasis on doing good which generally means giving out liberally mostly to brahmins. It is enjoined upon the the person whose father has died and who is performing the rituals after his death for salvation of his soul  that he should give so much to the brahmin conducting the ritual as would be sufficient to meet his needs for the entire year to come.
I think it is because of the Puranas such as the Garuda Purana that there is so much anger against the brahmins. When I , a brahmin myself, felt so strongly against  the author of this book, it is easy to guess the amount of angst the non-brahmins are likely to have against it. And it is not against this book alone.It has become generic i.e.against all the so called sacred books of the Hindus.And since the books were supposed to have been written by the brahmins, the ire has got transferred against them i.e. the brahmins. Today the brahmins are the most despised group of people in the country getting the blame for everything that is wrong with it including the ascendance of Dr. Manmohan Singh as the prime minister. I think that the books such as the Garuda Purana are responsible for this kind of antipathy to a considerable extent. But the lesson should not be missed. Sins of forefathers do visit their sons and grandsons, otherwise, we the brahmins of today would not have to suffer for the deeds of our ancestors.But the fact that the people are still asking a brahmin to read the Garuda Purana, even today i.e. in 2012 christian era  following the death of a member of their family speaks volumes about the vice-like grip that the religion has on our collective psyche.