Rajiv Gandhi Cancer Institute Rohini New Delhi

Review of the progress of recovery from the surgery undergone by me for removal of a cancerous esophagus entailed undertaking some more scans  such as CT scan and PET-CT scan.CT scan suggested a  recurrence of the tumour. PET-CT scan was indicative of a cluster of nodes suggestive of  a likely metastasis. In a layman's language the cancer had come up again. Or perhaps it had  never gone away. I was never convinced  that a mere surgery for removal of a cancerous growth would have led to a complete cure.This was later confirmed when I surfed the net. The net enlightened  me that cancer could  never be  cured, it could only be managed.
The good surgeon Dr. Agrawal studied the scans and concluded that perhaps there would be a need to  undertake a chemo or radio therapy and wrote his advice that I could get it done at a private hospital approved by the C.G.H.S.(central government health scheme).Reports about the Dharmshila Cancer Hospital were not very encouraging and therefore, I had to opt for the Rajiv Gandhi Cancer Institute and Research Centre  because I found that I might not be able to penetrate the bureaucratic system of  All India Institute of Medical Sciences to get myself registered  in their cancer therapy department.The Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC) was  far away from the place I reside.A visit by car would take  at least two hours.
Our first visit took three hours because before reaching that  place I had to visit the dispensary from where I get my medicines on a regular basis. The in-charge of the dispensary on the previous day had refused to grant the permission to undertake the therapies from the RGCIRC. I had  to request her bosses to intercede to make her agree to accord the permission. On the 16th of September2011, I finally got the permission letter.
At the RGCIRC the experience was more harrowing .The bureaucracy was more stubborn than the one we encounter in government offices. We were asked to fill in a form and submit that at a counter .We stood in a queue for about fifteen minutes at the counter before they were able to prepare the file.But then arose the question of payment . When we insisted that I was a CGHS beneficiary and a pensioner and that  my treatment had to be on a credit basis, the girl at the counter asked us to get the necessary endorsement from one Ms. Ghosh working at their basement office. Ms. Ghosh was a middle aged  grumpy woman who had perhaps no traces of sympathy in her personality.. She saw our papers and then curtly told us that we should get a colour photocopy of my CGHS card and submit it to her. On being told that it was not proper she shamelessly admitted that that  was indeed so but pleaded  her helplessness saying that that was a CGHS requirement.We had a black&white photocopy but that was of no use.She wanted a colour photocopy and that was final. We went out of the hospital in search of the photocopying facility.At a distance of about one and a half kilometre we spotted a Kodak laboratory on the opposite side of the road.After taking a U-turn we reached the place only to be told that that was a photographer's lab. and that  we would need to go to the  sector seven market to get a colour photocopy. We were able to  locate that sector after some time. Ankit, who had always been  accompanying me,  walked up to the first floor of a building which was housing  a photocopy shop and returned after about fifteen minutes.Two colour photocopies cost Rs.20 and two  black&white photocopies cost only Rs.two. On a photocopy of the permission letter Ms. Ghosh appended the required endorsement .We took the endorsed letter  to the reception window and produced the endorsement. The girl at the window then completed the file .At first she wanted us to deposit Rs. 242, a discounted amount for a CGHS beneficiary,as the consultation fee.But on our insistence that it had to be a cashless transaction  as I was a pensioner, she looked into the endorsement once again and relented finally.Then she directed that we should go to the second floor of the building and wait for our turn and that our file would be sent  through their own channel.Our file did reach after some time but our wait continued.We  had to wait for one hour and forty-five minutes before we could get to see the doctors.The doctors looked in to the history of the case and decided that a) I should get a complete hemogram done ,and
b)CT and PET-CT scans should be reviewed  so as to be certain that the cancer had returned.That would
 enable them to determine whether there was a need of chemotherapy or radio therapy or of both .
Again we had to stand in a queue to get us the receipts which were necessary for us to get the said tests done. While Ankit went to get the review done, I came to the second floor again to give the sample of blood. I was told that I could get a provisional report   around 4:30 pm the same day, but the final report would however, be available only the following day late in the afternoon. Similarly, the review report would also be available the following day. We came out of the building and boarded the car. Ankit got himself dropped  just about a kilometre away from the hospital and I moved  towards my residence certain that I would have to return soon.

Bail and Jail

A couple of days ago the Indian news channels went almost berserk when Amar Singh, an erstwhile Samajwadi Party leader was sent to jail.Amar Singh is a well-known figure in the Indian politics and people thought that he was so well connected that no one would dare send him to jail, no matter what he might have done.But this was proved as false and the magistrate Ms. Dhingra ordered that he be sent to the judicial custody, disregarding his plea for leniency on the ground that he was sick having undergone a surgery and a kidney transplant operation.
Of late, we are witnessing a strange phenomenon--instead of granting bail being a norm , denying it is becoming a norm. Nobody has the answer to the question :what happens if ultimately the person is acquitted? Who and what can compensate for his lack of freedom ? Perhaps ,we the people are not enough sensitive towards freedom. We do not value it enough . Amar Singh had been fully co-operating with the investigating agencies.            He is a well-known person and is not likely to run away from the law and the police. He is genuinely sick and is living on borrowed kidneys.Why is it then necessary to keep him in custody?
Not only Amar Singh, there are many other  well-known people who have been kept behind the bars for months together denying them bail which should have been  given to them in normal circumstances because their alleged crime is not in the category of most heinous crimes.They have not been accused of having committed a  murder; they have also not been accused of rape or of treason.They have been accused of having caused presumptive loss of thousands of crores of rupees to the Indian exchequer and in the process  having feathered their nest or having  caused unintended benefit  to some of the corporate houses in which they had  monetary interest.These are crimes indeed but these crimes are not such as to entail denial of bail.Then what is the reason? I think there are two important reasons---the gravity of their crimes has been blown out of proportion by the media-both print and electronic.And they are comparatively well-to- do people. In India, the spectacle of seeing the rich behind the bars is so rare that when an opportunity as such presents it self, media are far too eager to overplay it and people, who are the consumers of the media, are more than willing to lap it.That feeling of schadenfreude becomes more intense and consequently more satisfying  when the misfortune strikes those who are rich and powerful.
But all this leaves a big question  before us: are our destinies to be decided by the media? After all, it should have been media's pressure, direct or perceived,  that may have prevented the judges and magistrates from granting bail in these cases. Can we therefore expect any justice in such circumstances? The answer is an emphatic NO.Most of the Indians, at least those who are capable of thinking for themselves,  know it for certain that there is no such thing  as justice in this world and it is only a ruse used conveniently by the rulers of all countries to befool the public. We should all ponder for a minute  and ask ourselves: whether human progress, over the millennia has only meant  media becoming a tool of power in place of a piece of stone--perhaps the earliest tool used by man to exert power.

Release and other stories by Rakhshanda Jalil

The jacket of the book says that this is the debut collection of short stories by Rakhshanda Jalil but she  has earlier  edited a collection of short stories by Pakistani women which was extremely successful. And there is no doubt that it would be so.Because in Ms. Jalil  the literary world has  found a   sincere writer, at least of short stories.
All protagonists in her stories of the present thin  volume are muslims but not the muslims of ghettos or those on the margins of the Indian society but those who are reasonably well- to- do and perhaps not fundamentalists.For most of them drink alcohol  and are in the white collar jobs . Even women of these stories do not mind a swig at times.The title story Release is a mildly poignant tale of two cousins who were betrothed even before one of them was born  and how despite an intense affection and almost absolute devotion at least of the female protagonist the two could never get married because of the mulish stubbornness of the boy's mother and a little pusillanimity on the part of the boy  who fails to assert himself when  needed most. The boy, Hasan, and the girl, Azra do meet finally  but then  Hasan is 70, long retired from the Foreign Service and Azra is on a hospital bed in a coma.Perhaps not a modern tale but written beautifully nevertheless.In The Perfect Couple,  a husband, discovering that his wife has a paramour treats him with a kind of fellow- feeling ( instead of bashing him) when the latter comes to the hospital where the wife has been taken and is unconscious in the ICU. Some of the stories appear to be pen portraits such as The Failure and The Strange Man.  Surprisingly the stories are refreshingly free from the  politics except  A Real Woman wherein the chief protagonist Dia Mirza seems deeply affected by the contemporary incidents, so much so that she forgets all pleasures of  the  body  being promised to her by a long-known  visitor when the news of  serial bomb-blasts flashes on the television  channels.
Some of the stories are stories within stories -a style known to the humanity since the days of the Puranas . The Alif Laila tales have made an exquisite use of this style.But the stories in which Jalil makes use of this style are comparatively weaker.The Incident of Frozen Snake and A Holiday Gone Awry are two such stories.Humiliation and indignation of the girls and their twelve year old brother, in front of whom they are raped, has not been brought out  in depth in the latter story.  The former,  in which a frozen snake sent to an aspiring starlet by her  experienced rival just makes the starlet lose her mental balance ruining her promising career,  gives an impression that the things operate at a shallow level.
I read the book in just one sitting.The stories reveal a facet of the life of Indian Muslims that we may not be familiar with or we may not have tried to know,  swamped as we might have been by the stereotype images of Muslims of this country--- bearded men, having a scull cap on their heads, illiterate or half-educated, employed in unskilled or semi-skilled jobs, spawning a large brood of  malnourished children who would be  easy recruits for a terrorist organization etc. This thin volume of short stories tries ,albeit not much successfully, to dispel that erroneous impression of Muslims of the contemporary India. We look forward to more such and indeed much deeper stories  from the pen of Ms. Jalil. 

The Scare

It was Ankit who collected  the x-ray report.He reached my residence and immediately logged on to the internet.When I came to the room where the computer is located I found him  mulling over the numerous sites explaining 'pleural effusion'.Yes that was what the report had suggested.The left CP angle was obtuse meaning thereby that there was fluid in the outer layer of the the lung.The discovery, to say the least ,was nothing but a shock. There are many causes for the pleural effusion, but the most important include --tuberculosis, pneumonia and cancer. Since I had no symptoms indicative of the first two ,the ineluctable conclusion would be the third. This meant that the disease was now trying to get into the lungs and that I should bid farewell to any hopes I might be nursing.. Needless to say,the night was nothing but a long , uninterrupted  stretch of anxiety.Not only for me but also for my wife.So much so  that Monu, the son of my wife's brother, who was visiting us,  became thoroughly restless.The following day, he insisted that he would accompany me to hospital where the good surgeon had agreed to meet us to discuss the reports Ankit, my son-in-law was with us as he has always been .Even my daughter went along. As the Capital of the country was readying itself to tackle the likely law and order situation that Anna Hajare's fast for adoption of the Jan Lokpal Bill could create, traffic on many roads had been diverted resulting in long jams and denser crowds.We were late for the appoint ment.Dr. Agrawal, helpfully suggested on the mobile phone that we could see him in the OPD if we did not reach his office room in time. And we did not . He was in the OPD  with one of his team members examining patients. He greeted us  and asked us to wait. When finally he could go through the reports and the x-ray plate he said "Everything is okay".I expressed my apprehension about pleural effusion but he dismissed it as inconsequential and suggested that I could go for a CT scan if I so desired. It was an immense relief writ large on our faces.We thanked the surgeon and came out.
I realized how man can never be without fear and how important a role fear plays in our lives .

Review of Progress

 On  Wednesday , the 10th August 2011,I was again seating in front of Dr.Anil Agrawal,the surgeon who had operated upon me exactly seven months ago for removal of a cancerous growth in my esophagus. Ankit, my son -in-law was with me, as he always has been.Apparently, Dr. Agrawal was satisfied with the progress, since I was not losing any weight and was also not experiencing any pain or discomfort. As usual, he exhorted me to have a positive attitude and not think of the illness as such. I nodded and asked whether there was any way of disabling the programme that has caused the cells to so  misbehave as to cause this disease. He said  that that was in the hands of the Power above.Then he advised that I undergo some  blood tests and also get a chest X-ray done and report to him the findings at the next seating which could be as early as the  coming Wednesday.We thanked the surgeon and moved out of the room wondering whether anybody really knew enough about cancer.I was reminded of the Pulitzer Prize winning  author Dr.Mukherjee's book on cancer wherein he has called  this disease the emperor of maladies and revealed to the layman that there are a number of maladies covered by the generic name cancer but each of them is different.Some cancers, according to him, are on the verge of being deciphered as a lot of progress has been made in researching their causes and the course  they will take over a period of time; however, in the case of most others, we are not much ahead of what we knew about them in ancient Babylon when the disease was first noticed.Yes, the questions why the cells  begin  going berserk suddenly and why we can not re-programme them to become normal have not been answered satisfactorily till now.But the quest is on and millions of dollars are being spent on research projects to find an answer.But, does the causality principle really work? Should there always be a cause for a condition? People argue that God has not been caused by another cause.He is the first cause..But then God is not seen or is not perceived whereas, cancer is very real ,and causes immense pain and discomfort not only to the patient  but also to others who have some affinity with him.I sometime wonder what this world would be  if the mankind had not been having faith in the causality principle. (Yes it is faith only, for ,an action can have many effects or results, both immediate and long-term and nobody can predict all the consequences of an action.We still do not know all the consequences of the first major event of this Universe-the Big Bang ). Well, there would be no progress as we know of.There would be no cure for any of the ailments,there would be no airplanes, no electricity,perhaps no cities and even villages and not even the human race, for, even a caveman would know that if he threw a stone (cause) the animal or the bird would be killed (the effect) providing him with food,-- his and our basic need.Why only human beings,even animals have this innate sense of causality! How would they, otherwise, get their food?But I am waiting for the day when the principle of causality would stand debunked as generally false . Have not many things we had faith on  earlier, been debunked since then?What would life then be? 

Eternal Questions and Shourie's Answers

Asking the so-called eternal questions such as :why  we are here; whether there is a God; whether He is really omnipotent , omniscient and merciful is meaningless or say, the least helpful seems to be the theme of the latest book written by Arun Shourie---an ex-journalist, and an ex-minister who had also worked at the World Bank.The question precisely is: if there is an omniscient, omnipotent and merciful God, why is there suffering in this world--for individuals, for communities and for nations?Shourie seeks answers in the context of his son -Aditya's congenital illness (he is suffering from cerebral palsy) and seems to be coming to the conclusion that it is perhaps, no use asking these questions, for, there is no satisfactory answer in most of the religions  presupposing the existence of God. More helpful is the Buddhism---an atheistic religion which emphasizes action to alleviate the suffering rather than seeking it's causes. The book starts poignantly.What do you do to a father who thrashes, punishes and humiliates a son at every breath the son takes.You might think of reporting him to the police.But what if the father is The Father---both T and F capitalized!Yes , what if the father is God! What Shourie does not say in so many words but alludes quiet clearly is that his son's condition amounts to thrashing, punishing and humiliation .Can the same then, be attributed to God?If yes, then what happens to the tag of mercifulness He has been made to carry by most of the religions? Shourie  quotes extensively form the Old Testament ,the New Testament and the Quran and tries to quash the widely held belief that God is all-knowing, all-powerful and an unfathomable ocean of mercy. He then proceeds to do the same, albeit with much less success  to   the Karma theory described in Hindu scriptures and interpreted by sages and savants over the ages. A full chapter has been devoted to two great  sages of modern India---Raman Maharshi and Swami Ramkrishna Paramhans.These two sages of modern India are revered almost as gods. The number of their followers ran into lakhs and was spread in   several countries of Europe and America in addition to those in Asia  Africa and Australia. Many of their followers had highest reverence for them and not a small number believed that they had miraculous powers and could cure even incurable diseases.To their credit, the sages never claimed any supernatural powers.The astounding fact is that both these savants suffered from cancer and finally succumbed to that disease suffering not only the excruciating pain but all other consequences  as well. Some of the people believed that these sages had taken upon themselves the sufferings of some of their followers  so that the latter could stay free from pain. ( A similar tale is also carried about Sai Baba of Shirdi). Shourie just about hints at these tales but does not say much about them.Instead, he seems to ask the question: why did these god-like, sinless and pure men suffer?Having found that the Hindu scriptures, the Bible and the Quran do not answer these and other such questions satisfactorily, Shourie turns to the Buddhism and  finally finds some solace in the Buddhists' principle that there is suffering in this world and we should do whatever we can  to mitigate that suffering in a selfless way free from all traces of arrogance or pride.
 Needless to say the book is provocative making you think and think hard.  Erudition of the author is palpable at every page and so is the skill of referring to and quoting from whatever supports and sustains his argument.The author  also seems to be well-versed in the Urdu literature and seems to be fond of Faiz Ahmed Faiz whose couplet :laut aatee hai uther ko bhi nazar kya keeje-- has been quoted by him very appropriately by him.(Faiz  is the only Urdu poet who has been quoted more than once ) Let the book be read and re-read, debated and discussed and commented upon  fiercely Do all this and much more if you like, but please do not ignore  the book
.A few things that caused a mild irritation though, include a misprint of the word "vice-regent"  that too, twice at page 74. Another mistake is at page 363.Ten to the power 68  is 1 followed by 68 zeros and not 10 followed by 68 zeros as given in the book It would have been helpful if the English translation of bhajans and Urdu couplets had been given. But for most North Indian readers  this is perhap no shortcoming. ( Does He know a mother's heart? How Suffering Refutes Religions :Arun Shourie--HarperCollins India 2011,New Delhi) Pages435,Price Rupees 599) 

Arvind Adiga's Last Man In Tower

You may be forgiven if, after reading  Arvind Adiga's latest novel, Last man in Tower (HarperCollins India Hardcover), you come to the conclusion that behind the decent facade of civility , human beings are essentially evil and that it needs just a slight trigger to reveal their true nature.The trigger in the story is provided by the  "can't be refused' offer made by a builder -Dharmen Shah and all  hell breaks loose.Shah ,a man who has built an immense construction empire from a scratch, wishes to consolidate it further by constructing a fancy complex at a plot of land  which, at the time the story begins, is occupied by a co-operative group housing society, namely, the Vishram Group Housing Society ,Vakola, Mumbai..Although there are two Towers of the Society-Tower A and Tower B , the story is confined mainly to the residents of Tower A. The residents of this Tower are simple middle-class people, not rich but by and large happy with their lot,notwithstanding many unfulfilled desires  and unabated sorrows.They have  a pleasant togetherness and an  inclination to help one another in meeting their puny aspirations.There is Ibrahim Kudwa the internet cafe owener and his family.Then there  are the Puris,the Ajwanis,the Pintos,the Nagpals, Mrs. Rego and some others including Yogesh Murthy ,a retired school teacher who lives alone having lost his wife not many months ago.Murthy ,known in the society as Masterji had lost a daughter much earlier and his son Gaurav,with his own family, stays away in another ,more prosperous part of Mumbai  itself. Cat is thrown amongst pigeons when Shah's man makes an offer to buy their flats at Rs.20000/ per square foot when the going  market rate is much much less.Most of the residents jump at the offer.A few people are sceptical initially but gradually they too give in when they are assured that the builder would indeed give the money and would not hoodwink them.There is ,however, one gentleman--Masterji who is not willing to sell his dwelling unit,not because the money offered is not adequate,but because it is a matter of principle.The problem is that the building can not be sold unless every member of the society has expressed his willingness to sell his unit.The members of the society ,thereafter start coaxing and cajoling Masterji into agreeing to sell his flat.When that does not work they enlist the help of Gaurav,-Masterji's son.When that too, does not work they apply pressure tactics--resolving in the meeting of the society to abrogate his membership and disconnecting water and electricity supply to his flat ,sending street vagabonds to beat him at night and all that.So much so ,Masterji's priest of long acquaintance also refuses to officiate in performing the first anniversary "shraadh" of  his deceased wife.They (the residents) start a campaign that Masterji has gone mad. The Masterji still does not yield.What happens then is something that the reader should himself find out by reading the book. It is a hard-hitting commentary on   changing mores of the Indian society just as Adiga's earlier novel was. How one builder's ego and ambition can transform the conduct and behaviour of hundreds of other human beings by playing on one of their baser instincts i.e. greed has been brought out in a lurid detail. Greed transforms simple law-abiding friendly middle-class residents into demons is what the novel seems to be telling us.But then what is new in this?Do we not already know this?Have not our religious books been shouting this truth throughout the ages?Then what is new? The novelty is that though the theme is old, the presentation is   more than modern.. It does not say in so many words but the feeling is inescapable that the author is not comfortable with neo-liberal India that we have been witness to since 1991, when the economy was thrown open unleashing the demons of  I, me and myself , self-centredness and greed ,when Greed became not only good but also  God. The other significant feature of the novel is  a liberal sprinkling of similes and metaphors, at least in the initial parts reminding one of The Ramcharitmanas of the great Tulsidas  of which it was said that there could no doubt be a chaupai which is without  a simile or a metaphor but there can be no page which is bereft of these figures of speech.
Protagonists in the novel, though unreal,never look anything but lifelike.The book is readable and it stirs too but perhaps, is not disturbing enough.Perhaps, it was not meant to be.