Thursday, March 28, 2013

Outside the Intensive Care Unit (ICU) of a hospital

Obviously no one in his senses would expect Holi-like colours and riotous festivities outside the ICU of a hospital.  But that fact should not deprive one of the right to be dismayed about what one gets to experience.  It was about 9 pm.  Family members of patients in ICU were just recovering from the utterly clinical and sanitized lecture-demonstration given to them by a seriously matronly `sister' who emitted strong signals that she had seen it all and had neither belief nor interest in interactive sessions with her audience.  Her icy cold tone, curt demeanour and stony visage, which was completely bereft of even vestiges of emotion, made for a compelling spectacle and no one even stirred during the 4 minutes, which actually seemed like 40! Come to think of it, everyone suddenly seemed to have developed amazing breath control and was breathing in and out at half the normal pace, just so that he or she did not inadvertently become the target of wrath of the presiding authority.  The lecture part of the performance sought to sear into the minds of listeners the rules of play for the duration of their stay outside the ICU; the demo part involved the protagonist and a superlatively submissive minion, who enacted the role of an `attendant' (meaning, a patient's family member or friend).

Nothing was left to guesswork and even the exact locations from which the attendant should execute chores were identified on the floor with circles painted in white.  Finally, the drama ended with the dire warning that no attendant could ever move away from the immediate vicinity , because the 'shout' could come any time; 'if the attendant was not around to answer ...............' - the rest was left to the imagination and mine ran riot thinking of an entire hospital bed, with all the paraphernalia (oxygen cylinder, array of drips, monitors etc), with the hapless patient still strapped and attached,  being sent crashing out of the ICU for the attendant to take care of, whenever he/she chose to be present again!  When the matron flashed one final glare and left, there was a palpable lifting of the chill which had descended on the scene, pretty much like what Gregory Peck experienced in the presence of you-know-what, in the movie The Omen.  Still, no one dared utter a word for half an hour in the aftermath!

The prognosis neither looked nor sounded good and we are not talking of what was happening inside the ICU.  Let me make this clear since the medical attention given was consistently excellent.  It was made clear that the attendants had the choice of `resting,' even though the hospital staff were programmed diligently to avoid that crucial word in this context and their general drift was something like `do it if you can'.  Support for this proposed activity came from some stone benches and rickety chairs strewn about.  The chairs especially merit a full sentence.  It was one of those arrangements whereby four chairs were clamped together, joined at the hip as it were, and seemed innocuous when a family sat down.  But God forbid if the sitter on either end suddenly decided, without notice, to assume a more vertical position by standing up. When such an abrupt transition occurred, the other end of the arrangement swung up pretty much like a see-saw, causing serious disruption in the working of the vitals of those who continue to be sitters.

Or the attendants could retire to another room close by to await the `shout'.  One look at the specified lodging convinced this scribe that the  hardship outside, perceived and real, was a bed of roses.  There was an abundant supply of mosquitoes everywhere - one wondered whether the hospital authorities were breeding them as pets, with some ulterior motive! Some very diffused lighting could be felt rather than seen  (as if the management wanted to impress the clientele with their effort at creating a dimly lit entertainment area but abandoned the idea halfway through), which discouraged any attempt at reading anything.  One could identify the outlines of  a couple of very ancient pedestal fans of monstrous proportions.  They seemed more adept at producing a constantly loud `whoosh',  frequently punctuated by loud crackling noises indicative of their inclination to take off sooner or later, than being successful sources of air circulation.  The hospital no doubt installed them to further their stated objective of  keeping everyone awake.  Frequent `shouts' for attendants from staff members ensured that even `trying to nod off' became a pronounced Sisyphean activity.  Remember that Greek hero who is part of mythology for his endlessly futile effort? This scribe's grouse is that this glorious tradition seems to have ceased; such gutsy but fruitless activity is no longer given due credit.

The process of a staff member shouting the name of a patient and calling for the related attendant itself provided some comic relief from time to time.  The hospital did not necessarily screen the names of the patients for eligibility for ICU - not part of the criteria - and this gave rise to some occasional confusion, petulance and mirth.  When the call was for `Rafique's attendant', `Ravi's attendant' went bleary-eyed and half-comatose to receive instructions, his only mistake being he was relatively more awake.  He unquestioningly bought medicines worth a few thousand rupees from the pharmacy, paying cash, without realizing he was procuring medicines for a stranger.  When the drugs reached the ICU, they were administered promptly and correctly to Rafique, thank God, because the ICU staff was vigorously trained to focus on the destination of the drugs rather than the delivery channel.  A few minutes later, `Ravi's attendant' was again jolted from stupor with instructions to haul another load of drugs and other consumables.  When he saw the list, the only identifiable item for him as a half-awake layman, was 'Inspection Gloves-50'. He querulously told the sister he had just delivered 50 gloves, among other things, ten minutes ago and asked whether that item formed part of the night-time diet for all inmates of the ICU including the staff! When the mystery was eventually solved, Rafique's attendant got admonished for dozing off and gave an IOU for the cost of the medicines to Ravi's attendant because the former's treasury situation did not permit such an outflow immediately.  Hope was that the final settlement would happen to everyone's satisfaction.

A smart attendant, quick on the uptake, became acutely aware that even if no `shout' came his way, he could neither read nor sleep during the tenure outside the ICU.  While the tendency to blame the hospital for the state of affairs was inevitable in the attendant-victim, a clear thinking individual could definitely rise above the mundane and see the process as well as outcome for what they truly were - masterstrokes in achieving desirable social behaviour.  Obviously,  the authorities were creating genuine empathy in the attendants for those inside the ICU, without too much dance and drama.  When their near and dear ones were lying in the ICU, either semi conscious or in pain, how could the attendants shamelessly seek creature comforts, as if everything was hunky-dory?  This state of deliberate deprivation, carefully organized by the hospital through well-orchestrated moves, resulted in the attendants suffering a bit themselves and thereby forced to dwell on the trauma of the inmates of ICU.  There could be no denying the fact that if the attendant stayed in an air-conditioned room with 400 TV channels and music for company and was able to read Steig Larsson's `The Girl Who Kicked the Hornets' Nest' (I was honest when I reaffirmed to my wife I read the book during the daytime) or sleep for 8 hours like a baby, forget about empathy, not even a fleeting thought about the ICU inmate would have crossed his mind.  So, the hospital's superior motivation and well laid out strategy to help people achieve the goal should come in for praise rather than criticism, according to this scribe.

If, in the process, some attendant unfortunately developed malaria after a few nights' co-existence with the hospital's invasive mosquitoes or if continuous stone-bench-sitting-and-sliding aggravated one's sciatica or if the `uplifting' contraption of chairs caused grievous physical injury or if mere sleeplessness for a few days culminated in disorientation bordering on dementia in some dainty darlings, the positive aspect was that they were in the right place! The venue was luckily a hospital and one could  undoubtedly count on very prompt medical attention.  What more, one may, with some good fortune and help from the hospital authorities, gain entry into the same ICU as a patient and (a) make others outside go through the meticulous course in empathizing that the hospital had designed and (b) satiate one's baser instincts by gloating over revenge on the society at large!

PS:  With profound apologies to and prayers for all those inside all ICUs!!



Friday, March 15, 2013

Psyche of a rabid Indian Cricket Fan

Year 1967.  I was given my College Cricket cap by our Physical Education Master, a very good man - God bless his soul - who also doubled up as the `Manager' (I deliberately steer away from the epithet `coach', since he never pretended to be one during my 4 years with the team) for all sports teams.  His edict to the group was very simple and stern.  `You should win everything in front of you', he said, as if he was in the league of Alexander the Great and Napolean Bonaparte knitted together, marshalling the best army around to conquer all.  That he was gentle and soft of speech did nothing to support such comparisons. But we knew he was a good college-level cricketer of his time, so we refrained from smirking.  He had a very uniquely strange mannerism. Every five minutes or so he used his elbows, whether he was talking to someone or was by himself, to firmly hitch up his trousers; as if they (trousers, not elbows) were inexorably going out of control by slipping down,  making him vulnerable to potentially malignant charges of indecent public exposure!!  Knowing what was imminent when we were in his presence, we could not help paying greater attention to the much-anticipated and wagered-on next hitch-up move of his, to the detriment of any wisdom we could have gleaned from his exhortations.  But, we need not have fretted much, since we heard substantially the same content delivered umpteen times during the next four years, before the commencement of every match we played.  In essence, he averred that every ball we bowled should fetch a wicket and every ball we faced should be hit for a boundary, no less, opponents be damned!!  Very simple rules to play by, eh?  He knew it was a tall order for any team, but that did not prevent him from laying it thick on us every single time. And, if you thought he was just kidding, forget it. He had the gall to admonish us whenever we failed (time and again, obviously) to implement his carefully crafted, straightforward strategy!

But he was/is not alone.  I know many other seasoned cricket aficionados, otherwise known to be mature,  balanced and serene individuals and judges of life, consistently exhibiting rabidly one-sided views when India is involved in a match.  Such people cannot bear to watch the best batsmen of the opposite team cobbling together a reasonable partnership against the weakest links in the Indian bowling attack; they cannot sit patiently and watch three overs in a test match pass, if India does not get a wicket.  Some of them are known to switch off the TV in a real huff, when what they want to see is not happening on the pitch.  Once a friend, frustrated by the unsatisfactory proceedings in an Indian innings, actually threw the remote accurately enough to break the TV screen and had to go into hiding for the next week to escape the wrath of his cricket-averse father.  Others scream at the Indian team members from the comfort of their homes and condemn them summarily for their inability to get the upper hand.  It is almost as if the opposition does not exist or is just waiting to be rolled over, swatted aside by an Indian team, which is not really at its best.

My own dear father, who is otherwise the quintessential guru for us in life, is a personification of such an India fan.  He is normally so judicious about everything else in life but unfailingly indulges in this strange behaviour when things do not go well for the Indian cricket team.  He just shreds all those in the team and their ancestors for their past and present, real and imagined `sins' mercilessly (he readily activates his mental archive to cull dates of abject batting and bowling failures, recall pathetic fielding lapses etc) and petulantly shuts off the TV (earlier it was the radio), forcing others to scurry in search of alternatives. This phase is momentary, as one can guess; when someone informs him of an Indian success sooner or later, he rushes back to the TV like a kid and transforms into the vociferous supporter again, having no qualms being all praise for the batsmen and bowlers he had abused earlier.  Cricket does that to Indians, I guess; nothing rational about it.

If one pauses to think about it, one would find the above credo echoed by about 80% (may be more?) of India's cricket crazy population, with reference to the performance of the Indian team.  The general expectation seems to be that India should thrash any opposition in any condition anywhere in the world, despite empirical evidence staring in our face to show the team is struggling, rebuilding and is in fact near the bottom of the pile in terms of capabilities. Put it down to the manic fervour generated in India for the game or sheer irrational partisan behaviour of the followers, but that is the way it is.  When India struggled and lost against England recently at home, it was amusing to find that all those fans, including some former players-turned-pundits, did not spare a thought to the collective departure of Laxman, Dravid, Ganguly, Zaheer Khan and Kumble from the team in the recent past, the startling decline in the form of Tendulkar, Harbhajan Gambhir and Sehwag and the consequent impact on the overall balance of the team as well as performance.  Even the most pollyannaish supporters of the team should have realized that the newcomers were not a patch on the experienced campaigners India had lost and it would take time for the fresh combination to mature and transform into a winning one. That India was expected to roll over a resurgent England which had a couple of top spinners who could exploit Indian conditions was in itself indicative of the madness prevailing amongst Indian fans; but the chorus of wails that rent the air when the inevitable happened was nothing short of comical.

Why else would we have this spectacle of Dhoni's credentials as a good captain being questioned as soon as he loses a few tests, only to be restored with greater fervour when his team hammers a limp Aussie side, which is itself going through a major transition? Or take the case of Sehwag.  Whenever he goes for one of his expansive strokes early in the innings and gets out, hordes of arm-chair critics vilify him for not being paitent enough to build an innings.  These are the same people who usually applaud and urge Sehwag in a frenzy, expecting him to complete a triple century in one day.  When he fails to click, their verdict is `lack of patience'.  Cruelly ironical, is n't it?  Or how else would one explain Ashwin being celebrated as a worthy offspinner when he takes wickets by the bucketful against a lowly New Zealand side, which has historically and consistently displayed a woeful inadequacy in dealing with spin, only to be reviled as a third rate bowler when he fails against a much better equipped England team?  That all these flip-flops happen within a three month period should tell us there is a serious dearth of `balance and equity' in what the fans think and do.

Then there is a similar extreme behaviour provoked by personal  biases, carefully nursed over many years with utmost irrationality.  The most recent demonstration of this came through today as we were watching the second day's play of the Mohali test between India and Australia.  This friend of mine, probably one of the most passionate and clear-headed analysts of the game generally, was all over Dhoni as a wicket keeper or batsman or captain for, well, everything he did or did not do!  No exclusions here, even though the friend did grudgingly concede that Dhoni is indeed a decent, albeit ungainly, batsman.  Improbable nudges going through gully or short leg became `very easy chances' for the wicket keeper when Dhoni was keeping and the vehemence with which he was pilloried was simply frightening.  To drive home the point, my friend kept telling me `even you would have taken that in your heydays' without realizing that it did not come through as a compliment.  The hyper-critical state deprives one of tact, I guess. To bolster this point of view, time and again, he brought in his mother-in-law into play, a la Boycott, saying she would have done the job better than Dhoni, as if that good woman had an extended wingspan of twenty feet.  The withering looks his wife gave him from the next seat did nothing to stop him.  I guess he has done this before and reaped the consequences when he goes home!!  Quickly I banished all attempts to defend the poor skipper (no point, really) and asked the gentleman why he disliked Dhoni so heartily.  Dinesh Karthik is or was a better wicket keeper, so Dhoni is a usurper, was the answer.  Aha, as simple as that!!

The question that hounds me is whether football enthusiasts from Argentina or Portugal are as abusive of Lionel Messi or Cristiano Ronaldo if either does not score in a match or occasionally fluffs an opportunity. Is this kind of behaviour something all pervasive regardless of sport and country or is this something insanely unique to Cricket and India??









20th Century Breakfast Experience!

A friend was visiting Bangalore from Bombay.  A rather innocuous suggestion from my dear wife that he should grab a bite at one of the anted...