Between thoughts and words

Wishing you all a very happy new year 2025! As I sit back and think about 2024, I am overwhelmed by how much has happened in the year and how much it has enriched my life. There have been several dramatic twists and turns in the plot called life. One of the most important events that happened this year has been my career change. I vividly remember the conversation I had with a friend who had made a similar career change a few years ago. She told me, "Vijay, it is not going to be easy. But eventually you will get used to the idea that you don't have a regular job anymore. You will find yourself questioning your decision several times. But you will get used to a new normal." Those were indeed words of wisdom. I keep telling these words to myself even today when I question myself for having taken this decision.  I am now a primary care provider in a rural area. I would not characterise it as a remote area, nor would it qualify as underserved. Compared to when I started worki...

Our research assistant and I left to the far off village in our project area on his bike after the clinic on Sunday. The weather was pleasant. The wind blowing on my face, vast swathes of green fields on either side of the narrow cement road, and huge trees standing on either side of the road at periodic intervals as though watching over us as we rode towards the village, created a sense of warmth and happiness.  The bike did not have one footrest and so my left foot was cramping as I rode pillion. Other than that, it was a beautiful ride and when we reached the centre of the village, it was very quiet. 2.00 PM on a Sunday afternoon, with most people enjoying their post meal siesta, the two of us stood just outside the temple waiting for the people with diabetes to arrive. A peer support group meeting for men with diabetes had been scheduled and I had gone there to participate and interact with the participants in the meeting.  The community health worker for the village arriv...

Recently I have been working on a research study on women's lived experiences with diabetes. We interviewed several women to understand their experiences of navigating diabetes. Hopefully the findings of the study will come out in the form of a publication soon. This blog is not about that. It is about the impact of the social construct of masculinity on diabetes management.  One of the first things I do before starting the clinic is to visit the tiny hut near our clinic in which a couple run an idly shop. They make really good idly and when combined with the piping hot sambar (which must be pardoned for its watery consistency), pudina chutney and crispy lentil vada, it is a really wholesome breakfast to get the day started. My routine is 3 idlies and one vada. But getting the shopkeepers to limit the number of idlies to 3 and vadas to 1 was an uphill task. "How will 3 idlies be enough sir? you should have at least 3-4 more. Will you also have 2 poories in addition?" This...

There are age-dependent themes in conversations between friends. In the late 20s and 30s conversations tend to be about marriage, children, schools etc. In the 40s and 50s conversations move towards care of dependent elderly parents. In a typical middle class family caregiving for dependent elderly parents is included as one of the routine responsibilities. The living arrangements may not be amenable to providing physical care. Nevertheless even from a distance, the care responsibilities are often there and they are a major part of monthly budget planning and planning of day to day life. My parents are quite independent in many aspects, but the worry about how they navigate the new digital world, electronic transactions and everyday life which has now strongly become technology dependent is a constant lingering one. Yesterday I saw a patient in our clinic and her story was such a stark contrast to this situation.  Mrs. M came to the clinic with a swelling of her left foot, severe p...

I recently saw a patient and faced some challenges in treating her. This taught me a very important lesson. A basic capacity of imagination is crucial for effectively navigating our lives. Every thinking human being is endowed with this capacity to imagine, some more vividly and some scantily. When the capacity to imagine is weak, we end up with diminished hope, low self esteem and lack of initiative in doing things. I have been dreaming of being a writer for as long as I can remember. Starting from my childhood when I used to read Enid Blyton's children's books I have always marvelled at the capacity of writers to weave a magical universe in our minds with their words. I have dreamt of having books published with my name on the cover, the books displayed in the popular book stores and people buying them, reading them and discussing the content. But life took a drastically different course and I ended up being a clinician and researcher, and I mainly write academic papers now. ...

Within a few minutes of starting the clinic we got news from the village nearby that Mrs. M had passed away. The news of Mrs. M's passing was constantly in the back of our minds as we went about seeing patients and treating them. We had a full clinic that day and immediately following the clinic, we had committed to conduct a medical camp for children who were orphaned by COVID 19 in the nearby region. We were unsure whether we would even finish clinic early enough to head to the camp. But surprisingly the clinic slowed down and closed sooner than we expected. There was time to visit Mrs. M's home quickly before we can head to the camp. My colleague and I went in her car and as we neared Mrs. M's village, my heart started racing. I have witnessed so many deaths of patients, relatives, friends and even students, and have attended funerals. But it never gets easy. With a lot of trepidation we reached the village. It was not difficult to spot. Mrs. M's home is right on the...