Sunday, April 29, 2007

I ain't sleeping. I'm just taking a good look at the insides of my eyelid...

Tina's just back from work. At 3:30 am. So are 15 of her friends, and they all work at the call center newly set up in the suburbs of Mumbai. The nice part, is , that she gets transport to and from her residence every single day, and so her folks are not really worried; though her mother doesnt really relax till she hears the sound of a jeep driving into the building compound, and the beep of the elevator as her daughter takes her time getting out of it.

The pay is fantastic by Indian standards and a pittance by US standards. And so today, all kinds of outsourcing call center jobs are getting filled up as soon as they are advertised.

So are doctors clinics.

Time was when you did a decent day job, left around 7;30 am , occasionally bypassing breakfast to arrive early at the office. You returned at around 7:30 pm, to eternal cribs about how late you were coming everyday. You met up with your old friends for coffee on occasional weekday evenings, and everyone had a grand time cursing whoever was the reigning ogre at the office. Sleep would relax you, and tomorrow was another day.

Ever since the world, specifically the English speaking section, discovered India as a huge storehouse of cheap,well-educated,trainable,computer-savvy youth, the information industry has never been the same. Thanks to the weird and persistent drifting of continents millions of years ago, India is at work when America sleeps; what is worse, is, that it is also at work, while the US is at work.

This has given rise to a veritable flood of call centers, with almost all big companies jumping on to the bandwagon. Special training is given to Venkats and Nandini's so they can function as Dave and Sue, complete with American jargon and attitude. Saying "have a nice day" with a cyber smile at 2 am is the norm, there are supervisors functioning with a hawks eye to ensure that there is no verbal abuse on both sides, and for a girl, who looked forward to a secretary's job, where she brought her own packed lunch from home to save money, and travelled packed as one of the "sardines" in Mumbai's suburban trains, its a brave new world, where she is provided company transport to and from work, and an interesting pantry and cafetaria, where she gets midnight meals on the house, everyday.

After the first flush of euphoria, prosperity, and a sense that you have come up in the world, the little niggles begin.

Someimes it's lethargy; you lie down, count sheep, cows, goats, friends, even enemies, but sleep evades you. So you try to relax with a book, but it gets so difficult to concentrate. TV is the next thing you try. Its fairly a waste to watch, as nothing registers much.

Your Mom, worried, tries to tempt you with some freshly cooked stuff, and you try to hide the fact that your digestion is no longer the sturdy thing it was. You have joined the ranks of those with acidity. When guests come, you feel like disappearing into your room. Stress is the order of the day, and you realise that you really dont know your body anymore.....

The BPO industry , has given rise to an entire generation of young people, who have messed up their health, physically and mentally. Research indicates, that depression is a common finding among these troubled youths. Loss of hair, headaches, fatigue, sleepiness at the wrong time, reduction in body reflexes --- all these are terrible things to affect folks at so young an age. The body is being abused as never before, in pursuit of lucre.

Dr. Jeffrey Ellenbogen, a neurologist at Brigham and Women's Hospital, Boston, and a postdoctoral fellow in sleep medicine at Harvard Medical School is the author of a study, that seeks to find out the relation between sleep and learning. The American Academy of Neurology annual meeting in Boston, will have learnt about their findings during a meeting on May 2, 2007.

48 people between 18, and 30 were asked to learn 20 words. Folks were divided into groups, that stayed awake after learning the words, and also those that were allowed to sleep after learning the words. They were also given a second set of 20 words to learn. The findings, indicated that those who slept after learning these words, had a noticeably better recall, compared to those who were kept awake (76 percent for the sleep group vs. 32 percent for the wake group). This was more, than that anticipated by the researchers, based on their scientific initial conditions and parameters.

This has clearly proved that good sleep is essential for memory consolidation, given that our educational learning systems require excellent declarative memories (memory for facts and events and time). It turns out that good sleep also leads to good physical and cognitive functioning, an improved immune function, and a mental control over moods.

Prehistoric man, woke up with the suns rays dappling across him through the canopy of green, as he stretched and got up in his forest abode. He spent his time playing, hunting, climbing, fighting, and at some point, eating , probably the freshest of meats and forest produce, freshly processed over the latest discovery , fire. The setting sun, brought a natural end to the days activities, and he sank back into a comfortable sleep, unconcerned about gas prices, inflation, whether the insurance would cover the latest medical test, whteher he was going to be laid off at work, etc etc.

Although fire did generate some light, it wasnt enough to give people unneccesary ideas. It was not till Edison got into his act and discovered the light bulb, that folks got greedy, and messed up their sleep patterns, and energy patterns.

Before the advent of the BPO industry, sleep related health problems, were the domain of the elderly. Today the patients at sleep clinics are getting younger and younger , often suffereing from sleep apnea, which if ignored and left untreated, would predispose one towards hypertension and strokes.

Burning of calories is something that we do less of when we sleep. So one would conclude that if you slept less, you were expending more calories, and so there would be more weight control.

Turns out, that this too , is untrue. In 2004, Columbia University scientists conducted a study and proved that those who slept less actually tended to be more obese, thanks to the effect of lack of sleep on the appetite hormones.

Thee are two hormones, leptin and grehlin, in our bodies, along with a huge orchestra of other hormones, that maintain the body in a decent balance. Leptin , is responsible for controlling appetite and weight, and telling our body the energy available to it. Grehlin simply encourages people to feel like they should eat.

As can be expected, when you dont sleep well, the leptin levels reduce and grehlin levels increase, leading to an optimum situation for piling on weight.

A quarter of your lifetime of working odd hours, and abusing sleep patterns, and you have a great chance of predisposing yourself, and collecting most risk factors for all kinds of deadly things such as heart disease, liver diseease, angina, osteoporosis, and at some point, depression and dementia.

We need to worry. An entire generation of young people , in the pursuit of the lucre, is "marching into the valley of sickness", inspite of the "charge of the health brigade" , as Alfred Lord Tennyson would have said, had he been composing his poems in 2007. It forebodes ill , for an entire future generation, that is already having to face other problems, like pollution, harmful food additives, lesser green spaces and so on.

Unless attention is paid to the health aspects of the BPO industry, there is a danger of the youth of the future, losing out on the learning capabilities, and abilities, that make todays workers so valuable. There will be an entire generation of physically unfit parents, leading to problem progeny, , and over a period of time, one stands to lose ability to learn , that has brought the BPO industry where it is today .

Reminds me of what is supposed to have happened to T-Rex and his other dinosaur friends, long time ago.

The earth is supposd to have experienced huge climatic changes towards the end of the era of the dinosaurs. Unlike mammals and birds, reptiles have a problem with the type of sleep (slow wave sleep) required to boost memories, particularly those related to learning new skills. Slow wave sleep enhances learning and also physical performance. Reptiles , (because of their messed up slow wave sleep system) , are much more limited in the type of complex behaviour they can experience than other animals such as mammals and birds.

It appears, that subsequent to the tumultous climatic changes , reptiles proved incapable of deveoping skills, required to emerge from them. This slowly led to the extinction of the lot, while birds and other mammals , kind of sailed through.

Lest you think that I am making this up, this is actually research carried out by Dr. Niels Rattenborg, of the Max Planck Institute for Ornithology in Germany.

Unfortunately, we humans have a great capacity NOT to learn from our mistakes till its too late.

Sunday, April 15, 2007

Putting old on hold.........

When I first went to the US 35 years ago, there was one thing that used to amaze me no end. Say, you were visiting some old folks, and the lady of the house had gone out for lunch or something. It was usual for the gentleman to say that the "girls" were out at lunch, and expected back shortly. The first time that happened, the sound of their garage door closing heralded the arrival of the "girls", and I half expected young , granddaughter types to appear on the scene. The arrival of two ladies in their 80's, with wisps of silver hair, full makeup, matching shoes and purses, fancy brooches et al, had me completely speechless.

Seniors and Superseniors. And I am not talking about outstanding performers in college.

There is a new category of folks getting defined these days. Thanks to excellent medicine, good exercise habits, careful diet control, and most important, a permanent learning curiosity, today, more and more people remain fitter well into their mid 80's.

There is an entire generation of folks, whose children are now , what are classified as senior citizens.

In a recent talk at the St Louis meeting of the Ameriacn Association for the advancement of Science , in February 2007, Prof S. Tuljapurkar Of Stanford, spoke about the economic and demographic effects of the anti aging therapies that are currently in use. Between 2010 and 2030, people's life expectancy is supposed to increase by 20 years, with folks living into their middle eighties, routinely. It turns out that what the nations economic czars are basically worried about , is the ratio of the retired population, to the working population. And it is estimated, that consequent to adoption of various kinds anti aging therapies and medications, this ratio is lilely to quadruple by 2035.

That has a , if I might use the word, a deadly bearing on Social Security and Medicare policies in the US.

Concentrated usage of certain therapies and usage of certain medications predominantly by first world countries, would have a telling effect on prices of medications, set by pharmaceutical companies, hell bent on profits. That doesnt bode very well for a world where other countries exist, , where the root cause of all strife, poverty, lack of progress is almost, always, money, and what you can buy or not buy with it.

And today, the policy seems to be to indulge in militant and /or military interactions, to satisfy our national craze for overconsumption, of many things, predominantly oil. The same goes for the obsession with never looking your age. The pharrma companies literally milk you dry, and you ask for more, and outlandish expenditures becomes the norm, blinding us to the real situation on the ground.

Fiscal scenarios apart, it is educative to visuaise what would happen in a world of superseniors propped up by the pharmceutical Gods.

Imagine a family getting together for Thanksgiving. The family patriarch and matriarch , (terms you would have laughed at ) very much on the scene, trying to orgainse a table for 55 people. Their 4 children , 2 of them senior citizens themselves, driving in from about 100 miles away. Their children, some working with big companies, some in business and some in academia , trying to make this trip in a combination of air/train/automobile systems. And their assorted off spring ranging from elementary school to college, making, what they think of as a mandatory family trip for the year, never to be missed, no matter what. Someone special has been employed to cook the meal, the varieties of liquid refreshments boggle the mind, given the alcohol, sugar, lactose, and celiac restrictions currently in effect across the family. The family ranges from great grandpa at 95 to the youngest third grader, who thinks figuring out everyone in the group, is the worst quiz he ever faced.

Half way through the meal, someone will fall asleep at the table; probably the oldest and/or the youngest. Someone's shaking hand, trying to pick up a glass on their own will probably spill something on someone. Someone else will shake their head. Great Grandma, overcome by the excitement will fall asleep in the living room listening to her granddaugter's account of her trip to Bangladesh to study the rise in ocean levels and sinking of land due to Global warming there. A couple of Grandpa's will cross each other making repeated trips to the bathroom; its so difficult these days , isnt it ?

The women, discussing the latest mammograms of the eldest; shaking their heads at the inevitable waiting list for getting ordibnary diagnostic procedures in hospitals; and the topic will inevitably veer around to how all this outsourcing of medical diagnostic reporting work to third world countries, is forcing folks to deal with fake sounding Bills and Carolyns who still spell "color" with a u after the second o, and pronounce the letter Z as "zed"....

What has this miraculous anti aging medicine given us ? Beauty ? May be . Mobility ? Maybe. But Mobility was never an issue in the US. Comfort ? Physically, maybe. Alertness ? Sometimes . Better Healing ? Certainly.

Peace of mind ? I dont know.

When we say anti aging therapies and medications succeed, we are only talking about the physical aspects. The immediately visible aspects.

Not withstanding the fact that pharmaceutical companies, being those who are most interested in marketing these antiaging tricks, treat the body as a physical engine, it is necessary for us to keep in mind, that there is a mental aspect to it all; there is something called "mind and body", and everything good that happens to the body immensely depends on how happy and optimistic the mind can be.

The social system, with its obsession with individual independence and privacy, makes it difficult for seniors today to visualise a life with their children and grandchildren , together. One or the other thinks its a burden. Everyone is obsessed about what the insurance company will pay for and and what it wont pay for. Seniors have been reduced to being thought about as an expense.

Think of an entire extra generation of folks above 80, living into thei midnineties, maybe working till their mid eighties. Spruced up and spritely, not missing a single dose of their Omega 3- fish oil and Coenzyme Q 10 , Botoxed faces gleaming in the sun, their cars with special click buttons to aid semi arthritic trigger thumbs cope with doors and trunk openings, driving into their senior communty house, in a car with a GPS that they dont really use as they think its a bit complicated.

And they reach their suites/rooms, rest in their armchair, (with all the embedded call buttons on the arm rest, with a special hot link to the main office), and wish they werent home. Its lonely. It worries them that something may happen and there may be no family around them, no child to gaze at and pour out your best wishes to, as you get that sinking feeling. . All those stem cell therapies, electrical stimulation of brains, and what have you, cannot hide the fact that this body is now an old machine; the forgetfullness has increased; sometimes they remember things from their childhood, and its as if scenes flash in front of their eyes. Old episodes from their younger days come to life. You try to get up from the armchair in that dream about your youth, only to realise that bone densities have changed, and you need help. And your spouse cant help you either. She has fallen asleep with the coffee getting cold. You just wish you had your family around you....

This entire generation of superseniors as created by these anti aging miraculous medications and procedures, will be basically worthless unless acompanied by a hard look at the existing social family systems. Extended family systems. That help preserve the mental peace and sanity of an old person now in the evening of their life.

Life as we know it in the US cannot and should not be dictated by fiscal and monetary issues. Insurance should not decide whether a parent lives or dies.

It has often been instructive to study various populations in China, Mongolia, Russia, and various Asian destinations, where people merrily live well into their 100's, with their own hair (uncolored, untreated), their own teeth , and whats most important, their own self confidence.

Turns out that these folks dont make a special effort to imbibe all kinds of , so called magic foods, hitherto unheard of in the west. They have strong social family systems, eat local traditional food, the local traditional way, enjoy their drinks, are probably consciously unaware of things like cholesterol etc, but unconsciously probably eat all the correct foods over their lifetimes, in consonance with their physical surroundings, the local flora and fauna, and the local water.

Sicknesses are not considered calamities; they are events that are ordained to rest your body , maybe overstrained by some indiscriminate imbibing of stuff. Food itself can be used as medication, and that knowledge is constantly available in the family, updated and passed on to the newer generations. Tolerance for views of those different in age and attitude, comes with having close contact with all members of your family. Folks in the family chipping in , emotionally, during the bad times afflicting any member is a routine affair, and nobody glamourises it.

Various stages of ones life are defined with various functions. The Indian Scriptures, define , in addition to birth, childhood, adoloscence, marriage, a state called "house holding". Thats when you are a householder. You have children, support a family, slpervise the growing up and chanelling of the childrens energies. The children grow up , set up their own families. The Sriptures , at this point , define a way of life , which when loosely translated, means "retiring peacefully into the woods". The operative word here being "peacefully".

In these days of Global Warming and Inconvenient Truths, woods may be difficult to find. But many have interpreted this to mean that one now provides the family a virtual green area, where elders, having completed their family responsibilities, now help with the grandchildrens bringing up. Ambitions at the age on 70 are quietly ignored; occasioanlly an indulgent son or daughter urging the grandparent to go ahead and try something new is then a great pleasure.

These ways of life , may not be smart in a medicated world. But it is a way of life, tried and tested over a number of centuries, where the mind is given as much, if not more importance than just the physical body. Life has to be lived in balance.

Stress doesnt get reduced by defining it, or fiddling around with receptors in the brain.

If at the end of the day, we can honor these superseniors in our family, by giving them our time, place, care, dedication , and of course, occasionally, other resources like money, we would have earned the right to live well into a comfortable, happy, cared for (by family) old age ourselves.

What goes around often comes around. Life is hardly ever linear. Cyclic, more likely.

And that is why, although statistics says that we will have folks merrily working into their late eighties, causing all kinds of economic, congressional, presidential, fiscal, pharnaceutical, and other crises, I firmly believe, that there will be social family system upheavals that will force us to examine the existing set ups, leading to fairly strong changes, a reassessment of what is good, essential medicine and what is not, and the price that we pay for it.

In the meanwhile , maybe I can tell you about a friend, a lady who is 90, who disdainfully ignores all these physical antiaging therapies, teaches mentally challenged children a few days each week, reads to people at an "old" age home 2 afternoons a week, volunteers at the local library on the remaining few days, and says that what keeps her fit is all the gardening she does daily in the wonderful Northern California weather.

And if this is not enough, she is off with 3 other friends the same age as her, on a trip to Africa to watch the animals, flora and fauna.

Maybe she can teach the pharma companies a thing or two about aging, or should I say, non-aging ?.....