Saturday, September 24, 2016

A "shocking" morning.......

I never had much to do with nerves, so to speak. Idiomatically or literally speaking.

I cannot recall anyone shaking their head in anger and saying,  "My God, she has the nerve ...."  or anything like that. Being nervous and showing it was not usually an option, and the thing to do was to always get on with what one was doing and look ahead.

So why suddenly this conversation about nerves ?  Because someone decided my nerves were possibly misbehaving, and recommended tests. 

Given that all kinds of medical diagnostic procedures were introduced during my adult life, I have had an interesting time doing things like ultrasonography, mammography,  smear tests, and MRI's. And later blogged about it. Like the MRI's.

Technologies have since gone through versions .  While the technology is impressive  in instrumentation, size and capability,  one has things to say about preparations for the same.  I mean , ultrasound science shows you pictures of your internal tissues by moving a probe over your body, but hasnt been able to find an alternative to all that drinking of water, till you are desperate to go to the loo, and the receptionist telling you to hold on because another patient was inside.  Or having to remove your earrings, bangles and mangalsutra  for an MRI, wear a hospital gown , and lie down on a plank that slowly slides you into a dark sphere which rattles. No one else in the room , and chaps look at you through a glass pane, and click things on a screen.  And whats more, no one can accompany you  and sit alongside somewhere on a chair.  Some tests are downright embarassing in the postures you have to be in, but you see other folks being subjected to the same , and just join the masses .

A bad back problem, a ankle swelling and a burning feet problem, (the burning akin to standing in a kilo of ground green chillies for one hour), had me losing sleep and peace, and I saw a neurologist . After some physical movement examinations,  a lot of diagrams  consequent to my asking questions, I was advised two tests NCV (Nerve Conduction Velocity) and SSEP (Somato Sensory Evoked Potential) .   Fancy names. Very impressed, and I  Googled.

Then I booked an appointment and went in.

Turns out, that these are tests to find out nerve damage , and what kind of damage .  The nerves contributing to my feet burning originated in the spine. Old age does things to your vertebral column ,  and these tests are particularly useful to figure out nerves that may be pinched somewhere, or nerves that may be damaged , say internally . 

 Went to a big hospital in the suburbs where both recommended tests were done . Surprisingly,  while the NCV test is common , not many hospitals will do the SSEP test.

Thankfully , there was no change of clothes into hospital gowns, no drinking water and stuff like that. You lay down on a raised bed,  and someone then proceeds to stick electrodes at places on your scalp, hands , feet, behind your neck, and so on.  You are not supposed to have applied lotions, oils etc that day , and even then they have some conduction fluid thing which they apply after cleaning your scalp areas and rubbing it strongly before sticking the electrode.

After many years,  a rubbing of various areas of the scalp really brought back old memories.  I actually felt like falling asleep. But didnt.

Then the fun part began.  There is a thing like an electrical  two pin plug which they touch to predecided points on your body. The fun part is there is a current running in it and you get shocks.

 How your body responds tells them something about the nerve and how well and fast it transmits sensations  which are detected by surrounding electrodes at a known distance.Your are not supposed to move . Initially the shocks are small, and they gradually increase in amplitude.  There are occasional involuntary cries of "Aai Ga", and the young lady tells me to take a long deep breath , and exhale quickly. I see through it and ask her if all that deep breathing has anything to do with the shocks , and she smiles and says no.  They tell it to people so it distracts them from the shocks.  I tell her to keep the shocks going and ignore my cries . I need to get over with it.

This stuff is repeated for each upper and lower limb, with my lower limbs coming up with some creative shock sensations, thanks to the swellings. A break is announced before the ssep procedure is begun, as an paralytic emergency patient is scheduled for a quick test . I wait outside and try to investigate things on Google on my phone.

I am then called inside for the SSEP procedure .   This is basically designed to see how well the brain and spinal cord can react to messages to and from the various body parts. The speed with which nerves transmit the sensory messages, across known distances.  Brain to tips of the upper limbs, and likewise for lower limbs. So there are electrodes attached to your crown, again with the nice rubbing , and sticking.  A new electrode to your back at your waist, and then lots attached to your ankles. This test doesnt give shocks, but more of a buzz, like a big mosquito bite. Once again they apply voltages/currents, and for some reason the swelling in my ankles seems to behave like an insulation. Time an again i get no sensation from their electric touch, and they keep moving the probe in a certain area, till I overreact, when a slight electric  zing is felt. The test proceeds. I dont sense things going up and down my back, but they see stuff on the screen , and make knowledgeable comments to each other. Two hours later , I am through.

I am simply impressed by the two young girls, who handle these complicated tests, with varied patients. In between they interact with the doctors, as well as the administration/billing people, all this while answering  my questions, They also have excellent people skills, dealing with frightened types, older people who cant hear or language-disabled types.

I realize that while the body has all these glorious systems ticking away inside, it is the brainy high command up there that is kept informed by the nerves about the status of all.  Something doesnt respond to an impulse, something overreacts in pain, something works intermittently. Their are local responses, spinal responses and high command responses. Some nerves, being under an autonomous spinal control, go haywire , and it is sometime before the high command brain figures it out.

Sometimes the nerve itself has gone bad, sometimes the path it follows is in trouble.

And it occurs to me that this is so much like  whats going on in our country., Lots of people, locally controlled, going out of control, making random statements, accusing others, performing faulty actions. By the time people at the top find out, it's too late.

Medicine has all these tests for nerves . I wonder if we need such tests in society.  Backed by science. So we can take action if the person is at fault, and guide him if he is on the wrong path. The tests also tell you if this is a "gone " case, not likely to recover, and likely to lead to some serious affliction. Even then there are ways of making things tolerable.

As for me, I am still waiting to find out my nerve health, and if they have learned any lessons from the shocks they were subjected too .  The report is to arrive in a day.

Just think .Like the country,  sixty plus (and more) - decades of tolerating me, right from birth. I wonder what the nerves will have to say. In society, someone can always get up and give a speech and run someone down with choice epithets.

I think my nerves have more class ...   :-)

Hopefully, it will not be another "shock".......

Tuesday, September 13, 2016

Loo Architecture as if people mattered.....

Many years ago, in my working days at an Institute of National Importance,  there was a flurry of new constructions, and set ups, after years and years of making do with existing stuff.  Alumni remembered the Alma Mater, donated, the government too gave decent budget allocations, and our department got a new building , designed by a prize winning architect, who was featured on the cover of a professional journal .  

The most prominent feature of the new building was the open spaces inside , the great heights of ceilings, some kind of wide uncovered iron beams across classrooms way up,  a few labs without a single window , and a central staircase approachable from 2 sides (which made it interesting to chase people) , and the very roomy loos .

It needs to be understood that folks came to work from the far off suburbs by bus and train, be it  rain or shine, and often got completely drenched , quite normal for the Mumbai monsoon.  It helped to have a loo where there was a dry area for folks to change into dry  sarees and other outfits. .

A few months down the line, it became clear that the western style toilets were not exactly popular with the ladies, and since there was a provision for more than one toilet,  there was a move to petition the authorities to convert one to an Indian style toilet.

Such a simple request. But a letter was written, which went with all the signatures through the Head , to the Institute Estate Office that oversaw construction. Mind you, no one thought it necessary to consult the actual users of the building when the designs were being prepared and specifications of fixtures etc were being finalized. In something that always happens , things are approved at rarefied levels without involving the actual users and inviting their input.

One fine day, a committee of folks from the estate office, came by to inspect, various papers in hand.  Some of the ladies were called and listened to. Then nothing happened over a period of time.  Suddenly one day, some guys turned up and the loo was inaccessible to the ladies for a month or more, while all kinds of banging, scraping, hammering , drilling went on , incidentally , right next to a lab.

One fine day, the ladies got a loo of their choice.

I have never understood the concept where designing with western sensibilities is considered a step up in the world. I mean we were not a multinational. constantly entertaining and working with folks across the world,  but a simple request had to go through a Head, had examining committees, comments in writing by people  in authority, and so on, before the first demolition could happen.

From buying a system worth lakhs and crores, to a lowly bathroom modification, there were committees. No distinction between professional needs and personal needs.

Years before this , I worked for what was then the leading IT company in India. It is the same today too. Situated in the then iconic high rise Air India building , all the floors had identical patterns where office space and toilets were concerned, the latter consisting of an anteroom , and the actual toilet complex.

The place was centrally air conditioned, and one fine day , on entering the loo, one saw a pair of feet high up on a bunch of AC pipes that ran close to the ceiling and through it. The building was possibly getting AC maintenance done , but this was unacceptable. You couldn't have folks walking around at a height on pipes, in a ladies loo.  When our requests were ignored , we wrote to the then GM of our company, who later on was to become one of the most respected people in IT and was once called the Bhishma Maharshi Pitamaha of IT.

An hour after receiving the letter , he himself came with two HR people  to check out the situation, invited us to tell our problems, and a letter was sent off to the building management, protesting the whole thing, and asking them for better schedules and procedures of maintenance.  The next day onwards, people stopped walking on the pipes high up, and privacy was restored.

Perhaps , it was something that organization inculcated and learned from its founders. There are things where a solution is obvious, and there are situations which require deliberations .

Perhaps this story, illustrates something. (Story courtesy my friend Shanta Konaje)

Ratan Tata was holding a weekly meeting with Tata Steel staff at a football ground in Jamshedpur.

While watching the football match, to strike a conversation, a worker took up an issue.

He told Tata that the toilets for workers was terribly bad with leaking taps, clogged commodes and unbearable stink. No maintenance was being done for workers toilets, whereas the maintenance of officers toilet was very good, with air purifiers, dryers, hand towels, etc

Ratan Tata asked his top executive how much time he would need to set it right. He said 1 month. 

Ratan Tata said, " I would rather do it in half a day" and asked for a carpenter.

Next day the toilet sign board on workers toilet was changed to officers and officers to workers. There were instructions to change it back every fortnight.

Quality of both toilets became good.

Excellent example of Efficient Management  and Effective Execution.


Friday, September 09, 2016

Bappa : A State of Mind

The city, alive with Ganpatibappas arriving everywhere.

Some, with the building kids skipping along , chanting Ganpati Bappa Morya  with some parent carrying the deity home, lightly covered in the best household silk.

Some, in what look like chariots, emblazoned with the owner's name, escorted with a couple of bands,  drummers, ladies in traditional finery (sometimes on motorcycles) , and general leader types, walking at the head of it all.

Some Housing Society Bappas, on carts , being enthusiastically escorted to halls, where the residents wait to welcome him.

And then there are Bappas, who preside over depictions of society ills, victories of truth over falsehoods, congratulating the Olympic heroes, and recommending Swachh cleanliness as being next to Godliness.  

Ganpati Bappa, admired by people across caste and religion, an opportunity for folks to visit friends and partake of the celebration.

One goes back to one's childhood home in another city , on a visit.

There are more rooms than people there. Some having shifted for traditional reasons, some having flown the nest .  But the walls , chock-a-block with memories

There are childhood memories of Ganpati celebrations in the house, vociferous artis recited along with visiting friends and relatives; you never really sat down and learned the artis; you simply participated and they imprinted themselves in your memory , as you continued to bring clarity to the words as you grew up. The excitement of distributing prasad, evenings when folks gathered and kids recited things , performed dramas, and a whole bunch of small kids giggled behind covered mouths as they observed an elderly aunt singing something classical, and performing difficult taanaas . Someone always glared at them, but  Ganpati Bappa never did.

Then there would  be the day when Bappa would be leaving to return to his own abode. Prayers, artis, prasad , and there would be a Shidori or packed refreshments of Poha, dahi, jaggery etc that would go along with Bappa .

Lots of singing of "Ganpati Bappa Morya, Pudhchyaa warshi laukar ya " , lots of bravado , and a mind , not so happy at the departure of a special guest, Bappa.  A procession winding around the colony, making its way to the well nearby,  a final arti, an immersion, and a quiet return home, with some soil from the immersion site.     

Sometimes , for a moment , strangely one feels like Bappa. 

Once a year, a homecoming.  To a place , where there isn't anyone, but just someone you have known since childhood, who took care of you and assisted in the house. He is almost 80 , and has an amazing memory. You are in touch with him, mostly on the phone, and he never fails to ask about family who stay beyond he seas. Their children and their children's children. You are never at a loss for words and conversation when you meet him.  

There isn't any special decoration, but the walls come alive with old photos on the wall, some huge crossstitch embroidery laboriously done by you as a child, still displayed above a door. And old radio plays AIR , not the commercial version, but the local station; bhaktigeet in the morning, patriotic songs at some point, and assorted  small audio plays and announcements and news.  Like Bappa, you are there only for a day or two, so you do not want to get involved in getting the kitchen fully operational, meals and all. 

The phone rings. Someone has found out one has arrived. Lots of conversation, reproaches, promises made to come later. One also has to make some calls , and for a while the technology rules.

The daughter who has accompanied you for her own activities, take a round of the terrace; your bad back prevents you from rushing up and down with her.   She comes back gushing about the amazing coconut palm, huge colocassia leaves, and a wildly blooming ajwain bush. All nurtured by him .

He busies himself in the kitchen as you get organized for the day. The homecoming demands a home meal, and he looks disapprovingly at the daughter talking bout eating out. He has learned so much from the matriarch of the house , who is no more. For  a while you don't see him, busy as you are with getting refreshed with a wash,  a rest beneath an old creaking  fan , and a quick cup of ginger tea.

An hour later , at the ancient dining table for a simple lunch, steaming plates of rice and a potato rassa as only he can make it; the children of the family , and the children's children, swear by it.

And then he brings out the piece de resistance; the prasad of the day, as it were. 

While we were getting settled in, he has gone to the terrace, plucked a bunch of colocassia leaves, made a stuffing of spiced besan, steamed the colocassia rolls, and is now , having fried them, urging you to taste Aluwadis  अळूवडी, made from home grown ALu अळू or Arbi leaves.

These are special leaves,  he explains, not like the ones you get in the market, which often leave a scratchy feeling in the throat. This is Doodh-Alu , which is never scratchy, and a broken stem generates sweet white sap , hence the name.

There are no words to describe the meal and the Aluwadis अळूवडी. Much urging to have some more. Finish the rassa , he says , because he is "keeping a fast" . 

It isn't just the food.

It's a homecoming like no other.  To an otherwise empty childhood home. A single day  when it all comes back to you. 

An almost  annual visit, sometimes much delayed . But what a homecoming.

You leave the next day .  Full minds, full hearts, full eyes.

Like Bappa, who also stays for 1.5 days.

Like I said, sometimes strangely , for one infinitesmal moment, one feels like Bappa. 

Truly, Bappa is a state of mind ......