Friday, July 27, 2012

The Cunning of Healthcare

In my last post I had mentioned about my experience with a doctor named Dr K. G Kallur, Consultant Nuclear Medicine at HCG Bangalore Institute of Oncology during a nuclear scan. I had lodged an FIR against him with the police who, in turn, had referred the case to the Karnataka Medical Council (KMC) for investigation.

I had in my written submission brought to the notice of the Hon’ble Council (KMC) that according to Atomic Energy Regulatory Board (AERB) Safety Code, it is mandatory for a specialist doctor/nuclear physician to supervise scans such as mine and had annexed a copy of the relevant code.

The Code inter alia spells out that the nuclear physician shall:

(a) have the responsibility of dosage administration and maintenance of records providing name of the patient, nature of procedure, radiopharmaceutical prescribed, quantity prescribed, name of the nuclear medicine physician with signature and date, and name of the person administering the radiopharmaceutical with signature and date;

(b) prevent any possibility of misadministration and promptly report to the licensee and the competent authority in the event of any misadministration, adverse reaction or death of a patient administered with radioactivity;

(c) consider factors such as proper choice of radiopharmaceuticals, monitoring of procedure and immobilisation of the patient in order to minimise absorbed dose to the patient;

(d) inform patient on safety measures to be observed to avoid radiation exposure to the family members and others;

(e) instruct nursing and ancillary staff on radiation safety and precautions in nursing/management of therapy patients;

(f) obtain an informed consent from the relatives of the patient, prior to administration of therapeutic dose;

I had stated that all the above mandatory prescriptions of AERB were flagrantly disregarded by the specialist doctor, Dr Kallur, Consultant Nuclear Medicine, since neither he (who as per the money receipt was mentioned as the doctor to oversee the scan) nor any nuclear physician supervised the said scan. In fact, the doctor had not seen, leave alone examined and discussed any issue with me, the patient.

I had further brought to the notice of the Council that the HCG Bangalore Institute of Oncology Speciality Centre claims to have accreditation from National Accreditation Board for Hospitals & Healthcare Providers (NABH) Government of India. According to chapter 2 (CPP) Control of Imaging Processes and Procedures of National Accreditation Board for Hospitals & Healthcare Providers (NABH) [Page 41]:

“The imaging protocol shall address general population as well as provide for specific modifications in patient with special needs, e.g. children, pregnant, females etc. The quality of images shall be verified by the technician as well as by the supervising radiologist/nuclear physician in terms of its technical nature and the diagnostic content relevant to the patient’s condition.”

The above stipulation enjoined as a “Shall” requirement in the NABH’s Standard for Medical Imaging Services (MIS) was violated with impunity by Dr Kallur.

I had brought out that my apprehension that the nuclear scan was done without the specialist’s supervision was further vindicated upon receiving the report. While the radiologist’s signature was affixed to the report, names of three consultants in nuclear medicine were printed alongside, including Dr Kallur’s, though no signature of any of the three consultants had been affixed. This clearly shows that the nuclear scan was examined only by the radiologist, not the nuclear medicine specialist, Dr K. G. Kallur.

I had concluded that from the foregoing it was evident that Dr K. G. Kallur, Consultant Nuclear Medicine has breached every conceivable norms and standards prescribed by AERB Safety Code 2011, NABH, Society for Nuclear Medicine India, Code of Medical Ethics prescribed by the Medical Council of India. Also that the behavior of Dr K. G. Kallur, Consultant Nuclear Medicine, HCG has caused tremendous mental agony and harassment to me and the damage caused is incalculable. Such behavior – inexcusable from any denizen of a civilized society in normal times – is entirely unacceptable coming as it does from a service provider (specialist doctor) to whom the patient had gone seeking specialized service on payment of requisite fees.

In light of what has been mentioned above, I had prayed to the Hon'ble Council that it may be pleased to investigate the matter and find out the following:

i.            Can a Nuclear Scan be done without the supervision of a specialist doctor in the concerned medical speciality and if this is as per the universal medical protocol that HCG Bangalore Institute of Oncology Speciality Centre espouses and is required to follow? Does this not amount to criminal neglect in patient care?

ii.           How could the hospital, a service provider, flout its own stated commitment of a nuclear scan under Dr K. G Kallur and not perform the task for which they have charged an amount of Rs 17,000? Is there no accountability?

iii.            Can a doctor – because of being stressed, busy and/or excess workload (taking about 60/70 nuclear scans a day) – absent himself from a critical nuclear scan being taken? Is this as per the medical protocol prescribed for nuclear scans as well as critical care illnesses like cancer?

iv.             Was it fair and appropriate for the doctor to tell a patient – “You can take your money back”? Was not the doctor breaching the code of ethics and conduct by retorting to the patient in such a manner? It is well to remember that (as I had told the doctor) while money can be returned, what about the actual scan procedure experienced, the radioactive isotope injected into his body and the ramifications therein? Isn’t Dr K. G. Kallur’s insensitive words and behavior reprehensible/abominable and completely bereft of the moral and ethical fibre expected of a doctor in his dealing with the patient? Is this as per the MCI’s Code of Medical Ethics relating to the PROFESSIONAL CONDUCT, ETIQUETTE AND ETHICS for registered medical practitioners?

v.            Can a nuclear scan be done and findings prepared by a doctor who is not a specialist in that discipline when the specialist is available and whose name is mentioned in the money receipt? Does this not amount to cheating and fraud? I’d stated that since the issue is of wider public interest, as it affects the lives of vulnerable section of people (patients) who often are voiceless – the illiterate, uneducated masses knowing nothing what doctors they trust blindly do – and with wider ramifications, appropriate punitive measures as deemed fit in the form of cancellation of his license be passed against the errant doctor, Dr K. G. Kallur, in the interest of justice and in the cause of upholding the Hippocratic Oath that all doctors are sworn to.

Among other things, Dr K. G. Kallur in his written submission has given a new twist to his not signing the report. To wit from para 8 of his written submission: “I submit that Mr Mohanty’s PETCT report was dictated by me and left early on the day of this episode i.e. on 24th May, 2012. However, next day the driver of Mr Mohanty came to collect the report and he was in urgency to collect the report and repeatedly pressurized Mrs Chandrakala (PETCT – Coordinator) to hand over the report and that he has to leave urgently. Since I was not in station on 25th May, 2012, the report was not signed by me. Mrs Chandrakala had clearly informed the driver that I was not in station and that the report has been signed by Dr Shiva Kumar Swamy. S (Consultant Radiologist). Since the driver was in urgency, he informed that he would collect this report. Though there is list of names of doctors in the report, it is not mandatory that all should sign. PETCT report is a multidisciplinary approach. Radiologist is also involved. He is also a responsible person reporting. It is customary in most of the centers that at least one of the members signs the report if not all. In view of the unpleasant scene created by Mr Mohanty the previous day and based on the driver’s request, Mrs Chandrakala handed over the report. I submit that as per the hospital protocol, original report will be issued after getting the receiver’s signature in the outward register. In this case, since the original report was not issued, signature was not obtained from the receiver. The original report signed by all is still with us and the same has not been collected by Mr Mohanty or his authorized representative.”

The Karnataka Medical Council has passed the following ORDER on 19.07.2012:

‘Karnataka Medical Council is of the unanimous Opinion that the Respondent Dr K. G. Kallur has followed the Standard protocol while performing the PET Scan. The Complainant has failed to establish “Negligence” on the part of the Respondent. With the result the Case is dismissed.’

I desist from giving my impressions here. I am merely putting the facts in public domain for readers to judge for themselves. I need only remind readers to compare Dr Kallur’s version conveyed in his letter dated 8.6.12 published in Moneylife article titled Callousness and high-handedness of Bengaluru cancer hospital HCG with the one he has given now and quoted above [about my driver collecting the report (and even the CD of the scan – that he forgets to mention] in his written submission to the KMC. On 8.6.12 he had said thus: “He (i.e. me) has abused front office people and taken the report away from the front office of people even before I signed off the report. Now he is alleging that that I have not seen his scan images and not reported and this amounts to medical negligence.” Heavens! In my reply dated 10.06.2012 posted in the Moneylife site, I had said: “You (Dr Kallur) don’t have to give me an answer, nor to any one else, let you dialogue with your conscience. How your petulance, which prompted you to refuse signing the report because I had complained against you, has coiled you today in so many knots? To tell one lie, you’ve to manufacture few more numbers; the lies get squared and cubed, and on and on it goes gathering momentum and flight – an infinite loop that you’ll find hard to keep pace with. It’s already happened, and the more you try defending yourself through lies, more lies, and still more lies, you’re likely to get ensnared more and more, inextricably, and get caught in your very own self-created web of lies.” How gloriously Dr Kallur has lived up to the expectations I had reposed in him! This is, what I call, the cunning of healthcare in India today.

This has become rather long and I apologize! But truth must prevail. I know it’s a long haul. Well, I’m happily ready to travel the distance – seeking out every available constitutional mean in quest of justice.

Satyamev Jayate!

Tuesday, May 29, 2012

Healthcare Today: Is this what Hippocratic Oath Enjoined!

The news of post-graduate seats in radiology going at an astronomical price in medical colleges in India was news not long ago. Lesser disciplines (with lesser revenue-raising potential) charge less; the pecking order of rates charged, offered and administered seemingly in sync with present-day market demand or the perceived future (foreseeable, not distant) demand as it likely would pan out, with genomics and proteomics and other latest frontier discoveries duly factored in.
Today, US – the high-priest of capitalism – is in veritable quandary, wrung out, and ruing its healthcare model that threatens to blow up societal equilibrium. Activists and policymakers are in a funk in finding solution to high medical costs. A piece titled Cost Conundrum published in The New Yorker in 2009, which caught the attention of Obama and his Administration, observes: “In the war over the culture of medicine—the war over whether our country’s anchor model will be Mayo or McAllen—the Mayo model is losing. In the sharpest economic downturn that our health system has faced in half a century, many people in medicine don’t see why they should do the hard work of organizing themselves in ways that reduce waste and improve quality if it means sacrificing revenue.”
The McAllen model refers to one of the most expensive health-care markets in the country. The primary cause of this billowing cost is the across-the-board overuse of medicine and doctor-care when less would do; yet more is preferred because it helps revenue-swell. In contrast, the Mayo model that believes in accountable-care followed in the famous Mayo Clinic is one where the “needs of the patient come first – not the convenience of the doctors, not their revenues.”
Change tack to India and see how in our honeymoon capitalism we have monkeyed what US today is struggling to rid. Throw in our endemic and much-vaunted DNA to cheat and con, and see what a deadly cocktail we concoct. This piece seeks to put in public domain my recent experience in a cancer hospital in Bangalore. I am a patient of carcinoid cancer and underwent two surgeries to remove the offending tumour in the colon, a large part of which was excised. Ever since then I have been under the close observations of my doctors.
About a month ago, I experienced pain in the anastomotic site. The CT scan done shortly after showed up cysts in the liver, apart from inflammation and ulceration in my colon. The most effective treatment for carcinoid is the complete, surgical removal of the tumour(s), which in my case had been performed four years ago. But microscopic cells could even show up after years and it’s the tumour diasporic proclivity that prompted my doctors advise me a nuclear scan called Gallium-68 PET CT DOTANOC to zero in on the problem.
            For the uninitiated, this PET CT is a nuclear scan and radioactive isotope is injected before the procedure. After the scan got over, I requested the nurse if I could speak with the doctor and get a preliminary idea of the scan before the detailed results came out a day later. She said, “No doctor’s around. The technician did it.”
I puzzled, finding it hard to believe what I’d heard. “You mean to say that this nuclear scan was done without the supervision of a doctor, a consultant nuclear medicine?” She looked at me, speechless. I walked over to the edge of the console room and asked the technician if he could do the scan without the supervision of the specialist nuclear medicine. In my money receipt the specialist’s name was mentioned. I was livid. I demanded an answer.
The technician panicked and spoke with the specialist seated in Tower 1. My scan was done in Tower 4, about 200 meters away from where the doctors – consultant, nuclear medicine and the radiologists – sat.
Within minutes the technician materialized. “You can speak to Dr Kallur” and handed me over the cordless phone.
“Doctor,” I asked, my voice quizzical, “how is it that no doctor was around when my scan was done?”
His reply was pat. “I can’t be present in all the 60-70 scans done everyday. You can take your money back!
For all my ailments and my sundry visits to doctors across hospitals/cities wherever I’ve lived, I had never heard anything remotely resembling this. “That’s okay but what happens to the radioactive isotope injected that’s gone into my body? And is this the medical protocol your hospital follows?
He had no answer to my riposte. After a deafening silence that refused to die down, I heard a disembodied voice say, “If you want to meet Dr Kallur, you can.”
“But am I not speaking to him?”
“No, this is Pravin speaking.”
I asked him to come meet me.
He came half hour later – after two reminders. I demanded to meet the Chairman. “The Chairman’s in a meeting,” Pravin promptly conveyed.
“That he must be,” I said, my voiced dipped in sarcasm, “but know that that ploy won’t work. Please set up my meeting with him. Quickly.”
He shuffled from one foot to another. Then moved away.
I sought him out again, as my wife and I sat in the patient’s room in the high radiation hazard zone. It was getting to six in the evening.
Finally, Pravin after his string of meetings and phone-calls materialized to take us. But no, it wasn’t the Chairman of HCG, Dr Ajaikumar. It was Elizabeth, the Chief Administrative Officer. I told him I had nothing to do with her. After confabulation with Pravin, Elizabeth came over to us, now seated in the reception of Tower 2. She was nice. But I told her I wanted to see the Chairman and there was no point repeating things time and time again. She hadn’t been purveyed the full story. When she heard me her face mirrored her shock. I told her Dr Kallur wasn’t rude, his behaviour was downright obnoxious.
I was fasting since morning. More than two hours after my scan got over, we’re being escorted to the Chairman. I was asked for my visiting card. “I’m a patient. You know my name, below it write PATIENT”, I replied.
Dr Ajaikumar quickly apologized on Dr Kallur’s behalf. “I’ve already told him,” he said, “and I’m going to tell him again”. I asked if his hospital followed the medical protocol prescribed for nuclear scans. He was politeness personified but his answers were neither here nor here waffling with US examples. I knew they were faux excuses.
“How can a doctor ever mutter such words you can take back your money to a patient?” “Stress”, he tried to reason. “He’s a busy doctor!”
“Who isn’t? Certainly you don’t do 60-70 DOTANOC scans everyday! Your hospital says about 3-4!”
Little later, he said Kallur is “compassionate” and “an icon!”
“Compassion” to a cancer patient I’d freshly experienced. So I told him to disabuse culting his icon. “In my 56 summers spent on Mother Earth I’ve met many busy icons but they’re invariably polite and professional,” I said. “My personal ethics prompted me to meet tell you before I hammer out the next course of action for the criminal neglect in medical care in your hospital. This isn’t Hippocratic Oath that you doctors are sworn to, this is Hypocrites’ Oath! I speak here not for me but for the voiceless – the illiterate, uneducated masses – who know nothing what doctors, whom they trust blindly, do!” In my throat I added, “As you go seeking Mammon relentlessly throwing all medical ethics out the window!”
The morning next I saw a half-page advertisement in the front page of a national daily enticing cancer patients to this hospital. I gulped at the patent conning, my experience fresh in mind. In the evening when I got my report, my apprehension was further vindicated. I found the radiologist’s signature; three names (without signature) of consultants in nuclear medicine printed alongside, including Kallur’s – conveying the nuclear scan was seen only by the radiologist, not the nuclear medicine specialist who was to oversee the scan. Now I need to see another specialist in nuclear medicine to give me expert advice on my nuclear scan – to make my doctors wiser before they plan my imminent surgery. This after paying Rs 17,000 and with the radio-isotope in my system!  
Remember, my experience isn’t a one-off, an outlier. Exceptions apart, it is symbolic of the general malaise that afflicts, if it already hasn’t, hospital practice across the nation – to maximize revenue.

Sunday, April 15, 2012

Bangalore - Then and How

Two things happened almost around the same time. A friend had forwarded a clutch of old pictures of Bangalore and the morning next the newspapers carried the news of Bengaluru airport being renamed after its founder, Kempegowda.
The images of Bangalore were indeed refreshing as all things old are – the buildings, landmarks, roads, people, their attire – everything, and for me it brought back unmistakable nostalgia. It reminded me of my first visit to Bangalore in June 1980. We’re probationers on Bharat Darshan. We stayed in Hotel Kamadhenu what then seemed one dead end of the MG Road. My memory is fogged but the road appeared (but it couldn’t be as I realized later, since Ulsoor lake lay beyond) a cul-de-sac – leafy trees trimming either side of it. We paid twenty rupees for the double-bedded room and I remember having (only) sumptuous masala dosa (3 in number each repast; some gastronomic desecration!) for breakfast, lunch and dinner all the seven days we stayed in Bangalore. It was utterly delicious. I’d never had anything like that before, so quickly concluded with youthful exuberance that it was the best available in the WORLD! A friend with passionate sub-nationalism tried disabusing my mind saying Woodlands in his native Madras dished out better dosas than Kamadhenu. But Woodlands’ no patch!
I can’t remember how much it cost, maybe 1 rupee, it couldn’t be more, because Rs 10 (Room-rent) + 9 (9 Dosas) made it 19 and one rupee must’ve been on coffee (filter or instant I can’t recall). Our DA was Rs 20 and I’d resolved to live off my daily allowance the five months we Bharat Darshaned and splurge my humongous salary of Rs 1103 on books. The Cellar was the bookshop on MG Road I gorged on: the entire lot of Camus, Kafka, Sartre, Lawrence, Conrad, Orwell and others. The exchange rate of Pound Sterling was Rs 17/18 but bookshops charged Rs 20, and the books (mostly) were between 20-60 pence.
A small-town bumpkin who had never spent a day in any metropolis (Bombay was already a megalopolis) before joining civil service and extremely wobbly in my soul, I can’t forget the stars that struck me times without number looking at the plentiful books in these big cities and feasting on them. The books are still with me, proudly carrying my signature with dates. Reading them was of no great earthly consequence – then, even now; passion and show-off and gewgaws were all that mattered! Chinnaswamy Stadium was a must-visit where I exulted seeing Gundappa Viswanath and Syed Kirmani in flesh and blood (they looked so surreal!), paying off the taxi-wallah, close to where I stood, across the barricade. Later, years after, I told Kirmani first up about this when we met. TV, for us in Cuttack, was still in distant future! 
Bangalore was the city of PSUs. So we’re taken to BEL, BEML, NAL on educational tours. A double-decker Brindavan Express chugged us out of Bangalore (near Majestic which seemed neither majestic nor populated) and took us to Madras. We’re absolutely thrilled and kept darting up and down the two floors – one lower than the normal, the other none too high (kind of mezzanine) – and it reminded yokels like me of my first bus ride in Delhi’s double-decker a few months earlier.
Bangalore was quiet and sleepy. And, for someone brought up in hot and muggy Cuttack unbelievably cold in the ides of June. This despite being in deep south. It felt unreal; my sense of geography, bad in normal times, could find no answers. And internet and googling were still a millennium away! I wallowed pitilessly in my own ignorance. 
When on posting I came to Bangalore in 2006, it seemed an altogether different city. Though I’d come off and on the past decades, the traffic and tumult of the city had passed me by during the short time I spent here. The new century/millennium with its accompanying ITspeak had taken a toll on the quietude of this pensioners’ paradise. The incessant traffic majestically riding high on a soaring sensex had democratized the road. The nightly din was no different from the day’s. The paradise had been lost – to incipient tawdry modernity. Today, only memory remains, as images speak to my eyes and mind.

Saturday, March 31, 2012

Schools - Then and Now

               Despite the passage of time – a neat 50 years – the memory and images still hold fast in my mind. My father took me to the Principal, an Englishman, who said hello to me, I smiled and then sent me on my way to the class. It was my first day in school. I was un-informed and un-uniformed, knew little of English that was the lingua franca of the school, and here I was being welcomed this time by another person from the Empire, Miss Heavens, the English woman who was our class teacher. She was tall with slender legs that ran a long way down her skirt to the floor, and young and cherubic, and with a mobile face that effervesced when she spoke. She rattled off a few sentences which I didn’t understand one bit and amid the encircling confusion that had descended on my four-year old mind I sensed I was being welcomed to their midst. I was promptly given a chair (later I learnt how inappropriate it was – this kissa of the kursi) – a small one meant for small children my age – to sit in front of an appropriately small table and, once there, listened to the music that was serenading the class. For me, it was an easy and smooth initiation into the world of school and education.
            We made friends in no time and we picked up enough English to speak among ourselves in that language which was de rigueur in school. Mostly it was the slang that we picked up from seniors and some incredibly genteel expressions from our teachers. We played cricket, football, marbles, tops, and stone. As we moved up the ladder, along with our proficiency with games and the enrichment of our slang came newer subjects: science (Nature Rambles), geography (of climate and continents), arithmetic (9 x 8s = 72), history (Akbar the Great), Desk-Work (noun, verb, pronoun, adjective) that needed to be written down in pencil in the spaces provided for filling in – all sufficiently confusing to make us sweat when the lessons were on and enormously relieving (naturally!) when the blight was off our backs. But it was an easy life I had slipped into.
My dream run suddenly came to an end when my father was transferred to another place, a much smaller town than the city of Cuttack we lived in before. I had to move on to this place, no matter how much I hated to. Apart from the fact that it was a vernacular school where the medium of education was Oriya, my mother tongue, the school was in a shambles. The boys and girls wings were different, while the girls began early at 6.30 and finished at 11; ours began at 11.30 and got over only at 4.30 in the afternoon. The boys were rowdy and a ragtag combine, with no motivation to study. They were the ones who held the school to utter ransom. The furniture had been destroyed completely, so the classrooms were devoid of any semblance of tables and chairs, and it looked stripped and bared. Only one table and one chair meant for the teacher, sat flush in the front, close to the blackboard. We were expected to (and we did) sit on the floor, cross-legged, our books in front, row upon row of children, pen in hand, writing in the exercise book balanced precariously on our thighs, some right, some left, depending on who was what – a rightie or a leftie.
The light points and fans didn’t exist. They had been yanked out and carted away elsewhere with not a trace. The electric wires hung about naked though the power supply had been cut off to empty their potency and make it safe for the children to carry out their hooliganism. Some obdurate fans that didn’t give in to the obnoxious demands of the obstreperous boys had been mangled out of shape, their blades twisted inward into an ersatz floral design. Cows had a full run of the verandah that ran across and meandered about the H-shaped school building leaving their holy indelible marks of waste that no one thought proper to sweep clean. There was the winter that was quite severe in this part of western Orissa and it made sense to these bovines to seek the refuge of the school building that was so generous in welcoming them with open arms and legs of its verandah and the capacious innards of its numerous rooms. Winter was followed by quick-fleeted spring, then by summer – long, hot, and oppressive – and then came the rains when the angry clouds emptied its entrails on a thirsty and parched earth. Little wonder the cows counted their blessings – that our school was such an unstinting host of epic scale! Their yawns during the daytime provided resonant and amusant tune to our painful teaching.
My welcome here was exactly the obverse of the one I had experienced earlier in my kindergarten. My socks and shoes, and smart ironed uniform of my previous school I had put on instinctively, didn’t go down well with my classmates. I was careening into an endless combat mission Unaware to the ways of the school, I found no one wearing shoes: they wore (if at all) chappals that were pushed out off their feet and parked at the rear end of the class. That gesture indeed made good sense. For sitting cross-legged on the floor isn’t ever comfortable with chappals on. The feet were cleaner and the shods that invariably stuck to the chappals didn’t add to the filth we sat on. We considered ourselves lucky if someone among us took the trouble to go over to the school office and found a dari, a rug, and brought it to our classroom for us, the fortunate ones to sit on. We were in seventh class and not senior enough to deserve a dari. It wasn’t a fulfilling time by any means. My life’s goalpost had shifted back and was now looking inwards. The idea of shock and puzzlement snarled my unreconstructed mind. I wished I was stubborn and stalling, refusing to flow with the inexorable march of time. But I was helpless.
The culprit for this functional anarchy was the Headmaster of our school, a certain Mr. Verma, who lived in a cloistered world of his own. A nice man, he was still in a state of shock, from losing his only son born after seven daughters, who was picked up by a peddler of bread-bun-and-biscuit and murdered, hallucinating that the little dead boy’s Adam’s apple would help another childless couple to get started on a family of their own. It was one of the most bizarre things I had ever heard as a child. Distraught and still mourning over the loss of his son, Mr. Verma let the school spin out of control. It was indeed on auto pilot. He sat in his office room, never coming out of it to see what was happening in the world around him, and hardly ever saw either the teachers or the students. We never got to see the Headmaster, and for us new hearts in the school, out of curiosity we espied him from the window that opened a crack. He sat there; both legs lifted to the chair and while one lay horizontal hugging the seat, the right stood up vertically helping his right hand to rest on it in the process of writing. We pitied him and the fate that had befallen him.
Not so when it concerned us and our studies. We felt lost through sheer inactivity. The rowdy element among the students ran the school the way they thought it best. Left to their own devices, our teachers hammered out their own paths. While, in his own fuzzy way, Parida Sir was eloquent and inclusive, Bhanja Sir, who taught us social studies – history, geography and civics – in his own grumpy way, was erratic and intolerant. Tall and lanky, his teeth were long and went well beyond his mouth’s frame. In the classroom he walked around teaching and every time he spoke he puffed out a sprinkle of spit that found its way through the gaps of his enormous teeth, travelled the distance from his face at considerable height and through sheer gravity came down and sprayed us all seated on the floor in the first and second rows. It was like a revolving garden spray performing at quarter efficiency. On our part, we didn’t like this spray and tried to wipe out the frothy element now descending on us unremittingly and with a rapidity that was a natural outcome of Bhanja Sir’s teaching gathering pace and steam.
Kar Sir taught us English. “Rama ess a gooda boy,” he would say and explain the same in Oriya, “Rama gotiye uttama balaka.” Further: “He gooes to school everyday,” and in Oriya: “Se dainika bidyalaya ku jaye.” His mode was to teach English the Oriya way. Or to be more precise, his was English teaching made easy in Oriya. And this was not only on the issue of teaching; it went beyond – and embraced his sartorial sense. I clearly remember the first time he came to our class it was to teach Oriya. He was dressed to the nines in snow-white dhoti and kurta and black half-shoe. Next time he came it was to teach us English. His dress had changed and he had transformed himself to a complete brown sahib. He was now smartly turned out in terry cot trousers, full-sleeve shirt, and black shoe and matching socks. Thereafter it was going to be only English lessons for him, and so he religiously turned out in a wide repertoire of his new trousers and shirts we had not seen before. Amazed at the range of his ward robe, we kept counting his pairs of dress which he never repeated. After a while we simply lost count of it. They were just too many for our small un-mathematical minds still struggling to grasp the rudiments of mental maths (Sankhetika and Auikika) from Parida Sir. Little wonder we hated going to school.
But we had a Board exam to clear in Class VII. I was all at sea with the medium of instruction which was now Oriya. I understood nothing of Oriya Sahitya. Nor social science or general science. Even maths was beyond me. Only English was a cake walk. In the half-yearly exam I flunked in all subjects except English and, of course, Drawing. The last one was essentially due to my growing friendship with the Drawing teacher who played cricket with us after the classes in the school field. He liked to bat and given my dodgy artistry and with my future clearly at stake I unhesitatingly turned my arm over to bowl at him. I was right, he wasn’t an ingrate. By the time the exam got underway, I had struck up an equation with him. Not averse to nepotism he gave me the required 15 marks out of 50 so that I pass. Much against the Cassandra’s pronouncements of doom, I managed to get past the 7th Class Board exams with a high second. This was a huge relief. I was overjoyed.
Things changed for the better when we moved over to Class IX. This was thanks to the new Headmaster. We got desks to sit and write on. The fans started whirring overhead. The teachers were now more punctual and regular, and most of them tuned themselves to the new environ. But the results continued to be dismal. Of the 40-odd who appeared in the matriculation exam barely 10-odd passed. Needless to say, no one got a first, only 2 or 3 got a second – a low second – and the remainder barely scraped through with percentages in the low 30s. In the school exam, I got a bare 46 percent yet stood second in Class X and earned a prize. I was thrilled. I thought I had arrived.
On my father’s retirement I moved back to Cuttack and shifted school. Here I was admitted in Class XI in one of the best schools of Orissa. But I felt lost. My second position and the prize for doing well were of no academic consequence. Every student I came across was better than me! My self-confidence was shattered. Matriculation exam was just seven months away and I was adrift and tossed about like a flotsam. My immediate friendship with Ramnath did not help matters. His notes that I borrowed copiously were to me incomprehensible. My teachers pooh-poohed me. “Son, Ramnath is too good for you to understand!” intoned Sadhu Sir. “You must follow someone who’s your equal!”
I didn’t know who my equal was. I was confused. The matriculation exam was already upon us. Before I knew what had hit me I was down to writing the exam in a daze, and not sure what I had done. The results came out as scheduled, after a few months. When I reached school to know the results, my heart in my mouth, my expectation hovering between the slender line of passing and failing, my teachers with the result sheets in their hands were agog with my result. “Sudhansu, you’ve got a first class!” they said, their faces awash, more with puzzlement than happiness, “but how did you manage it?” I smiled back and my smile, I guess, must have been beatific. I was in cloud nine.
But they puzzled over my performance. “If Sudhansu could get a first class, everyone in the school should have got a first,” said the much regarded Sadhu Sir, who was my favourite teacher and who knew me and my calibre inside out, to the assemblage of students and teachers gathered there to partake the results. He wasn’t exaggerating. Nor was he running me down. He was only stating the obvious. My stock in the school was indeed abysmal. It was pathetic.
My mind travels to the generation next when my children went to school in the 1980s and 1990s. Admission isn’t as walk-in as it was in my case in the 1960s. Far from it. Not only did we teach our children – still toddlers – how to face their life’s first and foremost interview but we taught them what to say in reply to questions we had contrived to anticipate. Thinking back I realize it was insanity that was hard to match. But at that time seeking admission was a do-or-die affair as though the child’s life depended entirely on these precious few minutes. As parents too we faced interviews to prove to the grasping teachers that we are well up to take care of their inadequacies so that the good name of the factory answering to the name of a school didn’t suffer at the hustings, am sorry exams! But in reality, it was no different than a hustings. Money and pampering was all.
The liberalized India threw up its won dialectics. Corporate world opened up a floodgate of opportunities with emphasis on technology and management. IITjees and CATjees became the buzzword. Parents quickly worked up a reverse education strategy that placed premium on B.Tech from IIT plus PGDM from IIM as the open sesame to make good the reparative gestures they expected from their children. Young children of 12-13-14 left the cosy comfort of their homes and headed for Kota to take up full time residence, something reminiscent of gurukuls in ancient times – for coaching and schooling. Parents lost sleep over their children’s performance, their sleep bobbing up and down with their wards’ success or failure. From our time when parents hardly ever knew their children’s performance and couldn’t care less about it, the clock had now come full circle.
Television with multiple channels and internet opened up a world with limitless possibilities. Students were full with information. From everything in the library it was now down to anything in the net. The couch potato syndrome was aggravated with parental pressure to excel. Physical activity and games took a backseat. India was in ferment. Professionalism bred granting more attention to career, even at the cost of health and social life. The children’s world was getting cocooned, the carelessness and insouciance of teenage and adolescence missing from their armoury. The innocence of childhood was a thing of the past. Rat race and breathless competition had upset the applecart of enjoyment of my childhood past. It was no more a time of enjoyment; it was instead a time of intense action and cutthroat precocious initiation into life.
Deviation from the above cast-iron path was fraught with immense risk with the attendant danger of anomie. Without the accepted throughputs one wasn’t too sure what awaited the child and the parents if they hammered out a course that was off the beaten track. Was it bust as per the society’s value system? Was it an attenuated goal that fell short of the accepted norm? Normlessness didn’t ring sanguine. Out-of-box thinking was not the way to a happy life. So a good student was reckoned how well he performed in the exam not by how much knowledge he had acquired. Knowledge didn’t earn him a seat in college but marks did. The facile cart was overturned when life met career and good practicality drove out crammed theories that singed the mind with the limitation of its own avatar. Alas, it’s too late in the day for retrieval.

Wednesday, February 29, 2012

Festivals of Spring

           Of all the festive seasons, spring is perhaps the most redolent with a context. Not merely socio-cultural but one that is distinctly biological. For spring was the mating season before organized society and the concept of marriage came into being, when pubescent men and women indulged themselves in wine, song and dance. Sexual promiscuity took place with consequential pair-bonding, which in turn, led to socially sanctioned nuptial unions.
            Now, despite the accretion of layers of civilization, neither has the erotic element of the festival nor the convivial spirit and revelry paled into oblivion. On the contrary, each era has imparted to it different nuances of meaning and symbolism, with different communities and countries observing it differently. The ethos and causal factors of its origin though remain universal and unvarying.
            In India, the spring festival was known as Kamadev Mahotsav or the festival of Cupid or Eros. Still known as Kama Dahan in parts of South India, the spirit of the festival has remained alive in racial memory and folklores for scores of millennia.
            To this – Kamadev Mahotsav or esprit de erotique – have been knit various religious myths, parables and anecdotes over the years. Between 3000 B.C. and 600 B.C., a number of them were incorporated in Vedic, Upanishadic and Puranic literature, and were reproduced in drama, playlet, folk-dance-drama, and music in Vedic, Sanskrit, Prakrut, Pali and other patois languages and dialects.
            The oldest myth, still extant, is that when Shiva practiced Yoga on Mount Kailas and remained in mystic communion with the Supreme Being for a prolonged period, Indra, the king of the Suras and sovereign of Swarglok, grew apprehensive of his power. He persuaded Kamadev to go distract Shiva, deep in meditation. Kamadev is portrayed as an enchanting youth, armed with a bow, bedecked with flowers and five types of arrows, and with the elusive power to arouse men and women to frenzied passion.
            Once agitated, Shiva smouldered with rage and with his third eye reduced Kamadev to ashes. Anguished, Rati, Kamadev’s consort, entreated Shiva to pardon her husband and bring him back to life. Shiva, moved to pity, granted her wish but Kamadev wouldn’t return in corporeal form, he said; he would inhabit a subtler, all-pervasive form. Thus in the spring festival, Kamadev, in his invisible form, rouses natural impulses.
            Then there is the eponymous legend of Prahlad and Holika dating back to the Puranas. Prahlad, the young and immature son of Hiranyakashyap, the ruler of the Asuras, was a devotee of Vishnu, the head of the Sura clan. His fraternal fondness for the Suras became unbearable for his father, who tried his best to wean him away from such attachment. Failing in his endeavour and desperate, he made up his mind to sacrifice his young son to safeguard the future interests of the Asuras. His sister Holika had been blessed with the boon of remaining unhurt by fire. So he requested her to enter into a bonfire with Prahlad on her lap. Holika acted as her brother wished, but the result was a disaster. Vishnu interceded, the boon failed to fructify, and she was burnt and reduced to ashes; Prahlad came out miraculously unscathed. This occurred on the first full-moon day around the vernal equinox, which coincided with the festival of spring. Accordingly, the name of the spring festival was changed from Kamadev Mahotsav to Holika Utsav or simply Holi. Ritual observances such as the lighting of the bonfire on the last day of the festivity – Holikapoda or burning of Holika – were accentuated.
            The medieval ages ushered in the cult of Radha and Krishna. Vaishnavism became dominant. Radha was believed to be the symbol of universal Prakriti, nature, and Krishna, Ultimate Reality, and from their communion cosmos was created. In human form too their ‘lila’ manifested in the spring festival when they became the symbols of primordial entities of Prakriti and Purusha. These symbolisms got exaggerated in the festival of spring. The idols of Radha and Govind in a beautifully decorated swing or Viman or Doli or palanquin came to be worshipped in their eternal ‘lila’ of creation. The old name of spring festival came to be known as Dola Yatra or the festival of Dola Govind. Another accretion of ritual resulted. The decorated swing or Viman with the idols of Radha and Govind was made to swing back and forth to the tune of various musical instruments, songs, dance and merriment. People gathered in thousands in the revelry now known simply as Holi or Dola Yatra or Dola Melan or spring congregations.
            Colour has always been an integral part of the festival. Apart from song and dance, the celebrations included splashing red coloured water on one another or smearing crimson powder, known as phagu, avir or gulal. The colour red was symbolic of a woman’s menstrual period, who, in the beginning of human evolution, was believed to achieve fertility only during spring and summer. The bonfire is symbolic of the mythical burning of Holika, and the erotic songs are reminiscent of Kamadev Mahotsav during the breeding season of early man.
            Since marriage wasn’t institutionalized yet, the season, with its association of fertility, resulted in match-making by mutual consent. To preempt clashes among revellers, the pair-bonded girls put kumkum marks on their foreheads to ward off suitors. Over time, kumkum has metamorphosed into a symbol of marital status worn by married women even today.
Holi apart, the passing of winter heralds a round of seasonal festivity. Basanta Panchami or Shri Panchami, normally occurring at the end of January and early February precedes the Agni Purnima by 10 days, and is today observed in commemoration of the dead river Saraswati and its tributary Drushatvati, still a dominant part of the collective unconscious of the Indians. After the evolution and use of phonetic alphabets, the Rig Veda was transcribed from the racial memory in the riverine region of Brahmavarta bounded by these two rivers then in existence. Now Saraswati is believed to be the Goddess of knowledge, language and music. The day ushers in the vernal semester of learning to be spent in the residential seminary or Gurukul Ashram.
            The Agni Purnima, the first full-moon day before the vernal equinox, corresponding to the Ash Wednesday of the Christendom, is another spring festival. On this day bonfire is made in three heaps on the outskirts of villages and people bid winter adieu.
            Chaitra Parva or Chaitali is another festival observed by the Lunia and Kaivarta castes to launch their vocations on an auspicious note: salt manufacturing and fishing respectively. Dance on Chaitighoda or Pakshirajghoda (flying horse) is symbolic of their professions. Chaitighoda is made of a wooden horse-head artistically painted with colour and set on split bamboo contrivance, covered beautifully with flailing multi-coloured cloth representing Pakshirajghoda’s wings. The goddess Vasulai, the presiding deity of the aforesaid communities is believed to descend, possess and energize the idol of Chaitighoda. These folks go on visiting door-to-door in villages exhibiting their winged-horse dance, music and song. Another accompaniment of the troupe is Chadaiya and Chadaiyuni. Chadaiya, a boy playing the part of a female seagull and Chadaiyuni, a girl playing the part of a female seagull, amorously go on singing, dancing with erotic gestures and symbolisms. Though initially confined to the Lunia and Kaivarta folks, the doorstep performances soon earned them mass support. The symbols of this festival – Pakshirajghoda or winged-horse or Pegasus – could be found in the myths and mythologies of the Greeks.
            Maha Vishuv Sankranti or Pana-sankranti is one of the key days of vernal and aestival festivity. For the Assamese, Bengalis, Oriyas, Tamilians, Maithilis, the Magadhis and Keralites, it is the beginning of a new year. In Punjab, Baisakhi is celebrated with exuberance. Parallel spring celebrations exist even outside India.
            Our mythological Kamadev and Rati, the Indian god and goddess of love, have their counterparts in other cultures too, such as the Greeks’ Eros and Aphrodite and Cupid and Maia of the Romans. A still closer similarity is paralleled by the imaging of Cupid in the likeness of Kamadev; Cupid is imaged as an enfant terrible, young and enchanting and naked, armed with a bow and arrows like Kamadev.
            Easter, derived possibly from aestas (summer) or aestus (heat) was supposedly symbolic of the coming of the festivals of spring and summer. The origin of Christianity has influenced the spirit in which it is observed. Good Friday, Holy Saturday, Easter Sunday, Easter Monday and Palm Sunday are all metamorphosed versions of the spring festival.
            The month of May derives from Maia, the Roman goddess of love. May Day in places of higher latitude is a vernal-aestival festival and the May Pole, around which pubescent men and women sing and dance, symbolizes the phallus. The May Queen is the prettiest girl who presides over the May Day festivities, when the revellers indulge in ‘maying’.
            Lupercus was the Goddess of fertility of the ancient Romans. Lupercalia, the festival of fertility, which falls in the second half of February, was observed by the ancient Romans with offerings to the goddess Lupercus for begetting healthy children and leading happy, consensual conjugal life. Saint Valentine’s Day is another erotic spring festival observed in the west that’s caught the fancy in India today.
            The word ‘Lent’ in German and Dutch means the lengthening of the day, spelling the onset of spring. It falls forty days before Easter Eve and originated as a spring festival that involved merry-making and boat racing. Perhaps its association with academic pursuits could be compared to our own Basanta Panchami. Even now various European universities have a Lent term or semester. The spread of Christianity brought about changes. Today, Lent means the forty-day period of partaking of Lent fare, involving abstention from meat up to Easter Eve as penitence, in memory of the period when Christ was in the wilderness.

Sunday, January 29, 2012

All Humans are Products of the Society they live in

The past year has seen a slew of corrupt deals surfacing. Several important ministers, politicians, bureaucrats and corporates have been sent to jail on countless charges of malfeasance and misfeasance. The Anna Movement that followed as a sequel to the weak Government Lokpal Bill showed people’s ire against corruption. Today, the man in the street talks of rule of thieves or “kleptocracy” – the neologism added to the English lexicon.
            The recent exposé of the judges’ wrongdoings in Karnataka and Orissa High/ Supreme Courts is the saddest commentary on body corruption. How can the dispenser of justice be a party to this open defiance of rules and law including the ones formulated on the judgments pronounced by the highest court of the country? What will become of the country when the fence, purportedly meant to protect, starts eating the crop?
            Never perhaps in one’s fallible memory of contemporary India has the higher judiciary been exposed for violation of rules and procedures the way they have today. Let’s get real. The courts are deemed to be the last bastion of safety in a democracy to ensure that the rule of law is followed not only by the executive but also by the legislature. The courts are honorable places where the common man can go seeking remedy for perceived wrong or willful or questionable executive fiats or legislation. The judges are deemed honorable people looked upon with respect by the society. They also have the power of contempt to protect themselves from any motivated and tendentious criticism.
            The names, photographs and details of land questionably allotted in Bangalore to former and sitting judges of High Courts and Supreme Court in the Karnataka Judicial Employees House Building Society in alleged violation of its own bye-laws is pathetic. The membership of such Society, as per its own bye-laws, is confined to judicial employees. Judges of the High Court and Supreme Court are not judicial employees. As per the Supreme Court judgment delivered by a five-judge constitutional bench in Union of India vs Sankal Chand Himatlal Sheth (1977) case, “A judge of the High Court is not a government servant, but the holder of a constitutional office… A High Court judge has no employer; he occupies a high constitutional office.” Membership granted to these judges is not only violative of the Bye-laws of the Society but flies in the face of judgment delivered by the highest court of the land.
            The latest crisis that lists a string of names of serving and retired Orissa High Court judges – including one who became the Chief Justice of the Supreme Court – receiving favours in land allotment in Cuttack/Bhubaneshwar from minister’s discretionary quota has now come under intense public gaze. It is such a pity that judges who ought to be the guardian angels of the society and nation have indulged in day light heist, twisting and mangling well settled rules of law established by the judiciary itself.
            What does it show? Simple: societal values shape everyone – politician, bureaucrat, corporate, professional, teacher, lawyer, judges, and common man. Values are cachets that leave their imprimatur regardless of profession. If a society is corrupt, it would be facetious to expect dishonesty affecting one segment of society and not affecting others. This is what we need to be aware and legislate laws that encompass everyone without exception. If transparency is the buzzword today, and it’s good it is, let transparency suffuse everyone in public domain. Let openness be the fulcrum on which all transactions are carried out. Understandably there can be no exceptions.
            It is important to remember that the nature of the society affects all denizens much as children are affected by the environment they grow up in. If the parents have a liberal outlook the child is likely to grow into a liberal human. The values the society nurtures get rubbed off on the people who form this. To expect that some would defy societal value and imbibe qualities different from the society they inhabit are only exceptions. For the majority who form the microcosm of the society the societal norms set the tone for its denizens to follow – as a lodestar.
Only that, not always, such lodestars turn out to be admirable.