Tell your stories (So you’re a doc, a foreign cuisine and Corona happened)

I am a daughter of farmers by lineage. From a remote village where people used to hide behind the trees, bushes, houses when they saw strangers approach. ‘3 days walk from a town’ as my mother said when I was in my teens.  ‘It is important for you to know your ancestry’. ‘You work hard, we will provide as much as we can’ said my father signing in the loan documents.  ‘You didn’t have a choice, you had to be something better’, said my sister. ‘She is studying’, I remember my little brother saying when he came around the room to play rolling his eyes out. ‘Don’t worry. It’s all fine’, my older brother assured me over the phone as he was loading the trucks struggling with his ill-fitting shoes that he hated, trying to meet our monthly bills. 

Education gives so many things. To a lot of us, a ticket out to different ways of life as well, as I have quoted before. Thousands of young people from my country immigrate today to other countries, mainly the US and the UK chasing the golden geese, hunting for the golden egg. 

Here I am too. In a world completely different to what my father & mother told me in their tales. Where the skyscrapers look as though they are almost touching the sky throwing long shadows on the cities underneath with blinding bright lights all around. And hey, no one has even tried to steal the bulbs! Where trains come and leave on the clock, day and night and what a surprise!  Noone has taken an opportunity to grope my bum. Where, people are just rising from their beds while others are going to sleep. The computers are blinking continuously, phones are ringing from clients overseas and the atm machines are waiting every corner ready to be cashed out. 

Don’t know if there is a phrase similar to saying ‘Living an American dream’, otherwise I would have quoted ‘living a British dream’.  Here, there is never a limit to the word ‘enough’ when you see how much more you can have, knowing there are people out there in the world who have nothing. 

‘This is a land of plentiful opportunities,’ my uncle says all the time. There is no denying that truth having seen the other end. Naturally the expectations from them of their children are high.  When you yourselves have achieved extraordinarily from the hills of Nepal to London in the UK. You set no bars for them. 

Friday afternoon bank holiday. I am looking through my text messages scrolling one by one; an intimate moment of one of my girls with her partner, lost and navigating in some part of the forest of another, pictures of a little one following a complicated pregnancy of a new mom and seems like that one is still struggling to even get off from bed even crippling with depression. As I follow the texts trail of all my close friends, my history search bar continues to record ‘do and don’ts of a new relationship’.

Nobody prepares you for this stuff though.

Even if you have adult carers at home. Of Course it is a safety net to be rescued by your superheroes – your parents, your godparents; but sometimes in life you need mentors. And for many reasons, that role may not be something they can fulfil. 

Being an adult is hard. It is hard to live a life. To be responsible, keep track of ten different bills, hold a job, 8.30 to 5 pm and 12.30 hours odd shifts and relationships. Constant hustling. Of course, if being Peter Pan was a choice, I would have taken that. They would have taken that too. Never to grow old, no fucks given. But it isn’t. So they take the responsibility. And might still be doing hit and trial methods with you in your thirties, trying to navigate parenthood, simultaneously their own adulthood slowly gearing towards ageing life…

Got to wake up, wash up and dress up. What do you think, I should say to a 20 year old homeless patient threatening to go back and binge on alcohol if he cannot have an arrangement of constant roof on his head for free? An arrangement of a free flat? Grow up and work? The entitlement some people believe they have is unbelievable . Grow up. ‘Life is not easy. It is not. Don’t try to make it that way. Life’s not fair. Never was. It isn’t now. And it won’t ever be. Donot fall into the trap. The entitlement trap. Of feeling like you are a victim’, as Matthew McConaughey says. Noone is coming. I don’t know when he is going to realize that. 

I respect go-getters. Who have found their self worth. Pushed through it all and made something out of whatever they were born with, thrown with, handed with or helped with. They struggled. They made mistakes. But they learnt from it. And most importantly, they never gave up. 

A fine wine. A  fine wine for a fine evening served by a fine gentleman of a different nationality as well in one of the richest cities of the world. Surrounded by  humongous buildings with small cubicles. Inside small boxes staring at the tv, exercising, reading and just going on about their lives; feels like I’m living ‘The Truman show’ now.  A few tables down further are middle aged women, possibly 10 years older than us, well dressed, matched with their branded bags, jewelleries and watches. Well behaved, softly spoken, a few smiles, hardly changing their expressions. And suddenly my excitement for evening has left. 

My ultimate plan was to be financially independent somehow, so I work as a doctor not because I am depending on my cheque to pay rent but I wish to. Without being grilled to overwork, exhausting myself but overworking myself because I want to and I have that freedom to choose. 

‘All these efforts poured in building my career and here I am contemplating about living a subpar life?’, I thought to myself. ‘If you left the training now and worked agency shifts, you could easily make a comfortable living now.  You could easily book tickets to Hawaii and take your fam there next year!’.

I have learnt a vital truth about myself this year. ‘I am a person who lives in stories’. I can go a few days on fine wines but I cannot go more than a week without embracing that zest of life I actively seek for. I am now starting to rethink my pursuit of success. What is success for me?  It is scary to think, life and dreams can be limited inside cubicles and eventually our spirits are just going to be sucked out dry by glitters, TVs, magazines and materials. 

I was staring at him that other day. Trying to pinpoint the exact reasons why I had a strong attraction for a man I had only just met. Of course he is charming. My friends think, ‘we are doctors, we feel we have to save everyone’. Red flag. Red flag. Red flag. Every next road. ‘Be careful’, they have advised. ‘Watch the netflix show, watch the youtube videos’.

He is that canvas you know, that I probably was searching for, for a long time. His face has a story, his hands have stories, he is a person of story. And my inclination to hunt for each chapter is probably driving me. Grey, white, purple, yellow, black. One loops to another and another. It’s like the nib of the pen will flow out with ink smudging  the papers if you don’t write it fast enough. Some people are like that. They carry that in their soul. Like my parents do. 

I often forget how capable a person like that, who perhaps has been through a lot in life and hurt often in the past, is of hurting themselves and others. Not intentionally but reflexively. As they anticipate it based on their previous experiences and thereafter after a certain threshold, their reaction to every stimulus is a multiplication. In a place where a simple ‘no’ may have sufficed, there is a then loud apostrophe behind sentences  or an outburst of aggression. Not everyone is capable of accepting a person like that whole heartedly. We live in an impatient world. Especially not the ones, who may have had similar experiences with their anticipation of the unknown. As they dread the eventuality that they are certain is an outcome. The outcome? For sure, it will be colossal and as beautiful as it is to watch, it will be as heart-breaking to see them break each other into nothing. But, the human soul is a beautiful thing you see. Can be as blank as white, never known fear and grief, you want to protect them. Can be an abstract representation of every colours whatever there is, you may never know what they have seen and been through or are thinking, you still want to protect them. I try to be a positive person. Maybe these are not red flags but an opportunity to work on things together. Nothing in life comes wrapped in a bouquet does it? But again, if it did would I have wanted it? One of the important lessons my life, my parent’s life has taught me is, go for it. Whatever you like. If it doesn’t work, at least you have given your best, hold your head high then and walk away. No regrets. 

‘I want to give my kids everything so that they don’t go through what I had to’.

‘Me too’. I said. Of Course our context of the statement is entirely different, like our reasonings to agree with each other.  

Life is random. Unpredictable. Would be great if you could focus on this issue at hand, solve it and carry to next. But there are tens of puzzles coming from every direction. Like the randomness of these thoughts I am writing. Reflection on my evening, on my relationship, on my choices… Would my dad have ever guessed when he was sitting in a middle of nowhere, making fire under a stone, trying to heat a piece of roti to keep his hunger at bay that his daughter will be drinking champagne watching down from the rooftop into people’s cubicles and wandering about life as well?

A hard day today can be tomorrow’s sweet memory, something to laugh about or a milestone to compare the next rows of worse days. Life is in people. Life is in memories. Life is chase, pursuit, hustle, maybe in late night thoughts and decisions. Life is on the go. Life for me, seems to be in the stories.

Tell your stories to your children, will you? Trust me, there is always a lesson to take away. Even on a chance  there is none, there will still be a memory- of struggling to sit still listening to you while you  babble boringly for an hour. It’s a time you have chosen to give to them.

My mother once told me, she woke up with python slithering around her body in middle of night. The way she described it, it was very vivid. She has always been an extremely talented story teller. So is my father, but only when mom shares her platform which she can be quite reluctant to. Because, they never seem to agree on some recalls of their memories; like the description of size of the fish my mom’s uncle caught. 😅

A COVID pledge? (So you’re a doc, a foreign cuisine and Corona happened)

image source-Wikipedia

‘And Princess Margaret always had one in her fingers as well, all the time.’ Said my patient huffing as she made her way out of the building’s main door wheeling herself. Once she had parked her chair out in the open which seemed to be her usual spot, she started lighting a cigarette. I could really see how much she enjoyed puffing it. Igniting the lighter, curving her hand next to it so the wind won’t blow off the flame and taking a deep inhale; she was natural at it. Why wouldn’t she be? She had been smoking every day for past 50 years, had managed to knacker her lungs completely with it and now had a condition called COPD.  Chronic Obstructive pulmonary disease which is an irreversible lung condition at her stage. She took a really long breath to suck the nicotine in. I didn’t think she still had it on her. I mean, the physical reserve to inflate her lung that much. She was in a state, where she needed oxygen permanently at home, for at least 18hours a day. She couldn’t move from room to room if she exerted herself because of breathlessness. And her face, mainly her lips and ends of her fingers were sort of discoloured blue, an unhealthy-looking tinge of colour one develops when their body has been deprived of oxygen for so long.

‘This is one of the very few things I can still enjoy in my life now’, she said.

‘If she hadn’t been smoking that long and was addicted to it, may be there would have been so many other things she could have still enjoyed.’ I thought to myself. Knowing ‘Love of her addiction’ is killing her and despite that, choosing to continue on it; it is hard for me to not wonder what is going in her mind.

She tells me, she started smoking very early at beginning of her teens. Now she is in her late sixties and in a nursing home almost wheel chair dependent in majority of her activities; the cocktail of nicotine, tar and the chemicals has managed to destroy her life. ‘At least I always had my cigarettes’, she remarked, taking a puff and blowing out the smoke very slowly in the air, amusing herself with the cloud of smoke it created. ‘It was a thing you know at that time. All of my friends use to smoke. Everyone had a pack with them, everyone was offered one wherever they went’.

I don’t like the cigarette smell. That doesn’t mean I haven’t tried myself either. Like most children whose parents smoked, I was introduced to it quite young as well. My mom used to be an avid smoker. I guess she developed her habit by following a trend of accepting gifts and complimentary stashes distributed to soldiers very commonly at those times. Naturally the troops wives had access to what their husbands had. ‘Marlboro’ used to be her favourite. As children, when as we saw a cigarette box with bright red on a white colour, we knew it was ‘good stuff, had been imported and either dad or one of her family members who was in the army had sent it’.

There might have been many reasons why smoking became a trend and still is. ‘Advertisement’ comes in mind first. We all know how intrusive and invasive they can be in our everyday lives. An add everywhere in newspapers and billboards, add celebrities into the pictures with their fancy gowns and chic smiles; there you go a generation of brain washed teenagers and young adults who look up to their role models and are desperate to be a part of the rage. ‘To calm the nerves’ as was told to the soldiers, it was mainly sold as an anxiolytic. Papers and the studies preached its wonderful effects too, leading general public to believe ‘it was safe’. Following these slow movements into individual people’s hand, in the world wars the popularity peaked, in few weeks it became sensation. Then a social tradition. ‘To offer a cigarette to a guest or friend as a part of social courtesy’.

I came across a cigarette advertisement made in 1950’s in YouTube. It plays “Doctors in all branches of medicine, doctors in all parts of the country were asked ‘what cigarette do you smoke Doctor?’. Once again, the brand name most used was Camel. Yes. According to this repeated nationwide survey, more doctors smoke Camels than any other Cigarette.”

Imagine the confidence of the company in using ‘Doctors’ as part of their lure to the public. It alone proves how accommodating we were as a profession of cigarettes in our lives then that it used to be acceptable for hospitals to allow smoking in bays and while on consultation with doctors.

It was only much later the long-term effects of smoking was discovered. Lung conditions like emphysema, bronchitis; cancers of various origins like lung cancers, oral cavities/nasal airways, bladder cancer and disease of blood vessels, heart etc.  Anti-smoking campaigns started more vigorously world-wide as result. Strict rules were then imposed and enforced on tobacco companies with heavy taxes, prohibition of smoking was announced on general public areas and now, even what used to be my Mom’s favourite at the time; Marlboro cigarette on its pack mentions ‘smoking seriously harms you and other around you’.

When she learnt passive smoking can be more dangerous than active smoking, my mom left her habit for good. She caught on time about its adverse effects from few minutes of government broadcasts that would often pop on news channel. We were then no longer asked to go and light the cigarette for her. Kind of missed not having to, for some reason it felt exciting thing to do at that age. Initially, it was hard for her to say ‘No’ when they continued to arrive in gift packs and in fancy boxes. But she pushed on her determination and helped some of her friends to quit smoking too. She hasn’t smoked for many years now.  

In Nepal, people mainly used to use firewood to cook. It still is the case in many places. Cities mostly use gas while the villages are still dependent on it. ‘Food tastes better even rice on it’ my mom used to say when she prepared it while blowing air on the stove through a long metal pipe, coughing constantly with irritation. When Joey uses the firewood stove at his place now, to keep the house warm, I remember myself constantly asking her to use gas or the petrol fuelled stove. Most people in the village suffer from COPD lungs in remote parts of Nepal. I am glad, my mom gave up both, smoking and cooking on smoke before damaging her lungs irreversibly. Cities aren’t exception now either with pollution from the vehicles.  If you haven’t been in the autopsy room studying lungs of a diseased Kathmandu resident, you would find it very hard to believe how much of smoke/pollution can affects lungs. Even the visible physical evidence is dramatic.

My patient can’t have oxygen at home because of the hazard risk with fire. Staffs are careful that she doesn’t sneak in any inside and would rather have her move about often as needed when she requests to. At this stage, our intervention is to only support her with oxygen. Cutting out on smoke now will not change her outcome. So, if she finds relief on smoking and feels this is one of the very few things she can now enjoy in life, she should be allowed to. And she is welcome to.

NHS offers ‘quit smoking programmes’ which we suggest to all of our smoking patients. Occasionally patients will spot doctors sneak out for ‘nebulisation’, a term we use to refer ‘smoking’. But knowing the adverse effects and impacts alone doesn’t always determine one’s choice. People choose what they choose for various reasons as long as it is an informed choice.

My friend once suggested ‘try smoking. I smoke now at least 3 times a day to lose weight’. I remember, the hype there was among the teen age girls then.

World Health Organisation (WHO) on its website mentioned ‘The COVID-19 pandemic has led to millions of tobacco users saying they want to quit’, with World No Tobacoo Day 2021 pledge.

This is a good thing. All the best.

A dog story for a tradition (So you’re a Doc, a foreign cuisine and Corona happened’

https://www.spreaker.com/episode/49496172 podcast link

‘She is 10 years old. Such a shame. It will be one of my biggest regrets. She would have made an excellent therapy dog’. A patient said to me over the phone talking about his Labrador.

“I was waiting in the hospital for my appointment, sat on a bench outside with her. When a young bloke sat next to me. He was shaking/shivering when he sat. And he asked me ‘Can I pat your dog?’. ‘Yes’ I replied, and after patting her for some minutes he completely stopped shaking and he looked like a different man. That day I thought, I must put her as a therapy dog. But with all this COVID such a same that she couldn’t.“

Although the risk is very low, by now we know that COVID can infect our beloved pets in close contact and vice versa. The symptoms are very similar to us; fever, cough, cold symptoms, shortness of breath, lack of energy, diarrhoea, vomiting, flu like illness. On 10th November/2021 GOV.UK published on press release ‘COVID-19 confirmed in a pet dog in UK’. After the press release and even prior to the press release there has been various interesting studies done surrounding impacts of COVID on pets and their pet owners. Some of the conclusions suggest very positive impact for the owners in terms of having a psychological support in form of companionship during lockdown and on pets-with more pet time from their owners for training and activities. BBC news on 12th March/2021 posted ‘Households buy 3.2 million pets in lockdown‘, mentioning that the main driving factor for rise in the ownership was the ‘social isolation.’

Other studies shows, there may have been a handful of challenges to pet owners mostly in dogs in terms of coping with stress of behavioural problems with their pets, accessing pet services as needed and food supplies. While on the pets especially dogs; less out door exercise and play time. Overall, all these researches on pandemic has highlighted again, why our human kinds has always been very fond of acquiring and keeping pets since time unknown. And how these fury friends continue to help us in many ways and have won special places in our heart.

Joey parents have a cocker spaniel. He has a beautiful lavish fury golden coat. Just like fresh honey stolen out of a bee hive, but a little darker shade. Very handsome little thing. They absolutely adore him. One of the family member is always at home to make sure he is not left alone and on the days they are at work, he dropped at the care centre, where he apparently has made some friends. When he returns from the centre Joey is always super excited. The first thing he does when he wakes up on the weekends is watch out of window to see if his little furry friend that is barely a year old is out on the garden or not.

When we were growing up, we also had a dog. Dogs’ actually. One passed away at about 15 years old and other passed away quite young at about 2 years. We got the second one some time later after the first one passed away, the only male pup from a litter of puppies. He was a gift to us from our relative, who had promised us one when Dorje (my dog) ‘s mom was still pregnant. He had said ‘if only there are male pups’. Luck for us and he had 6 fingers on each legs on his paws!

My mom is very fond of dogs. I suppose I was at some point too. I love them, but not to an extent to emotionally invest on one. It is a big commitment so I try not to get sucked into their bewitching innocent eyes. Someday? Yes may be. But I would like to very much have a Himalayan dog again if I did. The one I had before on both occasions. But Joey tells me after some research, obtaining pet passports, health records, vaccination status and with flights it will cost me fortune. And also introducing a whole different breed of dog to the UK will be a lot cumbersome.

Himalayan dogs are amazing. We call them ‘bhote kukur’ in Nepali. They are generally big dogs, with big broad rectangular heads, black beady or brown eyes, furry, usually on heavy black coats or with brown patches on a black coat. My first dog was call ‘Bhalu’. Because he exactly looked like a black baby bear cub! When I first held him, I could barely lift him properly. Even for a few days old baby, he had massive big paws, very sharp nails. The second one ‘Dorje’ was a quite small compared to Bhalu, but he was also very handsome dog nonetheless. He had light brown/yellowish distinct patches on a black coat around his eyes, on his tail, on his chest and on his paws. It took me a while to like him, but how adorable were his 6 fingers on front paws! 22 total fingers! He was special.

My mom has her own story about her dog. And as I would pass along my little tale and description about the dogs I had, she passed me description and the tale about her dog. And in some ways, the day Bhalu passed away was the story of our start of tradition.

Her dog name was ‘Sindhuli’. She was a very massive black coated dog like Bhalu was, a very beloved family member and a hard working herding dog. Her job was to work with herdsman and guide the cattle up to the highlands called ‘bukhi’ in the winter for grazing and then bring them back down the village after the winter had passed, when some vegetations would have started sprouting back to life. Her job also involved making sure the sheep and the cows didn’t strand far along the route on the way or while they grazed and to protect them from the foxes, wolves and other predators. When the herdsmen made their way to village, mom says, she’d be the first one to appear in the village. With a big bell ringing as it dangled in her neck, everyone then would know the winter had passed, their men and the herd were coming back home.

‘She was obedient. She did her own thing. She knew what her job was. But, one day, she didn’t return back on time. Then the men came with their drums, beating on it to make an announcement for the village’.

‘The dog of the Oak family‘, they said ‘has become rabid. It is heading its way to the village now. All people are to stay clear of the dog. It is very dangerous’.

‘We were shocked. We heard, she had fought with some wolves while on high land and was now infected. When she arrived, she looked dirty, beaten with hunger and exhaustion, as though she was walking semi conscious. Saliva was trickling down her jaws, her tongue was out, her eyes were sticky with clumps of pus/discharge in corners. She recognised us. Would growl when she would come across any strangers but to us, she was docile. But we were scared to go near her. Rabid dogs are mad, they are dangerous and people die… She sat on our verandah and made growling noise every time she heard any noise, mainly water. She was scared of water’. At this point, my mom was crying, wailing like a child that was re-living her painful experience. And while wiping my own tears, missing my a friend of 15 years, I held her hands trying to calm her down.

‘The villagers were scared. They all gathered and came to us saying, the dog was dangerous and had to be put down. There was no option. A dog dies in 1o days with rabies but no one could wait. So my uncle said, ‘I raised this dog from the day it was born like my own child. I hand fed her, I took care of her. She is a family. So if it has to be done, it has to be me’.

‘We lured her gently with a meat loaf to a tree’. Mom started wheezing taking rapid shallow breath unable to complete her sentence. ‘Tied her on it with a rope and my uncle shot her in the head.’

‘The look she gave to him and to us while she understood what we were about to do…’. I was concerned for my mom at this point because she was starting to look flushed with bluish tinge on her lips, her eyelids were swollen and the tears were falling down relentlessly. ‘I can never forget it. The look she gave.. She was so shocked; from the pain, not from the bullet that was about to hit her but from the treachery, from the disbelief of watching her own master/ her family turn their backs and be ready to take her life. Before the trigger went and we heard the loud noise, we watched her close her eyes in defeat. Waiting to be done… Oh what must she have thought, after all these years of becoming loyal, my masters are killing me’.

Mom blew her blocked nose in a piece of tissue and put her hand across her chest trying to control her breath. It was then, I understood the trauma of her loss was much bigger than mine by many folds even after all these years. She is in her early 50s now. She was merely on her teens then. At least, Bhalu passed away of age, it was inevitable. I had some time to say goodbye, I cannot imagine if I could have ever gathered enough strength to put him down, in circumstances like that.

Its a loss of friend after investing so many years of emotions even though they are ‘pets’. It hit me harder than losing a human friend. I didn’t know her that long as long as I had known my dog. So I completely understand the panic it must have created in pandemic with anxieties building up with lack of care facilities and delay in urgent services offered for pets. As far as I am told, most were classed as ‘non -essential’ travels/services. Studies have suggested, there aren’t any robust plans for situations like this COVID pandemic for our pets, who are now very integral part of our lives and societies. Shouldn’t we be working on one now?

I read some stories where people gave up their pets last minute because they were not able to take care of them. I hope they found right homes. Better to give in for adoption than to raise in abuse. I have regrets of my own not being able to give my dogs the right care, not being able to give enough space to stretch their legs in urban city. I could barely hold Bhalu when he ran, he was so powerful, he would drag me sliding from one end of the ground to the other. Eventually I’d have to let him go and return home with bruises in my elbows, legs and face. Then Mom had to go searching, before the whole neighbourhood started panicking seeing the giant running around chasing their little fufu and toy dogs. He was very troublesome. Had a big personality. Loud and very unfriendly to others. But I loved him, we loved him in our own way to pieces.