Friday, June 19, 2020

Off the Cuff……..

 By Nihal D Amerasekera

 

Being septuagenarian closing on becoming and octogenarian there is a natural tendency to look over the shoulder at the perils and pitfalls of my generation. Lucky Abey’s recent misfortune is a cue, if one is needed, to knock on the door of your friendly GP and get the ‘Shingles’ jab and whatever else is available to avoid a nasty illness that can have prolonged unpleasant consequences.

 

We were brought-up in the golden era of medical education with Price’s Text Book of Medicine and Bailey and Love’s Surgery that remained the last word in their respective fields. Nowadays when medical information is required the first port of call is the internet. As the man on the street (including myself) would say “Google it”. Even for the most obscure information about Radiology I now reach for the wisdom of “Google”. Towards the tail-end of my career I was performing a testicular ultrasound on a curious young lad. He was constantly interrupting me with a barrage of questions disrupting my train of thought. I was indeed amazed at his knowledge of anatomy and pathology which he proudly said was acquired from the internet. I politely shut him up. His knowledge helped me to explain things to him much more easily than otherwise.

 

We are all in search of that Fountain of Youth.  Longevity is something to be earned and perhaps inherited too. Although the world is full of advice on how to do it,there are never any guarantees. The internet is a repository of such information. Despite all that, there comes a time for each of us to call it a day.It is a fact of life that either my wife or I will depart this world first, leaving the other a life full of memories. No one can prepare adequately for this, except by being aware. Then, in our home, every room will tell a story, and every picture and piece of furniture will be laden with memories. It will be our children and grandchildren who can soften the blow. Time, as they say, is a great healer.

 

Covid-19 has changed the world at least for the foreseeable future. Its eye watering cost financially and emotionally will set us back for many years. For us older folk this poses an extra tier of healthcare. Sadly, this has kept us away from our own families. I have travelled abroad every year for some winter sunshine but that will have to be on hold. Sports are not the same without spectators. It is sad to see the Lords Cricket Grounds barricaded and Tennis at Wimbledon cancelled.

 

Despite its many drawbacks the lockdown has given me an opportunity to sit back and relax and let the world go-by. Although now in retirement, I was rushing everyday. I know not why!! Much of it for mundane tasks which surely can wait. I have taken this opportunity to reflect on what’s gone and to take stock of the present. Much of the future is beyond my control but there are events that need a plan, if you get my drift. We all wish for a happy ending.

 

Nostalgia is an overwhelming emotion. The volume of archived memories increases with age, as does the desire to reach into them. When awake at night, there are always the inescapable journeys to the past. The happy times spent with my parents are priceless. Those special joys of my schooldays bring such great pleasure. Medical School, despite the hard work, had its unique brand of youthful fun.  Building a career, and bringing up a family, brought their own enjoyment - and heartaches. Delving into the past can also bring sadness, bitterness and grief. Regret is the demon I don’t want to carry with me into the future - but that isn’t easy.

 

I must take you on my personal journey through life, which has fashioned my own philosophy. I was born a Christian, was baptised and confirmed, and went to a Methodist school. As a schoolboy, it was a wonderful existence. I had someone to take my troubles to.There was a code of ethics in the Bible. As a child it is great to think, as we are taught, that God looks after and cares for us. When I saw death, pain and suffering while at medical school, I began to question all this, and found it hard to accept the existence of a God.

Then I looked at Buddhism, and found its philosophy appealing. One doesn’t have to be a Buddhist to practise some of the teachings. Meditation and mindfulness can help to overcome the stresses and strains of life. I don’t believe in rebirth. When we die we just go up in smoke into nothingness just like ‘Nirvana’. I like to enjoy the good things in this world, as we will not pass this way again. I will continue to hang on to my Christian upbringing and discipline which was such a huge part of my childhood.

 

We all need a place to relax and wind down. Being in the big city still I’m not far away from nature. We all need to know where we came from and where we belong. Regent’s Park in London is my daily refuge. It is just 5 minutes walk from my apartment. Lovingly cared for by a team of horticulturalists it is so beautiful any time of the year. Its cascading water-falls and the serenity of the lakes provide a peaceful environment to meditate and be mindful. The bird life changes with the seasons as do the flowers and the foliage. There are wooden benches strategically placed to appreciate and enjoy the scenery around.

 

The weather in the British Isles is uniquely difficult to predict. There is something very soothing for the soul in looking at the sky. On a sunny day the patterns created by the clouds is breathtakingly beautiful. This is enhanced by the trails left behind by a myriad of aircrafts. I’m reminded of an ancient rhyme often repeated by mariners.

“Red sky at night, shepherds' delight.

Red sky at morning, shepherds take warning”

 

I reach for the wisdom of Rabindranath Tagore:

“I slept and dreamt that life was joy. I awoke and saw that life was service. I acted and behold, service was joy.”
 Tagore

 

I am forever mindful that life can change irrevocably in a single beautiful gasp!!

17 comments:

  1. Nihal, enjoyed reading your deep thoughts, Since I turned 65 years, 12 years ago, I have been taking the flu vaccine annually and both pneumococcal vaccines.
    For those who have not taken theses vaccines as yet, I would strongly advise you to do so , without any further delay.

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  2. Sanath
    Thank you for your comment. I too remembered to take the pneumococcal vaccine and the annual flu jab. Hopefully the Oxford Group will be successful with the Covid-19 vaccine.
    I wonder if we still have Diphtheria and Polio our SL. I recall these were a scourge when I did my paediatrics in 1967. Do the kids get meningitis vaccine too?

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  3. i enjoyed reading your thoughts although I must confess that I am not a soothsayer! I wrote this little verse a few years ago and reading your post, I recalled it.

    Here it is:

    We are all in a journey, don’t hold your breath
    It starts at birth and ends at death
    Whether we are sad or happy is subjective
    There are no absolutes in this narrative

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    1. There are 2 things I dont understand in your comment
      1. In what context have you used the soothsayer? We dont need one to say we will all die one day.
      2. You say "There are no absolutes in this narrative" Death is indeed absolute.

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  4. Dear ND,
    Thank you for you articulating some profound truths so succinctly and elegantly.
    Just now I’m reading again Atul Gawande’s “Being Mortal”.This is a good read ,perhaps even an essential read for the likes of us.It deals with aging and mortality.
    AG is a surgeon at the Brigham’s Women’s hospital in Boston and a professor at the Harvard medical school.
    He writes “It is not death that the very old fear.It is what happens short of death - losing their hearing, their memory,their best friends,their way of life.”
    We need to think how we will cope if we are reduced and debilitated to live independently.
    Luckily in SriLanka good help is available at reasonable cost;but there needs to be close supervision by relatives and of course adequate means.

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    1. Dear Kumar
      Thank you so much for the kind comment. This is not an easy topic to discuss at anytime and I appreciate your willingness to contribute positively. We must enjoy life whenever we can but also be aware of the future and deal with it in a sensible way. I have come across the name Atul Gawande but haven’t read any of his work. I will indeed read the book you have so kindly recommended.
      Whenever I have tried to discuss this subject with friends of my age, some just don’t wish to confront this issue. Others hide behind philosophy and get inundated with theory which I find unhelpful. These are basic facts of life that we should understand with clarity and deal with sensibly.

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  5. Nihal, WHO declared Sri Lanka, free of polio, long time ago. There are only a few cases of nasal diphtheria now. There is no separate tracheostomy ward at LRH for a long time as well.

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  6. Sanath
    So pleased to hear that we don’t have polio anymore. Is the nasal diphtheria a killer like that in the throat. It broke my heart to see children die on admission in Kurunegala.
    Great to see changes for the better.

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  7. Nihal,
    Such a beautifully written post on fundamental truths of life we often prefer not to acknowledge. So realistic , yet very elegantly expressed.
    I agree , you don’t have to align yourself with any religion to practice their life enhancing teachings.
    Your thoughts on Regents Park and nature are so soothing and healing in themselves to read.
    This may sound contradictory- but for me, the ‘cherry on the top‘ is the truth you have expressed at the very end.
    Thank you for another fine piece of writing, expressing profound ‘home truths’.

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    1. Rohini
      It's great to have you back and thank you for the kind comment. I hope the autumn weather remains kind to you and you can enjoy walks on the lovely Mission Bay.

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  8. Nihal,Nasal diphtheria is rarely symptomatic and is never fatal,;nasal discharge unilateral, epsistaxis etc. More a problem of being a carrier and spreading infection. We have eliminated Maternal and Neonatal Rubella (MNR) as well.

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  9. Sanath
    I am so pleased to hear of the good news. I still remember the death of a 2 year old to diphtheria on the operating table and the agony of the parents --in Kurunegala in 1967. That image still haunts me even after so many years and will remain with me forever.
    I do admire your enormous contribution to Paediatrics in Sri Lanka

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  10. Nihal, the credit should go to to the primary health care workers. The real reasons are free health care and free education since independence,resulting in increased female literacy(which is very important for health education). Our immunisation coverage for vaccines in our NPI schedule is 99% during infancy, which is probably the highest in the world and vaccine hesitancy is minimal.

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  11. I always find Nihal's thinking deep, profound, logical, reasonable and puts me to reflect on most facts he brings forward and most things he says. I too have found it hard to answer all the questions that arise in life whatever category it falls into. Finally I too, just like Nihal, take refuge in nature and what it offers to us. And just like Nihal, during this lockdown, I have had time to stop and think and not rush around like a headless chicken. You are so right in what you say, Nihal and you always make us reflect and we are so lucky to have you and a few other very special people in our Batch. I hope we see more and more of their writings. Whenever I am away from the Blog due being involved in baby- sitting or other things, I have a kind of 'withdrawal syndrome'. It must be I am missing inputs on the Blog from Nihal, Kumar, Mahendra and others. Well done all! Keep this Blog going! Zita

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  12. Nihal, some of your 'off the cuff' remarks are profound. Some of those you voice are the very thoughts that baffle me. Why are we so careful and meticulous when it all ends with death and we make so much fuss over little things? The more one thinks about it the more baffling and unanswerable it becomes. I think we just have to accept everything as 'it is what it is' and try not to understand or assign reasons to them. We can say, this time is precious and put it to good use to make ourselves or another person happy. I know I have not answered any of these questions, but that's what it is all about. We just need to voice it and share it and move on. But it is good to talk about it even if there is no answer. Oh about what we did or didn't do over the Lockdown period, I think it had its good purpose. We didn't run around like headless chicken and okay, no sports, and that's bad but days pass and soon we'll be back to 'normal' whatever that means. Thanks sharing your thoughts! Zita

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  13. Hi ND, I too have been away from the blog, with my children and grand children visiting me. While reading your comments about life and death, yesterday I listened to a sermon preached by the senior Pastor from the Wesley Methodist Church Singapore on Death which is adefinitive occurrence and preparing for it. As you said many do not want to talk of death (i being one of them), yet it is something we all have to face someday. I agree with you what is clearly unknown is the pre and post that event. I believe what all our faith tell us, while we are hear make this world a better place than what we born into and lived in.
    Best
    Rajan

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