Forces of Evil

The clash of cultures in India and other parts of the third world is something that I have always thought of as an intellectual exercise. Recently, though, the realities have struck a bit too close to home for comfort!

Our culture is one that is dominated by family. The family is now mostly the immediate family and the closest relations, something an order of magnitude greater than the nuclear family itself. Previously such was a much bigger group in India very often comprising one's caste, (community or jaathi). Nowadays, for many of the city dwelling folks, the caste carries a little less weight, but the slightly extended family (SED), has taken over that role and dictates terms to the concerned individuals with an overpowering and imperative voice.

The Now Generation, the 6th - 7th generation of our youth (Millennium 1?) since this nation gained independence, is at a crossroads. They know, and their national constitution guarantees them, their rights, but the rights are on paper and cannot be exercised without causing much consternation in the SED. The SED decides on everything from dress codes, to schooling, to work, diet and even, yes, marriage partners. The confusion is compounded by the utter contrast between what these kids see on TV, on the internet, and what the SED is telling them.

Over the years, it has been our privilege to stand by those few brave souls who are willing to buck the system and insist that they do have the right as individuals to make their own choices. Not surprisingly, these individuals are those who have had perhaps more of an exposure to Western cultures, perhaps with parents who had themselves felt uneasy with the status quo but also quite often it is a matter of conflict from the word go.

Surprisingly, when in the midst of the heated, emotional and sometimes dangerous conversations that follow when a person moves against their SED, the question often boils down to economics: The SED has done a,b, & c for you at great cost to itself, therefore you cannot now go your own way. Obviously, the entire system, the economics of the SED way of life, is being called into question.

Reactions to challenges to the SED system of life are often even violent for so much is at stake. But the critical question is how this clash of cultures is going to work itself out? For one thing, those who want to accommodate the good in the older system (stable, long lasting marriages and families that are child oriented) find themselves in a bind for any change is not appreciated. Without the middle path it seems that only by open conflict will the system change!

Ground Zero is usually marriage. Arranged versus love marriage is the stark choice that faces our youth. The SED will not tolerate love marriages at all. Very often the few couples who proceed and succeed in getting married after falling in love, will face ostracism, often by parents and family on both sides. Some do survive the economic and societal pressures but often these couples are forced apart. The result is often disastrous with the couple deciding to commit suicide.

The only option within SED is to marry

whomever the SED picks out, and make the best of it.

It may have been a good system resulting in stable marriages and strong families at one time, but it only works when both husband and wife (and their kids!) are strictly role bound and do not ask any awkward questions. Given the ways in which the supporting culture is changing, it's only a matter of time before the questions will out and marriages that looked solid find themselves on the rocks.

Our youth will have to find their way through this difficult maze, and to some extent, one can see them succeeding in forging a new path especially in the cities. The rural scene is still completely bound in tradition and forced marriages and even honour killings are still a 'norm' whenever the rural SEDs and the local caste system are challenged.

Snake Dharma

Mahil's comment in the previous post made me think. I was particularly reminded of my first few hesitant months in the U.S. way back in 1974. I had come to study Biology and was trying to find my feet in this strange new place. It was a bit of an adjustment. I had been brought up in Africa, with very few people, infrequent electricity and ingenious but primitive seeming technology. For example, our fridge ran on methylated spirit and baking cakes in a firewood fed oven is a real challenge.

I was just as terrified of snakes as my fellow human beings right till the age of 11, which is when I ran into my first 'snake man'. There was a small reptile collection in the Mundawanga Zoo South of Lusaka. There I spent a day in 1969 and was amazed to see the local 'snakeman', one Mr. Chanda, casually handling snakes that I knew to be very dangerous. He eventually convinced me to pick up a Whip Snake (Psammophis), and it wasn't slimy, in fact quite dry, and even pleasant to hold!

That made all the difference! I became a friend, and wherever possible, protector of snakes. Shortly thereafter I found a 2 foot long black snake (unidentified) in our garden, and coaxed it into a large bottle and hid it in my bureau. I then took off to play. Unfortunately, the next morning my mom suddenly got the urge to clean my (admittedly messy) room. She casually pulled out the big bottle and set it on the dresser and kept cleaning till she thought she saw something move. Needless to say, things went downhill rapidly after that. I got home to find my mom standing in the garden shaking with fury, refusing to enter the house, and my dad looking rather helpless. After word of that incident spread through school, I was frequently called to my fellow students' homes to help out with snakes that had somehow crept in.

Anyhow, skipping forward a few years, here I was in Cincinnati, staying with my sister and her hubby (the Jeyaveerans) when a close friend of theirs dropped by. Roger Stuebing was an expert in statistics and worked at the U.C. computer center. Roger decided to try and help me out with my acclimatisation. We got to chatting and soon found that we had a lot of common interests one of which was snakes. A few days later Roger picked me up early and we headed out to join my first American snaking trip.
Now, I was amazed to find another true snake man who, like Mr. Chanda had been bitten by venomous snakes umpteen times - Dr. George T. McDuffie. A Ph.D. in herpetology (that roughly covers the crocs, gators, snakes, lizards, turtles, frogs and salamanders), McDuffie lived in a big brownstone with a huge basement. We joined an assortment of folks at his place and headed out to the hills. We were after any snake, but he was particularly interested in copperheads (Agkistrodon contortrix)
and timber rattlers (Crotalus horridus - below) both pit vipers.

McDuffie had his right arm in a sling and as we drove, the conversation veered round to his most recent snakebite, and hence the sling.

It turns out that he had been bitten by a rattler 3 days back and had a slightly swollen and painful arm. He had lost count of the number of times he had been bitten, but it had reached the stage where he had developed some natural immunity and McDuffie had also become allergic to the usual (horse protein based) antisnakevenom, and so could not be treated with that at all!

I had no idea what pit vipers were, so the day turned out to be very interesting indeed. We found one beautiful timber rattler and McDuffie had it on his snakestick when I saw someone struggling to hold the sack open with two more sticks. I promptly picked up the sack and held it up for the snake to be lowered in right between my outstretched hands. McDuffie calmly let the snake down into the sack and I bagged the snake and handed the bag to McDuffie.

He then looked intently at me and said "that was a very brave thing to do". I was really puzzled and asked what other way there was to bag snakes. Only then did it dawn on McDuffie that I may not know what pit vipers were! Indeed, in Africa there are a plethora of venomous snakes but no pit vipers.

The common vipers in Africa were the Puff Adder (Bitis arietans, not shown) and the very striking Gaboon Viper (Bitis gabonicus - left), neither of which have the heat sensing capability of the pit vipers.

That beautiful, big, timber rattler could clearly 'see' my hands as two large, live, hotspots on either side of its head as it was being lowered into the sack, and I didn't even have a clue as to the danger that I was in!

That was the same snaking trip where McDuffie caught a big Black Racer (Coluber constrictor) using only his teeth, but that tale can wait, as can the account of what we found in that large, hot, basement of his after we got back...

Bitten to the point of immunity, McDuffie really did live-out his dharma. I was saddened to hear that George died (apparently of natural causes) this April at the age of 79 - a true snake man and fondly remembered!

Snakes in the (Indian) Grass - The Big 4 - Dealing With Sankebites

INDIA'S "BIG FOUR"

A 'narcissistic' Indian Cobra
(Naja naja)










The Russell's Viper














Echis carinatus - the Saw Scaled Viper
Notice how variable the colouring can be.





Saranya, my daughter, did recover from a snakebite. It's part of the 'normal' risk for snake rescuers. I haven't really kept myself very up-to-date on the developments in treating snakebites for the last couple of years as my own snake rescue work has almost been non-existent (due to busyness). It's very good to see that the next generation is showing an interest in preserving these wonderful, though somewhat dangerous creatures!

Having had to brush-up on snake bites, I thought I would take the opportunity to summarise the steps to be taken when bitten by a snake...

First and foremost, no snakebite should be ignored. Most bites may be from nonpoisonous snakes and sometimes even venomous snakes do not deliver enough venom when biting to prove dangerous, but that is no excuse not to go to the nearest emergency room, get evaluated, and if necessary, have treatment started. Early treatment is the key to preventing complications, and to saving lives, limbs and kidneys!
In India, it is conservatively estimated that 20,000 to 50,000 people die annually from snakebites. Morbidity (i.e. nonfatal injury rather than mortality-death) is also significant. These are not small numbers, and there seems to have been little improvement in reducing the fatalities over the years in spite of now having good supplies of polyvalent antisnakevenom available in all population centers.

The major reason for the high mortality rate (about 10% to 15% of all those reporting bites) is the delay in getting the victim to treatment. All too often snakebite victims are sent great distances to 'big' hospitals and the delay in starting treatment is the direct cause of death.

Of course, one root cause for snake bites is that rampant human population growth has forced snakes and people to occupy the same space. In my experience many of the snakes one runs into in towns, cities and villages are nonpoisonous. Nonpoisonous snakes very commonly seen include the rat snake, water snakes, wolf snakes, trinket snakes, blind snakes, and and tree snakes like the bronze back and the lovely green vine snake. These snakes will bite when cornered but the bites should certainly not result in any serious medical problem. Clean the bite site and apply a good antiseptic such as Betadine. That's when you KNOW with absolute certainty (positive snake identification can be tricky) that the snake that bit you was nonpoisonous! The general rule (see below) with any snakebite is to take no chances and to immediately seek out professional medical help. Let the physician decide whether your bite was poisonous or not.

However, India's 'big four' are not uncommon but very surprisingly, about 80% of the venomous snakebites in India come from the small saw scaled viper (Echis carinatus), and though this is a little fellow, it can be deadly.

Snakes do not bite unless provoked, so it's probably true that a lot of the fatalities that do occur are in fact preventable. If you have a snake in your house or garden please be calm, do not approach the snake or try to drive it away, and promptly call a snake rescuer. In other words, right now get out and identify the snake rescuers in your area, store their mobile numbers well ahead of time so that you can save yourself and the snake comfortably.

Krait bites are also variable and result in little obvious pain or swelling at the site of the bite which can lead one to think that the bite was harmless - DON"T BE FOOLED - take no chances and treat every bite as potentially fatal. Some bites might even be 'dry' with the venomous snake biting but not injecting any venom. At the same time some bites can seem to be harmless but may actually have a slow start to symptoms - often Krait and saw scaled or other viper bites can have this innocent-seeming start but then turn very ugly. Just because there is no obvious pain or swelling DO NOT assume that the bite was harmeless. Treat every bite as potentially deadly till proved otherwise by the competent medical authority.

FIRST AID:

In the absence of a nearby doctor, those accompanying the bitten one need to first CALM the victim down and then immobilise the affected limb (if it is a limb). Not one of the Indian poisonous snakes brings INSTANT death. You do have time to get the victim to a hospital and treated, but do get moving immediately. If you know how to properly apply a tourniquet then do so (if the bite is on a limb).

DON'Ts:

Applying any sort of chemicals or external medicines, home remedies, nature cures, and cutting into the site of the bite to suck out the venom (was the mainstay of first aid in my youthful heyday) have all fallen out of favour.

DOs:

BE CALM >> GET MOVING TOWARDS A HOSPITAL >> CALL AHEAD FOR ANTIVENIN!

The use of pressure bandaging is controversial but if done with something like a crepe bandage after starting to move towards the nearest competent hospita, and not wound on too tightly, perhaps combined with a simple splint or sling, it may help to slow the spread of venom through the lymphatic system. The blood supply must NOT be cut off for too long! On the whole, perhaps if the bitten one will be getting to a HOSPITAL within 3 or 4 hours, it may be better not to attempt any pressure bandaging but advice on this point varies.
As you move the bitten one towards a hospital, try to gently remove any jewelery worn on the affected limb - like wrist watch, rings, bangles, bracelets, anklets, or metti (toe rings) as these may cause problems if there is subsequent swelling or edema associated with the bite. Also loosen constricting clothing like ties or belts.
Next, get the person to the nearest good hospital as fast as possible. Walking and running for the victim are to be avoided, as is movement of the affected limb. Try to carry the person at least on a pallet or makeshift stretcher if no vehicles are available.
Giving anything by mouth is best avoided except if dehydration is a risk, in which case consider sips of oral rehydration fluids (clean water mixed with a little salt and sugar will do OK).
Some poisonous snakes have cardiotoxins (poisons that can slow or stop the heart) so if possible try to keep the affected limb below the level of the heart.

The victim should be encouraged to:
Remain calm.
Move minimally.
Breathe deeply and evenly to bring the pulse rate to a steady state.

Particularly as you move towards the closest hospital, keep a watch on breathing and on keeping airways clear. If the person has difficulty breathing, first see that there is nothing blocking the airway (like the tongue, secretions, or vomit) and if necessary be prepared to help the person to breathe by doing chest compressions or mouth to mouth. Rarely will the heart be affected so early on, so full scale CPR may not be needed.
Those having cell phones should call ahead so that even if antivenom is not available, it will be made available by the time the patient arrives. remember that 10, or even more, vials of antivenom may be needed, so ask whoever is at the other end to ensure an adequate supply, OR in the absence of definite knowledge, try to take the victim to the nearest hospital. In Tamil Nadu, all the government hospitals are expected to have stock of antivenom.
Observe the snakebite victim carefully while taking them to the hospital. Note the time of the bite and its location and try to get as much accurate information on the appearance and size of the snake. Any symptoms such as discolouration at the site or of the affected limb, swelling, signs of bruising, changes in eyes (e.g. droopy lids), eyesight, speech, breathing, sweating, unusual eye movements, dizziness, bleeding, lowered level of consciousness, loss of consciousness, or other difficulties should be noted.
If the snakebite victim happens to faint the most important thing is to make sure that they are able to breathe. If possible lean the head backward and depress the tongue to keep the throat open. Do not waste time trying to make them recover from the faint. Make sure that they are breathing and concentrate on getting to the hospital fast. If, as you move towards the hospital, you do have access to a phone or mobile, ask the doctors who are waiting for you for advice particularly in case of fainting as sometimes this may indicate that a medical condition called "shock" is setting in and that is potentially more dangerous than even the effects of snake venom! It is important to keep the bite victim warm.
Try to get information on what snake it was, appearance, size, etc. but please don't waste time on this or on trying to catch the snake! Getting the person to a competent hospital is the only major priority!


TREATMENT:
Mostly, if there are symptoms, the doctors will immediately start the antivenom treatment and then one will most profitably spend one's time praying that there will be no complications. In case of allergy to the antivenin or an immune reaction the doctors will temporarily stop the antivenin, treat those symptoms, but then should proceed with administering the antivenin. Physicians should be competent at handling anaphylactic shock! - please see the PPT at the end for more details...

On admission, and at relevant intervals afterwards, doctors will probably check on how well the blood is clotting (bleeding time, clotting time, and sometimes tests like PT and aPTT), kidney function (urine output, blood urea, creatinine and electrolyte levels), and of course the vital signs - pulse, breathing, temperature, blood pressure and the amount of oxygen in the blood (pO2). They may also keep tabs on the patient's haemoglobin, blood cell counts (especially platelets), and perhaps the blood gases too.
Sometimes even after a day or two, things can go wrong with the patient starting bleeding, kidney failure, or even the heart could be affected, so keeping the victim under medical observation even after the antivenom has been administered is important. Most of the time, alert medical staff will successfully deal with each crisis as it arises.



Saranya (my daughter), was bitten by the Saw Scaled Viper (Echis, see above), but sometimes a non-big-four candidate can cause trouble.
In our our area of South India, especially in hilly areas, we do run into bites from the Hump-nosed Pit Viper (Hypnale hypnale pic. above)

or the Bamboo Pit Viper Trimeresurus gramineus

and very, very rarely,
the King Cobra (Ophiophagus hannah).






















There have been many hits on this article as well as requests for more information so I thought I would share some of the resources that I found most helpful:
1.Snakebite Envenomation in India: A Rural Medical Emergency Indian Pediatrics 2006;43:553-554http://www.indianpediatrics.net/june2006/june-553-554.htm
2. Kraits deliver some powerful neurotoxins that cause few initial symptoms at the site of the bite but can be deadly within a couple of hours. Detailed Instructions for Krait bites can be found here: http://www-surgery.ucsd.edu/ent/DAVIDSON/Snake/Bungarus.htm *Note that Indian polyvalent antivenom is effective against Krait venom also.
3. The University of Adelaide's toxinology resources website has an excellent database of information on most of the poisonous snakes in the world, first aid, treatment, and antivenins. Use the search engine to find the information you need: http://www.toxinology.com/fusebox.cfm?fuseaction=main.snakes.search
4. Snakebite Research Unit, Little Flower HospitalAngamaly, Kerala - First Aid
http://www.lfsru.org/firstaid.htm
5.A helpful interview with Romulus Whittaker in The Hindu: http://www.hindu.com/mag/2004/06/13/stories/2004061300400200.htm
6. Guidelines for the Clinical Management of Snake bites in the South-East Asia Region http://203.90.70.117/PDS_DOCS/B0241.pdf By the WHO is now a bit dated (1999).

FOR MEDICAL PROFESSIONALS: HERE'S A GOOD PPT ON TREATING SNAKEBITE

Snakebite Management in India

View more presentations from Ashendu Pandey

Living Poetry - Meet STACY BARTON

Some of this blog's (admittedly few) readers may have noticed that I do have a liking for poetry. As I explained in an earlier post, this particular bug started many years ago under the influence of one of my teachers, Dr. Jon Kamholtz of the University of Cincinnati.

Well, I met Stacy online last year at an emerging theology site called Open Source Theology (OST). It quickly became obvious that she was a real writer - someone who understands how to put the words together to communicate not just facts, but also feelings. Stacy Barton writes poetry (and she also does plays and short stories). Her latest sally is a collection of short stories called "Surviving Nashville".

Well, I visited her blog last week and found that in a couple of posts, she had very casually tossed up some fascinating poetry . With her permission, I am putting up the 'less finished' piece here in this post and another one (more finished?) further down in my sidebar.

So, here's June, which Stacy feels is less finished, or even unfinished. The idea of putting up an unfinished and unpolished poem is to allow any of my lucky readers to participate in finishing a 'living' poem. Well here's your chance! And a golden chance it is indeed. That rarest of things, a creative work in progress, and you get to participate!

So, if anyone wants to suggest some changes, or add a stanza or two, please go ahead and feel free, and if Stacy likes it, the poem may end up being properly published in one of her future collections (no promises)!

june

june means summer

which means kids and pools and sunscreen and sandy beaches

and hot dogs and popsicles

and sleeping in

and afternoon movies with the shades pulled.

summer also means forgetting to buy groceries

(thus the hot dogs)

or do the laundry

(thus the swimsuits)

or go to bed at a reasonable hour

(thus the sleeping in)

If you want to read more, then hunt your way down to the poetry section in my sidebar for Stacy Barton's "At Dusk"

The Other Side of 'The WAR'

John Doyle at Ktismatics just pointed out this article. It is important that you read it IF you have any interest in the truth about the conduct of the Iraq War.

Sometimes, perhaps too often, having an interest in the truth can be very painful. This is one of those instances. The collage on the right makes me feel physically ill, but i've posted it here.

If you prefer to feel safe, please do NOT click on it to enlarge!

When the loss of 3,600 young people is sooo sickening, what does one make of the loss of the 300,000 non-combatants in Iraq? Their pics are not posted anywhere, yet they are just as real and just as dead.

Follow the title link to a rather detailed article in The Nation where they have interviewed 50 Iraq war veterans in order to get a closer, if stomach turning, look at the real war in Iraq.

Not for the faint hearted!

A few posts down, I spoke of PTSD; well now you know.

It is also worth pondering the fact that George Bush Junior is planning on a permanent "occupation" of Iraq, since it is obvious that the puppet government there is completely incapable of holding that nation together on its own...

Pity the fate of the Iraqi people - how many do you think will now be wondering if Saddam was not the better of the two evils?

In case the link leads to an ad, click the "skip to" on the bottom right to go to the article itself.

Jason's New Word

My good friend and internet interlocutor Jason Hesiak has created a word and that word was just too good to pass up! It is not found in the Online Dictionary and Google has only two instances, both of which track right back to Jason himself:

"VISCESIOUS"

So what does this word mean? Is it related perhaps to visceral? Or, could it be something quite Differant? What could the other forms of this word be?

Weigh in with your ideas and suggestions please!

Going Bananas

Folks who have lived in or travelled to the tropics will testify to an abundance of interesting fruits at any time of the year.

There are so many delicious fruits to remember from Africa.

Two of my favourites from East Africa are the Baobab fruit (Adansonia digitata L. on the right) and the rare Victorias (? ref. neeed). More friends have broken arms and legs trying to be the first to get at the Baobab fruit on the slippery branches of these 'upside down' giant trees!
In India such delicacies as Jackfruit (Artocarpus heterophyllus Lam.),












Mangustan (Mangosteen, Garcinia mangostana L.) and the deliciously acerbic Jambolam (Black Plums, Syzygium cumini L.) arrive in sequence in the early summer and make life very livable.






The Genus Musa:
But nothing comes close to comparing with our varieties of banana!

We have super sweet varieties, soft ones, tough ones, red ones, honey flavoured ones and the list goes on... and on.

In Kerala, the all time favourite variety of banana is the Nenthram. The word 'plantain' is misleadingly used of this fruit. This is a robust variety with seeds and a very firm texture. The taste of an orange centred, ripe fruit is quite sweet but with a tart edge to it.

The unripe fruit can be sliced thin and fried into crisp tasty chips (only coconut oil is use for frying and the combination of flavours is wonderfully aromatic), while the ripe fruit can be steamed, eaten as is, or batter dipped and made into the tastiest fritters (slightly salty batter with succulent nuggets of sweet Nenthram embeded in it).

Needless to say, fried chips and fried fritters are out for me, but the steamed varieties I can still enjoy.

Each variety has it's special flavour, texture, aroma and taste. There is the red and quite robust Sevallai (right), the chubby delicately flavoured Rasthali, and the 'anytime after food digestive', the Poovan.

Let me assure you that the temperately available common variety 'Cavendish' just does not begin to do justice to real, fresh, tropical bananas.

Why I am particularly now reminded of these wonerful fruits is mostly because in the aftermath of my hearty lesson (previous post) my diet has been severely restricted; no oil, no meat, no eggs, BUT I can eat as much as I want of vegetables and yes - fruits!

I have little if anything to complain about when the abundance and variety of very tasty fruits comes to mind. I am also reminded that our first parents were set up in a (tropical?) orchard and appear to have been fruititarians, or so implies the book of Genesis!

A Close Brush with Life

For those who have yet to hear the news, I just had a close brush with life. Last Friday very early morning (June 15th) Aruna woke me as she heard me groaning in my sleep. This is one of those small coincidences as she had actually gone to bed upstairs since I had the lights on and was working that night. Somehow, very unusually, I slept off and crawled into the nearest bed and somehow, Aruna came back downstairs at around 2 a.m.

I awoke with a feeling of slight breathlessness and a sense of tightness under my breastbone. We both thought it to be indigestion and i took a couple of antacid pills, but to no avail. Apart from my jaws being very tight, there were no other symptoms. After an hour of fruitlessly waiting for it to subside, we called our family doctor and he suggested that we come in for a checkup. This was about 3 a.m. (dedicated doc Ravi Thyagarajan!). We got there about 3:30 and he checked my BP and pulse and both were normal. I had no temperature, no sweatiness, no chills, no other discomfort except for this steady 'almost pain' under my breastbone. The feeling of breathlessness had also faded away.

After some deliberation and observation Ravi put a tablet under my tongue, 'just to be on the safe side' and ordered me to a nearby cardiologist for an ECG (EKG) and whatever other tests they may decide. The tab melted off not too unpleasantly but then I felt a bit lightheaded and went home to sleep. This tab-under-the-tongue was concidence #2 for without it things would have gone from bad to worse that much faster!

On awaking, the discomfort was minimal, just a vague feeling of tightness and I was ready to ignore that but Aruna insisted and so at about 9 a.m., after sending the kids to school/college, we finally went to a nearby cardiologist's office where the ECG looked suspicious enough that they decided to do an echo and that showed that a heart attack was under way. The medical term is acute myocardial infarction, in this case affecting the muscles of the anterior wall of my heart. Due to a sudden lack of oxygen these muscle cells were unable to beat properly and would soon die altogether unless rapid action was taken.

I was rushed to a nearby hospital where good cath lab facilities were available. There, as luck would have it, mini miracle #3, a cardiologist who was also a good friend and the best in the city for interventional cardiology was handling the cath lab that day (Dr. J.K. Periyasamy) who on seeing my report, ordered me in for an angiogram. I went straight into the ICCU where an IV line was inserted, medication injected, test doses of the anesthetic and radio-opaque dyes were spotted onto my forearm and I was prepped for the angio.

Within a couple of hours they had me under the moveable head of the x-ray machine in the cath lab, with a catheter working its way up my right arm towards my heart. I was conscious and by now enjoying the whole show. The monitors were on my left and I could watch by craning my neck around slightly. The dyes started to be injected in double puffs of black, highlighting the arteries of my heart. The x-ray head swung in all directions as they got a fix on the two main arteries and studied them for blocks. It didn't take too long to find TWO 90+% blocks right next to each other on the artery known as the LAD. This was obvious even to my untrained eye as Dr. J.K.P. pointed it out and then asked if he could go ahead and put in a stent. After careful measurements they decided that they had a stent that was just big enough to cover both the lesions and that's coincidence #4 as without that 30 mm stent, it would have been a bypass surgery for sure and I would have lost some valuable heart muscle while I awaited that surgery. A very worried Aruna was consulted and shown the blocks and after she agreed, the doc inserted the stent and sent me back to the ICCU.

It turns out that ad hoc stenting like this is almost never done in India. There are too many risks involved and the cardiologist has to be supremely confident that they have seen and diagnosed correctly without needing to ponder the films for a couple of days at least! Yet, I was in that critical window period where if the blocks were removed, my muscle would be preserved and back to normal within a couple of weeks, otherwise the muscle would soon die (about 12 hours is all that's there) and an infarct would result - that's the scar tissue that results from an untreated MI.

That next 24 hours was really painful. I was feeling fine but flat on my back with bandages swathing my arms and under the watchful eyes of the ICCU staff, who flatly refused to even let me watch my own monitors!

The next day I begged to be let out, and the doctor reluctantly agreed. Then after 2 more days in a room at the hospital under observation, I was finally let go of but under strict orders to take rest. I've even been kept away from my computer till today and hence the delay in informing all of you.

I would like to thank in particular Senthilkumar (our adopted brother) and the staff of his company Ventura Omnitech Pvt. Ltd. for the constant and selfless support during a time of crisis!

If I can figure out how to podcast bits of my angio, that may also show up on this blog one of these days...

The Culture of Fear

Talking of PTSD led me to think about the ubiquitous nature of fear. Fear is all around us. Fear is within us. Yet we rarely acknowledge our fear.

What are our fears? Why are we afraid of fear?

Looking at my own little self and asking these questions I get a number of answers.

I am afraid of the future.
I am afraid of losing my job.
I am afraid of losing my health.
I am afraid that my relationships are too fragile.
I am afraid that those I love are getting into trouble.
I am afraid of doing something wrong and getting myself into trouble.
I am afraid of the changes in nature and environment that are taking place around me.
I am afraid that my country may lose its political and economic stability.
I am afraid of market forces controlling and spoiling the economy.
I am afraid of the rapid changes in Indian culture.
I am afraid of certain things in my past.
I am afraid of dependence.

These are generic fears, fears that perhaps most Indians would identify with.

But there are other fears. Fears of what is inside of me. Fears of my own inadequacy. Fears of my ignorance. Fears of my personality traits. Fears of my inability to hold together relationships. Fears of my inability to share. Fears of my neediness. Fears of my inability to love, fears of untruth, and the list could go on...

The way I deal with fear is basically to try to ignore it. I do my job. I spend time with my family. I spend time with friends. I watch TV. I blog. I read the newspaper. I read a novel. I go for walks in the woods. When I think, I try to focus on objective 'stuff'. I sleep.

During each of these avoidings, I carry my fears with me. The fears cause all sorts of turmoil, all the worse for being ignored!

Fear, the fear of fear, eventually drives me to face the fear. I recognise that fear. I recognise that the fear may be justified. I recognise that I may be causing the fear. I recognise that I have to change.

The conscious fear is also an indicator (the tip of the iceberg) of a trouble spot, a trend, a trait, or as John Doyle would perhaps term it, a strand. It is something that has to be dragged out, identified, and faced. Like the pain of a real wound, fear indicates that action is required.

Being 'frozen in fear' is an expression of our response to something sudden and terrifying. We have perhaps not even had time for a 'fight or flight' response to kick in. But, most of our fears do not fall into this category. They are insidious and if they are ignored they will prove debillitating!

Fear causes stress. If there is enough fear and enough continuous stress, you may not get PTSD, but depression and anxiety are probably already knocking on your back door.

The market dislikes fear. Fearful people will not be big spenders! The culture is supported by the market. Market forces and culture cooperate to keep the whole machine smoothly running. Therefore the market, supported by culture, actively suppresses fear. One way of suppressing fear is to revel in the fears of others. Reality TV, the News, and images of Iraq, are today's equivalent of the Roman Colosseum which boasted three types of gruesome 'entertainment'; the venationes, noxii, and munera. Another market-friendly way is to sell you a pill or two!

If you look at the map of ancient Rome, you will notice that the Colosseum is called the Amphitheatrum Flavium or Flavian Amphitheatre. it is suitably situated (territorialised) outside the main city but not too far away (I wonder why malls come to mind?). The analogy is perhaps just a part of life in any civilisation. But, in order to really deal with fear, the territory that it has staked out within one's soul will have to be identified and then reterritorialised!

Real fear is not talked about. Fear is the enemy. Let's suppress those fears!

The title link takes you to the "Rome Reborn" website. Check out the video clips under the gallery, especially the Colosseum in 3D!

The Hiding of Paranoia

PTSD, what do you really know about it? Posttraumatic Stress Disorder has been recognised as a common aftereffect of exposure to warzones since the early 1980s. The phenomenon was first identified in Vietnam Vets. Now, those were the days of my youth in college and I got to know quite a few veterans of the Vietnam War on-campus.

I distinctly remember that many of the veterans had a heightened sense of imminent danger that we would otherwise call paranoia. Now, the odd thing is that during a recent series of exchanges at Ktismatics (follow the title link) on fear, depression, and how we perceive/understand reality, I looked up PTSD on a number of sites and found that paranoia, a heightened sense of fear/danger, is prominenlty missing.

I wonder why? Are we afraid to recognise just how devastating a condition PTSD is? This is certainly possible for the fact is that more than 30% of all soldiers in any real war will suffer from PTSD and for many of these people it will be a debillitating, isolating, lifelong reality, of being dysfunctional in society.

I'm just curious, do any of you know warzone vets who are not paranoid? if I had been subjected to these kinds of stress continuously even for a short space of time, I would be!

But, the more fascinating question that arises is, "is there any reason for people in 'normal' (not war-torn) society to not be paranoid?" Are these Vets perhaps simply responding to real dangers that actually exist but that we have sublimated for some reason or the other? Maybe society and the global marketplace are geared to bury the fears, so that production and efficiency are not affected... Even if it is not a silent conspiracy, could it be that fear itself is societally considered the enemy?

The reality is that it is not only soldiers who need to worry about PTSD, or live with fear. Any psychological trauma can bring it on including motor vehicle accidents, having been a victim of child abuse, rape, a natural disaster, and other common occurrences within 'normal' society.

Any thoughts?

BIODIVERSITY versus Global Warming

A lovely new tool for comparing up to three different blogworld variables is available on icerocket and I used it to see how biodiversity was doing in comparison to global warming in the blogosphere.

The result was disheartening. Folks are much, much more worried about a crisis that is yet to come than they are about an ongoing and potentially much more devastating one - loss of BIODIVERSITY!

I AM A BIT AT A LOSS. How does one convince people that we are losing species permanently on a daily basis? Once stable ecosystems are endangered and will be irrecoverably lost if we don't start taking immediate action. Once a species is lost it will never be regained and once an ecosystem is damaged by species loss, that ecosystem is doomed!

Here are the actual stats as of May 18th, 2007:

GW = Global Warming, B = Biodiversity and E = Endangered Species

Trend Terms......Posts per day..........Average %.......Total posts

GW.....................1,353.91................. 0.1791.............121,852

B..........................53.16....................0.0069...............4,784

E..........................96.30....................0.0127...............8,667

That's at present something like 25 times as much activity on GW than it deserves and biodiversity needs to get 50 times stronger...

Any Bright Ideas?

The minute you start getting concerned about bioinversity and start blogging on it and doing something about it, these stats will surely improve.

Women and Men - Complementing Equality

As a Christian, that is, as one who seeks to follow Jesus, I am deeply saddened that injustice and inequality are being actively perpetrated by "the church" against women.

Now, there are segments of Christianity that have moved away from such discrimination, but large parts of the church, most notably the 'conservative evangelical' segment of the church can claim to actually be defending the bible by promoting discrimination against women!

I do not wish to go into why such controversies still exist except to say that it seems to have something to do with a wrong understanding of the bible, the misuse of power, an attempt to protect the authority of male dominated institutions, and a real fear that 'giving in' on this issue will be to let liberalism 'win'. In fact the so called "slippery slope" seems to be where all meaningful discussion is guilotined by these so called conservatives. In actual fact, a truly conservative reading of the New Testament and even of Genesis will show that any type of male domination is sin. It is a sure sign of the falleness of humankind. The gospel of Jesus shines particularly hard and bright on all such darkness however carefully we have treasured it in the nether corners of our hearts.

It's time to put this foolishness away. It is time to recognise the gifts that God has given to all humans and to allow each human to achieve her/his fullest potential - in true partnership and the building up of one another.

There are terrible systemic injustices; poverty, racial discrimination, casteism, war, genocide and so many evils that are perpetuated most obviously by our alienation from God. So, let's not blame God for what injustice and evil we do to each other, let us not allow culture to dictate what true justice is. Rather let us join together to celebrate the reality of our New Creation in God!

I my SELF?

In a fascinating post and discussion on what constitutes 'the self' Ktismatics has topped off a series of posts (developed over some time) discussing the ideas of Hegel, Derrida, Gadamer, Lacan, Deleuze, Tomasello, and many others, and charting out some new territory too on subjects as diverse as language, hermeneutics, psychotherapy relationships, and the self.

Particularly in our work with autistic children, but also with those who have other developmental problems, we often encounter the process of discovering and developing the sense of self. Our interaction, though, is always on the practical side. We are trying to 'correct deficits' and the norm is always what the majority of kids of that age group would attain.

How much is 'just' genetics and what effects do changes in nurturing style and other 'inputs' have on these children? Even if one is inclined to see the self as largely genetically programmed, one is still reminded that an awful lot depends on skill, and skill is something that is very relationally learned. But, my own feeling is that it is not even 50% genes. I believe that environment and social context make a huge difference. I have witnessed what effect some focused therapy can have on a child. We also see marked changes with modifications in physical factors like diet and sleep and exercise.

Children should indeed be encouraged and helped to reach their full potentials. How exactly we go about doing this is something that every parent, teacher, therapist, or anyone else that is around kids a lot, needs to keep struggling with. The child's sense of self and the child's developing personality do require and demand our attention and care.

I am very thankful indeed for Ktismatics' massive effort to help to clarify some very confusing issues even though a large part of my confusion still remains! Indeed very often the discussion has gone right over my head but always in the process setting off various trains of thought and bringing much needed fresh perspectives.

I won't even attempt to summarise what I am now thinking on this fascinating subject. I find that my reliance on a few thinkers such as Piaget has left me with an inadequate foundation (not Piaget's fault!) and so much rethinking is now going on in my mind that whatever I might say now would be just garbled. So, do read for yourselves...

I have some other selfish reasons for frequenting Ktismatics' blog one of which is the ongoing discussion with Ivan that was graciously hosted by Ktismatics shortly after a spam catcher on another blog set some of us adrift as we began a discussion on atheism, religion and evolution-creation! Which then led to the discovery of ktismatics nascent book on creation and in turn, that fascinating topic morphed into a fullscale, ongoing, exegesis of Genesis at OST. Right now, of course, the creation of the self is what it's about!

New Post at Ponnvandu

Follow the link to an important new post on

"NUTRITION FOR KIDS WITH LD"

Perspicacious and Prescient - Samuel Daniel

I read this poem during my second year at college not realising that one day I would be in India and reminded again of this amazing 16C poet.

Musophilus (Containing A General Defence Of All Learning)

Power above powers, O heavenly eloquence,
That with the strong rein of commanding words
Dost manage, guide, and master th' eminence
Of men's affections more than all their swords:
Shall we not offer to thy excellence
The richest treasure that our wit affords?
Thou that canst do much more with one poor pen
Than all the powers of princes can effect,
And draw, divert, dispose, and fashion men
Better than force or rigour can direct:
Should we this ornament of glory then,
As th' unmaterial fruits of shades, neglect?
Or should we, careless, come behind the rest
In power of words, that go before in worth?
Whenas our accents, equal to the best,
Is able greater wonders to bring forth;
When all that ever hotter spirits express'd,
Comes better'd by the patience of the north.
And who in time knows whither we may vent
The treasure of our tongue, to what strange shores
This gain of our best glory shall be sent
T' enrich unknowing nations with our stores?
What worlds in th' yet unformed occident
May come refin'd with th' accents that are ours?
Or who can tell for what great work in hand
The greatness of our style is now ordain'd?
What powers it shall bring in, what spirits command,
What thoughts let out, what humours keep restrain'd,
What mischief it may powerfully withstand,
And what fair ends may thereby be attain'd?
I should be offended by the presumption. After all, Indian culture predates and surpasses the British variety by a good five thousand years! But, in the modern period we have learned a lot from the Brits, both good and bad. As far as both politics and ethics go, India knows what not to do and be. So, despite the condescension, hats off to Daniel and his enthusiasm for spreading his variety of language and learning!

Three more examples of his work are further down in the next page tab (poetry).

I have to especially thank my English Prof. from the University of Cincinnati Dr. Jon Kamholz for his excellent introduction to 16 century poetry and to what English Literature is all about in the first place!