- An American , on his first visit to Ireland is advised to be careful about getting into any argument about Catholic & Protestant beliefs of Christainity (something similar to Shia & Sunni sects of Islam – again divisions of mind & belief systems, divisions & divisions alone… any way … For the readers information , Northern Ireland & Mainland U.K. has also gone thro’ lot of trauma of terror of IRA – Irish Republican Army , again settled thro’ dialogue with the guns falling silent ).
As the American is roaming thro’ the streets of Dublin, Capital of Northern Ireland, he to his horror feels the barrel of a gun into his back, with the voice booming behind, “ Tell me are you a Catholic or a Protestant ?” The American thinks , remembering the advice given to him, “ If I say Catholic & the terrorist is a Protestant, or the other way around, I am dead meat any way !” Doing some quick thinking on feet, he says, “I am a Jew !” The voice behind squeals with delight, “ O Allah, Never I thought an Arab will get a Jew to kill, in Ireland” and boom goes the gun.
Such are the chasms of human mind , Jews – Arabs, Shia –Sunni Muslims, Hindu –Muslims, Dalits - Upper Caste ! No other Species has been “intelligent” enough to do this to themselves !!! - An Israeli doctor says "Medicine in my country is so advanced that we can take a kidney out of one man, put it in another, and have him looking for work in six weeks." A German doctor says "That is nothing; we can take a lung out of one person, put it in another, and have him looking for work in four weeks. A Russian doctor says "In my country, medicine is so advanced that we can take half a heart out of one person, put it in another, and have them both looking for work in two weeks." The American, a Texas doctor, not to be outdone, says "You guys are way behind, we recently took a man with no brains out of Texas, put him in the White House for eight years, and now half the country is looking for work."
Friday, December 12, 2008
On a Lighter Note…….
‘MANDUKYA’ UPANISHAD ON SLEEP & STAGES OF HUMAN AWARENESS
Sleep remains one of the most unsolved of mysteries of human life & living. And why humans – sleep is one activity universal to all living entities, including plants.
Mandukya Upanishad expounds beautifully on the four stages of human existence, including sleep.
For the reader’s easy understanding, I have tried to summarize the four stages of human existence in the most scientific manner, as I understood it.
FIRST STAGE : WAKEFUL STATE ( जाग्रत अवस्था )
The body & mind are fully active.And even though body might be passive, Mind is always active – full of thoughts, because one is always reacting to the world around.
SECOND STAGE : DREAM STATE ( स्वप्न अवस्था)
Body being gross, gets tired easily ; loses its momentum & falls ‘dead’ – asleep. Mind continues, being subtle with its momentum & plays out the ‘real’ life dramas, perceived as dreams.
THIRD STAGE : DEEP SLEEP STATE ( सुशुप्त अवस्था )
Ultimately MIND also loses its momentum & ‘falls’ asleep- leading to the refreshing Deep state of sleep.
And the DRAMA once again begins after so called waking up as if in a reflex conditioned manner, taking up from where we left night before , apparently life after life which we obviously do not remember.
BUT if YOU have decided enough is enough, “ STOP THE WHEEL , I WANT TO GET OFF IT “ , the fourth stage begins.
FOURTH STAGE : TURIYA ( तुरीय )
Body & Mind stop running in a reflex conditioned manner – they are at ease all the time, in all the circumstances with an Awareness , said to be in Yoga. Thus never getting ‘exhausted’ the Yogi “ACTS” in life (not “REACTS” all the time ), really awake for the first time in ( so called ) wakeful , working state & never asleep in the ( so called ) Dream & Deep Sleep states. Turiya (meaning fourth) stage – You have truly Arrived in Life ! - Editor.
Mandukya Upanishad expounds beautifully on the four stages of human existence, including sleep.
For the reader’s easy understanding, I have tried to summarize the four stages of human existence in the most scientific manner, as I understood it.
FIRST STAGE : WAKEFUL STATE ( जाग्रत अवस्था )
The body & mind are fully active.And even though body might be passive, Mind is always active – full of thoughts, because one is always reacting to the world around.
SECOND STAGE : DREAM STATE ( स्वप्न अवस्था)
Body being gross, gets tired easily ; loses its momentum & falls ‘dead’ – asleep. Mind continues, being subtle with its momentum & plays out the ‘real’ life dramas, perceived as dreams.
THIRD STAGE : DEEP SLEEP STATE ( सुशुप्त अवस्था )
Ultimately MIND also loses its momentum & ‘falls’ asleep- leading to the refreshing Deep state of sleep.
And the DRAMA once again begins after so called waking up as if in a reflex conditioned manner, taking up from where we left night before , apparently life after life which we obviously do not remember.
BUT if YOU have decided enough is enough, “ STOP THE WHEEL , I WANT TO GET OFF IT “ , the fourth stage begins.
FOURTH STAGE : TURIYA ( तुरीय )
Body & Mind stop running in a reflex conditioned manner – they are at ease all the time, in all the circumstances with an Awareness , said to be in Yoga. Thus never getting ‘exhausted’ the Yogi “ACTS” in life (not “REACTS” all the time ), really awake for the first time in ( so called ) wakeful , working state & never asleep in the ( so called ) Dream & Deep Sleep states. Turiya (meaning fourth) stage – You have truly Arrived in Life ! - Editor.
IMAGE 2009 - PLANS , ASPIRATIONS , DREAMS.
We plan to come out with four regular quarterly editions of Image in the year 2009. It is also my burning desire to come out with a special edition of image, a collector’s delight containing the best of articles on matters of man, mind, medicine ; nature & nurture ; science & art of living. This desire is fuelled by a stray comment of a colleague, that, “ the Image remains for a week on the desk & then ends up in the dustbin !” Indeed this aspiration will not be fulfilled without your active support. Let us use our in-house magazine as an instrument of social change, starting with ourselves. The 2009 , first quarter edition , I would like to dedicate to the subject ,
“SOCIAL AWAKENING & TRANSFORMATION IN THESE VIOLENT TIMES”
MAHAN RASHTRA NAVNIRMAN !
HOW MEDICAL COMMUNITY CAN PLAY A PRO ACTIVE ROLE?
The subject assumes added significance in the wake of increasing violence against ‘soft’ targets - linguistic group, religious minority ,our own medical community & repeated terror attacks against the country as a whole !
With the elections around the corner – a possible turning point in a mature democracy (Americans once again have shown the way by electing a Black president!), Can WE Doctors lead from the front? How do we go about achieving our objective?
Please SHARE your thoughts, opinions with rest of the medical community thro’ IMAGE & formulate a strategy for National transformation in these times of crisis. We are part of the society (well hospitals are even under attack by terrorists!). If WE are not going to be part of the solution, then WE are the problem.
I appeal to all of you, let us play our due role as intellectuals & guardians of the overall health of society ; otherwise our children may not forgive us.
P.S.: All this can be done in a non-partisan, apolitical manner ( politics at present in our society is a dirty word & world. Yet somebody has to do the cleaning up ).
“SOCIAL AWAKENING & TRANSFORMATION IN THESE VIOLENT TIMES”
MAHAN RASHTRA NAVNIRMAN !
HOW MEDICAL COMMUNITY CAN PLAY A PRO ACTIVE ROLE?
The subject assumes added significance in the wake of increasing violence against ‘soft’ targets - linguistic group, religious minority ,our own medical community & repeated terror attacks against the country as a whole !
With the elections around the corner – a possible turning point in a mature democracy (Americans once again have shown the way by electing a Black president!), Can WE Doctors lead from the front? How do we go about achieving our objective?
Please SHARE your thoughts, opinions with rest of the medical community thro’ IMAGE & formulate a strategy for National transformation in these times of crisis. We are part of the society (well hospitals are even under attack by terrorists!). If WE are not going to be part of the solution, then WE are the problem.
I appeal to all of you, let us play our due role as intellectuals & guardians of the overall health of society ; otherwise our children may not forgive us.
P.S.: All this can be done in a non-partisan, apolitical manner ( politics at present in our society is a dirty word & world. Yet somebody has to do the cleaning up ).
AN APPEAL FROM EDITOR
The Bulletin of IMA , Mulund has been aptly named “IMAGE”. If we want to have quality IMA magazine , the Image of Mulund IMA, then we must contribute regularly,
· Feedback, Suggestions and Opinions on matters relevant to the medical fraternity & society.
· Summary report of CME’s being conducted for the benefit of one & all
· Interesting case reports / studies
· Reader’s recommendations on books - medical & otherwise.
· Travel experiences with interesting photographs.
· And share Special interests – like one colleague amazed me with his in-depth knowledge of music systems & speakers. It helped me no end !
I personally feel articles in Hindi, Marathi & Gujrati should also be welcome, since all of us are not most comfortable in English. And as someone has put it nicely, Hindi is mother & English is Wife – it is possible to love both equally ! “ Bahu bhi kabhi Saas ho sakti hai – Ekta Kapoor stuff.” In this age of SMS opinions, please voice your opinion to 9821131883 with, “ Language : Yes or No “ with your name please.
I also appeal to you to come forward to join Editorial Team to help produce quality IMA magazine & to form a core group to network with Police, Press, Politicians etc . I would like to form two teams one from each Mulund East & West.
· Feedback, Suggestions and Opinions on matters relevant to the medical fraternity & society.
· Summary report of CME’s being conducted for the benefit of one & all
· Interesting case reports / studies
· Reader’s recommendations on books - medical & otherwise.
· Travel experiences with interesting photographs.
· And share Special interests – like one colleague amazed me with his in-depth knowledge of music systems & speakers. It helped me no end !
I personally feel articles in Hindi, Marathi & Gujrati should also be welcome, since all of us are not most comfortable in English. And as someone has put it nicely, Hindi is mother & English is Wife – it is possible to love both equally ! “ Bahu bhi kabhi Saas ho sakti hai – Ekta Kapoor stuff.” In this age of SMS opinions, please voice your opinion to 9821131883 with, “ Language : Yes or No “ with your name please.
I also appeal to you to come forward to join Editorial Team to help produce quality IMA magazine & to form a core group to network with Police, Press, Politicians etc . I would like to form two teams one from each Mulund East & West.
CABG – WHAT’S NEW ?
Since the first Coronary Artery Bypass Grafting (CABG) performed in the 1960's, the operation has evolved to make surgical treatment of coronary artery disease safer and more durable. I have briefly outlined the three major aspects of CABG which have contributed to excellent results of CABG.
1. "Off-Pump CABG". The advances in CABG were mainly due to the heart-lung machine (cardio-pulmonary bypass) which made it possible to perform surgery on a still (arrested) heart. Despite the availability of latest heart lung machines, this "on-pump" technique is still associated with few morbidities like stroke, renal failure, bleeding and atrial fibrillation. To minimize these morbidities, we have adopted the "off-pump" or "beating heart" CABG. Off-pump CABG (OPCABG) has the following advantages: Decreased incidence of stroke / renal dysfunction / bleeding / atrial fibrillation; Overall length of ICU and hospital stay is reduced; Decreased cost. There is no significant difference in mortality with either technique. The off-pump technique is technically demanding with a steep learning curve and hence not available at all centers.
2. Total Arterial revascularization: Upto the mid 1980's the conduit of choice for bypassing diseased coronary arteries was the saphenous vein. The saphenous vein was easy to harvest, easy to handle with minimal complications to donor site. However, followup studies showed that patency was only about 50% at 10 years. Hence there was a shift to using arterial grafts for CABG. The left Internal mammary artery was proven to be the ideal conduit for grafting with patency exceeding 90% at 10 years. For multivessel grafting, both right and left internal mammary arteries; as well as additional arterial conduits like the radial artery can be used. With experience, the mammary arteries and radial arteries are easy to harvest and handle with excellent long term patency. Arterial grafts have Superior Graft Patency ; Reduced incidence of Myocardial Infarction and Reintervention and Improved Long-term Survival
3. Minimally invasive surgery. CABG can be performed through small incisions in certain patients with good anatomy. The access could be through a small or hemi-sternotomy; or sometimes via a small lateral thoracotomy incision. These approaches have shown to benefit patients in terms of reduced postoperative pain and also quicker discharge. Robotic cardiac surgery is in evolution and we can expect it to be available to our patients in the next few years. Endoscopic approaches have been used to harvest conduits (Saphenous vein and Radial artery). "Hybrid" procedures combining Minimally invasive CABG with angioplasty have been used for enhanced patient satisfaction.
Dr. Jayesh Dhareshwar,
1. "Off-Pump CABG". The advances in CABG were mainly due to the heart-lung machine (cardio-pulmonary bypass) which made it possible to perform surgery on a still (arrested) heart. Despite the availability of latest heart lung machines, this "on-pump" technique is still associated with few morbidities like stroke, renal failure, bleeding and atrial fibrillation. To minimize these morbidities, we have adopted the "off-pump" or "beating heart" CABG. Off-pump CABG (OPCABG) has the following advantages: Decreased incidence of stroke / renal dysfunction / bleeding / atrial fibrillation; Overall length of ICU and hospital stay is reduced; Decreased cost. There is no significant difference in mortality with either technique. The off-pump technique is technically demanding with a steep learning curve and hence not available at all centers.
2. Total Arterial revascularization: Upto the mid 1980's the conduit of choice for bypassing diseased coronary arteries was the saphenous vein. The saphenous vein was easy to harvest, easy to handle with minimal complications to donor site. However, followup studies showed that patency was only about 50% at 10 years. Hence there was a shift to using arterial grafts for CABG. The left Internal mammary artery was proven to be the ideal conduit for grafting with patency exceeding 90% at 10 years. For multivessel grafting, both right and left internal mammary arteries; as well as additional arterial conduits like the radial artery can be used. With experience, the mammary arteries and radial arteries are easy to harvest and handle with excellent long term patency. Arterial grafts have Superior Graft Patency ; Reduced incidence of Myocardial Infarction and Reintervention and Improved Long-term Survival
3. Minimally invasive surgery. CABG can be performed through small incisions in certain patients with good anatomy. The access could be through a small or hemi-sternotomy; or sometimes via a small lateral thoracotomy incision. These approaches have shown to benefit patients in terms of reduced postoperative pain and also quicker discharge. Robotic cardiac surgery is in evolution and we can expect it to be available to our patients in the next few years. Endoscopic approaches have been used to harvest conduits (Saphenous vein and Radial artery). "Hybrid" procedures combining Minimally invasive CABG with angioplasty have been used for enhanced patient satisfaction.
Dr. Jayesh Dhareshwar,
M.Ch (CVTS, AIIMS)
Consultant Cardiac Surgeon
Consultant Cardiac Surgeon
THE REMINISCENT
Editor’s Note : It was a pleasure listening to the history of Mulund, from a senior doctor. He has very interesting tales to tell. Read for yourself.
I started my practice in the year 1950, when Mulund was a village of Thane district and a sizable land was under cultivation. The then population was about fifteen thousand only. Most of them were average middle-class farmers and fishermen, Gujrathis, Kutchchis and Sindhis. Most of them migrated from Karachi.
.
There were very few doctors in Mulund. Most of the patients were depending on home remedies . Paying capacity of the patients was also meager. As there was no facility of pathology and X-ray I used to depend on my clinical examination and treat the patients accordingly. I used to charge the patient eight annas (50 paise) to a rupee. In time of need, I used to refer the patient to the nearest KEM Hospital, Parel.
I was performing various minor surgeries, which included ENT and tooth extraction. At times, I had to manage stab injuries. This was possible due to my surgical training at the Podar Hospital and Haji Bachu Ali Hospital, Parel.
.
I used to make home visit even at dead of night, some times tracking through paddy fields and occasionally encountering snakes. Day visit charges were three rupees. I was in Home Guards as a medical officer for twenty five years and rendered my services during Indo-Chinese war 1962, and Indo-Pakistan wars 1965 and 1971, conducting Civil - Defence first aid classes and night patrolling. .
During my time the family doctor was considered as a family member and relations were cordial. Quite a few criminals were externed to Mulund. However, the externees (Tadi-Par) respected the doctors, when they and their families came for treatment.
.
The development of Mulund actually started after the Brihan Mumbai Municipal corporation (BMC) extended the limits in eastern suburbs upto Mulund and in western suburbs upto Dahisar in the year 1956. When Mulund was merged in BMC the development of roads started. Gradually the tar roads were made. Some of them were renamed from Cown road to Mahatma Gandhi road and from Carter road to Netaji Subhash road. Tap water was made available. Quite a few gardens were developed in the west and east Mulund. A prestigious cultural & sports complex, Kalidas was developed in the west for public use. .
I and my wife, late Dr. MALINI started our hospital on Dassera day in the year 1956. We could provide facilities for major Gynaec. and General surgeries. For normal deliveries, the charges were Rs. 60/- which included stay with food for ten days.
.
At present due to change of time and advent of consumer protection act, the medical fraternity as a whole, has to be very alert to avoid ugly situations and litigations. In my opinion, if group practice is adopted, much of the stress could be relieved ; at the same time updating knowledge should be considered most important.
Dr. Mohan N. Parmar
I started my practice in the year 1950, when Mulund was a village of Thane district and a sizable land was under cultivation. The then population was about fifteen thousand only. Most of them were average middle-class farmers and fishermen, Gujrathis, Kutchchis and Sindhis. Most of them migrated from Karachi.
.
There were very few doctors in Mulund. Most of the patients were depending on home remedies . Paying capacity of the patients was also meager. As there was no facility of pathology and X-ray I used to depend on my clinical examination and treat the patients accordingly. I used to charge the patient eight annas (50 paise) to a rupee. In time of need, I used to refer the patient to the nearest KEM Hospital, Parel.
I was performing various minor surgeries, which included ENT and tooth extraction. At times, I had to manage stab injuries. This was possible due to my surgical training at the Podar Hospital and Haji Bachu Ali Hospital, Parel.
.
I used to make home visit even at dead of night, some times tracking through paddy fields and occasionally encountering snakes. Day visit charges were three rupees. I was in Home Guards as a medical officer for twenty five years and rendered my services during Indo-Chinese war 1962, and Indo-Pakistan wars 1965 and 1971, conducting Civil - Defence first aid classes and night patrolling. .
During my time the family doctor was considered as a family member and relations were cordial. Quite a few criminals were externed to Mulund. However, the externees (Tadi-Par) respected the doctors, when they and their families came for treatment.
.
The development of Mulund actually started after the Brihan Mumbai Municipal corporation (BMC) extended the limits in eastern suburbs upto Mulund and in western suburbs upto Dahisar in the year 1956. When Mulund was merged in BMC the development of roads started. Gradually the tar roads were made. Some of them were renamed from Cown road to Mahatma Gandhi road and from Carter road to Netaji Subhash road. Tap water was made available. Quite a few gardens were developed in the west and east Mulund. A prestigious cultural & sports complex, Kalidas was developed in the west for public use. .
I and my wife, late Dr. MALINI started our hospital on Dassera day in the year 1956. We could provide facilities for major Gynaec. and General surgeries. For normal deliveries, the charges were Rs. 60/- which included stay with food for ten days.
.
At present due to change of time and advent of consumer protection act, the medical fraternity as a whole, has to be very alert to avoid ugly situations and litigations. In my opinion, if group practice is adopted, much of the stress could be relieved ; at the same time updating knowledge should be considered most important.
Dr. Mohan N. Parmar
Bookshelf
Essence: THE PSYCHOLOGY OF ESOTERIC by OSHO
“Unconscious evolution ends with man. Man is the last product of unconscious evolution. With man, conscious evolution begins (only in those who choose to begin).” “Only in aloneness, enlightenment can be attained.”
Only a Master like Osho can utter such words. It requires courage to be alone. Meditation means living non-linguistically. It’s pointed out that mind has an automatic ability to verbalize anything & everything. And the first requirement towards a meditative mind is to be aware about it and to be able to stop verbalizing every experience. Consciousness and existence are beyond the language.
“Spiritual learning can not come from words but from the gaps.” Osho’s teaching is to help us see the gaps to understand that ‘life energy’ is one, it is neutral. It can be sexual. It can be spiritual. Then it makes profound sense for us in not creating a dichotomy for or against sex and sees it as simply biological energy force. Time and again, Osho’s emphasis is on transcending it and not in suppressing it. In order to do that, one has to move into it with awareness, witness it…and witnessing liberates!
Explaining “Kundalini”, he states that ordinarily, energy moves from centre towards periphery, where as in Kundalini it moves from the periphery towards the centre. Ordinarily, sex is the only non-verbal natural experience we are aware of. Osho guides us into another- Meditation. Becoming aware, practicing mindfulness, using breathing as the door to the mind instead of using thought opens newer dimensions.
In his commentary on the “Dreams”, he de-mystifies one of the greatest esoteric realms known to man. While explaining the intricacies of seven types of dreams and seven types of realities- kind of penetrating one another, he invites man to feel the body from within as the first step in the journey of transcendence. Fighting with desire creates ‘desire’ against desires. Osho’s emphasis is on meditation and not on knowledge as he believes that ‘the knowing mind’ is a hindrance. A stuffed mind is bound to remain ignorant. Truth is revealed the moment knowledge ceases. The essence is that life is always from the unknown towards the unknown.
“Sat-Chit-Anand” or “Existence-Consciousness-Bliss” is the pointer towards the boundary beyond which there is only divine silence. Experiencing of the divine is explained through the 3 windows of “truth”, “goodness”, and “beauty” he elaborates upon the 3 dimensions belonging to the human mind- the intellectual (truth), the emotional (beauty) and action (goodness or karma)- the eternal wisdom of “Satyam-Shivam-Sundram”. The master puts lot of importance into the process of “Right questioning” and asks not to ask certain questions- the theoretical, philosophical & metaphysical questions- come into the said category as they solve less and confuse more.
You can not grow unless you grow totally seems to be the master’s message to his disciples on the path of journey.
Dr. Amit Ghatalia
( 9869453148 )
“Unconscious evolution ends with man. Man is the last product of unconscious evolution. With man, conscious evolution begins (only in those who choose to begin).” “Only in aloneness, enlightenment can be attained.”
Only a Master like Osho can utter such words. It requires courage to be alone. Meditation means living non-linguistically. It’s pointed out that mind has an automatic ability to verbalize anything & everything. And the first requirement towards a meditative mind is to be aware about it and to be able to stop verbalizing every experience. Consciousness and existence are beyond the language.
“Spiritual learning can not come from words but from the gaps.” Osho’s teaching is to help us see the gaps to understand that ‘life energy’ is one, it is neutral. It can be sexual. It can be spiritual. Then it makes profound sense for us in not creating a dichotomy for or against sex and sees it as simply biological energy force. Time and again, Osho’s emphasis is on transcending it and not in suppressing it. In order to do that, one has to move into it with awareness, witness it…and witnessing liberates!
Explaining “Kundalini”, he states that ordinarily, energy moves from centre towards periphery, where as in Kundalini it moves from the periphery towards the centre. Ordinarily, sex is the only non-verbal natural experience we are aware of. Osho guides us into another- Meditation. Becoming aware, practicing mindfulness, using breathing as the door to the mind instead of using thought opens newer dimensions.
In his commentary on the “Dreams”, he de-mystifies one of the greatest esoteric realms known to man. While explaining the intricacies of seven types of dreams and seven types of realities- kind of penetrating one another, he invites man to feel the body from within as the first step in the journey of transcendence. Fighting with desire creates ‘desire’ against desires. Osho’s emphasis is on meditation and not on knowledge as he believes that ‘the knowing mind’ is a hindrance. A stuffed mind is bound to remain ignorant. Truth is revealed the moment knowledge ceases. The essence is that life is always from the unknown towards the unknown.
“Sat-Chit-Anand” or “Existence-Consciousness-Bliss” is the pointer towards the boundary beyond which there is only divine silence. Experiencing of the divine is explained through the 3 windows of “truth”, “goodness”, and “beauty” he elaborates upon the 3 dimensions belonging to the human mind- the intellectual (truth), the emotional (beauty) and action (goodness or karma)- the eternal wisdom of “Satyam-Shivam-Sundram”. The master puts lot of importance into the process of “Right questioning” and asks not to ask certain questions- the theoretical, philosophical & metaphysical questions- come into the said category as they solve less and confuse more.
You can not grow unless you grow totally seems to be the master’s message to his disciples on the path of journey.
Dr. Amit Ghatalia
( 9869453148 )
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