TALES OF TRAVESTY
By DR. JITENDRA SINGH
Worst ever vacuum in Opposition!

It is a strange concidence... perhaps unique of its kind that even as the respective ruling parties both at New Delhi and J&K donot individually enjoy absolute majority, they still hardly face any political challenge from their respective opposition groups. The Congress party at the Centre and the National Conference in the State appear to be atleast for the time being in an absolute commanding position despite their continuing inner factionalism and the credit for this goes to the worst-ever vacuum in Opposition witnessed both in the Parliament in New Delhi and the State Legislature in Jammu and Kashmir even though the main opposition party namely the Bharatiya Janata Party (BJP) has a formidable number in the Lok Sabha and the highest ever tally of 11 in the J&K Assembly.

The results from the recently held Assembly polls in Maharashtra and Haryana indicate that despite repeated beating at the hustings in recent months, the non-Congress parties both at the Centre as well as in the States have so far failed to get their act together. And, if on each occasion, the Congress is successful to get the better of its opponents, it is primarily less of a Congress feat and more of a non-Congress defeat because the non-Congress parties including the BJP are miserably unable to offer the voter the hope of a better or even a viable alternative. Added to this is the tragedy of parties like BJP being governed by too many heads even at highest level while the Congress ranks, rightly or wrongly, enjoy the advantage of avoiding suffering from confusion due to unquestioned writ of Sonia Gandhi whose command is the last word. Seeing the BJP mess in Karnataka, for example, one wonders how it would have handled Andhra if it was in power there and its chief minister like YSR Reddy had suddenly died in a crash followed by a clamour to instal YSR's son which was promptly put to a stop with a simple frown from Sonia Gandhi.

This certainly does not endorse the dictatorial high command culture prevailing in the Congress party but it does bring into sharp focus a moribund erosion of high command's authority in the BJP where every leader is unto himself. The result of this predicament is that a host of larger issues of national and public importance are passing off undiscussed, undebated and unopposed with the Congress-led government taking self-righteous decisions and the opposition parties too busy with their internal issues to make any corrective interventions.

Gone are the days when the common man could be taken for granted without repurcussions. In the emerging electoral milieu, the ruling party that fails to deliver is liable to be thrown into opposition and the opposition party that fails to conduct itself is liable to be thrown into a protracted wilderness. For Umapathy is today much more awakened about his democratic rights as well as the means to assert these rights, a La, ‘‘Main Chaman Mein Chahe Jahan Rahoon, Mera Hak Hai Fasl-e-Bahaar Pe’’.

Doctor - Patient relationship

By Dr Vikas Jamwal

Though society still accords the medical profession a fair degree of respect and considers it somewhat different from other professions, the disturbing trends of physical and verbal abuse of doctors, nurses and other Para-medical staff has become a growing concern for hospitals. This is unhealthy both for the profession as well as for the patients. The number of complaints against hospitals, clinics and individual doctors are on the rise for last many years. The quality of the patient care is important for both. The sanctity of such a relationship not only safe guards the interest of the patient, but assumes a doctor taking all responsibility for providing health care. The better the relationship in terms of mutual respect, trust, shared values and perspectives about disease and life, and time available, the better will be the amount of quality care and satisfaction of treating the patients. Where such a relationship is poor, the physician's ability to make a full assessment is compromised and the patient is more likely to distrust the diagnosis and proposed treatment. This relationship is a nucleus to the practice of medicine and is essential for the delivery of high-quality health care in the diagnosis and treatment of diseases.

This is the only relationship which stands above all relations in every discipline. A patient must have confidence in the competence of his doctor and must feel that he can confide in him. Most medical institutions do not have an effective teaching program to teach medical students from the beginning, before they start applying their skills in its practical form, to maintain a professional rapport with patients. Many believe the introduction of technology has changed the image of the doctor for the patient. The emergence of revolutionary advancements in pathology and radiology have lessened the art and interest of patient's examination and counseling. There is possible link for lack of communication and professional bonding. Listening to the patient is very important factor even if the diagnosis is written on his face. This is one of the failings which a doctor should avoid as this would leave the patient dissatisfied. After his clinical examination and required investigations, the doctor should spend time in analyzing his problems and come to a tentative diagnosis depending upon the situation.

Earlier a family physician not only mastered the full knowledge of anatomy and physiology but also of psychology as it often offers vital clues to the patient's condition and further management. The general practitioner is considered a member of the family by many. His counseling and advice are sought on all matters pertaining to health and sickness.

The patient has every right to terminate a relationship with his doctor at any time and seek the help of another. On the other hand a reciprocal right rests on the doctor to do. The trend of shopping for opinions or therapy mainly in well educated and resourceful sections of the society is another common practice for those who suffer from "VIP Syndrome". Since the patient is consulting more than one expert, each of whom is in ignorance of what the other is doing, and at the end of the day no one will accept responsibility in the event of any mishap. Multiple medical opinions breed confusion and harm the patient's interest as in such cases the patient moves from doctor to doctor, clinic to hospital, amassing a stack of documents which, at times, contain conflicting views and suggestions. Often, the new consultant orders repetition of tests that have just been performed, at another specified centre, for non- scientific reasons. Patients are also deflected to practitioners of alternative systems of health care and end up in total confusion, unable to choose between the many options offered. By trusting no one, they have destroyed the basis of faith. It is not uncommon for the patient to spend huge sums without receiving any relevant or effective care and when the illness has worsened to a critical state, he is sent off to a public teaching hospital 'for further treatment and management'.

Another issue of professional rivalries, prestige or tendency to hold on the patients longer than required time barred many doctors, either in the private or public sector, to refer patients to another doctor for taking expert opinion. The reluctance to part with a patient who represents a source of considerable income is not surprising? Worse, is commercialization of medicine because of various reasons, particularly the high cost technology, and the general societal trend of consumerism has certainly affected doctors as well. The situation gets somewhat complex when the patient has already undergone any treatment or procedure at the hands of another doctor who now refuses to refer him to another for a second opinion.

On the other hand the patient must understand that medical science is a biological subject and lots of decisions are made on the basis of experience and personal judgments and therefore certain things cannot be fully explained or predicted and should share the risk and responsibility involved in. The patient has full liberty to choose his doctor or the hospital carefully and with awareness. Having done this, full trust and faith should be restored by extending full co-operation with his attending doctor by providing full information about his illness, past history of any treatment and all the relevant social and family background. Before undergoing any intervention, one should read the consent for any procedure, and try to understand its implications and ask for clarifications, it required. In short a doctor should not look at his patient as a bundle of complaints and in return a patient should look at his doctor with 100% guarantee of cure but should understand the limitations both of the doctor as well as of medical sciences.

The crux of the problem is the missing civilized culture in hospitals as the physical and verbal attacks on hospital staff are more common than one might realize and in many cases the perpetrators of violence are not accounted for their actions, this medical fraternity believes does not make it justifiable or acceptable.

The violence in emergency departments is on the increase mainly driven in part by lack of resources, drugs, shortage of equipments and trained staff. Occurring mostly on odd hours and late at night when junior staff is at their most vulnerable. As already stated the physical and verbal abuse of resident doctors, nurses and other helping staff has become a growing concern for hospitals.

Now time has come to frame a policy decision to declare violent attacks on hospital staff a non bail able offence and with the victim's consent, a hospital should report every incident of assault or threat of assault to the police. The legal counsel or law officer on behalf of victim can also get involved to frame the charges for its legal proceedings to book the culprits.

"I am doing nothing"

By Arvind Gigoo

I dialled the number.

"Hello!"

It was my four-year- old granddaughter.

"Hello, Amia, what are you doing?"

"Dadu, I am doing nothing."

Doing nothing is the acme of wisdom.

Silence prevailed upon words. I kept the phone.

People do because doing means living. They are dynamic and hardworking, and are busy in doing for their families, the society and the world.

"I am not greedy or ambitious. But the people whom I know and don't know have sped ahead of me. I do not want to sit behind. I crave for recognition and superior position."

"Do you watch the full moon and the stars and the clouds and the sunset?"

"The skyscrapers block the view. Have you seen the drawing room of the Malhotras? They have two more flats. And their new car! It is very expensive."

Dear reader, I will digress.

Eating is a ridiculous activity. The unmistakable rapport and the perfect friendship of the hand and the mouth keep us alive and are the basis of life. And we do for remaining alive. We race against others and climb the ladders to accumulate wealth. We doom ourselves into doing, into exhibitionism, into show. We speed for we are in haste.

"Damn others, I want my buck. I will do for twenty years and then live."

"So you will live in twenty years!?"

(Amia had said: I am doing nothing.)

Sitting still is doing nothing or doing nothing is the cessation of all actions--- of the speed and the climb.

Doing is evil, curse, trouble, unhappiness. It is un-living or not-living.

He said: "Perform duty without thinking of the fruit."

Performing duty is attending to the ordinary and the commonplace. Doing breeds endless desires.

"Why shouldn't I desire the fruit of my doing? I want to prove myself."

Doing is "enjoying" illicit sex. When doing is in the process of doing souls and being get defiled.

Doers, stop doing.

As for me while doing i- don't- know - what I talked much and spoke nothing. Do nothing and talk nothing. Not-doing and silence are inaction- -- I mean in-action. What man needs is nothing. No-thing. Evil will disappear. The inside will flower. Your mind is curse. If you say 'no' to whatever 'is', you will stop doing and start living. It takes a flash to stop doing.

Doing is undoing the you in you.

Do and suffer.

Don't do and live.

When I stopped writing the telephone bell rang.

"Hello!"

It was my sixty-year-old friend.

"What are you doing?"

"I am doing nothing, ''said I.

"You fool, stop this nonsense. Dress up, come out and live."

I am the contradiction. I am the clever rascal. I am the evil-doer. I dangle between not-doing and doing. I live in silence and speech.

 Indo-China relations

By Brij Bhardwaj

Indo-Chinese relations touched a new low during the Dalai Lama visit to Arunachal Pradesh which included a visit to Twang monastery, the place where Dalai Lama had taken shelter when he was forced to flee Tibet after the Chinese occupation and thus turning the autonomous region of China into a Chinese province.

The presence of Dalai Lama in Twang and the grand welcome accorded to him upset the Chinese rulers is understandable as it was one more proof if any was required that China has yet to come to terms with its minority population in different regions of China particularly Tibet which saw a fresh uprising on the eve of Olympics staged in China as a showpiece to the world indicating the rise of China as a world power.

The Chinese in their forward march clearly consider India as a major challenge both in terms of its economic growth and a major power in South-East Asia. The Chinese hostility to India or their worries on this account are normally well concealed as the two countries under compulsion sometime and sometime in their own interest have no option but to cooperate when faced with the challenge from affluent nations of the West. They also have to keep in mind that too despite unsettled border issue and irritants like the presence of Dalai Lama in India along with his followers have strong economic ties which are growing every day and two have a booming trade.

Chinese who have been raising the pitch through frequent references to status of Arunachal Pradesh, denying visas to people belonging to that state and issuing visas to residents of Jammu and Kashmir separately instead of stamping the same on passports and frequent border incursions have created serious doubts in the Indian minds about the Chinese intentions. The Indian Government has been generally downplaying the rising tension between the two countries, but had no option but to stand firm when the Chinese wanted it to stop Dalai Lama from visiting Arunachal Pradesh.

The Chinese reaction to the visit to say the least has gone beyond the norms that are followed between two countries having friendly relations. The Chinese newspaper comments that India has forgotten the lessons of 1962 war was highly provocative. The Chinese need to remember that they have faced many more humiliations in their past and history never repeats itself. Since 1962 much water has flown down the Himalayan glaciers and the world has changed.

The prospects of any country resorting to use of force to settle a border dispute are rather remote and not an option. More so when two countries have a nuclear arsenal at their command. China may be far ahead as far as the respective strength of two armed forces is concerned, but India is no walk over as was the case in 1962. More over the two countries are also leaders in fighting world-wide economic recession being in the lead in terms of growth and returning to stable growth period.

As part of growing powers, the two countries are marching ahead and one can look at future when two can take their place in the world as engines of economic growth besides being two with largest population in the world. There is need to bring about some kind of realism in dealing with border issues including the Tibet problem. China has to recognize that it has to blame its own policies and people if unrest still persists in Tibet region of China even though Dalai Lama has been in exile for several decades. He continues to be a symbol of aspirations of Tibetan people and large scale investment by China in Tibet in terms of bringing modern world symbols like a train connection, industry and settling many outsiders have made no difference to the ground situation in Tibet where hostility to Chinese rule persists.

On the other hand people in Arunachal Pradesh have freely expressed their support for being a part of India as reflected in the elections held recently in the State by turning out in large numbers to take part in the democratic exercise. The welcome accorded to Dalai Lama was also historic and further endorsement of the Indian stand. The problem of the border region is an offshoot of Chinese problems with Tibet. The border has been defined in terms of agreement with Tibetan Government at that time in the presence of Chinese representative, though not endorsed by them.

There were many in India who did not agree with the Government of India when they agreed to Tibet being part of China. The Chinese Government on the other hand took a stand that all agreements endorsed by Tibetan Government were not valid. So a goodwill gesture by India has come back to haunt India. A time has come to tell China even if the old agreements have to be negotiated again there can be no question of disturbing the settled populations as otherwise they should be ready to reopen the question of status of Tibet also and seriously consider it as an autonomous region and a party to border dispute as the border is between India and Tibet and not India and China.