Swagat Varanasi

Assi Ghat, Varanasi

Varanasi is the oldest living city situated on the banks of the Ganga River. It is one of the oldest cities in the world, dating to about 1200 BCE of continual inhabitance. It is also one of the only cities on the Ganges where the river flows south to north. It is cradled around the tributary rivers of the Varuna and the Asi traveling into mother Ganga.

A city of many names over many millenia, Kashi is the abode of Lord Shiva and a great center of learning, music, religions, and textiles. It is the place where Lord Buddha acquired spiritual enlightenment, where Sant Tulsi Das wrote the Ramcharit Manas, where Adiguru Shankaracharya received the knowledge of Brahma, where maharishi (maha=great, rishi=seer) physicians studying under Charaka wrote the primary textbook of Ayurvedic Medicine, where alchemy was perfected by Nagarjuna and colleagues, and where Sushruta, the true father of surgery, developed and practiced various surgical procedures. Benaras is also famous for the world’s best silk sarees, carpets and a pageantry of culture and arts.

Banaras Hindu University, known in Hindi as Kashi Hindu Mahavidyalaya, is the largest campus University of India and of Asia. Founded in 1916 by the great visionary Pt. MadanMohan Malviya, it imparts teaching in almost all branches of Science, Technology and Humanity through 3 institutes, 14 faculties and 140 departments. Currently, it has 1300 teachers and 18,000 students.  BHU is the Cambridge/Oxford/Harvard/Stanford of India, but it is the only world-class University that has a devoted Faculty studying the oldest knowledge that mankind has produced on medicine.

After arriving on a flight with the little drama of a brake failure, we land safely and step into the shiny new airport of Varanasi (VNS). Some political candidate must have built this before his elections.   I make my way quickly to the hotel, drop my bags and run to the campus, intent to register in the month of July for classes that begin on August 1.  I am greeted first by Mr. LB Patel at the International Centre and then by Dr. Jha and taken to an impromptu MD-Ayurveda graduation ceremony, where I am asked in Hindi to make my first speech.  The year has begun.

Arrival

Barakhamba Road,
Connaught Place, New Delhi

Delhi receives me gracefully.  I arrive with no complications on Air India, my airline of choice. A non-stop 15-hour flight of 3 films, some audiobooks, some work on the computer, 3 meals, some dozing, and I am in India.  A friend close to the diplomatic corps has carried a piece of luggage for me and meets me at baggage claim.  We leave the airport, he in his VIP car, and me in the Fulbright van.  The Fulbright guesthouse has flooded in the rains, so I will be staying at a hotel.

A day later, I am at the Fulbright campus, tucked away neatly on a street facing one of the spokes of Connaught Place. The orientation is a packet, some conversation, some fact-checking about me. Then I run off to the US Embassy for a tour, and a presentation on how to stay safe in India.  I comment that his hints are true for any city. The fear factor and paranoia of the rich is apparent in his talk.

The thesis of the presentation is that Americans are thought to have more, so people will try to steal from them/us.  I wonder if the police officer knows that a 1000 sq. ft. apartment in Delhi starts at INR20,000,000, which is about $333,000. I wonder if he knows that there are more millionaires in Bombay than in any American city.  Anyway, it is true:  Americans are perceived as rich to Indians.  Some of this is because we don’t hide our wealth. As a society, we leave our valuables on display in our homes, and we wear our nice jewelry on the streets to show our status, and we travel with lots of stuff.  This makes us look wealthy. 

What makes us wealthy, really, is that we have the freedom to think and to explore. We can study what we want. We can travel. We can talk with people of other creeds easily. We can even sleep with them, marry them. We can do business as we please, stealing from the world without much consequence.  As Americans, we are assured that we can make mistakes on our bodies and have society pick up after us, in the form of medical insurance. We can make mistakes and explore our own dim-wittedness with little consequence.  But what really makes us wealthy is that we have the freedom to make our dreams come true, once we find them. 

So, I sit and listen to the officer quietly as he drones on about the dangers of Indians and hands me an emergency card to flash in case of danger. At the end, I politely exit the locked room and follow him out.  He cares for my safety: that is the main message I choose to take.

As I leave the grounds, I notice that the US Embassy has encroached on a huge amount of land in the prime real estate of Delhi. I wonder what their rent is for these hectares, all behind tall walls.  There is a huge fountain, fancy grounds, lots of walkways and buildings. 

Next stop: a meeting with the Executive Director of the India Fulbright program. A fellow grad of UPenn, I meet Adam an hour late due to traffic and Embassy timings. He lived in India during college and learned tabla in Varanasi. He is very good friends with one of my good friends. He is deeply devoted to higher education and cultural exchange.  He loves Delhi life.  We chat and I share with him about Ayurveda and my goals for the upcoming year.   He likes to know each of the awardees. I am sure I will see him again. With that, the India briefing is done and I go back to my room. 

Professor Jha calls to welcome me to India. He is the Dean of the Faculty of Ayurveda at BHU. He brings greetings from another Dean at a school in Delhi and a Principal from Bangalore, both good friends of mine. Jha has seen the articles which have suddenly appeared in all the newspapers on Sunday and Monday about my arrival at BHU. His warmth and enthusiasm light up my jet-lagged heart. 

The Doctor is

The Doctor is  In  Out

Lexington Avenue, Manhattan
New York, NY

Closing down the clinic space in New York has been a big decision. The space has been the home of healing a thousand souls. But, for their sake, and for the sake of future patients that will come hopefully, upon my return to New York, I must take a break, to heal my own soul.

People can see it. Occasionally, patients exhibit the audacity to mention it. The good doctor looks unfit. Weight gain. Hair loss. Imperfect skin.  While many doctors my age look this way, I know I have a different challenge.  Ayurveda must prove to me its validity through its work on me.  I want to learn the deep lessons and then transparently show them through the laboratory that is my body.  To do this, I have to leave the stress of running a private practice, a school, two households and a clinic space that costs me $2500 a month, entertaining countless visitors, writing two books, having no time for my relationships, and running all the errands that are required to clean out my life and keep it clean. The time for exercise, fresh food, and routines is deferred on many days.  Admittedly, I love the fast lane. But it is making me wilt.

It has been decided that the clinic furniture will be put into storage. I look around, and talk to my chief counsel, my power attorney, quick-thinking, sharp, and straightforward.  She is also my sister.  “Pay it forward,” she says. “Give it to the Universe and allow it to come back to you in another form.  The clinic’s value is not the couch, the cabinets, the heavy furniture. The value is in the faith of the patients, the invaluable collection of books, the herbs, the knowledge. Let the rest go back to the Universe.”  I wistfully agree to return the material wealth to the Universe and give away as much as I can. My tendencies to collect and hoard are facing a welcome challenge.

A few pieces go to use by friends and students. The books cannot be disrespected by putting them in the dead space of storage: they go to the willing bookshelves of students who will enjoy them.  The herbs come to my home apartment, which bulges with fullness. All else goes to storage.  After three weeks of packing and cleaning, the clinic closes on July 15.

A doctor colleague asks me the next day if I would like to share a clinic with him in Manhattan upon my return. Somewhere in the same area. Am I interested?  I smile. The Universe is responding. Onward and upward. 

Pigtails and Parinama^

July 8, 2013.

Now that the Universe – and the F* Board – has agreed the project on Ojas is worth funding, I have a budding inner girl jumping up and down, pigtails and wide grin, bursting with an excitement that a mature physician-scientist must never show. 

Those of us who manage to keep our minds young know we hold great secrets. One secret is that we are just children trapped in bigger bodies. We have learned how to position the 43 muscles in our faces to get our way (known as authority) by moving them subtly.

I suspect I will finally get to mother the little girl that was pushed to achieve because I could do the work of American 7-year olds when I was four.  She wants time to tell me all the things she learned while I was tied to books and backpacks. 

India rips our veils and exposes our soul: it shatters some, and is heart-opening for others. I know it will smash many walls of my adult self and expose parts of me I suppressed in order to survive the life of a self-reliant physician. 

That little girl is the ever-curious, benevolent sweet one that guides the research. She teaches students from a space of knowing what it means to not know. She is the winner of the Fulbright. My adult body will write the reports, monitor what good work is, and make it all come together, not just for my discipline, and several fields interested in immunity, public health and medicine, but also for my patients. But the little girl is really the one who will do the work of unearthing knowledge from the deep corners of Ayurveda; she is ready to show me what I can do when I finally spend some time with her.

^ Parinama is a Sanskrit term. In Ayurveda, it means the changes with time and season.

Inner Compass

July 1, 2013

New York, NY

Life is more difficult when we are forced by the inner compass of integrity and truth demanded by the Hippocratic Oath.

Today’s physicians do what the others do, because they can, …. and because it pays for their lifestyle.  Am I cynical? I have seen this with thousands of physician colleagues, and openly challenge any MDs to complete their patient advocacy scorecard.  Even the 20 celebrity physicians I know.  Or those from or at the best schools.

The issues are time and patience. Cardiologist colleagues quickly recommend angioplasty, rather than Dean Ornish’s medically-proven diet and lifestyle reversal of heart disease. One tells me he is heart-broken at what he has to do, but has worked hard for his chairmanship. He has to do procedures to keep the numbers up, for the rating of the department.  

Gynecology colleagues do coloscopy but throw in a cone biopsy “just to be sure,” rather than use vigilance and patience to watch clinical symptoms or consider the risk factors for infection from having an open wound for 4-6 weeks in the cervix.  One blindly tells me that she must follow the standard of care, else her practice colleagues will discontinue her from the practice. 

Of course, oncology colleagues insist on chemotherapy even when they have not a clue about maintaining the health of the healthy tissue surrounding the cancer. One tells me he only does what the literature recommends. 

My obstetrician colleagues do too many ultrasounds, too many cesarean sections, too little observation. They says it is a game of time management.  My friends blame it on “the system:” not enough time to see patients, ridiculous rates of payment for thankless, heart-wrenching work, and little support from administration, nurses, or those who “support” the system.

Their own unwellness is the source of this, Ayurveda suggests. When a physician is not healthy and clearly connected in mind, body, senses and soul, s/he will make decisions about others that are not of the highest use to the patient. 

Thus begins the journey to explore what Ayurveda prescribes:  how do I make myself healthier, stronger, more clear, so that I can serve my patients more fully?