BKD

औंसीको रात

सुराहीबाट ज्योति चम्की रहेछ

कसैको साथ खोजी रहेको छ

नडराउ नडराउ

जीवन संघर्षमय

I was depressed (both physically and mentally) at one point of my life. Everyone has. Some know that they are depressed, while some don't. It takes a lot of courage to accept what's happening around you. And it takes even lot of courage to ask for help. I did. But not everyone will.

When you are drained emotionally, it shakes you to the very core of your body. You feel like everything is going out of your hand. It feels like you are alone in the whole world. Nobody wants you, nobody needs you and nobody cares about you. Things escalate pretty quicky. You go downhill at an extraordinary speed. And the most scary part is you know what your end is when you hit rock bottom but you can't stop yourself from falling. And mostly you feel like there is no way out of it.

But there is always a way out. There is always a rescue.

Being medical doctor myself, I always have learned to 'shout for help' in situations. Well it might not be that easy to take the decision to 'call for help' when you are mentally and emotionally drained but believe me when you do, you stopped yourself from falling. That's step 1. It is never 'not ok' to call for help. You will not be less of a man when you ask for help. Even though you feel that there is noone who cares about you, you are wrong my friend. There are people who want you in their life, who care about you. Give yourself a moment. It is ok to share your fear, anxiety, to your family and friend. It is ok to see your physiatrist, it is ok to speak with your psychologist. It is OK to CALL FOR HELP!

I survived, many have. It is not easy but believe me at the end of the tunnel there is light. You are strong. Be gentle to yourself and to others. Be kind and humble to everyone. Always ask yourself, "are you allright?". Always ask others, "Are you allright?".

Life is full of ups and down. It is very hard to bounce back from a fall but you got to try. It is difficult to let go of things. It is difficult to forget someone. It is difficult to care about someone. But in the end, life will always find a way and if you give it a chance, it will always win.

I was on my 5th day of my 5 days long, 10 hours shift in the emergency department. I was already tired at the beginning of my shift. It was 2330 hours. Just 30 minutes before my shift’s over. I was waiting for a CT abdomen pelvis scan result on one of my patient. I clicked on the investigation tab to see if the reports were back. Yes! there it was. I clicked on it. I read the result and I bleeped the Medicine duty on call doctor. I read the result to him and I said that my patient will likely need to come for her further management. He agreed. Just before we hung up, he said, “Does the patient know about the scan results?”. I said, “No, not yet, I will let her know”. He said, “thanks”. We both hung up. I took a deep sigh. 

Out of all the task I do as a doctor, one of the most difficult task is to “break bad news” to patients, which I was about to do in a while. I was about to see her for the first time as I was handed over her care to me by one of the doctor who finished at 2200 hours. She was in cubicle 6. As I approached to the cubicle, I saw her. She was laying on her right side, wearing a lovely pink night gown. She was small in built and a bit thin as well. She was 75. I went close to her, I called her name. She was probably taking a nap, she opened her eyes. She looked at me. I smiled at her and I introduced myself. I began to ask if she knew what was happening with her? She said, “well I had a scan of my tummy and I am waiting for the results”. I said, “that’s true, but do you know why are you here today? In the A/E department?” She paused a bit, felt a bit confused. I came to her rescue and said the reason why she was there. She remembered. She was diagnosed with lung cancer recently. She was under treatment for it but she had some side effects to the treatment and had to stop the treatment since past few weeks. Since then she has been feeling unwell. Her appetite has been decreasing, she is not eating and drinking well, been feeling lethargic, has been vomiting and unable to cope at home. She lived alone and had her daughter come in to her home to help her with groceries and other bits and bobs. Her daughter called the ambulance today as she thought her mum was not coping well at home. She was hypotensive with the ambulance crew and a bit tachycardic as well. She was mildly dehydrated. It was evident that she had something going on, something both medical and/or a surgical problem. Thus, we decided to do bloods and scan her abdomen and pelvis as she had a huge ascites (abnormal fluid accumulation in the abdomen). 

Her scan results showed that her lung cancer had spread to the abdomen, to her liver, to her adrenal gland on right side and also to her bones. I was about to shock her and probably rip her off any hopes she might have been cherishing to survive out of this cancer. I pulled the curtains around the cubicle. I lowered my self to her face. My voice slowly turning low. I grabbed her right hand. I began to utter slowly, “I am here to discuss about your scan result. If it is all right with you?” And at that point she must have realized that something is bad. I could see it in her eyes. Her pupils dilated, she tried to make herself comfortable in the bed and she faced straight at my face. She said, “yes”. I began to tell her the horrible news, that her cancer has now spread to multiple sites. I took as much pause as possible and I tried to be as clear as possible. It is one of the hardest  task, where I need to step in my patient’s shoe and try to make them feel comfortable and cared and supported while I bombard them with the worst possible news in the most polite and graceful way as possible. As I said to her, “unfortunately, it seems that the cancer in your lung has spread to your abdomen”, she stopped me and said, “so is there no hope then?” This was the tough part, where as a doctor you want to show hope to your patient and at the same time show the realities of the bitter world. To tell them that they got cheated by life. I said, “as with any cancer, Love, once it spreads to other part of the body, it is very hard to contain it and to eradicate it. Unfortunately, it will spread and progress with time”. She blinked slowly and looked away from me. I was still holding her hand and gently stroking it. I can now see tears in her eyes as if I am able to see my own reflection on her eyes filled with tear. I placed my hand over her forehead and I said, “I am sorry, I had to tell you this terrible news”. I further added, “I know it is hard, but you will not be alone, we will help you and support you in all and every possible way we can”. She blinked again. Blinked again as if she did not want the tears to roll down over her face. There was a brief moment of pause. I asked if there is anything she wants. She grabbed my hand and squeezed it tightly and said, “do not worry about me doctor, I lived a happy life. But I do not like pain, can you make me comfortable, with no pain?” I said, “absolutely, we will support you in every way possible, you do not need to worry about it. We will involve all your doctors and we will come up with a plan. You are not alone, we are here for you”. It nearly broke me in tears when she said to not to worry about her because I was genuinely worrying about her. I saw her and I saw my grandmother, my mother. I have no words to describe the sadness I was going through. I nearly had a 10-15 min conversation with her. Just before I left her, she grabbed my face and gently caressed me like my mother and my grandmother. She said, “thank you doctor, you have been so kind, thank you for all the things you have done, thank you”.  It is like this events that you realize that you are so privileged to be a doctor, to come close to someone’s heart and emotion that you forget and later realize that you overstayed your duty hours, just to be with the patient you love and care so much. Just to provide them the tender loving care you would to your loved ones. 

In the august of infinite darkness,

Lies a small blue and white marvel,

Which harbours the life we know of,

The hopes and the humanity we're proud of,

So vulnerable and so isolated, yet,

So brutally IGNORED!

-bkd

This ia one of the first picture taken from the Apollo 8 crew in 1968.

Guru

This Guru Purnima I would like to begin my thoughts about guru with this sloka:

षडङ्गादिवेदो मुखे शास्त्रविद्या कवित्वादि गद्यं सुपद्यं करोति

गुरोरङ्घ्रिपद्मे मनश्र्चेन लग्नं ततः किं ततः किं ततः किं ततः किं

This sloka is from the Guru Astakam which was written by Adi Shankaracharya (a sage and philosopher of ancient time). It is a Sanskrit’s sloka and it translates:

Even though you know every scripts from Vedas and all the science in this world, and even though you compose and recite great poetries, what’s its value if you don’t commit your soul and heart to your guru’s lotus feet?

It tells you the importance of presence of guru in one’s life.

Guru is about being in a committed relationship with an unknown matter without any return, (the kind of matter which can never be described, never be measured, never be created and never be destroyed, it is just there!).

And the true sishya (follower) is the one who does his Karma and ask no return, but entangles in his guru’s spiritual bliss, the kind of bliss that one can only experience. These experiences are so blissful that you, for a brief period of time get lost to a place you don’t know. And this experiences are brief (brief as in millisecond) but unforgettable (unforgettable as in lifetime).

To my first guru, my mum and my dad.

Be it the gentle touch of my mother’s hand over my head when I lay on her lap, eyes closed, after my evening shift or be it the voice of my proud father when I close my eyes and bow down to his feet and seek his blessings, these are cosmic experiences for me and like always they are for a brief millisecond but unforgettable throughout my lifetime. As said earlier, being with your guru, all you receive is his blessing. And all you do is experience his blessing. I see everything in them.

And to all the guru who I have been privileged to meet and learn, Namaste to you all and Thank you for everything.

-bkd

I still remember she said to me one day, "Doctor, I have diabetes, asthma, if I catch COVID, I might die".

I cannot believe that she is no longer with us today. She died peacefully on her bed today. She was a humble being. I have known her only for 8 months but I know she was a good human soul. She was polite, kind and caring. She was fair and she was true.

I still hear her voice in my head, saing, "Doctor!".

May you find peace where ever you are and may you shine over us always.

We will miss having you in A/E.

Universe is a mysterious place. They communicate in words we can't listen. They bend space and time in ways we are still unaware of. And even in the august of this beautiful creation lies silence and darkness we can never explain.

But, we must try to understand it. Understand the darkness and silence within it, for which it is our purpose here. And try to reach an ambience of tranquility in it's silence and darkness because like author Hellen Keller said, "everything has it's wonder, even darkness and silence. And I learn, whatever state I may be in, therein to be content."

(In memory of The Fish)

जुपिको संझना

"ईश्वर तैंले रचेर फेरी कसरी बिगारीस् ?

सृष्टिको फुल रोपेर तेस्तो कसरी लतारीस् ?

ती फुल हरे मलाई दिई कसरी पछारीस् ?"

तिमीलाई संझिदा यि शब्दहरु संझिन्छु, जुपि

तिमीलाई संझिन्छु सदै मेरो माया जुपि

थोरै समय भए पनि माया धेरै बाँड्यो

There is no better way of wring a note or a memo or a diary. People say that one should be spontaneous, well, some people suck at it. I suck at being spontaneous. The last time I remember being spontaneous was when I agreed to travel to Khasa for no reason, 7 years back.

But what's the point of being spontaneous all the time? You have brains, that's constanly working for you. Your brain is your slave. You can command it. But sometimes this basic biology changes and people are slaved by their own brain. Well, that's a disorder. But who are we to level them as "disorder". Just imagine, billions of years from now, if our race ought to survive, what if, hallucination is normal? What if, being maniac or being depressed is normal? We are so occupied with policies, laws, guidelines, research, datas that we might just be wrong at all the things that we think is right at this very present.

So the key to life is "be open". Be open to comments, be open to judgements, be open to what so ever people throw at you, be open to your own thoughts. One's judgement is not who you are.

Think it of like a universe. Can you measure universe? No! I believe that you understand the fact that we are just a tiny tiny tiny tiny tiny tiny tiny tiny tiny tiny tiny tiny tiny part of this universe. What if that the things we are seeing are not actually the things that we are seeing? What if our brain is greared up in such a way that we just see things the way we want it to be seen? To understand the fact that what you are seeing might not be the actual thing that you are seeing and the actual thing that you are not able to see might be the thing no human can see, is to realize that our brain has limitless possibilities. If this is true then we are all just running in circle, trying to prove things that are not even there the first place.

Strange right?

O Beloved, O Wise, O Artist

Take me into your colorful world

Paint me in your canvas

O Beloved, O Wise, O Writer

Scrible me into your chapters

Shape me in your thoughts

O Beloved, O Wise, O Traveller

Put me into your eyes

Take me around the world

O Beloved, O Wise, O Saint

Take me into your mystery

Allow me to ponder

For I only seek peace, virtue and happiness.

O Saint, O Dear, O Guru

Give me strength

Give me liberty

Take me out of this worldly strife

Bless me with bliss

2018 was filled with lots of joy, happiness and few let downs. This year I nearly ended myself from settling in Australia to finally deciding to join MRCEM degree in Bharatpur, Nepal. I was virtually rich, with 45K dollar in my account for few weeks to absolutely loosing them all. In course of time, I met some awesome people, got to experience different culture and more importantly got to see the great bond of friendship.

2018 had ups and downs. There were times when I wished I had a great life, with lots of money, beautiful home and so on. But at the end of the day, the only thing that mattered was happiness. Trying to find happiness was my task for 2018. Comming out from a troublesome year 2017, I found myself in taking some bold decisions. But somehow, I think I have been victorious so far.

Her eyes are wary. She is in her 50s. Her hands are shaky. Her voice is soft. She looks tired. She looks empty. She must have had a very rough life. I am guessing it from the pictures in her wall. The emptiness she must have been feeling since many years.

However, she is innocent but strong. She is protective and she cares about little things. She finds happiness in everything. She never complains. She is religious. She is content. She waits and has patience. She is calm and confident. She is bold. She knows to speak up for herself. She is easy to get along. She never judges and she never lets anybody down. She has a wonderful family and she loves them.