Shrink's Views

ramblings of an unknown psychiatrist

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Transformation of Saul: a painting

Posted by Dheeraj Kattula on April 28, 2013

Image

Title: Transformation of Saul

1998 – 2001

Medium: Watercolor on Handmade paper

Stories of transformation are inspiring. I love to hear these. Psychiatrists long to create these. The process of transformation in psychotherapy takes a lot to time and energy. It is still worth all the effort. Even in psychotherapy there are few sessions where one feels there is greater progress, when an insight is received and a strong resolve to change is made.

In life I have seen sudden transformations too. My friend’s father quit smoking when my friend at the age of 5 asked his dad, if he could try the same. We have all heard of such men who give up things like drugs for something greater like love for the family following a life changing event.

The picture here is that of Saul. He was a Roman citizen by birth, Pharisaic Jew by religion and was a student of Greek philosophers. He persecuted followers of Jesus Christ with missionary zeal. He had a life transforming experience on the road to Damascus. He witnessed God and heard from Him. His life was never the same. He became known as Apostle Paul. He became part of the community he persecuted. His knowledge and skill became useful to build, what he wanted to destroy. He suffered imprisonment, humiliation and finally death for his faith in God.

I started this painting in year November 1998 and finished it in June 2001 [most likely]. It is an art work I had kept pending for the longest. It is one of the two paintings I have done during my MBBS [Medical Schooling] training years. It speaks of how busy I got in college stuff and how non-serious I was about art during those days. However a couple of years later, there was a transformation in me, a change I cherish.

May your life be transformed too for the better towards the more meaningful and eternal.

Blessings…

 

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Tropical Sunset: a painting

Posted by Dheeraj Kattula on December 29, 2010

Tropical Sunset

Title: Tropical Sunset
Watercolor on Handmade paper
Painted over 6 hours
5 December 2010
It is framed and gifted to my in-laws on my Engagement day on 11 December 2010

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In My Buddy’s Suffering: a poem

Posted by Dheeraj Kattula on October 16, 2010

My friend when you are in pain,

Feel parched like land without rain.

Life appears barren, cold and dry,

Being numbed, I couldn’t even cry.

 

At these times we feel very sad,

Think why these trials are so bad?

Tests are meant for us to get in shape,

My fear is, in these we don’t break.

 

Though circumstances don’t have reason,

We haven’t suffered heavenly treason.

At all times God is our steady hope.

Worship and prayer are our only dope.

 

Wishing your burdens I could share,

With a heart that would truly care.

What else dear brother, can I say

Except to promise to kneel and pray.

 

I assure you that I am with you.

Blessing God will see you through.

 

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They Found God and We Lost Something: a story

Posted by Dheeraj Kattula on October 11, 2010

It was a not a busy day in Madras Central. I did not have to stand for too long to get a ticket. I was going to Tirupathi to attend the wedding of my niece. I might not be welcome. I was going there only because my sister insisted tearfully. I did not even know how her husband and other relatives might react. I was going late intentionally to miss the muhurtham, the auspicious time for the knot to be tied to bind the relationship for a lifetime.

I remembered my own wedding. It was such a simple event. It was a chance to meet all our relatives. Incidentally, I too got married in Tirupathi. That was about 35 years ago. I had not even seen my wife till we got married. It was an arranged marriage. I was working in a bank in Bombay during those days. My wife Laxmi is not very educated, but she is a wise woman. She handled home well. I had no worries, when I went out of station on work related matters. She was simple, thrifty and yet generous. I love her more and more, even as I grow older.

I was lucky to find a window seat in the train. As the train went past Tondiarpet, I had nostalgic memories of our children growing up. My daughter was born here. My sons did their primary schooling in a nearby corporation school. Our house was close to the railway track. I remembered how difficult it was for us to sleep at nights with blaring noise at regular intervals. But, of course, we all got used to it slowly. It is natural for one to adjust in life.

We had great dreams for our children, like most middle class parents. We expect them to fulfil our unrealized dreams. Our expectation from children was not that of economic success but was of academic achievement. Education ensures a regular income. Competence acquired through education appreciates with time. Value of money depreciates with time and it can disappear leaving one orphaned. Education is like a faithful wife. Money is probably more like an adolescent child; there are no guarantees.

My three kids did well in school. Though they studied in Government Schools, they performed very well. My two sons studied in IIT, Madras and my daughter graduated in Medicine from Stanley Medical College. I am proud of their abilities. I gave them full freedom to read what they wanted to read, go where they wanted to go and do what they wanted to do. They had much higher level of moral sense than many of their peers. In many ways, their lifestyle was within safe limits of the boundaries that we follow as a community.

Sadly, Sundararaman my eldest son and Kasthuri my daughter crossed certain boundaries in religious domain. We are Hindus. We were born like that and we would die like that. When my son joined IIT, he began to read Gandhiji’s works. When he came to know Gandhiji was influenced by Leo Tolstoy, he began to read Tolstoy’s books. Tolstoy was a Christian pacifist. Sundar later began to read the Bible and became a Christian believer. He had even explored Islam. He had read Gita from his school days and knew many chapters of Gita by heart too.

He knew more philosophy than me and had amazing persuasive skills. I could never win an argument with him. I could not stop him either, as he was over-all a good boy. He respected us and loved us. He taught his younger siblings. He involved himself in literacy work in slums in Velachery, near the IIT. He did not have bad habits. He was morally upright. He went to RTO office about 6 times to get his licence. He was being failed as he was not paying a bribe. He said it was not wrong to fail but it was wrong to bribe. He paid a personal cost to avoid a social sin. I could only cite cultural/ traditional/ sentimental reasons to remain a Hindu. I knew, I could not expect him to buy those arguments.

Under his influence my daughter, Kasthuri became a Christian too. She too was a gentle girl. I gave her freedom expecting her to grow out of religious insanity. That did not happen till now. She continued to be a Christian. She slowly stopped keeping ‘pootu’ on her forehead. She stopped praying to our gods. She stopped eating ‘prasadam’ after family poojas. She also started going to a Church near her college. She came home one afternoon and announced that she had got baptised in a Church.

My wife and I did not even know how to react. Had we given too much freedom to our children? I appreciate secularism as a public policy, but when it came home it was not easy. I did not know how my extended family would react. They might do the final rites for all of us and consider all of us dead. Such social isolation would be difficult to tolerate. Things were not going to change, even if I ventilated to my relatives. On the other hand, our family might get ostracised, if they knew what was happening.  So, I decided to keep all these things as secret.

I could not keep it a secret for long. My eldest son Sundar, was clear that he wanted to marry a Christian girl. He wanted us to arrange a marriage for him. I hated him for asking us to do it. Could he not find someone for himself and leave us for good? But, on deeper thought I respected him. He was faithful to his conscience. He was faithful to us as a son. He wanted US to choose a girl for him. He was not the kind who would elope with someone. There are such people even among my relatives, who have done so despite being brought up in orthodox ways. I was afraid of advertising for him in the matrimonial columns in newspapers. I was fearful of someone recognizing our identity. So, we decided to respond to ads that sought grooms.

I was so surprised that many Christians were not like broad minded like my son. When they sought brides they always looked for convent educated, tall, fair girls from respectable families. They also sought excuse from SCs/ STs. I wonder why such forgiveness is required. We Hindus are at least consistent. We ask for what we want – be it horoscopes or dowry. We don’t preach against some things and then go and do those very things.

When we applied to many Christian families, they rejected his proposal. He was 186 cm tall, fair, graduate of Computer Science from IIT Madras, was from a respectable family, in fact from the most respectable community of Hindu society, a believer in Jesus Christ, an official Church member but still he was a reject. I wondered, why? Was it because of his family, which was still Hindu?

At last a Tamil family from Tirunelveli accepted the proposal. The prospective bride was a Lecturer in Economics in Stella Maris College and was pursuing a PhD. Her name was Janet. She was the last of 5 daughters in her family. We conducted the wedding in her hometown. Only my immediate family members attended the wedding. We did not inform anybody else. It was a pretty simple wedding.

Sundar purchased all the essentials to start off his new home. He was against taking any dowry and his in-laws were in no mood to give anything either. They were sort of burnt out after four weddings that they conducted before Janet’s. I was tempted to think, that they offered Janet only because they could not have afforded a boy from traditional Christian families. Whatever be the truth, I was very happy with Janet. She was an intelligent woman. I felt that she could be a good mother to my grandchildren. I did not have any other expectations.

It did not turn out to be that cool. Her family could not even handle my son’s name. They wanted him to change it to James or John. The word ‘Raman’ irritated them to the core and they did not want to call him by that name any longer. They called him Sandy in short. When we gifted Janet a red coloured Kancheepuram Silk saree, she rejected it. She said that it looked like a saree made for Hindu weddings.

Within a couple of months of marriage Janet expressed that she wanted all idols in my house be removed, if we expected her to come to our home. She did not want ‘evil’ influence of idols on the child she was carrying. Sundar never told us, what he was going through. He was so good. He truly loved us. He slowly stopped bringing her home, but continued to visit us regularly. Soon it was time for the child to be born. We knew that Janet was admitted in the Hospital. We did a pooja at home, for the safety of both mother and the child. Laxmi prepared to go to the hospital. In addition to fruits and milk, she took some ‘prasadam’ of the pooja and also the sacred thread to ward of evil eyes. Luckily, I spotted it. I stopped her and warned her that it might hurt Janet. I know Janet believes that we being idol worshippers had evil influence upon her child. This really hurts.

Her husband is our son. Her son is our grandson. He has our genes. He carries our family name. He is going to take our generation forward. We love the little one. We could give away our lives for him. But look at the irony, we are afraid to even take the child into our arms. We do not know how the reaction might be like. We love our son a lot. So we released him to live his own life with the one, whom we had united him with.

Only when we saw Janet, we realized how good Sundar and Kasthuri were. They shared exactly the same faith as Janet. They too did not participate in our poojas or eat our prasadam, but they showed us that they loved us. Though they did things which we did not like, as they had convictions in their conscience that they could not go against, they convinced us that they still respected us at all times.

Having gone through all this in the case of Sundar, we took great initiative to find a boy for Kasthuri from a similar background like ours. Like Sundar, she had only one condition, that the boy should have Christian faith. I could understand that. Why send our daughter into a Hindu family and make her a Janet of some other home? We were lucky to find Jagannath Panda, a Christian from an Oriya Brahmin family in Puri. He was an aluminus of IIT, Kharagpur, who was working in Accenture in Chennai itself. Sundar found him in a weekly prayer meeting they had in their Office Complex, where all Christian staffs of different companies meet for prayer and fellowship.

Jagannath was thrilled to find a Brahmin girl with Christian faith and that too a medical doctor. She was a perfect fit into his life and his family. Theyplanned the wedding in an unorthodox way. It was conducted in Hindu traditional style by a Brahmin priest of Christian faith. They did away with rituals that were not acceptable to them. Whatever we saw was acceptable to us. So we were happy too. We cannot imagine seeing our daughter in a white gown on a marriage day! We could invite few of our relatives. My Tirupathi sister and her family came. Her husband, who was a local leader of a Hindu political party, could not accept that we were accepting our children’s faith. He was open in expressing his displeasure in relating to us. This was the cause for my anxiety, while going to attend his daughter’s wedding.

I care a damn about his sentiments. I love my sister. I cannot think of hurting her. She knew that we might avoid coming. Last month, she came to our house secretly and insisted that I came. She was in tears. After all, her daughter was born in our house. My parents were no more then. It was my wife, who nursed her during child birth. That is why we share a bond with her daughter.

As the train whizzed past a Hospital called Yasodha Hospital close to a small village railway station, I remembered Kasthuri. Kasthuri works in Yasodha Hospital in Chennai. She is well settled with her husband. Sad thing has been that after their marriage, Jaganath’s immediate family was put under pressure by the Brahmin community of Puri. They wanted Jaggu’s family to snap ties with their son or face social boycott. It is difficult to imagine such a thing happening in modern India, but it is a reality.

Jaggu’s family conducted the last rites of him and my daughter too! Jaggu and Kasthuri can neither visit his home or visit his relatives anywhere. I sometimes worry, as my family is also losing its social support base, who will help my children in times of trouble?

Harikrishna, my second son too is married. He fell in love in his student days with his classmate called Sheikh Noorunissa Begum, a Muslim from Andhra Pradesh. Atleast, Sundar and Kasthuri wanted to marry someone with an ideological match. Hari had gone bonkers. Hari was a devout Hindu, more ritualistic than even us. Noor was a devout Muslim who did her Namaaz five times in a day, fasted in the month of Ramzaan, engaged in charitable works and hoped to go to Mecca someday. Such a match was inconceivable. We loved him enough to not consent for such a marriage. Sundar and Kasthuri loved him enough to go and sign as witnesses in a court. Hari and Noor lived in Chennai too. They visited us often.

When I fractured my spine and was admitted in the hospital after an accident last year, Noor was the one who took care of me every night for three months. She gave respite to Laxmi, who was taking care of me in the day time. Noor managed a job in the day. Hari worked on a night shift during those days. The equation was balanced. They balanced it, willingly. As days passed by, I realized that Noor is a great woman. I am proud of being her father-in-law.

Noor never mentioned to us that we had not gone to their wedding. She is impervious to presence of idols in our house. She does not mind, Hari’s Suryanamaskar or Sandhya Vandana. At the same time, she is devout as a Muslim. From whatever Islam I know, I wondered how it is that she fell in love with a ‘kaafir’ and got married into a family which does ‘shirk’ everyday. Did she know her theology? If she does, is she living a life of contradiction? I do not even want to know and I do not care about the answer.

All I know is that Noor and ones like her are basically good human beings. They bring harmony and peace wherever they are. They form the cement in building up a decent human society. All religions are exclusivist. Unless we are living in a madhouse, we cannot say all religions are the same. There are irreconcilable differences in their philosophies and their theologies. I know all religions cannot be true as mutually exclusive ideas cannot be true without qualification. I am not going to defend my view of Hinduism now. Considering the case that an individual’s religion is true and all other religions are false, does that mean consistent adherence to that religion means we become intolerant to practitioners of other religions?

It might be, depending on what that religion teaches specifically regarding this, but I feel the variance in observed tolerance level among people is important at the level of individual. Is not Janet an intolerant Christian? At the same time is not Sundar a tolerant Christian? Are Brahmins of Puri not intolerant Hindus? Is Laxmi not a tolerant Hindu? Who in my family ever thought that Muslims were tolerant, till we saw Noor?

I sometimes wonder who can be defined as ‘ours’? We Hindus especially us Brahmins, reject ‘our’ own children, if they embrace some other religion. Christians like Janet’s family do not accept Christians from Hindu families as ‘theirs’ despite a genuine conversion. It looks like we are all looking for reasons to reject each other rather than accept each other.

I am privileged to be father of my children, who too are good human beings like Noor. They would bring peace and harmony around them. In being consistent with their inner voice, they might suffer in life because they might be victims of others’ intolerance. Surprisingly, they get their strength from the God they pray to.

I remembered a shloka that I studied in my school

“Ayam Nijah paro veri, ganana laghu chetasam,

Udhar charitanam tu vasudaivakutumbakam”

It can be paraphrased as:-

“The ones with a small mind think in categories such as these are ‘our’ friends and ‘those’ are our foes; but the large hearted feel that the whole world is their family.”

The train screeched to a halt in Tirupathi. I called up my sister on her mobile. She did not pick it up. May be she is busy, I thought. I remembered my brother-in-law’s expressions on my daughter’s wedding day. It sent a chill down my previously broken spine. I cannot predict his reaction.  I caught an auto and asked for ‘Sitaramuni Kalyana Mandapam’, where the wedding would have been held few hours ago. I prepared to face my relatives and thereby face the consequences of unconditionally accepting choices and wishes of my kin. I would rather get ostracised with good human beings like my children than ostracise them and identify with small minded society of mine.

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I Pray I don’t succeed…

Posted by Dheeraj Kattula on October 9, 2010

I pray I don’t succeed, so much so that…

I forget where I began.

I forget what I need.

I forget who made me,

my family and friends indeed.

I pray I don’t succeed, so much so that…

I don’t notice the changes

in my attitudes and me.

I feel alienated

thinking others envy me.

I pray I don’t succeed, so much so that…

I consider myself

worthy of more.

I ascribe meaning to others’ words and deeds

more than what is called for.

I pray I don’t succeed, so much so that…

I lose happiness.

I lose  peace.

I lose  love.

I forget God.

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Religion,Depression and Suicide:an Observation

Posted by Dheeraj Kattula on July 26, 2009

Kandhamal district of Orissa is stunningly beautiful. In the peak of winter there is a place here where it snows. It is surrounded by mountains and is covered with thick forests. The air is pleasantly cold. The canvas of it’s beauty was marred by violence that struck its heart in August 2008.You may read about what happened here.

It is sad that I have not seen Kandhamal in its best of times. I have been there on two occasions.Once it was as a Medical Officer from Red Cross to look into health issues in Nuagam Relief Camp in November 2008. Recently I went with a team of other doctors and conducted camps in four different sites in the district.

A carpenter looks for nails everywhere. I, a novice carpenter of the mind looked for stress related mental disorders. I expected to see PTSD, Severe Depression, Anxiety disorders, Insomnias, complicated grief and suicidal ideation. What else do we expect in a group of people who have lost all their assets and have no clue what the future had in store for them?

I was wrong.I did not find even one PTSD case in about 1000 consultations that I had in the Relief Camp. Of course people were concerned about their future and were sad about the persecution they faced,but they had enormous faith in their God,who they felt allows suffering but is in control. I found that they had tent prayers everyday.

Situations have changed. The situation now is not at all as bloody as it had been. There may be tensions. There may be animosity, but the situation is now in control.The Governments are trying their best. In this state of peace, I recently went to Kandhamal again.

In this visit I  saw about 250-300 patients. I did find people with depression. I found a couple of them quite severely depressed. When we mental health workers probe about very personal thoughts and behaviors, we usually ask open ended broad questions and slowly zero-into specific areas.

In case of depression,we usually enquire if the patient feels himself to be useless & worthless, then ask if he feels lonely and helpless, then ask if he thinks that things are going to improve in future. If he says yes to these then we tell him,”when life feels so difficult many people feel it is better to die,have you ever felt like that?” If patient says yes, then we ask regarding suicidal intent,which will have a bearing on how we would manage the patient by asking ” Have you ever felt like killing yourself?”

I have seen a many people in Tamil Nadu, easily consider the thought of killing themselves when overwhelmed with stress. In a study in Vellore,the average annual suicide rate was 95 per 100 000 for the years 1994-99. The rates in adolescent males and females and those over 55 years were 148, 58 and 189 per 100 000 respectively.(The British Journal of Psychiatry (2006) 188: 86.)

In Kandhamal I had a shock.I did not find even one person consider suicide despite overwhelming adverse life events and financial distress.Individual cases were depressed clinically, but they were not feeling ‘hopeless’.Many reflected their view to be like,”Yes I feel bad.I have nothing left.I do not know what I will happen tomorrow.I wish to go back to my village to start a new life.I hope they allow me to start again.I feel sad,but I know God is there.He has helped us till now.If it were not him,I would not be here today.He will continue to take care of me and my family.Why would I kill myself and hurt God?Things will improve.We are praying.”

The pattern forced me to think if indeed religion and faith protected people from suicide and mental illness in general. Why is it that I did not find a single case of PTSD in a relief camp after a spate of bloody violence?What makes them stronger than American war veterans from Vietnam!!?

Harold G Koenig’s review in Candian Journal of Psychiatry 2009;54(5): 283–291  concludes stating that “In general, studies of subjects in different settings (such as medical, psychiatric, and the general population), from different ethnic backgrounds (such as Caucasian, African American, Hispanic, and Native American), in different age groups (young, middle-aged, and elderly), and in different locations (such as the United States and Canada, Europe, and countries in the East) find that religious involvement is related to better coping with stress and less depression, suicide, anxiety, and substance abuse.”

Considering suicidality in specific, an article in Journal of Affective Disorders reports that its results suggest that religious attendance is associated with decreased suicide attempts in the general population and in those with a mental illness independent of the effects of social supports.

Indeed, research validates my observation that religion does help in coping stress and prevent mental illness and decrease suicidality.

References:

1.In the name of God.

(http://www.tehelka.comstory_main40.asp?filename=Ne130908CoverStory.asp)

2. Manoranjitham et al.Suicide in India.

(http://bjp.rcpsych.org/cgi/content/full/188/1/86)

3.Harold G.Koenig.Research on Religion, Spirituality, and Mental Health:
A Review

(http://publications.cpa-apc.org/media.php?mid=793&xwm=true)

4.Daniel T.Rasic et al.Spirituality,religion and suicidal behaviour in a nationally representative sample.

(http://www.jad-journal.com/article/S0165-0327(08)00344-3/abstract)

Posted in anxiety, depression, distress, grief, mood disorders, philosophy, psychiatry, religion, spiritual, substance abuse, suicide, Uncategorized | 3 Comments »

“Power cut was good”

Posted by Dheeraj Kattula on May 14, 2009

lanternBaripada is burning. A power cut at such a time could tempt the best of people to curse. Few days ago power-cut left me happy !!! Let me share, how?

It was 5 pm. Closing time for the hospital OP.It had been a hot afternoon. Suddenly the clouds filled the skies with darkness. A sultry feeling was beginning to set in. Baap re  line gola. Our generator battery had problems. Thankfully there were no lab investigations pending. What could be done now? Got to pass time in the darkness :-/

I was planning to discharge a patient who had been admitted for two weeks. He was a patient with chronic renal failure and an old stroke, who had come in with pneumonia and cardiac failure. He later developed other complications of electrolyte imbalances, a couple of seizures and a breakthrough manic episode. All his problems  settled in 2 weeks. He survived his problems and also my treatment! Last summer, he had been admitted for lesser problems. He dared to stop medicines after discharge ! He survived for an year by God’s grace 🙂

I saw his son’s silhoutte against light in the nursing station. I called him into my chamber. I went through all his father’s problems and explained the need for a close watch on him as each drug had effects which could worsen his other existing problems. Despite two weeks stay he had not understood his father’s problems as much as the 20 min discussion in darkness that evening. I expect the likelihood of following up to be much higher now. 🙂

Another man  was waiting to discuss if he could bring a patient in future ! I glanced at the ultrasound abdomen report in the dim light of  a dying torch. It was a report full of findings for which one could do nothing specifically. Still I spent about 10 min explaining the person’s problems and impressed him with the knowledge of what the patient was probably experiencing. Lo behold! Next day that patient was first to register for morning OP.

Good for an extra half an hour’s work. 🙂 There are many things in life, which are irritating. It takes a small change in the way we see them and use them. They  could make us happier that the routine ‘comforts’. Isn’t it?

“Interruptions can be viewed as sources of irritation or opportunities for service, as moments lost or experience gained, as time wasted or horizons widened. They can annoy us or enrich us, get under our skin or give us a shot in the arm. Monopolize our minutes or spice our schedules, depending on our attitude toward them.”

-William Arthur Ward

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