Shrink's Views

ramblings of an unknown psychiatrist

Posts Tagged ‘empowerment’

Pehle Hum Hindustani Hain: a poem

Posted by Dheeraj Kattula on September 29, 2010

Background:

India awaits the judgment on Ayodhya’s controversial site on 30th September. Apparently the Moghul Emperor Babar demolished a temple and built a mosque. Fundamentalist Hindus demolished the mosque in 1992 wanting to erect a Ram temple in the site. Both parties Hindus and Muslims stake claim to the historical site wanting the structure of their choice to be erected there.

Do ordinary Hindus or Muslims have any stake in this decision and what comes after it? This poem is written from the perspective of Ali, a muslim Riskshaw puller. It also echoes sentiments of his childhood Hindu friend Shyam. Having lost close relatives in communal violence, both realize that more than religious identity what binds people together is basic needs or rather the lack of it. The poem ends with a patriotic note that Indian identity comes prior to all other identities of religion, caste, language and class.

Pehle hum Hindustani Hain

main hoon Ali, mera dost hai Shyam,

main Musalman, uska devta hai Ram,

Ayodhya mein hamara janam hua,

vahin par ham donon bade hue.

 

hamari yaari itni pakki thi,

log iski kasam khate the.

kisi ko agar kuch cahiye hota,

turant madat pahunch jata tha.

 

Hindu log jab Babri mazjid tode,

charon oor dange fasaad shuru hue.

Shyam ke saale ne mere bhai ko mara,

jis bhai ko maine bachpan se pala.

 

mere bête ne aatank machane ki tani,

bahana chaha khoon jaise ki pani.

Bomb banana kisi ne use sikhaya,

haivaniyat ka kharab rasta dikhaya.

 

Bomb ki durgatna mein bête ka haat kat gaya,

dange fasaad mein he Shyam ka saala mit gaya.

sab kuch lutakar, main aaj bhi hoon ek riskshawala,

mera yaar shyam bhi hai, ek sadharan paan wala.

 

kal mandir bane ya masjid bane,

kisi ko kya fark padta hai.

mere aur Shyam ki kaun sune,

dangon ke baad, zindgi sadta hai.

 

ho sakta hai ki kaum hamara chahta ho,

vahan Mandir ke badle masjid ho.

usi prakar shyam ka jo sangh hai,

manta hai ki Ram mandir he tik hai.

 

mandir se ya masjid se,

kya kisi ki pet bharta hai?

jise tand se kampan hota hai,

kya ent patharon ko od pata hai?

jiske ghar par chat nahin,

aaradhna ka jagah, vo chahe kahin?

 

hindu ho ya musalman, sabko yahi chahiye,

Ram ya Raheem ke pehle, Roti hame chahiye,

Mandir ya Masjid ke pehle, Makan hame chahiye,

Kafan our Kabr ke pehle, Kapde hame chahiye.

 

Jaanta hoon main aaj bhi ki,

Shyam ke vichar mujhse bhinn nahin.

Dharam, jaat, bhasha, varg halanki alag ho,

Pehle hum hindustani hain, Yahi baat hai sahi.

*****

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Posted in distress, fiction, HINDI, indian society, poetry, religion, social | Tagged: , , , , , , , , , , | 7 Comments »

Bollywood, Brothel and Being Born Again: a story

Posted by Dheeraj Kattula on September 25, 2010

This is a sequel to the story ‘A Dirty Job’ that I had written a couple of weeks ago. You can read it by clicking this.

It was the story of a girl who had very traumatic childhood. She landed in a brothel at an early age. She was rescued from there. She was given therapy to overcome her problems. She was also trained to live a decent life. She chased a dream to dance on film sets after she gained majority. She ended up having an affair and mothered a girl child. Hunger and desperation pushed her to the streets to solicit men.

The story was harshly realistic, reflecting lives of scores of women who land in brothels having chased a Bollywood dream. Is life over for them or is there any other way? Please read on…This story reflects a hope that I believe in.

Bollywood, Brothel and Being Born Again

Bollywood dream is over. I was not getting chances as expected. I made a new choice- to do the dirty job. I had detested it. I always had maintained that I would never do it. I was warned of this by few people. I wonder how they saw this possibility. I do not even want to think about where I went wrong. I always had prided in living in the present. No one knows what the future holds and no one can change the past. So why bother about these things which are not in one’s control. This is how I always thought. The doctor I had met used to advise me of being mindful, but my mind was full of ‘never mind’ philosophy. I think when one crosses boundaries and chooses to go far away from the previously set boundaries; it becomes easier as one moves along.

Having slept with a man once again to satisfy my hunger pangs, I was willing to continue this to sustain myself and my child decently. I went to Kamathipura and joined a brothel. I was given a small room. There were four others with me sharing the room. There were times when two of us were servicing our clients with only a cloth separating us. In the beginning I was a bit disturbed when I used to hear my daughter cry when I was engaged at work. I could see her through the diaphanous cloth which was to shield my shame. I have since gotten used to it. It is all right for a child to cry once in a while, especially if the tummy is getting filled thrice in a day.

I do not know why, but many of my clients come back to me for more. I had a record for this in our brothel. Mohammad Altaf was a local goonda who used to come for me frequently. He looked terrifying. He always carried his revolver with him. Another such regular client was Inspector Chogle. Chogle used to even bring biscuits and milk for my kid. Chogle had apparently recommended one of his bosses an IPS officer Mr Tripathi. He too came regularly. My status in brothel increased. I was given some freedom of movement. Moreover, I was voluntary here. Other girls who were trafficked from Nepal and Andhra had no contact with outside world except the clients.

One day Chogle came and told me to dress well for an outside engagement. He took me in a taxi to Bombay Orchid Hotel. He told me that it was one of the best hotels in India. The hotel looked astounding. He took me to a room more luxurious than the hotel. It did not require me to be an intelligence officer to know that I might have to service a big-shot.

I was shocked to see him. He was a minister. Everyone in the country knew him. Xavier Francis was his name. I had seen him debate on TV on issues of women like rights, dignity and self- reliance. He always wears Khadhi and speaks desi stuff. This is his real face- sleeping with young women in star hotels. After the job was done, he threw two bundles of Rs 100/- notes. I had earned Rs 20,000/- in one hour! I was thrilled. Suddenly he asked me to return the money. As I was giving him back, he tore few pages from a book that was placed near the table lamp. He wrapped the money in those papers. He then secured them with my rubber hair bands that I had left on the table and gave back the money to me with a smile. I liked his gesture.

When I went back to my brothel, I unwrapped the covers to take the money out. I was about to throw the papers, I thought I could as well read them. It was long since I read something in English. I might forget it fully if I did not read on and off. One sheet was the first page of a book. It had a seal stating ‘placed by Gideons International’. The other sheet had a story.

It went like this,

“But Jesus went to the Mount of Olives. At dawn he appeared again in the temple courts, where all the people gathered around him, and he sat down to teach them. The teachers of the law and the Pharisees brought in a woman caught in adultery. They made her stand before the group and said to Jesus, “Teacher, this woman was caught in the act of adultery. In the Law Moses commanded us to stone such women. Now what do you say?” They were using this question as a trap, in order to have a basis for accusing him.

But Jesus bent down and started to write on the ground with his finger. When they kept on questioning him, he straightened up and said to them, “If any one of you is without sin, let him be the first to throw a stone at her.” Again he stooped down and wrote on the ground.

At this, those who heard began to go away one at a time, the older ones first, until only Jesus was left, with the woman still standing there. Jesus straightened up and asked her, “Woman, where are they? Has no one condemned you?”

“No one, sir,” she said. “Then neither do I condemn you,” Jesus declared. “Go now and leave your life of sin.””

I got shocked. There were many things that I did not understand in the story like what are olives, who was Moses, what is this trap thing for this man Jesus etc but I did understand one thing. I am like that woman. I could be caught by police and tried according to the law. This would not happen as people like Chogle sleep with me. This man Jesus was different. He could have condemned that woman but he did not do that. He did not use this position in any other way too. He just told her to go and leave the life of sin. “Go now and leave your life of sin”- that statement rang in my ears for few minutes. I was so lost in these thoughts that I did not even notice that brothel keeper and my co-workers came and took away my money.

When I came to senses, I did not even feel the loss of money. I was awakened. Something was new in me. May be like a sapling. It was alive and growing. I was beginning to see things a bit differently. I do not know how to explain this. I could no longer enjoy the services I rendered. I was lost in some other world. My regulars also noticed a difference. Many of them asked me if I was not well. In fact I was feeling more than well. I realized that there is a thirst in me that needed to be quenched.

A few days later I was on my way to a beauty parlour. I was on an over-bridge near railway tracks. A drunkard walking with a cup of tea on the bridge spilt some tea on my shoe. I looked around for some waste paper. I saw an old man stand in a corner of the over-bridge giving away some booklets. I took one and tore a sheet from it to wipe my shoes and threw the rest of the booklet away.  Just as I was about to throw the sheet off, I realized I could read some English like I did on and off.

The passage went like this:

“Now he had to go through Samaria. So he came to a town in Samaria called Sychar, near the plot of ground Jacob had given to his son Joseph. Jacob’s well was there, and Jesus, tired as he was from the journey, sat down by the well. It was about the sixth hour.

When a Samaritan woman came to draw water, Jesus said to her, “Will you give me a drink?” (His disciples had gone into the town to buy food.)

The Samaritan woman said to him, “You are a Jew and I am a Samaritan woman. How can you ask me for a drink?” (For Jews do not associate with Samaritans.)

Jesus answered her, “If you knew the gift of God and who it is that asks you for a drink, you would have asked him and he would have given you living water.”

“Sir,” the woman said, “you have nothing to draw with and the well is deep. Where can you get this living water? Are you greater than our father Jacob, who gave us the well and drank from it himself, as did also his sons and his flocks and herds?”

Jesus answered, “Everyone who drinks this water will be thirsty again, but whoever drinks the water I give him will never thirst. Indeed, the water I give him will become in him a spring of water welling up to eternal life.”

The woman said to him, “Sir, give me this water so that I won’t get thirsty and have to keep coming here to draw water.”

He told her, “Go, call your husband and come back.”

“I have no husband,” she replied.

Jesus said to her, “You are right when you say you have no husband. The fact is, you have had five husbands, and the man you now have is not your husband. What you have just said is quite true.”

“Sir,” the woman said, “I can see that you are a prophet. Our fathers worshiped on this mountain, but you Jews claim that the place where we must worship is in Jerusalem.”

Jesus declared, “Believe me, woman, a time is coming when you will worship the Father neither on this mountain nor in Jerusalem. You Samaritans worship what you do not know; we worship what we do know, for salvation is from the Jews. Yet a time is coming and has now come when the true worshipers will worship the Father in spirit and truth, for they are the kind of worshipers the Father seeks. God is spirit, and his worshipers must worship in spirit and in truth.”

The woman said, “I know that Messiah” (called Christ) “is coming. When he comes, he will explain everything to us.”

Then Jesus declared, “I who speak to you am he.”

I got excited as I read this. This is the same man Jesus. I had difficulties in understanding everything. Of course I was reading a passage out of a story book and I cannot get an understanding reading a small portion. I asked the man distributing for another copy. He gave piercing looks and looked at the booklet I had thrown away. It had landed open and face down on the railway tracks. I knew what I had to do. I ran as fast as I could and got there before a train came and destroyed it. I sat in the platform and read through this booklet. It was called ‘Gospel of John’. It was about Jesus. It says a lot of things about love.

It said that “God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. For God did not send his Son into the world to condemn the world, but to save the world through him.”  It also said, “Light has come into the world, but men loved darkness instead of light because their deeds were evil. Everyone who does evil hates the light, and will not come into the light for fear that his deeds will be exposed. But whoever lives by the truth comes into the light, so that it may be seen plainly that what he has done has been done through God.”

What I had read earlier was also in this booklet. I realized that I was living in dark. In reality brothels are dark places. Many of our clients want their visits to Kamathipura to be kept in dark. I was living in dark and I was doing evil. Do I have a choice? Can I make a living for my child and me in a way that is not evil? Even if it were to be possible, was I willing to come into the light?

I realized that if I could do it, it would mean plainly that I have done this through God. I prayed to God to help me know the right thing and do the right thing. I went back to my brothel. Life was never the same. I could not enjoy my work at all. It was seen by my clients and soon my brothel keeper would know it. I could fake being happy, but I could not bring myself to do it. There was a discomfort welling within me about being untruthful. I could not even fake it for my survival. I was happy acting in line with my feelings.

I decided I must leave this brothel and this life style. I can work as a maid servant and life a truthful life. I should not let my daughter enter this dirty world if I really love her. Usually the brothel keeper never lets me out with my daughter alone. I had to find the right reason to take her out. That very week Chogle gave two passes for an amusement park nearby. One was for an adult and one was for a child. I had the right reason to go with my daughter and no one else would be with us.

Where would I go with my kid in Mumbai? Whom could I trust? I just wondered. I remembered that things are possible with God. I phoned Mohammad Altaf from a phone booth. I knew Altaf was a goonda and was a ‘bad guy’. Anyway, I decided to trust him, as he was on the wrong side of the law and was faithful to people on the wrong side. Chogle, Tripathi, Xavier etc appear to be on the right side of the law and are unfaithful to the ones on their own side.

Altaf came in about 15 minutes. I told him, “Altaf, I want to leave this trade. I need money to leave this place. I know that you are a tough guy, but I also know you are a good guy. So I have trusted you. Please help me. I want to do the right thing.”

“Laila. Come let us go to ATM…How much do you want?” he asked. “How much ever you can offer”, I answered. He gave me Rs 10,000/- and said, “Leave Mumbai. It is not safe here. They will be able to get to you. Wait for a minute… I will buy you a burqa from the shop near the mosque. You can cover your face.”

He came within five minutes and gave me a burqua. He told me to go behind the pan shop to wear it. In the meantime he took my daughter behind a barber’s shop and cut off the hair of my daughter and dressed her up like a boy. I was so happy for his resourcefulness. We had a chance to escape in nice disguise. As we were about to leave, he got emotional, “Laila, I wish I was a good guy. I would have given you a new life. My life has no future and so I can never commit. I would always love you.”

I always had this intuition that Altaf was a good guy at core but had life had built this tough shell around him. What else can you expect? His mother was also a worker like me, who died of HIV few years ago. He never knew who his father was. I was glad at least he realized there is something called love. I prayed that he too understands God’s love and power to change our lives.

I took a train to the place where I was treated as a teen-ager. I still remember the doctor who cared so much for me and gave me so much of advice. I hoped that he was still there. The hospital had not changed much. Extensions had been made in existing buildings. I went to the room where he used to meet me. I peeped in. He was there. His hairs have greyed a bit and he has put in few kilos of weight. His assistant wanted me to show the appointment card, which I did not have. All of a sudden the doctor came out, probably to grab a cup of tea in between few sessions. I called out for him. He took a couple of seconds, but he recognized me by my name. I was so happy. I was Laila, Lovely or Darling to many men according to their choice, but to the doctor I was, who I really was. He told me to wait till he finished his appointments. He asked me if I had eaten before he went in and resumed his work. I knew I reached a place which had some concern for me.

The wait felt very short. I told my whole story to him. He was not amused. He took it in as if he knew it all. He made some phone calls and then told his assistant to take me to the destitute home. He told me this was a short term arrangement till we could work out a long term plan. The home had 20 destitute women who were old and infirm. They had been deserted by their families. I enjoyed work in the home. Those ladies took good care of my daughter as well. I began to learn their language. There was a nurse who visited us twice in a week. She used to sing songs of Jesus at the beginning and at the end of her work. I shared with her my story. She got excited. She started praying with me for future of me and my child. I began to realize that this place was not my long term home. I wanted to move back to the brothels and help rescue many little girls and young women who are forced in to this trade.

I discussed this with the doctor. He bore the same expression he had when I had shared about wanting to be a dancer in Bollywood. He was true in believing that sparks should be kept far away from fuels. He thought it was intrinsically risky with the promise of earning powerful enemies. There was also the risk of me falling back into the trade. He encouraged me to stay at destitute home to help in the daily chores. He also encouraged me to complete my schooling.

I found a new love for books. They told me about how the world operated, a world created by God. This love made me learn with enthusiasm unlike the way I studied earlier. In a couple of years, I finished my XII standard. I even appeared for the Nursing School Admission test in the hospital where I had got treated. I got selected. My doctor and his friends supported me by paying my fees. They were also supporting my daughter’s school education.

In five years I completed my Nursing course and accumulated two years of experience. My daughter finished her VIII standard. It was an easy choice for me to wait for four more years till my daughter finished her XII standard and secured a seat in Nursing School. I continued to feel the pull to go and rescue girls who were caught in the dirt of flesh trade. I discussed with my doctor. He felt I was a mature woman now. He had developed links with NGOs who are trying to rescue girls and women who were trafficked. He said he would put me in touch with one of those NGOs. I put my daughter in hostel attached to our destitute home. My daughter knew the importance of my work. She was glad to release me. There was a mobile in the home. I could contact her anytime in the evenings.

In the first one month of my job, we were off on a raid. My job was to provide support to the rescued girls. We had social workers, volunteers and police in the raid team. The vehicle’s windows were covered. When the door opened and we alighted, it was like a déjà vu for me. The scent was familiar, the landscape, the building…everything. In fact it was not a déjà vu-It was all real. We had come to the place where it whole thing had begun for me about 20 years ago.

We rescued 15 girls that day. On our way back, I had tears in my eyes. I too had been rescued once, but I had fallen back. I needed a saviour. I knew these girls need a lot of love and a lot of grace to make this rescue meaningful. In our journey back, I prayed for each of these girls as they slept around me in the van. Maybe I lacked someone’s prayers and therefore I got back into the mess. I would not let that happen to these children. I have received love and it is time I share it.

Epilogue:

I became 50 years old few weeks ago. My daughter has become a nurse. She is a nursing tutor in the hospital that took care of us. Her husband is a Physiotherapist. They have a beautiful daughter Raksha.

I chose not to marry again though I had few proposals. I dedicated my life to a mission to rescue girls and I did not want any other engagement in my mind.

I have had my own share of problems too. I have been assaulted numerous times during the raids. I have had fractures a couple of times. Once I had a gunshot wound in my thigh and I lost a lot of blood. I was reminded of my saviours shed blood for me. Without sacrifice of some body, no good would come to this world.

I have been part of numerous rescue operations. Hundreds of girls have got rescued under my eyes. I do not know what has happened to each. I am sure there may be quite a few who have gotten back to the trade. I also know of numerous examples of those who get a new life after a rescue. I have seen them marry and establish homes and families. It is such stories which keep me moving forward. God has been faithful. He always gave me the needed strength. I would carry this on till my death. That is what I am called for.

******

Goonda- Ruffian/ Hooligan

Khadi- Indian fabric usually made employing rural populace

Desi-Refers to people, cultures and products of Indian subcontinent

Burqa- is an enveloping outer garment worn by women in some Islamic traditions to cover their bodies in public places which includes woman’s loose body-covering, head-covering and the face-veil.

Posted in children, christian, distress, education, emotion, fiction, gender, indian society, love, marriage, parenting, personality, prayer, psychiatry, psychotherapy, religion, social, spiritual, stigma, women's issues | Tagged: , , , , , , , , , , | 11 Comments »

Rights and Love: a story

Posted by Dheeraj Kattula on September 7, 2010

He was a tall man. Dark and young, his name was James. He came for a full cup Chai* five years ago. He never stopped coming. To him, Chai was like petrol. It kept his engine running. He made friends easily. He became friends with Rafique on the very first day. Rafique was here to buy his bundle of beedis. The minute James realized that Rafique has just discontinued studies; he spent an hour with him to get him back to school. He failed. Of course! Who can convince a thug in the making. I have been hearing Rafique’s mother Salma begging him to study properly for the past 10 years now. It was of no avail. Rafique played the fool throughout his school life. He was no different from most of the guys in Dharavi. Honestly, at his age I was like that too. I left my home in Allepy when I was younger than Rafique. My original name is Abdullah. People now call me Nair. When I came to Mumbai, I wanted to be a hero, a star.  Fate had its way. I became a chaiwala*. I work hard and earn my roti*. That is a decent life. Isn’t it? At least I did not do crime.

Even though Rafique did not take advice, he realized that James was his well wisher. He became his friend and partner in his work. James was like a student who was interested in finding out our problems. He wanted to know about our lives. He wanted to find how we decided what was right and what was wrong. He wanted to know what we did when we perceived injustice. Rafique helped him meet up people in the slum. James came twice a week and did his job. He never missed his full cup special chai in my shop.

In about a year, James started educating us about our rights. He told us about how the real system ought to work. We knew how it worked. The constable on beat was the symbol of all authority to us. Give him a free cup of chai, he would not bother you for the day. The other symbol of power we know is the neta*. His ilk come here before the elections and would never show up again. The bigger guys here keep in touch with the netas. James taught us that these fellows are there to serve us and not get served by us. He also told us about the court system. In fact, that year Police picked Zuber and locked him up. They had suspected him in some bomb-blast case. We knew Zuber as a hard working tailor. He was cool and liberal. He could have no such links. James came to our rescue. It was then that we came to know that he was a lawyer. It seems he had studied in one of the best law colleges in India. I heard it is in Banglore. To us he was like God. Zuber was back. We learnt we could fight.

He fought few other court cases for our slum people. One was a divorce of Janaki and Kadam. Kadam’s drinking was routine. He beat his Janaki black and blue. One night she fell on a doorpost and bled from her scalp. It required 4 stitches to control that bleeding. Next weekday was the day James usually came to our slum. He spoke to Janaki and other neighbors and reported to the police. Police laughed at the issue. They said domestic fights between husband and wife are normal and they should be sorted at home and not police station. With James around they anyway had to register the case. James tried counseling Kadam. I would not have even tried. Some people won’t change. Atrocities on Janaki increased. Janaki decided to leave Kadam. Where would she go in Mumbai? How would she feed herself and her little five year old son Babul? She was concerned as Babul too was getting beaten regularly. She was also afraid that he could become like his father.

James fought for her and got her a divorce and also the custody of the child. Guys like Rafique too were not very happy with the divorce thing happening. Why? Aren’t other women adjusting with alcoholic men? Aren’t other women tolerating few beatings received from their husbands? James reasoned that we all have basic rights common to all mankind. One such thing is a right to life, liberty and security. He said our liberty should end one foot away from his neighbor. Here we had Kadam always violating his wife’s right to security and exercising his pseudo-liberty. He also felt Janaki could leave her husband exercising her right to liberty. I can very well understand that. Marriage should be based on mutual continual nurturing relationship. I was sort of convinced that she had a right to break the marriage. James also found Janaki a house maid’s job in Rajiv Gandhi Nagar, which is not too far from Dharavi. Kadam has died two years ago in a train traffic accident. Obviously, he should. He was totally drunk and was crossing the railway tracks. I wonder how he had survived 40 years on those tracks.

During last year’s elections most of our area’s people had gone to election campaign programs for money. There was very little business. I could have some personal time with James. I asked him about how he spent rest of the time. He said that he visited slums in Thane and Pune on a regular basis. He was doing the same thing that he has been doing to us, providing legal aid. I asked him how he managed to live. He smiled and said that few friends support him. Many of them were from a  network of Lawyers. There were others who also contributed. A dozen of them gave about Rs 1000/- each per month. That probably washed their conscience of the guilt of not doing anything for the poor. Many of those lawyers had monthly income running into Lakhs*. His wife Agnes was a teacher in a school and she earned another Rs 5000/-. They managed their livelihood in Mumbai with that money. It was difficult to imagine the kind of place that he was staying. He probably was not too better off than us.

Last year, he started coming less frequently. I was busy with pregnancy of my wife. I did not notice that I did not see him for six months. He came two weeks ago. He looked tired and worn out. His head was low as he walked past my shop.  I shouted for him, “ Saab. Chai?”  He pulled himself to the bench in my shop and sat down. I gave him his usual -special full cup Chai. He looked at me as he sipped and smiled. He looked older and mature. His dynamic force was gone. He was sober but looked to be in control. He finished his cup and went to meet others in the slum. I got busy with my work.

That evening I met Rafique. I told him that James had come that morning. I also shared my observations and expressed my wonder at the change. Rafique smiled and said, “You will never believe what he has gone through. He appears different, but this is what he really was- all the time that we saw him.” “Why? What happened? Tell me what you know”, I asked knowing very well that Rafique being close to James would know more.

Rafique narrated this story, “ Agnes, the wife of  James Sir had been suspecting him of having an affair with someone. She put strictures on where he could go, when he would be back, whom he would talk to and so on. She also felt that he was trying to kill her. Six months ago she stabbed James in his stomach with a knife. James was lucky; the knife pierced his bowels but spared his blood vessels. His neighbors heard the shriek and rescued him. They took him to Lokmanya Tilak Municipal General, Hopital in Sion. They did an operation and saved him. In the meantime his wife Agnes was arrested for attempted murder.”

“Oh! My God. It should be tough on James to go through all this”, I asked “What happened next?” Rafique said, “I am still shocked at what James has done. After his discharge, he fought for release of Agnes and won the case. He then got her treated in a psychiatric facility. They gave her shock treatment and medicines.” Rafique added, “She had not responded well to treatment. She is now on the best medicine in the world for her problem. James Sir takes her for blood tests every week. She still has not improved. She is suspicious of him even now. James Sir still lives with her, though he had to change the locality. The locals requested him to vacate. Our great lawyer chose not to fight.” I felt numbed. I could not say anything. Rafique had his cup of chai and left.

I could not sleep well that night. How can James live with his wife after what she did to him? How can he continue to be with her when she still poses a threat on his life? How can he share home with such a dangerous woman? Why can’t he divorce her and start a new life? He has helped so many people start afresh.

When he came today, I asked him, “Saab, Can I ask you something personal?” He agreed with his usual smile. “Saab, I heard what has been happening in your life from Rafique. I feel very bad about it. I want to know why you want to continue living with a person who is suspicious of you and has tried to even murder you? Can’t you choose a life of liberty that you want us to have? Why…?”

James then said, “Nair, we all have rights. Don’t you realize, if we all had our rights then nothing will be left. We all give up our rights for those we love. Don’t we? You have every right to eat from what you earn. Would you spend it eating Chicken Biryani alone or would you spend money to eat normal food with others in family? I have a right to liberty. I can divorce her as she would not allow me to be close with her, but I also have a duty to care for her. I have made a promise to be together in health and in disease, in happiness and in suffering. I will keep my promise even if it means to give up some of my freedom.

“But…You fight for our freedom”, I asked. He said, “Yes, I do fight for freedom and so many other rights. Many of our friends are unaware of their rights. If they are aware they would like to claim them. I help in raising awareness and helping fight to claim it. If someone does not want to claim a right for a different purpose, it is absolutely acceptable. It would be nice if that purpose is rational. Do you remember, last year Shinde joined BSc in Maths though he got a quota seat in Engineering. It is rare for someone to get to college level from Dharavi. Everyone scolded him. I knew he had a higher agenda. He wants to prove himself. A person who can run does not need crutches. Shinde will come up in life. He will live with self respect. Watch him. Anyway coming back to the point, rights give people a chance to make their life beautiful. Giving up your rights too can make life beautiful. In the case of me and Agnes, it is not yet beautiful. I agree I do not know what can happen to me, but that is alright. In a grand plan of people caring for their family, it is already beautiful.”

As I saw him walk away, I wondered James did give up much to be with us and has made life more beautiful for us. I found a new definition of love: That which makes the subject give up his/her rights to make life more beautiful for the object of his love.

————————————————-

*Chaiwala- One who deals with Tea.

*Roti- Pancake made from wheat. Contextual translation- bread.

*Neta– Leader, usually political.

*Lakh- 100,000.

*Saab– Sir

PS:( added on 25th September 2010) A sequel to this story “Love: Feeling, Reason and Choice” can be found here.

Posted in distress, drug therapy, education, emotion, ethics, fiction, gender, indian society, law, love, marriage, psychiatry, schizophrenia, stigma, women's issues | Tagged: , , , , , , , , , , , , , , , | 18 Comments »

The Dirty Job: a story

Posted by Dheeraj Kattula on August 27, 2010

My mother was admitted in the hospital. She had burnt herself. We went to see her every day. Our grand mother took us there. The doctors in the Government Hospital were not friendly. They would not let us stay in the burns ward for long. My mother suffered from burn injuries, which I still think were not very serious. I have seen many with worse burns make it to life. She died within a week of her admission. It was the doctors who killed her with their treatments.

Ramesh took Choti and left the village just after my mother’s admission into the hospital. Choti was born to my mother and Ramesh last year after they started living together. I think my mother knew she was going to die, even though she was conscious in the hospital. She wanted her family to take custody me and my other siblings Babloo and Moti. Her family is big. My grandma and her other children promised to take my brother. They did not want me or my sister. After all we were girls and they were afraid that we would grow up to be like our mother. I was seven years old and my sister Moti was four. An old lady in our village took sympathy on us and took us in. We addressed her respectfully as an aunt.

I missed my father and mother. My father was an alcoholic, but he loved us. He visited us every alternate day and gave us stuff to eat. My mother had wanted to keep him away from us. She used to shout at him, when she saw him meet us. I realize she too loved us. She was beautiful. We all look like our dad. Choti looked like our mom. I missed Choti too. My father never took another woman. He loved our family. A few months after mother’s death, I heard his body was found in a gutter in the neighbouring village.

This aunt who took us into her home was old. She found it difficult to control me. I was indeed naughty when I was small. I was always in the street playing with other girls. I did not help her as much as I troubled her. She put me into a hostel. I like school. I studied for five years.

In the summer holidays, I came back from hostel to be with my aunt. She was taking us to her native village. I refused. It was a dirty little village. We would have to share our room with two buffalos that they have. The smell was horrible. Instead of going I could stay alone in our village. She told her friend who lived few streets away to take care of me.

Her friend whom I called as Padma mausi took me to her house for a couple of days. She fed me well. I liked her. She took me to her aunt’s place which was few more streets away. The house had many young girls. They were all involved in dirty work. I knew that. My aunt too was involved in it, when she was young and able. There are no dirty little secrets in our village. Everything was open. Even primary school children knew what happened behind closed doors.

Our village had night school. It was where all children slept, when their mothers were busy with dirty work in the night. I knew it all, so I could tolerate it. I could accept the girls in the brothel. We played in the free time. I got good food there. It was better than what my aunt gave.

After a month, the care taker of the house called me into her room. A young man was there. She showed me to him and left the room. I was afraid. I screamed. He was strong. I could not fight. It was painful. I wept. He abused the care taker for giving him such a lousy girl like me. The care taker smiled and said, she is fresh to the trade. I was beaten that night for having shouted. Padma mausi never came again. Neither did my aunt. I was stuck there. I am now a 14 year old prostitute.

I could not leave the brothel. I was confined to the indoors. I had freedom inside. I could wear anything. I could eat as much as I pleased. I had the company of many girls, though many were older than me. Once you get used to everything you begin to enjoy what you once detested. I enjoyed the company of men. I liked the sensations of my body. When I lived in hostel, I liked Abdul. I dreamt of marrying him. His memories have got erased now. I lost the fear of men. I have seen them all. The rowdies who come and demand us for free, the police who are supposed to protect us, young men contemplating marriage, middle aged men who lost fancy for their wives and old men whose wives have died.

I was kept hidden for the fear of a police raid. I was moved from one brothel to another for protection. Indeed there was a raid and I was rescued. I was kept in a home run by the Government. Apparently my brother Babloo contacted a NGO and they had organized the rescue operation. I hate Babloo for having done this. I had adjusted to a new life. I was even enjoying it. I did not have to go to school. This rescue screwed my life up.

I was kept in this Government run home. I was not yet 18 years old, so I did not have right to be involved in this business. There were many girls like me in that home. Many of them were forced into it, just like me. They too began to enjoy their new life, just like me. They too were not getting any money, just like me. The men who came to us gave us money. We were to hand it over to the caretaker. She would give back a small amount to the older girls. The younger ones would only get food, clothing and accommodation.

After I joined the new home, they did some blood tests on us to check if I had contracted any disease namely HIV. I did not get it. The new home had a teacher who came to teach us some basic stuff. I was best in my class, as I had completed my primary school. Most other girls were dumb. I was getting irritated with their fixed schedule. I used to shout back to the teacher and the warden. They would beat me at times. They also taught us moral ways to live. I could see from the lives of our teacher and other staff that there are better ways to live.

I get confused at times about what is happening? The past and future flood me with irritation. I get tensed and do things that I later regret. I just cannot control it, when I get into that rage. Last year I broke the TV, Computer and telephone in a fit of rage. They thought I became mad.

They took me to a doctor. He admitted me in their hospital. He was a young man. He looked respectable. I saw him joking a lot with his friends in the hospital canteen, but he was serious with me. He looked straight into my eyes. He probably was mystified with my story. He had sessions with me regularly.  I avoided his eyes in the beginning. I became more comfortable with him and shared more freely. Of course I avoided many areas which were uncomfortable for me to discuss with. In fact I do not remember much of those either. He was interested in those things, as if they had a key to a treasure.

He asked me one afternoon, “You did not go to your aunt’s village because you would have been uncomfortable. Am I right?” I thought it was obvious. He then asked me, “If you had gone off to your aunt’s village, would you have gotten into this mess?” I was shocked. It is true; I would not have gotten into this puddle of shit if my aunt was around. She was old. She was in the dirty trade herself, but she was strong enough to protect us. He then said,” There are many things in life, which are uncomfortable. If we run away from them, then we would get into situations which are even more uncomfortable. Isn’t it?” I agreed.  He then added, “Can you see a difference between what feels good and what is good?” I did not understand that, but I nodded. He smiled and said “Good!”

He taught me how to relax my mind and how to ventilate my anger in acceptable ways. The day of my discharge grew nearer. He asked me of my dream. Of, what I wanted to be. I told him what I always desired, “A dancer, in the movies.” I could see his eyes sink. He was not happy. He tried to tell me that it felt good to be a dancer in the movies but it might not really be good. He said that the movie industry had risks for girls like me. He said it is likely that vulnerable people may get into wrong things.

I am sure I am not getting into bad things. I detest the dirty work myself. I would never do it to get a chance to be on silver screen. There is something called talent in this world and people would recognize and reward it. The doctor is educated. He can know what is in books. He cannot pick dancing talent. He has stereotypical beliefs on movie industry. Other girls in our hostel have danced on movie sets. They have told me that they did not have to do dirty work to get dancing chance. They told me the heroines do it not dancers.

When I got discharged, I could see that the doctor smiling. His smile was empty. It looked as if he knew something dangerous was lurking around. More knowledge spoils the mood for everyone.

Next year, they will release me from the home. I still am unable to love my brother Babloo, though he had done everything in my interest. It is probably because I fomented hatred over him just because he caused me the discomfort of moving me to the Government home from the brothel. I don’t care about Choti and Moti too. It has been many years, since I saw them. I have lost feelings for those whom I can call as a family. I can be a free bird with no restraints. I can chase my dreams. I can go to Mumbai and try my shot in movies.

Epilogue:

"The dirty job is always available."

After discharge from home she went to Mumbai to become a dancer. She fell in love with a light-boy. He left her after a year, leaving behind a two month old daughter in her hands. She was hungry and her baby had no milk to feed. She came to know why her mother sought Ramesh despite having a husband and three kids. The main roads are busy and side lanes are dark. The dirty job is always available.

PS: (added on September 25th, 2010) There is a sequel to this story ‘ Bollywood, Brothel and Being Born Again’.You can find it here.

Posted in behavioral therapy, bussiness, distress, economics, emotion, fiction, gender, indian society, personality, psychotherapy, social, stigma, women's issues | Tagged: , , , , , , , , , , , , , | 5 Comments »

“Can you please give me some poison?” – Part III

Posted by Dheeraj Kattula on July 10, 2010

It was usual Wednesday morning. Patients on Clozapine lined up to get the investigation request signed. It is a quick process for the doctors to sign a small bunch of slips. The OPD assistant filled in those slips and gets the job done. I looked up for a moment to see the patients. I saw Murugan’s aunt. I had come to know her well by then. You can read the posts “Can you please give me some poison?” and “Can you please give me some poison?- Part II” to get the context.

The first post was about this lady who was the sole care giver for her nephew who had Schizophrenia. She was struggling for long to get him well. It required an admission into hospital to make him better. She had no supports to facilitate that. In that post I promised that old lady that I would visit her village to help her bring her nephew to the hospital.

The second post was about my visit to their village and my encounter with the patient. Though I could not bring the patient that day, the patient came to the hospital for an admission as a voluntary patient. He was started on Tab Clozapine, the most efficacious anti-psychotic drug in the world after a fully informed consent. He improved much and got discharged. The senior psychiatrist of the hospital made a rare exception to Murugan by making hospital purchase Clozapine from an outside pharmacy to be given to Murugan for free. Murugan was lucky.

He was supposed to come every week for a routine blood test. This is because the drug Clozapine is associated with a rare but dangerous side effect in which the blood cells required for fighting the germs decrease badly. In rare instances, it can cause death too. Therefore we are very careful in monitoring the counts of those blood cells every week.

Murugan’s aunt asked me how she could get his test done as he has not turned up. What?!!! A Clozapine patient has not come for the routine blood test. He could die of agranulocytsis, where his blood cells which fight infections get reduced in the blood. The fact of this risk had been explained to both of them many times. They consented to come regularly for blood tests with their thumb impressions. Our explanation should be quite fresh in his memory. How can he not come? How dare this dear lady come and ask for ‘repeat medicines’ like it had been the practice before? I had every reason to be irritated.

I asked her, “OK. Why has he not come? Did we not tell that he MUST come for blood tests? What is he doing at home?” She said softly, “He has gone to the mill.”

“Mill? Did he go for work?” I asked with surprise.

“Yes. He started working last Friday. He gets Rs 120/- per day.”

Oh my God! This guy had not worked productively in any place for the past 20 years. He never earned a rupee. From my experience in their village, I knew that he had potential to work. When I was waiting at the bus stop, I heard a man call him out. Murugan had come with me to send me off. This man told Murugan to be ready by 6.00 am the next day. Apparently, that man wanted help in keeping an eye on a four wheeler for an hour the next day in a nearby village. All that Murugan would have received for that job is a bunch of beedis (rolled tobacco leaves about ¼ the size of a cigar).

I was amazed. Murugan has got a job in a spinning mill. I remembered my co-passenger had asked me if I was looking for such a job in a mill. Murugan has successfully found such a job. I credit Clozapine for such magic. If Clozapine was to continue, then it is mandatory that he came for the test.

I pulled a small sheet of paper and wrote a note to him. “Dear Murugan, I am very happy that you have found a job. Congratulations. Your blood test is very important. Do come and get it done.” I expected them to come the next day, but Murugan came back to get the test done before we closed work that evening. I also had an opportunity to write a letter to the manager of spinning mill to kindly give him leave on Wednesdays, so that he can come for certain blood tests which are necessary for his problems.

Next week I found Murugan had not gone back for work. His aunt prevented him from delivering the letter. She thought I had probably written to the manager mentioning details of his mental illness. She reasoned that such a letter could go against him because of the stigma attached to mental illness. She felt I was uninformed about the status of the real world as I was limited to ‘high society’!

I reassured her and explained to her what I had written. Murugan then informed me that it was not only this fear but the prophet-parrot had predicted that Murugan was in a ‘bad time period’. In India soothsayers/ fortune tellers use parrots to pick cards which are supposed to bear the secrets of the future of the client. His aunt had wanted to shield him away from authorities, just in case they stopped him from work. He was as irritated about her behaviour as me. I gave her a strong dose of scolding. Poor people take even a scolding in good sense, when they think that you are a concerned person. You cannot assume this for the rich patients. The rich though can be deceived by sweet talk even if you are not really concerned.

Next week Murugan was back. He had delivered the letter to his manager. His manager was okay with a weekly ‘off’ on Wednesdays. Murugan would regularly come from now on. His aunt wanted a letter to get a weekly ‘off’ from her company too. We gave one for her too. She too would get a weekly ‘off’ on Wednesdays. From now on she can happily accompany him. I am amazed at how much difference a typed letter sent to an employer by the doctor could make to the patient. I would use this method more and check if this makes any more difference than just encouraging patients to go for work.

Murugan’s story is a miracle. It is a miracle because of Clozapine, health care workers, hospital and the spinning mill which employs him. It is thrilling not only to see a homicide and suicide prevented, but also see lives transformed when modern medicine works along with social services and occupational rehabilitation.

Does this old lady want poison, now? May be…to kill rats and cockroaches! 🙂

Posted in challenge, drug therapy, emotion, indian society, love, psychiatry, schizophrenia, stigma | Tagged: , , , , , , , , , | 4 Comments »

eros@ergon.con*: a conversational story

Posted by Dheeraj Kattula on July 6, 2010

Recently an Indian CEO was sacked from his company because of a complaint of sexual harassment. He maintains what they had been in a consensual, flirtatious relationship that grew out of a close friendship with a colleague. This story triggered me to think on these issues.

Here is a fictitious story in form of conversations bringing out few issues which might have relevance to sexual harassment. I am no expert in this field. Though I have heard of many stories on domestic violence I have not heard much on sexual harassment. What I know is limited to conversations I have had with friends, patients and co-passengers in trains. I call the story “eros@ergon.con”.

*******

“Have you heard of what is happening?…This is bullshit going on here in our company.”

“I know. I work in Vicky’s team. I also know the reasons for all this.”

“What exactly happened?”

“See, Rashmi joined our team six months ago.”

“Is she the one we saw in the theatre last month?”

“Yes. She is the one. Remember, she was there with her boy-friend.”

“I remember being introduced to him. Ramesh is his name. He is in the accounts department…Ok. So, what did she do?”

“She has not been doing well in the job. Vikram had to admonish her for her mistakes. She felt offended. She filed a complaint of sexual harassment against Vicky.”

“Oh my goodness! I heard about that complaint but did not know the background. Anyone who knows Vicky can vouch for his integrity. It is terrible for his name to be stained like this. I wonder how he and his wife have taken this.”

“Rashmi has been roaming around with Ramesh whenever she is off duty. Their relationship is secret. Ramesh’s parents would never agree for their marriage. She is probably stressed. This gets carried to work. Instead of accepting responsibility she has used her trump card to defame Vicky.”

“Vicky’s name would clear off after the enquiries, but what about the trauma he is undergoing. She loses nothing for filing such a complaint.”

“She should be sacked for raising wrong allegation, when Vicky is cleared.”

“Some of these girls are crooked and some are just sensitive idiots. Last year, I had a complaint against me.”

“YOU!”

“Yes. It was a tough season. Our team leader Mrs Johnson wanted us to finish a job within 24 hours. She announced this at the end of the working day. It meant that I would not be going home that night. Our friend Raju was admitted in the hospital and I was to go to relieve his wife Laxmi for few hours. I was so pissed off at such untimely deadline, I pointed my middle finger as Mrs Johnson left the room. I basically meant **** off.”

“I can understand.”

“You have seen Swathi in the party two weeks ago. Didn’t you?”

“Oh! Is she the girl, who was sipping coffee when we were gulping beer in the party?”

“Yup! The very same girl. She saw my gesture. She went to Mrs Johnson and complained of this offensive gesture the next day.”

“Oh my God! What happened?”

“Mrs Johnson came and congratulated our team for staying up the whole night to finish the work. She also said that if we had not completed the job then she might have had to send us home to…as she said that she pointed her middle finger.”

“Really? She is cool.”

“We all had a good laugh.”

“Except Swathi…Perhaps.”

“We have to be sensitive to people around us. It is very true, but what if someone does not fit into our culture at all. What can we do if a person is overly sensitive? Thankfully Mrs Johnson is cool. If she was another sensitive nut, I would have had it.”

“It is a pity that Swathi could interpret a sign of frustration as a sexual gesture. But I respect her. She is good at her work and has good character. She is not like Urvashi, who sleeps with the boss to get promotions. In fact she has to do such shit to even retain her job.”

“Isn’t it interesting that everybody knows that the CEO is sleeping with a staff and nobody batters an eye lid. Urvashi’s father is a professor of Sanskrit and Indian Culture. I cannot believe how a girl like Urvashi is born into his family.”

“Who knows one fine day Urvashi might file a case in the court against the big boss for sexual harassment? Ha ha ha”

“Yes! The world would believe it to be harassment too. Poor girl…what other option does she have in this male dominated society…She had to do it…She kept it secret for long because she was stuck with fear…etc.”

“Absolutely true. These are bullshit arguments in her favour. She made her choice. She is doing this to move ahead in the corporate ladder and nothing else. If she really has some emotions for him, then she would realize with time that the CEO is just using her. Rashmi sleeping with Ramesh hurts the company in an indirect manner. It does not affect others directly. Urvashi’s sleeping with the boss is a lot different. She is growing in the ladder bypassing many worthy people. This would hurt the company more. Don’t you think so?”

“Incompetence and physical beauty put a girl at risk of being solicited for sex in her work place by people who can cover her incompetence. If she is ambitious, she uses her beauty to bait men around her to cover for her lacunae. I really do not think this kind of thing can be called sexual harassment. It is happening with the choice of the woman.”

“Whenever there is less difference between two people and the difference that a senior can make to them is huge, favours including sexual would tilt the scales. You can take the entertainment or fashion industry for example. At least this is not so much pronounced in our technological industry.

“True. In fact, the ones who can be considered as harassed because of sex like this are people like Mrs Johnson, Vikram and us. We work hard and finish our projects but we are sidelined to make way for people like Urvashi.”

“Hmmm…That is right. It is OK. In the long run we will catch up. So long as we enjoy our work and our compensation, why bother about others? Anyway, I got to go buddy. Bye for now. I will catch up with you in the mall this weekend.”

“Ok. Bye. Take care.”

************

(Inside a sub-urban train)

“Hey! What is up man? You look sad.”

“Sure. I do. I have reasons for it.”

“Want to share? You could…if you want to?”

“I got fired today.”

“Oh I see. Any reasons?”

“See, I am a laboratory technician in a college lab. I am in love with a final year student in the college. The college management feels that if they fire me they would send a strong signal to discourage romantic love inside the college.”

“Don’t mind this…Did you do something?”

“No…Nothing that you might imagine. We have not even touched each other. We know each other for the past three years. There was some Chemistry between us. We learnt more about each other over coffee. I proposed to her three months ago. She accepted. We have planned to get married after her graduation, which is two months from now…and now…I am unemployed.”

“What the hell is this? There is no complaint, no problem in your work or her studies, just arbitrary dismissal for being decently involved in love though there are marriage plans. This is surprising.”

“I am not surprised. Last month my friend gave a love letter to a colleague proposing to marry her. He got dismissed for this itself. She filed a complaint of sexual harassment.”

“Oh my God! This is ridiculous. I cannot stand this. Where do I go? Is there an escape from this kind of persecution? Looks like anyone can harass a man. A day will come when men file cases against men saying the boss is sexually harassing them. I have developed a phobia. I am going to leave working for a company. I will not start a company too, where I might have to employ people. I have to try my hand at politics. That is a safe place, where no one talks about even about the culpable ones. It is a place where the daring can brazen and the phobic can hide.”

“I don’t get you.”

“You don’t have to get me. Even I don’t get me. May be I need to consult my friends in NIMHANS $, Benguluru.”

*********

*

“Eros” in Greek means Romantic love

“Ergon” in Greek means Work

“Con” means

1. on the negative side

2. to trick; involve in abuse of confidence

$

NIMHANS- National Institute of Mental Health and Neurological Sciences ; a premier psychiatric facility in India

Posted in bussiness, distress, emotion, ethics, gender, indian society, law, love, management, social, stigma, women's issues | Tagged: , , , , , , , , , , , , , , | 5 Comments »

“Can you please give me some poison?” – Part II

Posted by Dheeraj Kattula on June 20, 2010

This is the continuation of the life story “Can you please give me some poison?” Please read it if you can, to get the background. It was about a lady who was the sole care giver for a nephew who had Schizophrenia. She was struggling for long to get him well. It required an admission into hospital to make him better. She had no supports to facilitate that. In that post I promised that old lady that I would visit her village to help her bring her nephew to the hospital.

I did not keep the promise. Life is quite busy in Oddanchatram. Four weeks passed and the lady came back as proxy for review. I can never forget the look on her face. It showed how much of expectation she had of me and how I had let her down. I had missed four weekends to do a job I promised. If I had a conscience, I had to do something that week.

On the third day, I wound up my work by 5.00 pm and rushed to the Oddanchatram bus-stand. I bought a large coconut bun as a gift. The bun is usually cut into eight pieces before being sold. It was not very costly. In fact it was the item with maximum volume for a given price in that bakery. I believe volume matters to the poor and price matters to the rich in judging the quality of the gifts. I had filled my mp3 player with psychology lectures, to listen during the travel. I never switched the player on, as I was sooooo excited.

I would fulfil my promise. My challenge was to bring an unwilling disturbed patient, who had never seen me before, to the hospital for an admission. I didn’t have a team to assist me. I couldn’t apply restraints. I was not carrying rapidly acting injectable antipsychotics. I heard from a Public Health practitioner that practicing psychiatry in community is like trying to control a lion in the jungle. Controlling a violent patient in hospital is more like controlling the lion in a circus, he said. I was prepared for the worst. I kept my ID card, so that I can get help from people and police…Just in case…However my plan was to talk the person into a voluntary admission.

 I reached the nearest town in an hour. I had to wait to catch a bus to her village. It was getting dark and cloudy. It could rain at any time. I had second thoughts. Is it possible for me to bring an involuntary patient through this complicated travel back to Oddanchatram in a rainy dark night? Though I could abort my mission at that time, I did not. Could I face that lady again, without keeping my promise? Only God knows if one gets another chance. In about 20 minutes, I got the right bus. I asked the co-passengers, to tell me when the right village came. A teenager told me to follow him as he was to alight in the same village. He enquired if I too was going there to find job of a daily wage labourer in the spinning mills located in that area! This is when I was wearing formal clothes and leather shoes. I consoled myself, thinking I was able to relate with him so much that he identified me as a co-worker. 🙂

Once I got down from the bus, I found a street running perpendicular to the main road. I enquired from people if it was the right place. I asked for Murugan’s *house. “Which Murugan?, they asked. Reluctantly, I said,“Mentally deranged Murugan.” I was not comfortable using such a label to identify him. His aunt had wanted me to enquire like that. She had said, “If you ask for the ‘Mentally deranged Murugan’, even the village dogs will show you the way to our house.” I was told to go near the temple, located deeper the village. It started to drizzle. I walked faster. I found a group of people in a circle, chit chatting and having fun in verandah of the village school. When I asked, they pointed to a man who was engaged in a chat with another group nearby.

 He looked like an average poor man. Thinly built and unshaven, he wore a shirt and a lungi. His lungi was pulled up so much so that it exposed his thighs. As I looked at him and his mannerisms, I understood, he could easily be an object of mockery. It was difficult for me to imagine that he could be stoned to death in the village as his aunt portrayed. He smiled innocently as I introduced myself as a doctor from the hospital where he gets his medicines from.

He was happy to receive a guest. He left his group, as he understood that he had to take me to his house. On the way he said that his aunt had brought the Injection but he could not yet get the shot, as the village nurse was not coming regularly. By then it began to pour. We ran to his house, which was not very far from that school. He was surely not as bad as I thought.

 His house had tiled roof and brick walls. It had three compartments. One was the corridor, right in front of the door. On the left was an elevated area, which was used as a kitchen on distal end and store area on the proximal end. On the right side there was another wall which had a door in the middle. The door led to a bedroom. That room had a cupboard, a chair and a trunk. Few clothes were scattered on the floor. His aunt was cooking rice at that time. She was excited when she saw me. She hurriedly cleared the scattered clothes and ordered Murugan to get me a ‘colour’. I figured out that she meant a cool drink. I told her not to bother as it was cold and raining. I had the magical thinking that rain would stop soon. Aren’t some of us are extreme optimists, especially if we take some action?

They spoke in a language called Kannada. I asked about their roots and how they came to Tamil Nadu etc. I then moved to the business of getting Murugan back to the Hospital. I knew the journey was long and difficult. I did not mind the cost of throwing the half cooked rice away to get back to Oddanchatram as fast as possible. I gave the coconut bun. Murugan was happy to take it. He asked me if it was cake!

I gave Murugan the Flufenazine shot that was due to be given. I explained the reason for my visit to Murugan. I asked his aunt about what she wanted to do. Murugan listened to everything. At last he asked me if I would be there in the hospital, if he came. It was as if he said, “If you are there, then I will come.” I got excited. At least some rapport has got established.

In my heart I was keen on taking him personally. I cannot believe judgement of a psychotic person. It could change anytime. His aunt told me if Murugan said something, he would do it. She said, “Now that Murugan knows you and likes you, I will not have any difficulty in bringing him to the Hospital.” I thought I would leave the issue at that point. This was more so because of logistic problems.

The rain showed no inclination to stop. It was already dark and getting late. If I delayed any further, could miss the last bus passing through the village. I packed and secured my mobile and mp3 player in a plastic cover. I walked to the bus stop in the heavy rain after bidding good bye. Murugan also walked right beside me. He wanted to give me a ‘send off’! I enjoyed getting drenched. The tiredness of the day got washed away, as I walked with the hope that Murugan would come to the Hospital after many years.

Three weeks later, Lo behold! Murugan and his aunt came to the hospital for an admission. We had already decided that Murugan’s aunt need not pay any money to the hospital for the in-patient care. There was an arrangement made to procure free food for him too. We explained the possible side effects of Clozapine and the need to come to Hospital weekly for a blood test, before we started him on Clozapine. He and his aunt agreed to the contract. On Clozapine, his behaviour started improving. Before we reached the full dose, I had to go to another part of the country for some work. So I did not see him at discharge. I heard that he improved much by the time of discharge.

What a joy it is to be involved in people’s lives to change it for the better. In the trip to his village I learnt much. The label of being ‘mentally deranged’ transcended even love. Even his dear aunt used it. It was not as bad as I thought. The stigma of mental illness is less palpable in villages, as people did relate with the patient. They chatted, played and smoked with him. After all, he was their friend who got ‘mentally deranged’. The picture was different from what his aunt described. Anyway, what I saw was a snap shot. I might understand these issues more in the future. Murugan comes regularly for follow up, now.

What happened after Murugan got discharged? That would be covered in a future post.

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* Name changed

 ‘Murugan’ is a very common name in Tamil Nadu

Posted in challenge, distress, drug therapy, indian society, psychiatry, schizophrenia, stigma | Tagged: , , , , , , , , , , , , | 15 Comments »

“There is a limit to suffering one can take. I have to poison her before she brings disgrace.”

Posted by Dheeraj Kattula on April 5, 2010

She had an innocent smile of a child on her face. It was the first time I was seeing her. She was of dusky complexion, cute looks and shy behaviour. She had been on low dose anti-psychotics for few weeks. Her mother complained of her missed periods. Every day, we reassure a lot of people regarding menstrual abnormalities secondary to anti-psychotic use. As I reassured them, I could see that her mother was not satisfied. She complained of swelling in her lower abdomen. I smiled sarcastically at her ignorance. I felt she was worried thinking of menstrual blood getting accumulated down there.

Ignorance is fought with education. A couple of minutes of psycho-education could let them cool down, I thought. As I reassured them again, I noticed a smile of the patient. It was not the usual smile. It had a touch of mental retardation. I became serious. I knew she is a likely victim of sexual abuse. She was single, female, poor, beautiful and mentally disabled. I looked at her parents again. They obviously knew better than me of the possibilities. That was why they looked so distressed. They were afraid of the worst possibility- PREGNANCY.

The elderly couple also have a son. He has chronic Schizophrenia. He is dependent on them. The patient in front of me was dependent too. The grown up children cannot do any meaningful labour in the marketplace. Their mother is the bread winner. Their father is unable to work anymore because of old age. He minds the kids at home. The old lady was already in tears. I told her that she was not alone and such suffering is not uncommon. I realize these words are empty. Suffering hurts most when it hurts you.

She wiped her tears with the free end of her saree. She said “There is a limit to suffering one can take”, as she blew her nose she added, “I will have to poison her sometime, before she brings any disgrace to us.” I could understand her pain. I was shocked to see her daughter smile innocently as she heard this. I knew why this ghastly filicide had not happened till now. It is not tough to kill someone who would submit to you with a smile. It is impossible. Her mother loved her much. She just did not know how to handle her situation,  if at all there is a right way to handle it.

I wanted to send the patient for a pregnancy test. I also wanted to treat her with dignity as an individual with some ‘capacity’. So I asked her if ‘any man had come close’ to her. She agreed with a shy smile. My heart sank. Her mother nearly fainted. She reached out to the nearest bench that was available. I told them not to worry. We could find out if she is truly pregnant in the first place. Her missed periods could be due to medicine itself.

 Her parents did not want the test!!! Why?? I was shocked. They should be asking for it not me! They told me that a test would take time and if they do not go back in time, their schizophrenic son might wander away. Our OP assistant gave them an idea. Her father could return home and mother could take the patient back after the tests are over.

After a couple of hours, I saw them again. The pregnancy test was NEGATIVE. I sighed with relief. I am pro-life. I cannot think of recommending an abortion. We don’t do it in our hospital either. In fact if she was positive, I really do not know what I would/ should have done. Thank God! The old couple would not get another dependent into their family. They also did not have to kill a weak and helpless unborn child.

I told the mother to teach her to keep a distance from unknown men. Of course I know the ones who abuse are usually the known men. But here it was the case of an unknown man. Her mother told me that she had beaten her number of times to teach her that lesson. I wondered why she had to beat her daughter before an act was done! She knows her daughter and their situations better. I better not theorize how to handle these at this stage.  Anyway, now that the patient has experienced a ‘reward’ for the act, I predict she would continue to seek it. This is not my guess .It is the law of effect in maintaining behaviours called ‘operant conditioning’. I suspect that the mother understands this risk. She can never be in peace.

They left, temporarily relieved. I know God does not test us beyond what we can stand. I hope and pray they do not fail the test. We can imagine but we would never know tough it is. How could one help the patient live in safety? What should this mother do now, to prevent such happenings? What are her options given that are such daughters have right to liberty granted to them by International law like Convention on Rights of People with Disability? Where do local laws/ policies stand in situations like this?

Do comment and help me write the responses to the questions stated above in my future posts.

Posted in behavioral therapy, challenge, children, distress, ethics, law, love, mental retardation, schizophrenia, stigma, women's issues | Tagged: , , , , , , , , | 11 Comments »

“Divide and Serve”

Posted by Dheeraj Kattula on December 29, 2009

I worked in a Hospital associated with Leprosy work for quite some time. Few months ago I went back to my parent hospital and my own specialty. I returned few weeks ago to cover for absence of a doctor for a period of 3 weeks. Dr Johnson, the doctor whom I have relieved was also here for a short term replacement only. I went with him to the Leprosy home for a routine visit. I found that the whole atmosphere there has changed. Patients were more involved in care for themselves and also for others. This came as a shock to me. I have seen them for years. I found them indifferent to their own problems, not to speak of problems of others.

 Dr Johnson organized games after the clinic was over. I was overjoyed to see the participation of the inmates. I was curious to know, what magical spell he had cast that the whole culture had changed in a span of 6 weeks that he was here.

The problems that patients faced were usually reported to the paramedical staff. Those staffs were responsible to settle the problems and refer appropriately to the hospital. The paramedical staffs are also responsible for arranging food, supplies, accounts etc. They were not answerable to the hospital administration directly. Their broad job descriptions and not being in span of authority of anybody on a daily basis gave them freedom. The patients suffered. Hospital could only help when hospital staff visited the Leprosy Home or when patients came themselves to the hospital. My predecessor and I tried to change the organizational structure for the better. We failed. So, we reduced the target of quality and tried the best that we could do instead of looking at the best that patients could get.

Dr Johnson changed the system without changing organizational structure in any way. He divided the patients into groups of 6-8. He selected young, intelligent persons within their group to the group leader. He divided the groups in such a manner that each group had a balance between young and old, fit and disabled etc. So there were groups among men and groups among women. He selected one representative from men and one from women. The group leaders are supposed to meet these representatives everyday and report the problems faced by individuals in the group like who has got fever, who pricked her/his foot with a thorn etc. These reps were senior inmates who have received some medical training. They knew when a patient could wait for the next visit of paramedical worker/ nurse/ doctor and also when a patient needed to be moved to the hospital.

Within a short time the groups became alive. They met regularly. They knew each others problems. They started to help each other in other ways as well. Their attitudes changed. Initially, they had to report their problems to STAFF. Now they had to report their problems to their OWN people, which is much easier. Dr Johnson taught me the principle of decentralization in a novel way. The paradigm that patients can care for each other is also new. The beauty is that it also works. There is another lesson. Individuals, as weak as they could be can become more self-reliant in groups. Leprosy home visit would remain memorable for many reasons.

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