Struck down in the prime of life

Wives of stroke victims struggle to come to terms with their husbands' impaired physical and mental abilities

Photo: Fostin and Margaret

By Shevlin Sebastian

On January 14, 2005, Lucy's life changed forever. Her husband, James, a surgeon, suffered a stroke. There was a huge clot on the right side of the brain. “His left arm was paralysed,” she says. Lucy did not realise it then, but her husband's career as a surgeon was over.

Six years later, Lucy says, “Initially, I thought James would recover completely. But as time passed, this did not happen. I tried to adjust to the situation, but there have been moments of anger and frustration.”

In her spare moments, she would hark back to the life they had before the stroke. “I would think about that many times a day,” says Lucy, who works as a nurse in a private hospital. “Now it is much less.” It was a happy carefree family. The couple had met in the Kottayam Medical College, fallen in love, and got married. They have two school-going girls. “We had a good life,” she says. “My mother-in-law stays with us and looks after the children. It enabled me to concentrate on my work.”

But now the rhythm of their lives has changed completely. They have to forsake family outings, or social get-togethers. “I feel angry with myself, because of my inability, sometimes, to accept the situation,” she says.

What has affected the family dynamics is the change in James's character, post-stroke. “He has become anxious about everything,” says Lucy. “James always feels a sense of doom, as if something is going to happen to our children and myself. So, he restricts us from going out.”

And when Lucy does go out, James will call her and say, insistently, “Where are you, where are you?'” Earlier, there would be more than a hundred calls a day. “Now it is much less,” she says. “I got angry with him often.”

Clearly, Lucy is under pressure now. “Yes, that is because I have to take the burden of shouldering the family now,” she says. But like most women, there are times when she becomes depressed. “My moods go up and down,” she says.

Meanwhile, P. Margaret is just recovering from a shattering experience. At 1 p.m. on May 25, her 50-year-old husband, Fostin, drove a motorbike to the medical laboratory in Njarakal, which he was running with the help of Margaret. A few minutes later, he suffered a paralysis of the hands and the legs. It was a stroke, although an initial MRI scan did not reveal any clot in the brain. “It takes about 48 to 72 hours for the clot to appear in a MRI scan,” says Dr. Sasikumar, of the Kumar Centre for Stroke and Neuro Rehabilitation, at Vaduthala, Kochi, where Fostin is undergoing treatment.

Initially, Fostin had a lapse of memory and could not recognise his wife and children, Noel, 18, and Niya, 15. “I wanted to die,” says Margaret. “I felt shattered. One moment, my husband was fine and the next moment, he did not know who we were.” But, over the past month, Fostin has gradually recovered the use of his arms and legs. But his memory is still fragile. So a therapist is showing him photos of apples and bananas, and saying, “A for Apple, B for Banana.” It is an unnerving sight. As Kumar says, “A stroke comes into the brain like a thief.”

Over the past few weeks, as her husband began to make steady progress, Margaret's hopes have soared. “I know that there will not be a full recovery, but I am happy at the improvement he has made so far,” she says. So far, the family has spent Rs 6 lakh. And Fostin has been lucky that his brothers in the UK and Canada have helped him financially.

At the rehabilitation centre, Fostin receives electrical stimulation which is directed at his brain and the legs. Apart from that, there is speech, physio, play and music therapy, apart from weight training. As she recalls the events, suddenly, it becomes overwhelming, and Margaret bursts into tears. Soon, her body is wracked by sobs. She cries for several minutes. Finally, she says, “I pray to God that such a calamity does not happen to another person.”

In today’s highly stressful world, unfortunately, there are many tragic stories of families getting devastated as bread-winners lose control of their minds and limbs and become a vegetable.

(Some names have been changed)

(The New Indian Express, Kochi)

The Ghosh Chromosome

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Amitav Ghosh's second novel of the Ibis trilogy, 'The River of Smoke' has just been released. He talks about the power of the imagination, the joys and pleasures of writing, and what it is to be a full-time author

By Shevlin Sebastian

There was something wet and cold plastered against his cheek. He [Bahram Modi] raised a hand to wipe it off, but just then the ship went into a steep roll and he ended up smearing the stuff on his lips and his mouth. Suddenly, in the pitching darkness, with chests and containers sliding and crashing around him, his head was filled with the giddying smell of opium.

This is an excerpt from Amitav Ghosh's just released ' River Of Smoke '. It is part two of his Ibis trilogy, the first one being the acclaimed ' Sea of Poppies ', which was short-listed for the Man Booker Prize in 2008.

Set in September, 1838, it follows the lives of unforgettable characters like the Parsi, Seth Bahram Modi, who travels, on a ship, from Bombay to Canton in China to do business in opium. In Canton there lives his estranged half-Chinese son Ah Fatt. Other interesting people include the plant-hunter Fitcher Penrose, amateur biologist Paulette Lambert and the painter Robin Chinnery.

Ghosh writes about events that led to the Opium Wars between Britain and China. Throughout the book, there are so many vivid scenes that a reader feels as if he is physically present at the various locations.

“When you write a novel, if it is not real to the author, it won’t seem real to the reader,” he says. “I have a technicolour image in my mind. But it does not come immediately. It is only in the process of doing draft after draft that the image becomes clear.”

At first, it is like a pencil sketch. “And then, I ask myself, 'What are they wearing?' Then I will go and do some research. Slowly, the colour gets filled in. And soon, there comes a time when I see the characters with the utmost clarity,” says Ghosh, who was on a one-day reading tour to Kochi. “In fact I can hear their voices clearly and see them move around. By the time I finished writing this book I knew a place like Canton intimately.”

Astonishingly, for a big novel like the River, which is 553 pages long and contains 1.95 lakh words, he had no structure planned beforehand. “The characters take a life of their own,” he says. “It sounds chaotic, but I am literally blundering my way through. Many times, I have moved in the wrong direction. Then I stop, go off on another track, but, thankfully, in the end it all works out.”

Ghosh, who splits his time between Kolkata, Goa, and Brooklyn, is a full-time writer. So he starts work at 9 a.m. and writes throughout the day, with a one-hour break for lunch. But the writing life is tough. “You don’t get a regular salary,” he says. “There are long periods when I don’t earn anything at all. But I don’t get stressed out by it.”

A few years ago, Ghosh was a Distinguished Professor of Comparative Literature at the City University of New York. He had a steady income, apart from an easy work schedule. “But that stressed me out,” he says. “To write you need the uncertainty. Otherwise, it takes away the edge. You have to feel you are on the brink of a precipice all the time.”

As a result, Ghosh has had a distinguished career so far, and won many international prizes, like the Prix Medicis, the Sahitya Akademi Award, and the Arthur C. Clarke award. His work has been translated into more than 20 languages. In 2007, he was awarded the Padma Shri.

So what are the tips on writing that this master novelist can impart? “Anybody who wants to write should read a lot,” says Ghosh. “You should also write regularly. Writing is like music. To be a good musician, you have to do your riyaaz every day.”

And Ghosh is feeling out of sorts because he is unable to write while on this book promotion tour. “I am missing my riyaaz,” he says, with a smile. “When I get to my desk, it will take me two weeks to get back into the groove. I am like a musician who realises that he is working with an instrument that is out of tune.”

(The New Indian Express, Kerala)

Novelist Amitav Ghosh meets an old friend

By Shevlin Sebastian

Photo: Amitav Ghosh (left) conversing with Cherian J. Punnathara
Credit: Manu R. Mavelil

When Cherian. J. Punnathara, a Kochi-based senior journalist hears that Amitav Ghosh is coming to Kochi, he feels that it is time to meet the famous author. At the Vivanta By Taj, he accosts Amitav and says, “I am Cherian.” Amitav immediately replies, “From the CDS (Centre for Development Studies).”

Cherian nods and the two shake hands. They are meeting after 28 years. In 1983, Amitav, a research scholar from Delhi University, had come to use the library facilities at the CDS in Thiruvananthapuram. There, he befriended Cherian, an M. Phil student, and Tirthankar Roy, who is now a professor at the London School of Economics.

And it was in Cherian’s room that Amitav used his friend’s Olivetti portable typewriter to type out the first draft of his critically-acclaimed novel, ‘The Circle of Reason’. Asked how his friend is, Cherian says, “Amitav is the same bubbly and chirpy person I knew so many years ago. The only change is that his hair is completely white.”

Cherian, of course, is an admirer of Amitav’s writing. “He has a wonderful narrative style, and there are so many plots and sub-plots in his novels,” he says. “Amitav captures the social milieu so well, and his focus on detail is admirable.”

As the friends begin chatting, Amitav says, “One of the most memorable experiences during my stay in Kerala was our trip to the waterfall in the Bonarccad forest, near Thiruvananthapuram.” Cherian, Tirthankar and Amitav had spent the night out in the open besides the waterfall.

“Those were good times,” says Cherian. “It was nice to meet Amitav after such a long time.”

(The New Indian Express, Kochi)

In Intensive Uncaring Units

Elderly people have a bleak time, on the economic, social, and psychological fronts, says Helpage India CEO Mathew Cherian

By Shevlin Sebastian

Photo: Mathew Cherian of Helpage

In the town of Virudhu Nagar, 40 kms from Madurai, the people have adopted a practice called Thalaikoothal. An elderly person is given an oil bath. Thereafter, he or she has to drink several glasses of coconut water. At night, they are forced to sleep outside in the open. Some suffer from thermal shock. Within a day or two, the person is dead.

“This is the method by which the people, in a few communities, in Virudhu Nagar get rid of their old parents,” says Mathew Cherian, the CEO of Helpage India. The District Collector was informed. Thereafter, the State Government has constituted a committee to enquire into the practice, which has been going on for decades.

For Cherian, this is no surprise. Helpage recently completed a survey, ‘Elder Abuse and Crime in India’ where they surveyed the lives of elderly people in nine cities: Delhi, Mumbai, Ahmedabad, Kolkata, Bhopal, Chennai, Patna, Hyderabad and Bangalore. Some conclusions: among the poor, verbal abuse is the most common form of harassment, while for the upper classes, it was neglect. “The abuse goes up after a person crosses 70 years of age,” says Mathew.

Among the higher classes, property issues were the most common reason for friction between parents and children. “In earlier times, children waited for the parents to die, before inheriting the property,” he says. “Now they want it earlier. I would put the haste to the rampant materialism in the middle classes.”

There are cases of parents who were unwilling to sign away their property, and the children have retaliated by locking the couple up, and beating them. “There is an elderly couple in New Delhi who has spent many years in the balcony of their house because of ill-treatment by their son,” says Mathew. “There is a widespread decline of moral values.”

Surprisingly, 98 per cent of the parents did not file any complaint against the abuse. “There are various reasons for this,” says Mathew. “One is that the parents do not want to go against the children. Secondly, it would spoil the family name. So they absorb the humiliation in silence.”

On the rare times when they have complained, the police have been indifferent. “For them, this is a matter of low priority,” says Mathew. Also, unscrupulous policemen inform hoodlums who then rob the house of these vulnerable people.

The biggest problem facing the elderly, especially the poor, is the low pension given by the central government. “It is a paltry Rs 200 a month for those below the poverty line, and reaches only 1.6 million people,” says Mathew.

Last month, the Chief Minister of Tamil Nadu, J. Jayalalithaa had increased it to Rs 1000. “This is more substantial,” he says. “The Kerala government has not made any announcements. Pension and provident fund money reach only 9 per cent of the population. The remaining 91 per cent do not have any statutory benefits.”

Apart from economic problems, old people suffer from loneliness. “The children are frequently living in other cities or are abroad,” says Mathew. “There is no support system. Some people call a helpline, just to hear a human voice.”

Helpage encourages schoolchildren to meet elderly people in their homes. “You can visit them in your own street,” says Mathew. Meanwhile, the scenario in Kerala is also bleak. “Increasingly, children are treating their parents with a lack of respect,” he says. “Verbal and emotional abuse has increased dramatically. The main cause is the breakdown of the joint family.”

However, in Kerala there are efforts to provide palliative care. But when people are terminally ill, they like to die with their relatives and friends near them. “Instead, the tendency of hospitals is to isolate them in the ICU,” says Mathew. “So death is not dignified at all. We are trying to set up an Indian protocol for elderly geriatric care.”

All those who are reading this should realize that one day they are also going to become old. “So treat your parents the way you want to be treated, when you become an elderly person,” says Mathew.

Giving blood for a good cause

June 14 is World Blood Donor’s Day. Regular donors speak about their experiences

By Shevlin Sebastian

Photo: Roy James Kappan receiving an outstanding donor medal from former Chief Justice K.G. Balakrishnan

One day, in 1980, Venkata Subramanian who works in the State Bank of Travancore, went to the Fort Kochi government hospital to consult a physician Dr. Rao. While there, he noticed a 75-year old man who needed blood. “His wife was crying because they could not find anybody to donate blood,” says Venkata. So the banker offered to give his blood, but he was O negative, while the patient needed B positive.

However, a few days later, Dr. Rao called him and asked whether he would be interested in being a donor. “Somebody needed O negative,” he says. And that was how Venkata started donating. Till now, for 31 years, after every three months Venkata donates blood.

He was recently transferred to Palakkad. “But whenever there is a need, I come to Kochi and give blood,” he says. Usually, each time 300 ml of blood is taken. After that, there has to be a gap of three months, so that the shortfall can be regained. Venkata says that it is a myth that you feel weak after giving blood. “I always feel fine,” he says. And the blood donated is just 1/20 of the body's total capacity of six litres.

Asked why he does this, Venkata says, “When a person can contribute without any loss to oneself and at the same time save the lives of others, what is wrong with that?”

On February 27, 2010, Roy James Kappan received a memento as well as an outstanding donor medal at a function organised by the IMA.

The citation read: 'We are pleased to inform you that the IMA Voluntary Blood Bank has decided to honour you for your dedicated efforts and for your enthusiasm to propagate the concept of voluntary blood donation. You have set an example which will be followed by many in the years to come.' Incidentally, this was the fifth time that Roy had received this medal.

Roy, 45, began donating blood in 1979. “When I came to know that my blood group, A negative, is rare I started giving my blood regularly,” he says.

Thus far, Roy has donated blood 47 times. Whenever he sees an advertisement on television or in a newspaper asking for blood, he goes at once. Once he went to the Lisie Hospital. There was a 22 year old college student, who was suffering from haemophilia -- the lack of clotting of the blood. “He had a cut and had lost a lot of blood,” says Roy. “I willingly gave my blood. The family was so grateful that they offered me money. But I refused. For me, it is a social service.”

Meanwhile, at the IMA blood bank, they distribute about 3000 units every month to 60 hospitals in and around Kochi. “There is always a shortfall,” says Dr Sachidananda Kamath, the president of the IMA Cochin branch and a trustee of the blood bank. “But we hold regular blood donation camps. Thanks to the media there is a widespread acceptance among the public about giving blood.”

Incidentally, the blood group, ‘O positive’, is the most in demand. “The majority of the population has this blood group,” says Kamath, The rare ones are A and B negative. When the blood is collected, thanks to advanced technology, it is divided into three components: red blood cells, plasma and platelets.

“If a person is anemic, we give red blood cells,” says Kamath. “For liver diseases, plasma is required, while for leukaemia or dengue fever, you need platelets. In essence, we can give one unit to three people.”

June 14 is World Blood Donor’s Day. “My appeal to the people is to donate blood,” says Kamath. “A life somewhere can be saved because of your generosity.”

(The New Indian Express, Kochi)

The dark side of student life

Many children suffer from depression. Unfortunately, most parents and teachers are not aware of this. Timely treatment can ensure proper healing

By Shevlin Sebastian

Lakshmi (name changed) was a bright student. She regularly got the first rank in the exams in Class 5. One day, she had a headache and fever. For a few days, she could not go to school. When she returned, the teacher said, “Why were you absent? You missed some important chapters.” That casual remark had a devastating effect on Lakshmi.

For many days she complained of a headache and did not want to go to school. “The teacher will scold me,” she repeatedly told her parents. Lakshmi missed school for days together. Soon, weeks went past.

The desperate parents took her to psychologist Dr. Prakash Chandran. After regular counselling, Lakshmi returned to school and sat for her exams. She did well. Then the summer holidays came up. There was a gap of two months. “When school re-opened, she did not want to go back,” says Prakash. “No amount of persuasion could change her mind.”

In her family, an elder sister, who is studying in a degree course, has no problems.
“Lakshmi’s illness may be due to a chemical change in the brain,” says Prakash. “I don't think the parents can be blamed.” Unfortunately, for the past three years, Lakshmi is being tutored at home. The good news is that she is doing well in her exams, but going to school still holds terrors for her.

Not many people know that children, like Lakshmi, are suffering from depression. There are various causes for this. In kindergarten a child suffers from a separation anxiety. They are being moved physically from their parents and siblings and taken to a strange environment. So, the child becomes depressed.

Another cause is when a second child is born. “The parents show more love and affection to the baby,” says Prakash. “This affects the elder child.”

Thirdly, unknowingly, parents create a fear psychosis about school. “Sometimes, parents will tell their children that they can get away with all the mischief they do at home, but in school, the teacher is bound to scold them. So, children develop an anxiety about going to school.”

Stress can also cause depression. If class work is beyond the capability of the child, he or she can become depressed. “Parents in Kerala put too much pressure on children to do well in their studies,” says Prakash. “There are fathers and mothers who start teaching the syllabus of the next year before the summer holidays have finished.”

Since children are unable to verbally express their depression, they take it out through various actions. They will destroy toys or eat paper, pencil ends, erasers, or suck their thumbs. “They might suffer from psychosomatic illnesses like head and stomach aches, vomiting and fever,” says Prakash.

Unfortunately, parents and teachers are unaware of the mental fragility of the child. Teachers usually describe unruly behaviour as naughtiness.

“Ninety per cent of the parents as well as teachers have no idea that a child can suffer from depression,” says Prakash. “It can begin at the age of three. But depression is a disease and can be cured, provided the child receives timely counselling and treatment."

(The New Indian Express, Kochi)