Thursday, January 12, 2006

Our group had gathered at friend's house to usher in 2005.'Group" consists of friends who had met for the first time when they were students in 5th std. in Bharda High school opp. V.T. A common passion for cricket had brought us together though we were not in the same class in subsequent years.After S.S.C. all of us joined Science stream in KC. college and after passing out Inter Science, I joined medicine in Mumbai,others went for engineering used to meet during vacations,go for cricket matches, evening walks on Marine Drive, party together-Prohibition was just removed from Mumbai- go for Christmas and New Year eve parties, go out on picnic together and over the years, group became cohesive.We were close friends. Luckily for us, all of us got married in'74-'76 period,shifted to suburb Juhu-Andheri at the same time,had first child -all daughters-in '76-77' and second child -sons-in '81-'82 period.Because of these happy coincidences we could remain together as group.
Now we were partying with families, go on vacation tours together, and though the children had their set of friends, the unwritten rule was that they had to be present in group's parties and tours arranged during vacations. Years flew by. Here we were ushering in 2005. we,friends and spouses were present. Children had moved to US for studies. Girls had graduated and were holding good jobs, all of them except A..... were married and Boys were doing their Masters in US. There was sense of satisfaction and happiness in the air. As if our life's goals, mission had been achieved. What more could one ask from life?
All the friends had good prosperous lifestyle, could give good education to children, daughters was married, and sons were planning to settle in US( They will manage, wont they?). Now we were free to plan and live life as we wanted to. Do things or pursue hobbies which we had put off for years.
Anchors on the TV show had started countdown and 2005 had arrived. We hugged and wished eachother and then as if on cue, children phoned in from US wishing us Happy New Year, all of them had to wish all the uncles and aunties !!. Everyone was in high spirit but H... was not well, she had upset stomach, so she wouldn't join for dinner.In the euphoria of the celebrations no one noticed.
Next day afternoon she phoned me.She was passing blood in stools. I immediately fixed up her appointment with the surgeon friend. He phoned me in the evening.There was a Large Colorectal Polyp. she was posted for Colonoscopy next day. There was large Polyp in colon.we took biopsy and now had to wait to find out whether it was cancerous or not. we spent anxious 5 days and then the verdict was out-it's benign tumour.Second opinion was taken and CT scan done. Same finding. Non cancerous Polyp. Gastroenterologist was confident that he would be able to remove it by Colonoscopy. As it has broad base he may need 2-3 sittings.H... had undergone 2 c-sections and was not willing for surgery. Besides she feared that colostomy will be done and she was not prepared for that.No amount of arguing could convince her, so we decided to go for colonoscopy. But 2 session of Colonoscopy removal convinced us that surgery would be the best option. By then it was time for her daughter to come to India to purchase her wedding dress and jewelry. Then there wasn't sufficient time between Surgery and her US visa interview date. (There was 4 months wait for Visa interview!). They got their Visitor's Visa and now there wasn't sufficient time to recuperate from surgery before she was to fly to LA. So she went for her daughter's marriage, friends from the group went to US to attend the wedding. She returned to India and we took appointment for Colonoscopy.News was bad ,Polyp had grown in size and CT Scan had suspicious area. She was posted for surgery in Lilavati Hospital. I accompanied my friend and we waited in the big lobby on the 1st floor.After long wait-operation lasted for 5 hours- surgeon came out.we hurried to meet him.
He just said " She will need Chemotherapy".This almost shattered us but I recovered,
You could get clear margin and remove the tumour?
Nodes involved?
Liver metastasis?
Local metastasis?
Ya, in Paracolic gutters and P.O.D.
He walked away. So much for breaking the news gently.!! Such are vagaries of life. This Slow growing Cancer did not spread to the surface of Polyp, instead it chose to spread towards the base, through the wall of the colon to the area outside. Not a single Biopsy showed even a suspicious or pre cancerous cell.!! Here we were faced with Stage III cancer.This is the reason why people believe in Luck,Destiny and stars!
That one sentence had shaken my friend.Now onwards life is going to be different. Ours is generation which made transition from Joint family to Nuclear family. We grew up in large families -what you see in 'Saas Bhi Kabhi...Grand-parents,parents,uncles,aunts,cousins and even guests from native place lived under one roof.There was solid extended family support for everything.The strength was in number and families could take illness,financial disasters, scandals,deaths in it's stride without flinching.But we had moved out from this big comfortable shelter, and were living independently with wife and children.the extended family was there, but it was scattered. After 25 yrs it was not possible for the family to be together as cohesive force.Ones brothers and sisters and cousins were just a phone call away,but they had limited time for you and years of separation had weakened the bonds.They will phone ,come and meet but for an hour or two.Then they have their life,children,and other problems to take care of. One realizes comfort and strength of joint family during such phases in life. We had added disadvantage. Children were far away from us.They would phone everyday but it was not possible for them to come and be with us. With this cancer ,its treatment and possibility of complications, it will be difficult to manage work and look after his wife.He had to go out of town often on business trips.Now it would be difficult to leave H... alone. But the group became the extended joint family.After being together for almost a lifetime we were one family. Circumstances had conspired to force us to be together,to join forces to face the adversary. We were there to give support,to comfort each other,to allay fear of unknown future, and to let everyone know that he/she is not alone.H... has completed Chemotherapy. She did not loose her hair( Her biggest worry) rather she tolerated chemo. very well and had no adverse reaction.She is 'CURED' at present.
We have gathered to usher in 2006. Mood is sober.Events of 2005 has not dampened our spirit. This year children have come home to celebrate Christmas and New Year.There is hope in the air,K.... will be leaving for US in Jan to be with her daughter who has on 28th delivered a healthy baby boy ! The first of the Grandchildren. Life is beautiful once again.We have something to look forward to. God willing 2006 will be year of Grandchildren and group will visit U.S. to bless them. Anchor has started reverse countdown.... but mentally we are already in 2006.

Wednesday, January 11, 2006

Million Missing Girls

The recent article in Lancet has again focussed on Female Foetecide that is practiced in some parts of India.There will be edits in Newspapers-TOI- has it as lead edit today.There will be seminars and discussions, but at the end of the day whats the solution? how do we tackle this problem?
As this study has shown, all the 'established' causes have fallen on the wayside.
Its not poor but Middle class and rich are major offenders.
Dowry is not the cause for aborting girl child.
It's not illiterate mother, rather well educated mother prefers to have male child. It also absolves husbands who were accused of forcing their wives to get Sex determination done.
Our society is supposed to be agrarian so extra pair of hands(Son) was preferable. But now statistics show that even in rural economy females contribute more economically, so its not an issue.
As obstetrician I feel really helpless.As technology advances, with 3-D Ultrasonography, better resolution on good machine,it's very easy to know sex of the child. It is now possible that on 3D USG machines even mothers will be able to know sex of the child when USG scan is in progress.
With newer technique even Abortion is easy to perform.Few tablets and female foetus is dead.It will abort on its own or Doctor will have to do to protect mother from severe infection.
In ART methods , its possible to Pre select sex of the foetus before Embryo Transfer.
So where do we go from here? You cant educate well educated mother. All that we have done so far is to show danda of PNDT act to doctors.But there will be black sheep in every field and there will be greedy doctors who will be willing to carry out USG scan.With these newer machines he wont have to even say anything.Mothers will recognise sex of the foetus.
I sincerely hope that we will be able to find out some ways to reduce this.I believe that there is steady decline in demand for sex determination tests.May be after few years ratio will correct itself. But till than I will keep my fingers crossed.---PK