Tag Archives: #healing

Trinity Cares Foundation fight against COVID-19 in Jangamakote Village. (Creative Commons License 2.0)

Don’t Forget People Are Still Dying In India

It started in mid-March 2021, the many videos of grandparents hugging their kids post-vaccination in the US. Families reunited safely after a year or more of waiting to touch. Pictures of social interaction among vaccinated people started appearing on social media feeds. People sat outdoors in restaurants in the sun. The CDC guidance changed about masks for vaccinated people.  

I live in the NY area. Perhaps, we can go to Broadway shows again soon. Maybe, we can relegate to memory those days of heartbreaking pictures of daughters looking in through the windows of nursing homes to get a glimpse of their mothers through the glass and families trying to decide whether to have Thanksgiving dinners sitting as far apart as possible in different rooms.

I do like the current optimism in the US on COVID. But for some of us, the pandemic is far from over. As an immigrant from India, I wish American media covered more world news.

For me, the pandemic is still very much alive. When I check my WhatsApp in the morning, before the fog of sleep has cleared, there is news from India. It may be that again someone we knew has passed away from COVID. In Facebook groups, someone else is looking for oxygen. The lucky ones are waiting three hours in line for a vaccine, while others don’t know when they will get a dose at all. They don’t need beer, donuts, or million-dollar lottery prizes as incentives to get vaccinated. 

There is a raging pandemic going on in India and in major parts of the world. If you believe in the overarching value of human life, you ought to be worried. 

I have been living in the US for more than two decades. As an immigrant, my threshold for pain is different. Even in regular times in my community, only the lucky children get to physically run and hug their grandparents once a year on a trip to India. We are lucky if we get to attend weddings of close relatives or be present when nephews and nieces are born. Every time we leave home in India, we aren’t quite sure whether we will see the very old ever again. 

No, the pandemic hasn’t ended for me. 

My septuagenarian father in Kolkata, India, who is disoriented after losing his wife last year in August, and has been socially distancing in the pandemic for so long, can neither go to the bank to stand in line or go to the fish market like he used to. He still has not been able to return to a fully independent life of doing the things he used to do. He has been taking social distancing seriously and I just long to hug him after my mother’s passing.

My father sits in a room surrounded by buildings that block the sky on all sides. There is no place to take a walk safely without running into people, even though that number continues to decrease because of COVID-related deaths. One neighbor, who called before my mother’s shradh ceremony (which is similar to a funeral) to inform us that she couldn’t attend, passed away just a few days later from COVID.

I talk to my father on the phone every day and tell him that all this will be over soon without really knowing what to believe myself. So, I switch to a conversation about how things are looking up in New York – at least he is happy that I am safe. 

Cable news channels in the US constantly state that the pandemic is ending. Occasionally, there is some coverage of other countries on the chyron when some complex US political complication is being discussed animatedly on the main screen. While there was never very much coverage of world news through the pandemic, I had hoped that we would hear more about those that are passing, at least from here in the US.

I live in the US and have lived here for twenty years. I am hoping the pandemic ends here. I teach in a college in Manhattan. I’m fully vaccinated. I’m eager to see my students in person just like anyone else. I’m hoping everyone else will be vaccinated when I take the train to Penn Station from New Jersey in the Fall. I, too, am hoping to sit in a cafe and write. I’m glad I can bring in groceries, now, without disinfecting them obsessively. But even as I think of my life here, I’m aware of the suffering of people in other countries. That is not just because I’m an immigrant. It’s because even before I became an immigrant, I grew up with the consciousness of the world through world news in India. 

For the first year of the pandemic, my experience of the pandemic in the US and India was parallel. I was looking in through the glass at my ailing mother last year all through her 5 months of sickness in Kolkata. I couldn’t visit her during the first Indian lockdown and the first wave of COVID in India. The glass in my case was not a hospital ICU wall but a phone video screen. The video was often blurred. Sometimes, I thought she recognized me on the screen. Sometimes, I thought she only saw the phone. She lost speech and then we eventually lost her in August 2020 through indescribable hardship.

For those of us, who lost someone close in the COVID world, the post-COVID world, if and when it comes, will never be the same.

For months I have been planning on how to visit my father in India safely. I have planned various scenarios in my head through the spikes in COVID cases in the US and India, and through lockdowns, flight cancellations, planning local transportation in India, COVID tests, seat availability, vaccination – tracking every little large and small last-mile problem through my mind’s eye. 

Yet, I have only ended up reassuring my father in India over the phone that he will go to the fish market soon, that he will be able to stand in line at the bank soon, that it will be safe for him to walk on the teeming Kolkata streets soon. My visit almost worked out when I completed my second dose of the vaccine in the US, but that’s when the deadly second wave hit India in April. My travel plans are on hold again.

World news should matter. Worldwide deaths should matter. Worldwide deaths should matter and not just because a virus mutating in the developing world can put the developed world in jeopardy. 

Death should matter just because we value human life.

Madhura Bandyopadhyay is a Doctoral Lecturer in the English Department at John Jay College, City University of New York (CUNY) in Manhattan, New York. She grew up in Kolkata, India and has lived in Florida, California, and Singapore. She lives in New Jersey now. Apart from being a teacher and scholar of writing, she blogs in her spare time just for fun on her blog at bottledworder.com 


Why Indian Immigrants Are Facing a Unique Wellness Challenge

As America celebrates the loosening of the mask mandate, on the other side of the globe, there is a contrasting scene unfolding, complete with doom and gloom. Since April 2021, India has been battling the second wave of Coronavirus. Mass funerals, new variant reports, vaccine shortage, and an overwhelmed healthcare infrastructure are the new themes in the Indian media outlets. 

Whatsapp is abuzz with concerned messages from loved ones as well as news of losses and hospitalizations. Social media is brimming with not only political whodunnit analyses but also generous fundraising efforts.

Stories abound on how nepotism and bribery came to the forefront, especially when procuring a hospital bed. While in the same thread, we hear heart-tugging stories of kindness and sacrifices, where the human spirit has triumphed.

If you are an Indian immigrant living in the United States with family back home, then you are likely living the nightmare you have always dreaded – that late-night call. 

The fear that you are unable to be there for your family during their darkest hour.

The survivor’s guilt has possibly reached its peak within you. 

Neeta Jain worries in the US about her family in India (Image provided by Author)
Neeta Jain worries in the US about her family in India (Image provided by Author)

 The visa limitations due to outdated immigration policies and the newly imposed travel restrictions further exacerbate the situation for some immigrant families.

Indian immigrants are experiencing high levels of anxiety right now. Some are grieving, some are feeling helpless or guilty. The impact these emotions could have on their health and wellness is unimaginable. Especially given the always-on work culture in corporate America. 

As Indian immigrants continue to power through Zoom meetings, work deadlines, and deliverables, there is little empathy shown in most Corporate American settings. There are not enough conversations about the toll this second wave is taking on the wellness of Indian Immigrants in the United States.

The anxiety attacks. 

The sleepless nights.

The emotional eating disorders.

The survivor’s guilt, which is probably the hardest to reconcile.

While we continue to hope for the situation in India to improve and demand immigration policy reforms, here are five things we can do to take charge of our well being right away:

PLAN A FAMILY ACTIVITY: While our families are in lockdown in India, create a simple daily or weekly activity together, where you and a family member are bonding. Here is an example for inspiration. Bring out a new book and write down recipes from your mother, father, grandmother, or sibling. And even attempt cooking it! Food is love and food is nostalgia, and hence a powerful medium to stay connected. Also, most family recipes are hearsay and rarely documented in a structured format. So this will be a prized possession for years to come!

FOCUS on BASICS: Sleep & hydration. During extreme moments of anxiety, insomnia could surface for some of us and sleep quality and quantity may be negatively impacted. In addition, watching our water intake could take a back seat and we could be hydrating ourselves poorly. When you are going through a rough phase, it is best to keep things simple and focus on basics i.e. Sleep and Hydration. Moreover given these are emotional times, our food cravings could also come back with a vengeance. Maintaining good sleep hygiene and staying hydrated will help with those food cravings too.

GET GROUNDED IN NATURE: With the weather warming up in the northern hemisphere, getting out in the sun and soaking in the abundance that nature offers, will help destress and calm those nerves. Also, feel empowered to take a social media break, a news break, or a complete digital detox to reconnect with nature in any way that feels most aligned with you.

GRATITUDE JOURNAL: It has been hard to stay positive for even the most optimistic person in the room. And hearing for the nth time “Stay positive” or writing affirmations may neither be effective nor helpful right now. But having a gratitude practice, especially in the form of a journal can be transformational. When you bring paper and pen together, the brain is able to process the emotions a bit better, especially those of anxiety and grief. Write 3 things every morning that you are grateful for before you get immersed in the daily grind (Note: this can be the littlest thing!).

FACE THE GUILT: Lastly and likely the most challenging, as facing the Survivor’s guilt requires a great deal of vulnerability. Becoming aware and acknowledging this guilt, which may be wrecking those who have had losses amongst their families or friends is hard. Moreover, there is still a fair bit of stigma around getting help from a therapist or a counselor in the South Asian community. However, try and step beyond that stigma if you can and get help from a licensed practitioner to process this guilt.

Neeta Jain is a health coach and the founder of Her Shakti, a wellness company that helps immigrant women transform into their healthiest, strongest selves. Go from overwhelmed busy bee to nourished goddess with her free tips.


Cremation grounds in India (Image unrelated to ongoing currents events in India)

Firewood: Processing COVID in India From Afar

I was fully vaccinated in March 2021.

In the third week of April, I was planning to fly to India to check on my mother and extended family. My sister was in line for her second shot of the Covishield vaccine against COVID-19. We were excited to celebrate April birthdays and Mother’s day after 2 years. My bags were packed.

India, the second most populated country in the world with over 1.3 billion Indians seemed to have a decent handle on the pandemic. The world watched the initial twenty-day lockdown in India, followed by the mass exodus of migrant workers. Perhaps innate immunity to tropical diseases was helping Indians against COVID. Was the blistering heat not conducive to viral proliferation? Was the COVID-19 strain in India less infectious?

The Serum Institute of India was gearing up for vaccines for domestic and international use. Before Indian citizens were vaccinated, Indian vaccines were exported out of the country. Indian government and citizens were confident of their innate immunity. Steeped in a false sense of bravado, India reopened for business in early 2021. Unmasked gatherings, cricket matches, political rallies, and weddings continued while the B.1.617.2 variant of COVID-19 was raging in a vulnerable unvaccinated population.

Meanwhile, the weeks-long Hindu Pilgrimage congregation in Haridwar (Kumbh Mela) was not canceled. This year Hanuman Jayanti was on 26-27th of April the night of the pink full moon (Chaitra Purnima). This holy dip in the Ganga (Shahi Snan) was considered to be very auspicious. Many devotees tested positive and spread the disease in crowded trains and buses and to their contacts back home. The infectious curve changed from a plateau to a wall. The health care system was overwhelmed. Hospitals ran out of beds, oxygen, medicines. Meanwhile, there was an acute vaccine shortage, and hurdles in getting the vaccine.

My friends and family members are not fully vaccinated to date. So many innocent lives were lost! Fires burnt nonstop. In the first wave, it took five months for the 98,000 a day caseload to about 10,000 a day. This time, the peak is much higher and the downward trend of the second wave could be prolonged. The only hope is to raise herd immunity by mass vaccinations.

I composed two poems, out of my anguish. My idea is not to criticize. I am trying to process the trauma in my community. My poems document our complex human frailty. 



“I will make such a wonderful India…” @Narendra Modi 4/11/18 

Maskless. He addressed them. 

Rows upon rows, their

brains steeped in fervor. 

They cheered and rallied, then

thronged on the shores of a 

weary Ganges, sullying her body

of water. Over and over again.

Inviting Lord Yama to extinguish

their breath. 


He came with a vengeance. 

Coronavirus vanquished thousands. 

Breathless, their bodies crumpled on

the streets. 

No oxygen. No vaccine. No potion. 

No healers. No chant. No mantra.

No yantra. No tantra. No soothsayer. 

No friend or family member 

could save them from their own folly.


They burnt in communal fires in 

parking lots. The stench of death 

smearing the khadi shawl of 

Mother India. She wept

and rued their misguided deeds.

The pandemic raged on, 

mindless of caste, creed, age, gender 

or status. Even the mighty were 

snuffed out. 


But who will be held accountable

for cremating those innocent souls 

who died without rupees for firewood? 


Flying Monkey Moon

The moon maiden was full

and deliciously pink 

A bit pompous, 

A butter macaroon, freshly baked 

Double pink peony daydream. 

Cumulus cloud carpet

Covered the midnight sky.

Sweet salutations were whispered

She smiled and lowered her veil.


Millions gathered on the bank of

the Holy Ganges to take a religious

dip with the Moon and floating diyas

The last day of the Kumbh was 

specially ordained to wash away 

their sins. Coronavirus raged in 

homes, hotels, sky scrapers and 

hovels. Hospitals were out of beds, 

doctors, nurses and life support ran dry.

Fires burned day and night in open 

crematoriums. Mortals chanted the 

Maha Mrityunjaya Mantra for protection.

Hanuman opened his eyes and flew

across the heavens. He thought,

they only remember me on

my birthday. 


I do not want to criticize the government, their policies, or the people who helped spread this scourge.

I am very worried. I am one of the millions who do not know when they’ll be able to see their dear ones – parents, daughter, son, grandson, brother, sister.

In the interim, I keep watching the news, donate money for COVID relief, pray to Hanuman every day.

Monita Soni grew up in Mumbai, India, and works as a pathologist in Alabama. She is well known for her creative nonfiction and poetry pieces inspired by family, faith, food, home, and art. She has written two books: My Light Reflections and Flow through my Heart. She is a regular contributor to NPR’s Sundial Writers Corner.


Amma reading to Medha (Image by Author)

My Mother Kept Her Promise

Like many of us, one of my biggest fears was always that of losing my mother.  Life without her was not conceivable. 

When I was a little girl, and I was exposed to the idea of death for the first time, I remember asking her, “Amma, will you die too?” 

My mother sat me down, looked me in the eyes, and with complete confidence told me, “I will be here as long as you need me.  I will go only when you tell me that you do not need me anymore,”

In my childish mind, that was all the reassurance I wanted.  I would always “need” my mother, and that meant she could not leave me.

Life went on with my relationship with my mother evolving and changing as time went by.  By the time I was 44, my mother was older and frailer, and my relationship with her was that of one between two close buddies.  It was a two-way relationship with my relying on my mother for advice about raising my kids, and seeking comfort when some worldly affair troubled me.  My mother started relying on me to discuss her innermost worries about her health and the family.  The two of us settled into a very comfortable symbiotic relationship. 

This was until January of 2013 when my mother was diagnosed with cancer.  I was now in the US teaching at a university and raising two kids under the age of 10.   The news hit me like a ton of bricks.  I applied for a sabbatical from work to make the most of the time I had left with my mother.  The year was spent shuttling between India and the US, and trying my best to stay present wherever I was.  In March 2013, I was in India for my mother’s 74th birthday.  I got a cake, invited some neighbors, and had as normal a party as possible.   My mother and I both knew but did not acknowledge the elephant in the room – that this could be my mother’s last birthday with us.  My father was not aware of the gravity of the situation, and none of us had the courage to tell him the harsh truth. 

One of my brothers and I took turns to be in India to help our parents.  When I went back in June 2013, my mother, who by now was a lot weaker, still made trips to the local market with me.  Shopping for kitchen goods was our shared passion and, in a typical Indian steel kitchenware store, we both behaved like kids in a candy store.  I could tell that my mother was pushing herself to make the most of the time she had left.  When we sat down in a coffee shop, I could no longer hold the sorrow inside. 

I blurted out to my mother – “Amma, I cannot live without you.”

My mother looked deeply into my eyes and said, “I will leave you only when you are brave enough to let me go.”

I responded “Amma, that will never happen.”   

In my vulnerable mind, if my mother had promised not to leave me until I was ready to let her go, she couldn’t leave.  She always keeps her promises. 

Amma Sadabhishekam
Amma sadabhishekam (Image provided by Author)

September 2013 –  I traveled back to India to give my brother a break from caregiving.  My mother was in the ICU.  Her condition came as a shock to me.  She could barely talk and she could not see anymore.  We did not know this then, but the cancer had found its way to her brain.  The two weeks following that were a blur.  My mother faded into a semi-coma.  Her body was still there but we could no longer communicate with her.   It killed me to see her stare into space when we called her name. 

Then, the bad news arrived.  It was confirmed that the cancer was in the brain.  Our family doctor told us that this was the end and that we should not try any more life-saving measures. The next day, when I was in the hospital, I told the resident doctor in the ICU that we had decided to sign the “Do Not Resuscitate” order.  He pulled out a form and had me read through it.  From where I sat at the doctor’s desk in the ICU, I could see my mother – eyes taped shut, and all kinds of tubes going into her to keep her alive.  The doctor explained to me that when she fails to breathe on her own, her throat would be punctured to insert a ventilator.   Those words punctured my heart.  I looked at my mother feeling fiercely protective of her and told her in my mind: “Amma, I won’t let anyone trouble you anymore.” 

Without any hesitation and without any tears in my eyes, I signed the form.  I walked over to my mother and whispered in her ear “Amma, please go.  This body is not working anymore.  Don’t worry about Appa.  I will take care of him.  Look at me, I am not crying.  I am fine.  Please go”. 

My mother hung on for a few more days, giving my other siblings the opportunity to see her before she passed away on October 9th early in the morning.  I felt numb.  But, I also felt a strange peace.  My mother was no longer suffering.  She had escaped her cancer-ridden body.  She was free. 

A few days later, I remembered my mother’s promise to me –  “I will leave you only when you are brave enough to let me go”.  I cried.  My mother had kept her promise. 

I returned to the US back to my husband and my children. 

My 9-year-old son snuggled up with me one night and asked me, “Mamma, will you die too?” 

I said to him, “I will be here as long as you need me.  I will go only when you tell me that you do not need me anymore.” 

My son heaved a sigh of relief, hugged me tight, and fell asleep.

Shailaja Venkatsubramanyan has taught information systems at San Jose State.  She volunteers with the Plant-Based Advocates of Los Gatos.  http://www.plantbasedadvocates.com/


Arnav Mishra with cards for seniors (Image provided by Arnav Mishra)

San Jose Teen, Arnav Mishra’s Efforts Bring Smiles to Senior Citizens

In a time of collective trauma, Arnav Mishra provides a source of healing through his work for senior citizens in the Bay Area. Mishra’s organizing efforts, creating colorful cards and drawings for seniors, is deemed a “work of heart”.

Since the beginning of the COVID-19 pandemic, 16-year-old Arnav and his younger sister have been busy writing letters and sending their colorful creations to assisted living facilities and hospice centers across California and the country.

After receiving an overwhelming response from grateful seniors, many of whom have been unable to see their own grandchildren in more than a year, Arnav formed the organization Pumpkin Letters and recruited groups of elementary and middle school students to help in his effort. Since April 2020, they have brightened up the days of more than 3,000 seniors with cute cards, letters, and words of encouragement.

Pumpkin Letters online platform (Image provided by Arnav Mishra)
Pumpkin Letters online platform (Image provided by Arnav Mishra)

“I knew that my grandparents were really missing our visits during the COVID-19 shelter-in-place, so my little sister and I started writing letters and cards and dropping off to them regularly,” said Arnav. “I realized that just like my grandparents, there were so many other grandparents and seniors who couldn’t see their grandkids and were lonely.”

Arnav juggles a full schedule as a guitarist in his school’s rock band, an intern for a Bay Area political campaign, and a student with challenging Advanced Placement (AP) classes. Yet, he remains inspired to continue writing letters to seniors by the responses he receives. He is working to reach even more seniors but needs other students to help in order to expand the effort.

“The demand for these cards and letters from senior homes is overwhelming and he needs more kids involved in this project to help cover even more care homes,” said Arnav’s mother, Ruchika Mishra. “We know there are a lot of kind, compassionate, and creative kids who would love to cheer up lonely seniors.”

Since his project kicked off more than a year ago, 260+ children have been able to send cheer to more than 900 seniors. Many seniors share their cards with others, spreading the love even further.

Students ages 8-17,  teachers registering their classes, and group home caregivers, can sign up to volunteer or request letters by visiting the Pumpkin Letters website. Interested persons will receive information on how their drawings and letters can help seniors fight loneliness and instructions on where to send their completed work.

Pumpkin Letters Volunteers on a Zoom Call (Image provided by Arnav Mishra)

Since many schoolchildren are also struggling with limited social interactions with their friends or aren’t attending in-person school due to the health crisis, Pumpkin Letters hosts monthly Zoom meetups where children and teens gather to work together on their art projects, laugh, share ideas, and become inspired by the work of others. These events are often based on themes that are related to the seasons and upcoming holidays. Learn more or sign up for an upcoming meetup at www.PumpkinLetters.com.

Srishti Prabha is the Managing Editor at India Currents and has worked in low-income/affordable housing as an advocate for children, women, and people of color. She is passionate about diversifying spaces, preserving culture, and removing barriers to equity.


Women at sunset

Step Into the New…You

Renewal: You and The World Around You

As I tuned into this topic, I became aware of the internal environment that is created because of the people in our lives and how we perceive ourselves in relation to them. Often keeping others comfortable becomes our comfort zone. Stepping out of it rocks the boat. As we step into this New Year, I invite you to step into the New You.

It is too long that you stayed in a shell to keep others comfortable.

There are some around you who have always loved you, with whom you are amazing and it is easy. You feel safe being yourself.

Then why walk on eggshells with everyone else? Why numb the goodness and brightness in you? 

Nobody realizes that you are simply trying to fit in. You value them too much, even more than yourself.  You are getting comfortable with that. In your mind, you are being nice to them. And yet often feel miserable. They are also getting used to that. Stop…just stop!

Look at those who really ‘see’ you. You seem to do everything right by them. Break the shell and crack it open. Do what it takes! It’s worth it!

They will find others who feed their comfort. Yes, give them a shock.

They will have to step up to understand you and cheer you in your growth. They will have to know your pain.

You in your truthfulness will mourn your perceived loss of some of them because you truly cared about them. That’s why you kept them comfortable while you suffered.

Yes, I know you also wronged some people. Those too will reach out to you or you to them, in your growth. Just know that you are not accountable to all of them this very minute, so don’t judge yourself too hard.

Go ahead take that step, a small change, break open, fly. The ones ready for growth will grow with you. Some will fall away, as you both cannot see eye to eye now.

Forgive yourself, forgive them, love yourself, love them, allow yourself to Be, allow them to Be. Trust me, it’s worth it. When you feel stuck and choose to wiggle out, it hurts, it’s worth it.

The ones who care for you and the ones you care for will have to accept you as you are today. Let them know you are one of them but be stronger on your own path.

Pragalbha Doshi lives with her husband and 2 teenage boys in San Jose, CA. As a yoga teacher, she facilitates therapy & change for people who struggle with chronic symptoms of stress, physical & emotional, and who want a productive & fulfilling life. 

The contents of this article first appeared on my personal blog Infinite Living on Jan 5, 2017. Find more inspiration in poetry and prose at the link.

A Poet Born Through Healing

Poetry as Sanctuary – A column where we explore poetry as a means of expression for voices of the South Asian Diaspora.

Poetry was never something I imagined to become this significant to me, it was not even a sliver of a dream of an unimagined future.

I spent the first 3 decades of my life trying to fit into the mold of a perfect, normal life. I moved to the US from India at a young age, always striving to keep a smile, raise 2 sons, and remain optimistic. Something still felt missing. I was drawn to the teachings of yoga & philosophy. That seemed to satisfy my need for continual answers to the meaning of life.

All of that came crashing down when I got afflicted with a brutal skin disease that attacked me in every single way – physical, familial, emotional – I was isolated from society for the next few years. Modern medicine did not have any remedy for me, so I chose holistic methodologies from ancient times to find my way back to life. My new normalcy turned out to be as brilliant, as painful it was to go through dismantling my existing reality.

With very few humans around to know and really understand the drastic choices I made about my healing, I was unaware there would be a subsequent spiritual awakening. The world did not make sense to me anymore. There was this ocean revealed within and I needed to learn to swim.

It took a while to befriend poetry as a gift. It brought alive my relationship with the Universe. I remember the exact moment and setting when the first surge of inspiration began and I started rhyming in my mind. I had to drop everything and type. It was a very strange yet powerful feeling. Even stranger was to look at my writing and think it was poetry. 

I thought each one that came was the last. I couldn’t own it or name the place it came from. I started sharing them on my blog and Facebook. I had people message me that these poems were helping them get through the day, giving them hope, peace, courage, guidance. As I stepped into the fourth decade of my life, poetry had become a living, breathing part of me.

People asked me how did you start writing. My reply to them came through this following poem:

Just how did the writer in me get born?

When drippings from a touched soul find their way in writing
A poet is born
When the beauty is undying and the joy so fulfilling
A poem is born
When feelings are heart wrenching and clarity is killing
A poem is born
When a surge comes as discomfort and words pour out
A writer is born
When the harmony felt is such that there is no choice but rhyme
A poem is born
When made-up words bring meaning and no-rhyme verse feels musical
A poetry is born
When living alive to feelings, words come to life
A writer is born
When clarity becomes more intense than the pain that afforded it
A writer is born
When no human around can suffice to contain the expression
A poetry is born
When a release is looking to flow out at an unearthly hour
A writer is born
When words choose the person as if a channel
A writer is born
When none can be planned to rhyme or reason
A poet is born
When human spirit gets broken to million-times-ten pieces, yet finds beauty
A poet is born
When Life decides to peel back layers of truth down to the core
A writer is born
When each level of façade is stripped down to bare soul
A writer is born
When all the suffering was a gift, lived through or let through
A writer is born
When there is no knowing if there is more from where it came from
A writer is reborn
When it comes from a place that is hard to own
A writer is born
When the essence of being is wrung out in best expression
A poetry is born
When it feels like a soft glove over the brutal thing
A poetry is born
When the loneliness in truthfulness is more than can enjoy yet
A writer is born
When inspirations come out of nowhere as if universal cues
A poet is born

So if you can just rest
In the drippings of the writer’s soul
Momentarily let go of the sufferings you insist on
A poet would feel content for being born.

– Pragalbha Doshi

After 4 years of this amazing adventure, I had felt a lot of grief when I thought poetry was leaving me. I did write some more after that, and the flow trickled to a stop. It was time for me to visit life in a different way. I trusted Poetry to know that – in time, it will come back to me.

My poetry found a voice and new life within a year when, at the beginning of the pandemic, I joined a local group called Poetry of Diaspora in Silicon Valley. Poetry is that gift and sanctuary that leaves out all supposed normalcy and brings us closer to who we truly are. 

Pragalbha Doshi lives with her husband and 2 teenage boys in San Jose, CA. As a yoga teacher, she facilitates therapy & change for people who struggle with chronic symptoms of stress, physical & emotional, and who want a productive & fulfilling life www.yogasaar.com

That Good Night: Life And Medicine

Writer Sunita Puri, a doctor and writer, uncovers the role of the doctor when families need medical care and advice the most – at the time when they seek palliative care for loved ones. Issues surrounding healthcare delivery are being discussed every day and Dr. Sunita Puri’s first person account is thought-provoking and raises pertinent questions that all of us need to confront – patient, family members, doctors, healthcare executives and hospital administrators.

How do we want to live and how do we want to be treated when options are exhausted? A taboo subject that forces us to consider personal decisions that affect the public sphere. Here is an interview with Sunita Puri on her book – That Good Night, Life And Medicine in the Eleventh Hour

Q: Palliative medicine is a newer subspecialty of medicine that focuses on treating the suffering of patients and families facing a serious illness. What initially drew you to this field ad when did you know you wanted to be a palliative care doctor?

SP: If you’d told me at the beginning of medical school that I’d end up practicing hospice and palliative medicine, I would have looked at you blankly and asked you what those words mean. And once you explained, I would have told you there was no way I’d put myself through medical school only to care for patients I couldn’t cure. When I was in medical school, my preoccupation with studying and treating the body often blinded me to my patients’ very human needs and concerns, particularly when they suffered from advanced and terminal illnesses. And yet the times I felt the most like the doctor I wanted to be were the times when I sat with a patient I knew I would lose in the coming weeks or months, and focused my attention on addressing their physical and emotional suffering. In palliative medicine, I get to guide patients and families through the hardest yet most universal transition we will all face, and I get to help make that experience as comfortable and dignified as possible. We will lose the people we love. There are no do-overs. And there is no greater privilege in medicine than to make that loss peaceful and humane.

Q: This is the first book written by an American palliative care physician that, in a very personal way, reveals what it actually means to have discussions about a patient’s goals and values at the end of their lives. Can you describe how you, as a medical doctor, learned to have these sensitive conversations that often veer into complex emotions and spiritual beliefs? Why is open and honest communication about dignity and suffering—with patients and with their families—so important?

SP: Clear, compassionate communication is the cornerstone of the relationship between doctors and patients. Although I worked hard in medical school to learn to diagnose and treat an array of ailments, I didn’t learn what might seem basic: how to tell a patient that they have a life-threatening diagnosis, how to talk with them about what quality of life they value if time is short, and how to discuss the best way to care for them when a cure isn’t possible. I was drawn to the architecture and impact of conversations with very sick patients because I witnessed the way that wordsour oldest, non-technological toolscan comfort and heal. In palliative medicine, words are my instrument, and conversations are my procedure. My practice requires fluency in the language of scientific medicine as well as the language of the spirit. As human beings, we all share a common focus on maintaining our dignity even amidst unimaginable suffering. Though it may seem unusual for a physician to use these words, this is the vocabulary that most of my patients have been waiting to hear and to use.

Q: Medical care in our country is suffering from severe depersonalization. You write that doctors are taught to treat patients “like a panoply of diagnoses, biological mysteries to be solved.” What can the profession of medicine learn from the principles of palliative medicine?

SP: Medicine is a deeply humanistic profession, but our health care system doesn’t always allow physicians to spend the time we need to care for patients as fully as we’d like. Palliative medicine focuses on the many ways that patients experience sufferingphysically, emotionally, spiritually, and existentiallyand seeks to improve patients’ quality of life and well-being by getting to know them as human beings. But in order to do this well, I need the luxury of time with my patients, and I’m very lucky to be able to spend an hour or two at a time with them if necessary. What surprises me is that our health care system supports this time investment when a patient has an advanced illness, but not always before then, when it might actually assist in preventing some of the untimely deaths I have witnessed in my career.

I think medicine could be profoundly transformed if the principles of palliative medicinea focus on controlling bothersome symptoms, and on having careful conversations about what matters most to a patientbecame part of everyday medical practice. But this would require a parallel cultural change in our health care system and in its financing. Patients shouldn’t need to have a bad diagnosis in order to benefit from the compassionate, humanistic approach to care that we provide in palliative medicine.

Q: You seem to live between multiple worlds – as the daughter of immigrant parents, as a doctor, and as a writer. How do you navigate each, and what inspired you to turn your experiences into a book?

SP: Though I’m very proud of being a blend both of cultures and professions, being a citizen of several different worlds hasn’t always been easy. Being a more artistically inclined physician always made me feel like a bit of a freak; if I was always thinking about writing essays and stories rather than doing research projects, was I really supposed to be a doctor? Similarly, as a teenager and young adult, I wondered if I was ‘Indian’ enough, and fretted over whether I stayed true enough to the culture and heritage with which I’d been raised. But I’ve come to see that we are each a patchwork of different identities, and how we navigate the tension between them is what makes each of us unique. I began to ask myself why I thought a doctor shouldn’t write, or what it meant to be ‘Indian enough.’ For me, writing and reading have been ways to find company during the often isolating experience of figuring out who I really am and what I’m meant to do, both in the hospital and in my wider life. And the writing of the book was very much about discovering, on the page, the many facets of myself, the way that they shape each other, and how they collectively came to influence who I’ve become.

For this reason, the book is as much about my parents and my heritage as it is about medicine. It’s as much about my love for language and my puzzling, yet very human, inability to apply it in my early medical training. It’s about discovering how mortality did and didn’t scare me, and how being a doctor helped me to learn important spiritual lessons of acceptance and surrender, alongside my patients. Because all of these things live in me, and the writing of the book was a way to place them side by side and find the universal human experiences in my particular journey. Though the writing of the book was often painful and deeply emotional, as Cheryl Strayed has said, not writing the book became harder than writing the book. It is, as Strayed has also said, the story I was meant to tell.

Q: Many patients turn to spirituality for solace when faced with an advanced illness. But many physicians struggle to discuss spirituality with patients, given that this is a highly personal and sensitive matter. Can you talk about how your upbringing taught you to embrace life’s temporality, and how that helps you to navigate conversations about spirituality with patients?

SP: I was only five years old when my fathera deeply philosophical manfirst told me that life is temporary, and beautiful in part because it is temporary. Much of our suffering in life, he said, stems from an inability to accept the fact that life is both finite and constantly changing. He and my mother spoke openly of the suffering they endured as children living in poverty in India, and how they were able to transcend it through prayer and through remembering that everything in life, both our joys and sorrows, is fleeting and impermanent. Though we talked about such profound truths when I was very young, it wasn’t until I was in my residency training and taking care of patients facing the end of their lives that I began to understand just how many spiritual questions the experience of illness can pose. And although my parents shared mostly Hindu and Buddhist teachings, they taught me that every spiritual tradition recognizes and respects life’s temporality, and the suffering we all endure, in different ways.

I am always careful to ask patients how they define their own sense of spirituality, but often find that even patients who consider themselves atheist or not particularly spiritual struggle with the meaning of their existence and their suffering. Being able to help patients talk openly about these very personal matters, simply by normalizing and acknowledging their illness, can spark deeply spiritual and existential questions. These conversations also help me to be a better doctor to them. I have a clearer sense of the interconnectedness between their spiritual pain and physical pain, and can treat both more fully.

Q: 25% of Medicare spending is on costs related to care in the last six months of life. Based on your own experiences, why do you think this is the case? What is the thought process behind pursuing aggressive treatments that may not alleviate suffering? 

SP: I’ve observed that both doctors and patients focus mainly on living as long as possible, and have difficulty accepting medicine’s limits and talking about the inevitable end we will all face. When I was in my residency training, I myself subjected dying patients to treatments and procedures that I knew wouldn’t ultimately help them, because as a physician I felt tremendous pressure to offer anything I could to sustain their lives. I didn’t know that an equally important part of my job would be to recognize death’s approach and to talk with patients about what was most important to them in the short time they may have left.

Just as I, as a physician, felt an obligation to save lives, I’ve heard many patients describe pressure to continue “fighting,” trying any treatment offered to them, lest they be perceived as “giving up.” I see this unfortunate cycle daily at work: physicians believe it is their job to keep patients alive, and struggle to discuss what might matter most to patients in their last days. Patients and families navigating the fear, uncertainty, and grief that accompany serious illness may not know what questions to ask about the trade-offs implicit in choosing aggressive, hospital-based care for ultimately incurable ailments. Breaking this cycle involves earlier discussions about mortality, particularly for patients with a serious illness, so that they can avoid painful, ineffective treatments at the hospital, when many may instead prefer to spend their final days at home with their families, free of pain and anguish. Because the true and most tragic cost of the often excessive care provided at the end of life is the human costthe suffering that patients and families and physicians experience when they seek to postpone rather than confront life’s end.

Q: In THAT GOOD NIGHT, you write a lot about your mother, an anesthesiologist, and her influence on your decision to become a doctor – as well as her reservations about the field you ended up choosing. How did your relationship with your mother shape your doctoring? What does it mean to you to have followed her into medicine but to practice a very different type of medicine?

SP: Some might say that my mother and I practice diametrically opposed fields of medicine: anesthesiology is concerned primarily with keeping patients alive in emergencies and during surgery, whereas palliative care seeks to normalize, embrace, and openly discuss mortality. And yet I modeled my own style of doctoring most heavily on my mother’s. My mother’s doctoring is very different from the styles of other doctors I knowincluding the internists, surgeons, and other palliative care doctors I typically work withbecause she openly believes that a mastery of science and a respect for the sacred are equally essential to doctor well. She prayed with her patients before taking them to surgery, and prayed before she started a case in the operating room, taking comfort in both her mastery of technologic medicine and the oversight of the divine. But though she and my father long emphasized the fleeting nature of life and the inevitability of death, she struggled to understand why I would use my medical education to ease the suffering that accompanies the last stages of life. During my training, we fought often about my choice to practice what she considered a very depressing medical specialty. As she and her friends and family age, she is personally confronting her sometimes conflicting feelings about aging, dying, and medicine’s role in both. Ours is an ongoing conversation – though she often accepts and admires my work, I occasionally have to remind her gently that my field focuses on the simultaneous embrace of life as well as an acceptance of its ultimate end: much like what she and my father taught me.

Q: You describe dying as a messy, imperfect experience and suggest that the dying are not enlightened teachers of life—as they are often portrayed in books and movies—but rather that they are simply trying to continue living the best they can. Can you share more what you have learned from caring every day for patients facing the end of their lives? And from their families?

SP: Being with my patients reminds me how life can change in an instantthe ordinary instant, as Joan Didion writes. At the hospital where I work, the average age of the patients I see is between 45-50. Some of my patients are my age or younger. Others look and act like my parents. One day, they may have a cough and a fever that they assume is the flu; the next day, they are told they have incurable lung cancer. Accompanying them through the many losses of living with an illness reminds me that I shouldn’t take anything for granted, even the things I do mindlessly: chewing my food, or going to the bathroom without assistance, or walking around my home without getting winded. With both my patients and their families, I am the privileged witness of the incredible tenacity of human beings – we think we cannot face and survive the unimaginable, but we can and do. They have taught me that forgiveness is a gift and a balm, that love is elastic and accommodating of even our most despicable thoughts and behaviors, that we truly carry each other through this lifetime.

But this is not to romanticize what it means to be with dying patients: although they are often at different stages of understanding and accepting their illness, most of them are still trying to live and maintain a sense of normalcy, whatever that might mean for them. There’s only been one time when a patient has sat with me and said, “Let me tell you what I, as a dying man, have learned about life.” And his advice was two-fold: “Everyone should experience the love of a dog. And the cliché that we don’t know what we’ve got till it’s gone? It is absolutely, one hundred percent true.”

Q: You discuss how emergency medical care is very well coordinated, but end of life care and palliative care are much trickier areas. May families find themselves lost and confused in a maze of figuring out how to care for a dying loved one. What are some changes to our health care system that may make it easier for patients and families to get the type of care they need and value at life’s end?

SP: Part of why patients and families are so lost and confused when discussions of end of life care arise is that we often have these discussions in moments of crisis. From the moment a person gets a serious diagnosis, we should start discussions about their own personal goals and values, and about what palliative care has to offer. Far from discouraging people or taking away their hope, early discussions about mortality actually normalize the topic and help patients and families to plan for what they want for themselves. This is why major medical organizations including the American Society for Clinical Oncology recommend palliative care consultations early in the course of a serious illness, rather than at the point where a patient is critically ill in the ICU. Not only does this help patients and families to have the time to make better decisions for themselves, but it has even been shown to lengthen the lives of some patients.

I hope that in the future our health care system will integrate palliative care consultations into the routine care of patients with advanced cancer, heart failure, liver failure, and other serious conditions so that we proactively help patients and families to plan for hard scenarios well ahead of time. Since I have taken care of patients not only in the hospital but at home on hospice care, I have seen firsthand that dying well at home takes advanced planning and adequate resources. If a patient tells me that it is really important for her to be in her own bed and in the company of her family at the very end of her life, it is much more likely that we can grant her wish if we plan for it.

I also think that doctors and nurses in training need earlier and more comprehensive exposure to palliative care, so that they understand their role in caring for patients who they may be unable to cure. Mandatory lectures on and exposure to palliative care and hospice must be integrated into all medical and nursing school curricula so that all future care providers understand the important role they must play in caring for the dying. Acknowledgment of medicine’s need to deal better with death isn’t an impediment to innovation.

Q: What you see and do on a daily basis is very emotional and impactful. How do you cope with the difficulty and emotional strain of this work, and with facing dying so regularly?

Many people wonder why anyone would choose to practice palliative medicine, and most assume that it is dreadfully depressing and demoralizing. But it’s actually incredibly uplifting and satisfying, because I can make a huge impact on patients and families during one of the most vulnerable times in their lives. If I can control a patient’s pain well, they might be able to make it to the wedding of their granddaughter or renew vows with their own spouse. If I can help them to clearly identify what is most important to them in the time they have left to live, they may be able to admit that their time is better spent going to the beach instead of the chemotherapy suite. But it isn’t easy work. For many years, though I helped patients stay healthy and feel well, I didn’t understand what it meant to take care of myself. I’ve learned the hard way that if I don’t take care of myself, I cannot do this work. Every day, I remind myself of two things: firstly, the frequency of the physical and emotional suffering I witness is not normal. Secondly, my work and my life, though interrelated, are not the same. Acknowledging the boundary between the two keeps my workaholic tendencies in check, and ensures that I find ways to care for myself, so that I can continue not only to do this work but to enjoy my own life. I find tremendous comfort in nature, and try to go hiking, or visit the seashore, or even sit in a courtyard outside the hospital and look at the trees between visits to patients. I joke around with and vent to friends and coworkers, try new restaurants and bars in my neighborhood, and go to yoga. I also regularly watch the best satire around: reruns of The Colbert Report and Scrubs, episodes of John Oliver’s show, and random YouTube videos of cats befriending dolphins, lions hugging their old trainers, and dogs behaving badly. Thank God for the Internet!