Tag Archives: #spirituality

Adil Hussain's namaste in Star Trek

Diving Into the Divine Depth of the Namaste

How adventurous would it be if you were intergalactically taken forward to the 32nd century? I imagine you would be excited to no end! The experience would be even more enthralling if you saw a motivated public servant greeting another with a namaste!

I’m referring to none other than the season finale of Star Trek: Discovery Season 3 which concluded in January of this year. The character of Aditya Sahil, played by National Award winner Adil Hussain, welcomes commander Michael Burnhum (Sonequa Martin-Green) with folded hands as they meet for a second time in the concluding episode.

The internet has been buzzing with an avalanche of praise for Aditya Sahil who stands as an emblem of hope and positivity. The cherry on the cake is that the namaste that has warmed the hearts of so many Indians. In an interview with Positively Trek, Hussain shared how he had requested director Olatunde Osunsanmi to incorporate a namaste! The gesture represented our part of the world in the prestigious sci-fi show that celebrates diversity.

Exploring the etymology of namaste 

It’s a simple step with the hands over the heart in a prayer pose with a slight bowing of the head. But embedded in this gesture is a beautiful meaning. Derived from Sanskrit, ‘namas’ means ‘bow’ or ‘salutation’ and ‘te’ means ‘to you’. So the literal meaning is ‘bowing to you’.

As per the tenets of Hinduism, there is a spiritual value ingrained in the gesture. It is believed that the divine and soul are the same in everybody, so greeting someone with a namaste means, “I bow to the divine in you”!

Appreciating the sublime philosophy

Why ‘namaste’ has become the perfect pandemic greeting, an article by Jeremy David Engels, he makes just a casual reference to how the namaste, in lieu of the handshake, has emerged as a lifesaver during COVID-19 and focuses more on the sublime aspect of this timeless Indian tradition. 

A spiritual practice endorsed by Ralph Waldo Emerson is akin to the meaning rooted in namaste. The renowned American philosopher had motivated Americans to recognize the divine soul in others every time they spoke, using the metaphor of light to imagine this inner divinity. Engels cites this example to emphasize and draw the connection that the concept of recognizing divinity in others is a sacrosanct part of both Indian religion and the 19th-century traditions of American spirituality.

A very pertinent point is made when the author says that one does not have to be a Hindu, or a Buddhist, or a yoga teacher to say namaste. He says, “Namaste can be as religious or secular as the speaker desires.”

Furthering the dialogue, Akkaraju Sarma writes for India Currents and delves further into the possibility of replacing the handshake with the namaste during the pandemic and beyond. Sarma insightfully mentions that “Aside from its simplicity, the namaste posture implicates mutual fairness. There is no prominent or submissive interpretation implied. Whereas, with a handshake, a person with a firmer grip is seen as more authoritative. In contrast, a person with a less firm grasp is seen as submissive. Namaste levels this field of cognitive conflicts.”

Namaste is so much a part of our lives

Apart from greeting one another, we get to see this gesture on a regular basis in religious rituals and various Indian classical dance forms. With increasing awareness for health and fitness, yoga has become a global phenomenon with namaste being incorporated into the practice worldwide.

Why is namaste an integral part of yoga? A brilliant explanation comes from the yoga journal: “For a teacher and student, Namaste allows two individuals to come together energetically to a place of connection and timelessness, free from the bonds of ego-connection.” 

As a meditation technique, an individual joins his hands to submerge deep into the heart chakra which acts as the center of compassion, empathy, love, and forgiveness.

Garnering unity and drawing on humanity

Respect for one another is what constitutes the baseline of humanity. Only when the feelings of empathy and deference for our fellow beings flow through our veins can we boast of a meaningful existence on earth. A reflection from my side. Yes, we do the namaste as a mark of courtesy or to express hospitality and gratitude but it would just be wonderful if, rather than mechanically following the gesture, all of us can practice the philosophy. That would definitely make the world a much better place to live in!

Rashmi Bora Das is settled in the suburbs of Atlanta, GA. She has written for various platforms including Women’s Web to which she regularly contributes. You may visit her at www.rashmiwrites.com 


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

One Nation Under God

We’ve been witnessing some amazing resilience in the time of the Corona crisis. The governments around the world, doctors, entrepreneurs, educators, community members stepped up in unprecedented ways to support the system, support one another. It’s fascinating to see the kids transitioning to a brand-new lifestyle with great dexterity. 

But what’s going on within us, if each of us is considered a nation?

The ancient scriptures of the Sanatana Dharma talk about “self-reflection” in all 4 of the Vedas and the corresponding Upanishads. Although we, as humanity, are fascinated by these questions – who we are, where did we come from, where are we heading to – in recent times most of us been busy running around the clock to contemplate on our elemental existential purposes. 

I was a bit scattered at the beginning of the lockdown but I found myself in this ecosystem of learning. Discussions about ancient wisdom, talks about public policies, exchange of lifestyle-related notes among friends .. everything surfaced at my fingertips, in the comfort of my home. 

I chanced upon a physicist turned philosopher, life-coach Dr. Prasad Kaipa, who shared an in-depth analysis of self-reflection in reference to the scriptures. Right from the Rig Veda (the oldest written Veda) to Sama Veda, Yajur & Atharva: our ancestors gave us step-by-step subject matter guidelines.  Relevant to our current situation as the Corona-crisis demanded this contemplation, asking us to look into our very core, our relationship with nature and nurture. 

Photo credit: British Library, photo by Jeffrey Boswall, a natural history broadcaster, film-maker, and producer.

The process starts with the concept of “Prajnanam Brahma” – Introduced in the Rig Veda and concluded in the corresponding Aitareya Upanishad. It talks about the nature of our true perspective. The BIG picture perceived by our unique sense – the consciousness. According to this, by fishing out irrelevance, Neti Neti in Sanskrit (not this, not this), we land on our true nature. 

Next, “Tat Tvam Asi” – Introduced in the Sama Veda and the conclusion drawn in Chandogya Upanishad. What is it that’s not been seen but becomes visible, within us, around us? Never heard, but becomes audible? Unknown becomes known…

By merely asking these questions, we get in touch with our humility. Everything is not known to us, yet. Hence, the scope of pursuit. It gives us eligibility. Takes us to the path of inquiry on how an incredibly small seed can give rise to a tree, how the consciousness of the living beings (Jeeva Atman) is part of universal consciousness (Param Atman). We relate to it by experiences. 

Ahm Brahma Asmi” – In Yajur Veda, concludes in Brihadaranyaka Upanishad. After thinking and experiencing, we meditate on the concept. Through astute practice, we feel oneness with the Supreme Divine. It’s possible to attain bliss by connecting our consciousness with divinity. 

I’d like to mention here, after probing this, I couldn’t stop thinking about the enormity of fall-out in “interpretation” at the very conceptual level, as shown in the popular TV series on Netflix: Sacred Games. Amazing depiction – horrors of human ignorance. Through the journey of the protagonist, Nawazuddin Siddiqui, we see the tale of reflection, rejection, retribution, redemption, and finally .. hopefully, renewal. Beautiful! 

And, then? 

The culmination of self-reflection comes with the realization of “Ayam Atman Brahman” – Conceptual introduction in Atharva Veda with conclusive notes in Māṇḍūkya Upanishad. It’s not about humans manifested in social hierarchy. It’s about preservation and sustenance through our thoughts, actions, practice, and pursuit, in perpetuation, day after day, year after year, age after age, with grace and gratitude for all that we have, all that we don’t. And, all that we wonder about, aspire to become. We are in this together. 

Soma Chatterjee is the Diversity Ambassador for India Currents and a Board Member for Silicon Valley Interreligious Council representing Hinduism on behalf of HAF

Inputs from Dr. Prasad Kaipa. Co-author of From Smart to Wise, You Can, and Discontinuous Learning

Featured image and license.

Was Krishna The First Psychotherapist?

I was ten or twelve years old when I first heard of the “Bhagavad Gita.” We lived in Bengaluru, and once a week, my spiritually-inclined, civil engineer father would explain its concepts – meditation and other virtues – to my siblings and me. He loved these sessions.

He told us the essence of the Bhagavad Gita was that “Krishna asks everyone to perform their duties to the best of their abilities.” And yet, I still could not make any sense of it. I just felt overwhelmed.

A few years ago, my father passed away and my life came to a standstill. It took days afterwards, filled with sadness, for me to start a transformation that helped me appreciate the Bhagavad Gita’s wisdom and the love and kindness in my surroundings.

The Bhagavad Gita is a profound dialogue between two friends on a battlefield nearly 5000 years ago. When the war begins in the great battle of Kurukshetra, Arjuna declines to fight. Krishna, the mystic, patiently explains a psychological battleplan that navigates a pathway from confusion to knowledge, virtuosity and happiness in the midst of war and chaos.

The mind today is a similar battleground between thoughts and emotions. We face challenges and confusion every day from childhood through adulthood, but there are answers to be found in the Bhagavad Gita.

Swami Chinmayananda calls the Bhagavad Gita “a piece of art of strange beauty and it stands apart from everything else, in a class all by itself.”

Its eighteenth chapter contains a philosophy of living which resonated with me when I moved to the US twenty years ago.

My son was enrolled in the Chinmaya Mission and I became intrigued by their discourses on the Gita. I began reading chapters from a Bhagavad Gita my husband had bought at a temple and which we kept at our prayer altar. The scriptures began to influence me in my daily life.

One idea that I found particularly useful said, “You have the right to perform your prescribed duty, but you are not entitled to the results of your actions. ”

It taught me how to perform my duties to the best of my abilities but not stress about the outcomes.

It was one of many profound lessons the Gita has taught me.

I have learnt from the Gita to adjust and accept situations and people. I have realized that each person is uniquely gifted with different emotions and virtues. And the Gita helps me make better decisions that give me happiness.

A few years ago, tragic life events – death, accidents, illness, would depress me for days. Somehow today I’ve developed a better understanding of Karma, the concept of ‘law of action’ related to fear, life and death.

My reaction now is quite different. While I still feel some sadness for a while, I regain my sense of balance far more quickly.

Individuals who intellectually absorb and assimilate the knowledge the Gita offers, become “liberated from confusion and sorrows, and reach a state of inner tranquility and happiness,” says Swami Chinmayananda. I do believe he’s right.

I’m trying to integrate the principles of Bhakti (Devotional)Yoga, Jnana (Knowledge) Yoga and Karma (Work)Yoga into my own life.

Quite simply, this means channelling my emotions in order to discipline my mind (devotional or Bhakti yoga), discipline my body and its actions to help control my mind (work or Karma yoga), and practice meditation, reflection and detachment to ‘lift the mind to silence’, and reach a place of serenity, peace and calm (knowledge or Jnana yoga).

Every day, I attempt to apply the Divine – positivity – in my work and life . When my mind brims with positivity, I’ve noticed that negative emotions don’t invade my thinking! My mother-in-law is a great example of this practice. She works with utmost care and patience and is mindful in all her tasks, whether drawing a rangoli or chopping vegetables. The motto “Work is Worship” is apt for folks like her who are inclined towards Karma Yoga.

Was Krishna the first psychotherapist? Perhaps!

When I read the Gita it often feels as though I’m being personally guided by a psychotherapist friend to make stress-free decisions. And yet, it contains concepts that transcend religions and borders. These ideas have helped reinforce positivity, love and hope in my own life – but I also believe there are lessons to be found in the old teachings to navigate the crises of our present times. As the world battles the stress and anxiety of the coronavirus pandemic, the Gita can offer peace, hope and answers that humanity seeks to fight an invisible enemy in a different kind of war.

Kumudha Venkatesan is based in Atlanta and loves to read the Bhagavad Gita and often writes about the vegan lifestyle and spirituality.

Edited by Meera Kymal, contributing editor, India Currents.

Image 2: By Mahavir Prasad Mishra – https://archive.org/details/MahabharataTejKumarBookDepotMahavirPrasadMishra, CC0, https://commons.wikimedia.org/w/index.php?curid=66704373

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!









Where Ras Leela Happens Every Night

Before you get ready to see Lord Krishna at Brindavan, you have to watch out for the monkeys! They snatch your cell phone and glasses. At every corner, vigilant citizens shout out to visitors to take off their glasses and to hide their phones. What use is a cell phone to these cheeky imps – I wonder; naughtiness fills the air of Brindavan thanks to these monkeys.

It is also the place where Krishna and the gopis still dance every night!

Frozen into dancing forms, the trees of Nidhivan come alive every night. It is believed that as the sun dips beneath the horizon, Krishna enters the Rang Mahal in the Nidhivan gardens, and dresses his favorite gopi, Radharani. The garden closes at 5 p.m. every day for the Lord to make his way to the garden where gopis await him. The trees come alive unfurling their twisted limbs to dance with him as his gopis. Not even the monkeys dare enter Nidhivan after dark where this nightly divine dance occurs.

After the Raas Leela dance, the duo Radha and Krishna rest on the sandalwood bed in the Rang Mahal. It is found unmade every morning, the sheets askance. The water in the silver jar placed by the bedside is gone as is the pan (betel leaf with areca nut) and the neem datun (herbal tooth-brush). The tour guide narrates this as he sings his way down the path of the garden watched keenly by the monkeys. Red color streaks some of the trees. Holi, the festival of colors, is still more than a month away and already the gods are sprinkling fun upon the city. The guide asks us to twirl, clap our hands and laugh in happiness. It is the place to dance!

In Nidhivan, Krishna and Radha had once appeared before Swami Harisen, guru of Tansen, Emperor Akbar’s court singer.  Swami Harisen was singing when Krishna and Radha appeared before him and became one form, it is believed. The resulting statue of Krishna bent in a sensual “S” shape, curving at the waist and neck, was named Banke Bihari.

We head to Banke Bihari temple where this statue is now established. As we peer at the statue of the Lord, every few minutes the priest draws a curtain breaking our gaze. Staring continuously at the beauty of the dark idol of Bankey Bihari Ji is not recommended. The curtain breaks the spell that Bihariji’s beauty casts on the devotee. It ensures that the devotees cannot look at the Lord for a long time at a stretch and be overpowered by divine love.

The bells toll for the evening worship. Unlike other temples where the loud bells of the morning service or mangal aarti, wake up the lord sometimes as early as 4 am, in the temple of Bankey Bihari he sleeps in late. Shayan Sewa, the evening service aarti prepares him for the night.

We had entered the temple just as the evening service or aarti was starting. The beauty of the temple, with a central courtyard and Rajasthani palace design overwhelms us. The priest distributes sweet, milky pedas and draws a streak of red on our foreheads.

A small commotion ensues as we exit onto the street. I had forgotten to take off my glasses as I fiddled with taking a picture. Before I knew it a monkey had swiped them off my face. All the boys in the neighboring lanes started shouting at the same time. One chased the monkey and the other ran to me. “He took your glasses! Two hundred rupees and we can get you your glasses back,” they shouted urgently as I groped blindly. “Yes. Yes!” I affirmed, and quickly struck a deal. Just as I was thinking about what the Brindavan monkeys wanted with my Warby Parkers – voila! – the boys threw a fruity drink at him. He caught the drink and dropped the glasses. Rs. 40 for the fruity drink, Rs. 160 for the quick thinking boys and Warby Parkers for me, a bargain deal. I heaved a sigh of relief as I stuffed them into my pocket. It was time for a snack.

We headed to the shop of Titu Cheele wala, steps down from the Banke Bihari temple. Titu folded yummy cottage cheese filling into mouth-watering crispy savory chickpea-flour pancake and spooned some mint chutney over it. “How much do you reckon I could sell the cheela for in the US?” asked Titu. When I demurred, he confessed that he was in talks with a franchisee in London who had said the pancake would easily sell for 8 to 10 pounds a pop. I nodded in assent, and left the business planner behind to head back to the hotel. Lord Krishna stepped into Nidhivan with other things in mind.

The ISKCON temple I learnt wasn’t that indulgent about the nighttime activities of the Lord. They still woke him up at 4 a.m. with the morning service or mangal arti. Devotees were swaying to the chants of Hare Krishna when we entered the temple at 4 a.m. A line of dhoti-clad young boys sang gustily to the lord. The gentleness of the linen clad congregation harmonized with the wisps of fragrant smoke that filled the soft dawn light. Magic filled the air. Sounds of conch shells trumpeted through the air. The doors opened and the Lord made His appearance. A bright light illuminated his being. The girls gathered around the tulsi plant to offer their prayers and the men formed a circle in the courtyard. A sweet-smelling flower passed through the congregation. We inhaled its fragrance. The soft light of the lamp washed us with its promise of enlightenment. Soon it was time to leave for the Radha Valabh temple that woke the Lord at 7a.m.

The Radha Valabh temple is special as the devotees  present marijuana or hashish to the Lord. The story goes that a very diligent priest who served the Lord had one failing – he loved to smoke marijuana. When the temple authorities threw him out of his job, the Lord appeared in the dreams of the other priests looking very sad. On enquiry, “I’m not getting any hashish these days,” said the Lord.  On hearing this, the temple authorities realized the mistake they had made and instantly reinstated the priest.

We entered the Radha Valabh temple. A number of women were singing softly as they sat in the little marble square in front of the garba griya or the sanctum sanctorum of the temple. The singing, starting gentle, picked up rhythm and as the time approached to open the doors to the deity, a frenzy of singing erupted.  Loud shouts and gusty hailing ushered the Lord into a new day. Thrusting hands were warned that the prashad would only be given to those who waited patiently for the blessing. We emerged from the temple clutching a packet of sweet powder, our reward for good behavior.

A trip to Brindavan is incomplete without a visit to Prem Mandir, the latest addition to the temple tour. Inaugurated in February 2012, the 54-acre site on the outskirts of Brindavan is dedicated to Lord Radha Krishna and Sita Ram. It took about $23 million, 30,000 tons of Italian marble, and 1000 artists toiled for about 12 years to build the complex. Tableaus that recreate scenes from Krishna’s life surround the marble temple. As evening approaches, the white marble façade is lit up. Awash in many shades of changing lights, the temple is a beautiful sight. Spiritual master Kripalu Maharaj conceived and established the temple. Shimmering green, red, and purple lights signal the end of our day.

It is time to retire for the night. Outside the Prem Mandir, on the wall above the fruit vendor, sits a monkey clutching a green woolen cap. A grey haired man below tosses him an orange. The exchange is completed as we head to our hotel.

It is now time to leave the city to Krishna and his gopis.

How to get to Brindavan

By Road : Brindavan is situated on Delhi-Agra NH-2. Another road that leads there is the new Yamuna Expressway. Delhi is about 200 Km away. It can take about 4 hours to traverse this distance.

By Train : The major railway station nearby is Mathura on the Delhi-Chennai and Delhi-Mumbai main line. Several express and passenger trains connect Mathura from other major cities of India like Delhi, Mumbai, Pune, Chennai, Bangalore, Hyderabad, Calcutta, Gwalior, Dehradun, Indore, and Agra. A rail bus runs between Brindavan and Mathura station 5 times a day. Vrindavan or Brindavan itself is a railway station.

By Air: The nearest airport Agra is 67 km away. The nearest international airport is Delhi.

Ritu Marwah’s travel tales reflect her deep interest in history. Her well-researched articles are informative while making for interesting reading.