Tag: three months

Slow deaths and sudden deaths

My parents both died slow deaths. My father spent the last three months of his life in hospital, of which the last month was in intensive care on ventilator support. He had been rendered immobile, and when the ventilator tube and food pipe went in, there was absolutely no way in which he could communicate to us during the brief times we were allowed to meet him.

My mother’s was a different story, but on a shorter time scale. She spent her last month in hospital, with the last ten days in intensive care and on ventilator, again what I think was fairly painful existence for her, living in a fairly isolated and airconditioned room, not being able to communicate with anyone, with all sorts of tubes and measuring devices stuck all over the body.

In hindsight, I regret my decision to allow them to be put on ventilator. I feel guilty for having extended their lives in a way which was both painful to them and where there was little meaning, for they lived cut off, and unable to communicate (and in both cases, had I thought rationally, I would’ve known that there was little chance the time on ventilator would allow them to recover). The only upside to this was that it gave me time to prepare. That it gave me time to prepare for their impending passing,

People who attended either of my parents’ funerals might have been surprised, a bit shocked even, to see that I was quite composed and in control of things. I wouldn’t be wrong if a number of them thought I was a heartless emotionless wretch. The reason I behaved thus was because it was only an incremental change as far as my mental preparedness was concerned. Till the day prior to both my parents’ deaths, I knew that the chances that they would recover and get back home was minimal. Delta. Epsilon. The death, normally a “discrete event” had only pushed this chance to zero, not a big change in probability.

I was thinking about all this two nights back when my grandfather-in-law passed away, once again after a prolonged illness (he refused to be admitted to hospital or be put on life support so in a way he was spared of time on ventilator), but his condition had deteriorated steadily enough for us to know that he would be gone soon. Several family members reacted quite badly, but several others were quite brave and acted bravely. The slow death was the reason for this, I thought.

There are too many factors that affect death, and no one can choose either the time or mode or pace of dying, but I have been thinking if slow deaths are better than sudden deaths or vice versa. The upside of a sudden death is that there is little suffering on the part of the dyer, but the discrete nature of the change (probability that the person would be no more the next day would jump suddenly from close to zero to one) would imply a huge shock for family members and friends, which they would take considerable time and effort to come out of.

A slow death, on the other hand, is extremely painful for the dyer, while it gives time to the family members to come to terms with the reality. Here, too, of course there is usually one big discrete step involved (like that Monday night when in the matter of less than an hour, my mother went from happily chatting with me to gasping for breath so uncontrollably that they had to immediately wheel her to intensive care and a ventilator; or that Thursday morning when my father suddenly realized he had lost all the power in his legs and couldn’t stand on his own), so it is more like a time-shifting of pain (for relatives/friends) rather than the pain being amortized over a number of days.

Once again, there are no clear answers to this question about which mode of death is better, but ever since I saw my father spend his last three months in hospital I’ve believed that sudden deaths are superior. I’ve found myself reacting to other people’s sudden deaths saying “good for them they went without suffering”. Again, no one really has control about how or when they’ll die. It’s only a question about what to hope for in life.

Flower Sellers

If you have ever been to Church Street in Bangalore, you would have come across this girl. It is extremely hard to miss her, and it is likely that she has pestered you at least once in your life. She was little the first time I saw her, but I happened to come across her recently, and she seems to have grown up now.

She is a fair girl, with a pleasant face. Her hair is usually tied up in two plaits, and whenever I have seen her, she is wearing this woollen pullover over her salwar. Her job is to sell flowers, red roses to be precise. And the first time I happened to see her was four summers ago, when I was walking down Church Street with a girl to whom I hoped to give red roses. And as her profession warrants, she was trying to sell us a red rose.

The worst insult you can give to a street vendor is to turn them into a beggar. Hawking on the streets is respectable business, it is a signal that you are willing to work for your living and don’t want to be shown pity. It is another matter that most street vendors don’t really get this and literally beg you to buy their product. Nevertheless, they do get extremely offended if you were to treat them like you would treat a beggar. That fundamental difference is there.

My companion on that day hadn’t wanted the flowers, not even if I were to gift them to her as a token of love. The flower seller, however, wouldn’t go away. Maybe she had figured that marketing to couples was an extremely profitable strategy, and didn’t want to let go of this opportunity. My companion had proceeded to pull out twenty rupees and give them to the vendor, asking her to keep it and not give her any flowers. Incensed at being treated like a beggar, the poor flower seller had run away. I don’t know if something snapped in me at that moment, but we broke up under inexplicable circumstances a couple of hours later.

Cut the scene forward by three years, three months and three days, and change the venue of the scene to Gandhi Bazaar in South Bangalore. It was a different vendor this time, and she was selling jasmine on strings. It was dark, and her face was dark, so I don’t really think I’ll recognize her if I see her another time. It was late in the evening so her stock of jasmine was almost over, and she was trying to get rid of whatever was left.

I was meeting this girl (not the vendor) for the first time that day, and her reaction was swift. “I’ll buy some for my mum”, she declared and quickly cleared the vendor’s stock. My mind quickly went back to that day on Church Street three years, three months and three days earlier.

Louis, I thought, this is the beginning of a beautiful friendship.

Collateralized Death Obligations

When my mother died last Friday, the doctors at the hospital where she had been for three weeks didn’t have a diagnosis. When my father died two and a half years back, the hospital where he’d spent three months didn’t have a diagnosis. In both cases, there were several hypotheses, but none of them were even remotely confirmed. In both cases, there have been a large number of relatives who have brought up the topic of medical negligence. In my father’s case, some people wanted me to go to consumer court. This time round, I had signed several agreements with the hospital absolving them of all possible complications, etc.

The relationship between the doctor and the patient is extremely asymmetric. It is to do with the number of counterparties, and with the diversification. If you take a “medical case”, it represents only a small proportion of the doctor’s total responsibility – it is likely that at any given point of time he is seeing about a hundred patients, and each case takes only a small part of his mind space. On the other hand, the same case represents 100% for the patient, and his/her family. So say 1% on one side and 100% on the other, and you know where the problem is.

The medical profession works on averages. They usually give a treatment with “95% confidence”. I don’t know how they come up with such confidence limits, and whether they explicitly state it out, but it is a fact that no disease has a 100% sure shot cure. From the doctor’s point of view, if he is administering a 95% confidence treatment, he will be happy as long as his success rate is over that. The people for whom the treatment was unsuccessful are just “statistics”. After all, given the large number of patients a doctor sees, there is nothing better he can do.

The problem on the patient’s side is that it’s like Schrodinger’s measurement. Once a case has been handled, from the patient’s perspective it collapses to either 1 or 0. There is no concept of probabilistic success in his case. The process has either succeeded or it has failed. If it is the latter, it is simply due to his own bad luck. Of ending up on the wrong side of the doctor’s coin. On the other hand, given the laws of aggregation and large numbers, doctors can come up with a “success rate” (ok now I don’t kn0w why this suddenly reminds me of CDOs (collateralized debt obligations)).

There is a fair bit of randomness in the medical profession. Every visit to the doctor, every process, every course of treatment is like a toin coss. Probabilities vary from one process to another but nothing is risk-free. Some people might define high-confidence procedures as “risk-free” but they are essentially making the same mistakes as the people in investment banks who relied too much on VaR (value at risk). And when things go wrong, the doctor is the easiest to blame.

It is unfortunate that a number of coins have fallen wrong side up when I’ve tossed them. The consequences of this have been huge, and it is chilling to try and understand what a few toin cosses can do to you. The non-linearity of the whole situation is overwhelming, and depressing. But then this random aspect of the medical profession won’t go away too easily, and all you can hope for when someone close to you goes to the doctor is that the coin falls the right way.

Shoes

I bought these Adidas sneakers earlier this year. Maybe in February. I ddn’t really need a pair of sneakers back then – my old Nikes were just fine, but I thought some retail therapy might help cure my NED, and hence the new sneakers. The therapy’s effects were short-lived. I got back to my then-ground state of NED the following day. NED meant unwillingness to wear my new sneakers to the gym, or to work, or anywhere else. So they lay, in a box, until I brought them to Gurgaon three months back. The old faithful pair of Nike was left behind in Bangalore.

I don’t know if my feet have grown in the last ten months. Or if in my eagerness to shop way back in February, I didn’t check properly for the size. But the sneakers are simply too tight. One theory is that my right foot is bigger than my left, and when I had tried out these sneakers in the showroom, I had put the left one on, found it perfect, and bought the pair. This reasoning is based on the observation that it’s only my right foot that hurts, and my left one does fine. The length of the shoes is perfect. It’s a problem with the width. The fourth and fifth toes of my right foot end up getting squeezed.

Having made a mistake the last time I shopped for sneakers, I don’t want to take any chances now. I don’t want to buy another 2K+ pair. I want something cheap, yet comfortable. Went shopping last weekend, checked out all the major showrooms, and whenever I found what looked like a good pair, I would chicken out, head and feet full of self-doubt. I still wear the same tight pair to the gym every morning. And the fourth and fifth toes of my right foot still hurt.

It is winter in Delhi, and gets fairly cold in the evenings, and sometimes even during the day. In Bangalore, Madras, Bombay, etc. my normal footwear (when I wasn’t required to wear formals or sneakers) was floaters. That clearly doesn’t seem to be an option here in Delhi. Which means I need a general pair of shoes. So far in my life, I’ve owned only one “general” pair of shoes. The rest have either been uniform, formals, floaters, bathroom or sneakers. That one general pair I own has been left behind in Bangalore. It’s an old faithful comfortable Liberty pair. Now, the presence of that shoe in good condition, even though it isn’t accessible, deters me from making up my mind about spending on a new pair. Last weekend, I found some really good shoes at Woodland, but again chickened out. Maybe the scars of the wrong choice of sneakers has started affecting in my other shopping decisions also.

On a different note, one thing I’ve noticed here in Gurgaon is that service providers who come home (for example, the guy who fixed the washing machine) refuse to take off their shoes when they enter your house. They even don’t think twice entering the kitchen wearing shoes. Coming from a background where shoes inside the house are a strict no-no, I find this fairly shocking. I remember reading in A Farewell to Alms about differences between Japan and Europe. Japan seems to be like South India in this regard, outlawing footwear inside homes, while Europeans had no such restrictions and is hence like Gurgaon.

why is the level of English in North India so low?

I had sent this mail to a mailing list of 60-odd super-intelligent people. unfortunately, in their fondness for Savita Bhabhi, Vidarbhan farmers and child-eating, they weren’t able to come up with any convincing explanation for this. So I thought you super-intelligent readers of my blog might be able to help. I begin.

Three months back I moved to Gurgaon from Bangalore. And one thing I’ve noticed is that here practically no one can speak English. I’m referring to service providers here, people who are typically from the lower middle class. Taxi driver. Electrician. Waiter. Accountant. etc.

None of them can speak a word of English, and  I mean that almost literally. In Bangalore and Madras, we can see that people in these professions at least make an effort to speak English, and even if you don’t know their local tongue you will be able to communicate with them and get your work done. Here, unless you know Hindi, it is impossible. There is only so much you can communicate in Dumb Charades, right?

I suppose one argument will be that people in the North would have never had the need to learn English since most people they come across can speak Hindi. And that since linguistic regions are much smaller in the South, there is greater incentive for people to pick up and learn new languages. And since they know that a knowledge of English helps get them more business, they make an effort to pick it up.

But again – even if you exclude those who haven’t gone to school, the knowledge of English here is horrible. Isn’t it aspirational in North India to send kids to English medium schools? If not, I wonder why this is the case – given that in the South practically everyone want to send their kids to English medium schools.

Ok here is my hypothesis – remember that it is a hypothesis and not an argument. I wonder if people who are native of regions where the same language prevails over a large geographical area are linguistically challenged. because everyone they need to interact with know their language and there is no need for them to learn any new language. and this affects their ability to pick up new languages. on the other hand, people from linguistically diverse regions will tend to find it easier to pick up new languages.

extending this, it might actually help if the medium of instruction in your school is not your native tongue. having learnt a new language early, you will find it easier to pick up new languages as you go along.

sometime last month I was at a high-end restaurant with a couple of friends. spoke to the waiter in English and he didn’t understand. one of my friends who was with me said “don’t bother talking to these guys in English. if they knew some english, they’d’ve been working for Genpact and not become waiters”