Tuesday, April 22, 2014

Dealing with body wastes and other issues - II

I was about to begin this post with a rant about how TV is turning people into zombies, about how it is reducing interaction between people,, about how it is reducing the attention span of kids...when I saw this passage by P.G. Wodehouse in A Damsel in Distress:
In as much as the scene of this story is that historic pile, Belpher Castle, in the county of Hampshire, it would be an agreeable task to open it with a leisurely description of the place, followed by some notes on the history of the Earls of Marshmoreton, who have owned it since the fifteenth century. Unfortunately, in these times of rush and hurry, a novelist works at a disadvantage. He must leap into the middle of his tale with as little delay as he would employ in boarding a moving tramcar. He must get off the mark with the smooth swiftness of a jack-rabbit surprised while lunching.Otherwise, people throw him aside and go out to picture palaces.
If Wodehouse has to get off the mark quickly, then I am left with no choice but to follow suit. Prolefeed has a peculiar hold on people, as shown in this Vadivel comedy scene. (Apparently, it helps in population control. Who knew?) It is quite a sight to see the nurses standing immobile like Midas' unfortunate daughter (or if you prefer, like Lot's disobedient wife), unable to take their eyes off the TV. This happens even if the program is in a language that they can't understand so long as it is a movie or a serial.

I once had a nurse who had an inability to keep quiet that often drove me crazy. I was once watching something on Discovery Channel. She was chattering away and I couldn't hear a word of the program. Once it showed a flock of gannets on a sea shore and she wanted to know which bird it was. She said various names in Tamil which I didn't understand. Then she said 'duck' and I blinked 'yes' hoping this would make her keep quiet. I succeeded...for all of one minute. Then the damn things started to fly and she immediately exclaimed, "But ducks don't fly!"

There was only one nurse who had no interest in watching TV but she was extremely slow. What other nurses could do in 15 min., she took an hour. This pace was not enough if I wanted to do something urgently, like pass urine. After a couple of days, I started telling the nurse about urine 10 min. before it became urgent. Sometimes when I called for passing urine, she will stare blankly at me and then continue her work. And what was she busy doing? Reading religious books! For whatever she was told, she will agree immediately by saying, 'Ida vanditten!' (just coming). There will be no sulking or arguments. The only problem was that she will take her own sweet time to come.

Jaya has to tread the fine line between annoying the nurses by constant monitoring and letting them do what they want. What was curious was that many tasks that they are required to do will be a lot less taxing than cleaning motion but the same nurses who had no problems cleaning motion will omit the simple tasks. In Family Matters by Rohinton Mistry, Roxana finally employs an ayah to take care of her bed-ridden father. There is a description of the ayah by the 14 year old son of Roxana which resonated with me.
Her name was Rekha. Mummy explained her duties and demonstrated exactly how she wanted things done, in the hygienic manner to which she and Grandpa were accustomed. Rekha followed the instructions when she was being watched. But mummy often caught her skipping steps if she came upon her without warning. Usually, it was the urinal - she would not rinse it clean each time Grandpa used it. I remember, once,Mummy  found her proceeding to fetch Grandpa's soup from the kitchen after emptying  the bedpan, not bothering to wash twice with soap and water. 
"Your toilet hands you use to carry food?" shouted Mummy. "Not even once you apply  sabun!"
"Arre bai, I forgot this time."
"I've seen you lots of times, taking shortcuts!"
Inbetween the irritations, I will feel sorry  for the nurses. All of them will have sorry tales to tell. Some will have a drunkard as a father or husband, some will be single mothers with their children in some hostel, some would have been ill-treated by a previous employer...

Tuesday, April 15, 2014

Dealing with body wastes and other issues - I

I recently read Family matters by Rohinton Mistry which describes many difficulties involved in taking care of a bed-ridden patient. In the novel, the 79 year old Nariman Vakeel is cared for by his daughter Roxana after he broke an ankle during a walk. It describes the anxiety, stresses and strains, the patience and the physical strength required for looking after a bed-ridden patient. These aspects are often missed when people see the finished sausage.

Probably the most demanding aspect of the work is dealing with body wastes. Technology has made a lot of progress but there is no easy way of handling body wastes which are messy and don't smell nice. Waiting for insects and bacteria to do the cleaning would be a bit inconvenient. When I was in the hospital after the stroke, one doctor used to say that I was the only patient in the hospital without smells. I used to wonder about that because nurses with similar training used to look after the other patients. I was lucky in drawing the most dedicated nurses.

In Sea of Poppies by Amitav Ghosh, a Zamindar called Neel is imprisoned on a charge of forgery. He finds himself in the same cell as an opium addict who suffers from withdrawal symptoms because he is denied the drug. Neel watches in horror as the prisoner lies helplessly having periodic convulsions, mouth drooling, having scabs and sores because of insect bites and body caked in feces. (Dinosaur feces and dinosaur pee may be fine but being plastered with your own feces is not a fate one dares to think of.) The plight of that prisoner is a world away from the care I get.

For eg. some months back, when I was suffering from back pain, I inadvertently and unexpectedly passed motion on the bed. No preparations had been made since there was no one in the room who I could warn. It was a while before Jaya came to the room and I informed her about the mess that I had created. Then she and the nurse had to spend an hour cleaning me up, changing the sheets and ridding the room of the smells. The task was made more difficult by the fact that I had to be manoeuvred around the bed with great care because of my back pain. If somebody had come into my room after the cleaning, he wouldn't have known that the room had been a mess some time back.  I don't know how but the cleaning is often done with good humor as if nothing had happened.

If I am sitting in a wheelchair and can give a few minutes warning when I feel as if I might pass motion, I can be shifted to the bed quickly and the necessary arrangements can be made to make the cleaning process easier. But if I am unable to give a warning (as it happened when typing this post) then cleaning up the mess is mighty difficult. And the stink! If I can smell it (my ability to smell is reduced- I was thinking of writing that my 'olfactory prowess is compromised' but Orwell would have frowned) you can guess that Jaya and the nurse would not have had it easy. And my best laid plans for the day would have gone astray. I will feel, like Agastya Sen in English, August, 'hazaar fucked'.

While returning from the enjoyable trip for the reunion, I passed motion at the Mumbai airport. (At that time my bowel movements were a bit irregular because of the antibiotics and painkillers I had had. This meant that I was in some tension throughout the trip but nothing happened till the final leg of the journey.) Nothing could be done at the airport and it was almost midnight by the time we reached home and I could be cleaned up. A bottle of perfume was purchased at the Mumbai airport and sprayed on me at regular intervals. The bottle was empty by time we reached home. There wouldn't have been too many occasions when a bottle of perfume had been used so liberally.

And I bet not many have  enjoyed watching the Queen's Necklace at night while sitting on shit. Boy, the tension I was in throughout the trip! But I was fully packed, the perfume was doing its job and the passengers looked relaxed so maybe I was exaggerating the possibility of a stink. Stephen Hawking travels a lot and I wonder how he manages such inconveniences. Talks about black holes are fine but I also want to know about more mundane matters.

There are other regular routines like brushing, trimming nails, shaving etc. Over time, Jaya learnt to do these things smoothly. Doing these activities on oneself is much easier than performing them on others.  You are not sure how much pressure to apply, for eg, during shaving. Too much pressure and you nick the skin, too little and you don't remove the hair. And you have to be  more careful because I might suddenly cough. Once a barber nicked my nose when I coughed suddenly. He remarked that he had caused nicks at many places in the face but this was the first time he had nicked anyone's nose! Nowadays Jaya does the shaving for me.

She has to do all this and also do outside work like go to the market and bank since her father no longer drives a vehicle. She also has to help around the house since her mother has had two knee replacement surgeries. And she has to look after a teenage son which is more stressful than looking after two babies simultaneously. Sometimes when people find her sleeping at 5 pm they will be surprised. They will not know that she may have slept after 3 pm, that  I may have woken her up because I suddenly wanted to pass motion, that she may have had to wake up 2-3 times the previous night because I had wanted to pass urine...

Apparently there are people whose job is to act as standardised patients and feign myriad diseases, syndromes, conditions, and habits. I wonder if someone acts as a standardised patient for brain stem stroke. What sort of training do they get?

PS: Just as people have to do horrible tasks for me to relax, many people have to do mind numbing jobs for us to get the stuff that George Carlin talks about.

Sunday, April 6, 2014

Sozzled philosophers

In this discussion with Christopher Hitchens, I came across 'The Philosopher's Drinking Song':
 Immanuel Kant was a real pissant        
 who was very rarely stable. Heidegger,  
Heidegger was a boozy beggar     
 who could think you under the table. 
David Hume could out consume     
Wilhelm Friedrich Hegel, 
 And Wittgenstein was a beery swine     
who was just as sloshed as Schlegel.
 There's nothing Nietzsche couldn't teach ya     
'bout the raisin' of the wrist. 
Socrates himself was permanently pissed.
 John Stuart Mill, of his own free will,   
 after half a pint of shandy was particularly ill. 
Plato, they say, could stick it away,   
'alf a crate of whiskey every day! 
Aristotle, Aristotle was a bugger for the bottle,     
and Hobbes was fond of his Dram. 
And Rene Descartes was a drunken fart:     
"I drink, therefore I am."
 Yes, Socrates himself is particularly missed;
 A lovely little thinker, but a bugger when he's pissed.

Wednesday, April 2, 2014

The rice issue

There may be people who are adept at murdering mosquitoes with a sledgehammer but as far as I know (correct me if I am wrong), the weapon of choice when embarking on the said mission is somewhat different. I had a nurse whose tactic for solving a particular issue was metaphorically equivalent to the action of a sledgehammer-wielding personage massacring the pesky blood-sucker.

Among the number of nurses who came after the long-serving nurse had left was one nurse who seemed to be inclined to stay for a while. She seemed OK with the work she had to do and we were satisfied with what she was doing. She was on the older side (around 50) so she couldn't supply the muscle power necessary for some activities but we were willing to live with that for the time being. The only catch was that she was not happy with the variety of rice we used.

She was used to the large-grained variety of rice that is widely used in Kerala. None of us like that variety so it is not purchased and what we buy is a more standard variety which is smaller grained. This was a problem that had never come up earlier. We don't know if the variety of rice she wanted is available in Coimbatore. She said that she will adjust to the variety of rice that we had and the issue did not come up again.

Some days later the nurse informed us in a  somber tone that she had just received a phone call informing of a bereavement in her family. She said she had to leave immediately to attend the funeral and that she will come back after a few days. Since it was night, she couldn't leave that day. Early next morning, Jaya dropped her at the bus stand and the nurse promised to call after reaching home regarding when she will be able to come back after all ceremonies.

She then called up the next day to tell us about the funeral and the ceremonies that had been scheduled. She said that it will take a couple of of weeks for her to return so we decided to ask her office for a reliever for that period. Her office got back to us after a few hours with startling information that the nurse had been lying all along! No one had died in her family and she had concocted such an elaborate story because she could not eat the variety of rice we had and wanted to leave.

If we were unable to procure the variety of rice she wanted and if she was unable to adjust with the type of rice we had, she could have said so and left. Why spin such a yarn to solve a simple issue? And why carry on the charade long after she had 'escaped' from here? It was bizarre.

PS: The title of this post is like the title of a Robert Ludlum novel. He wrote novels with titles like The Bourne Identity, The Scorpio Illusion, The Matarese Circle etc. From this talk by Christopher Hitchens, I came across an anecdote about Salman Rushdie. In a discussion which Rushdie was not paying much attention to, someone asked what the title of a Shakespeare play would be like if it was written by Ludlum. Rushdie immediately perked up and came up with titles like: Hamlet -The Elsinore Vacillation; Macbeth - The Dunsinane Deforestation; Othello - The Kerchief Implication.

Tuesday, March 25, 2014

I attend a wedding

My cousin's wedding dates had been fixed and my Aunt insisted that I attend it. As the date of the wedding neared and we did not have a nurse, it was decided that Jaya and I won't go for the wedding. But the day before the wedding we got a nurse. Jaya casually asked her if she was willing to take me to Kollengode (which is about 70 km from here) the next day for which she would have to get up by 4 a.m so that we could leave by 6 a.m. To our surprise she readily agreed .

So we quickly changed our initial plan of not attending the wedding, called up the taxi service to arrange a car of our specifications and checked with an acquaintance if he could come with us to help in shifting me. It was 8 p.m. by the time all the arrangements were made and our trip was confirmed. Jaya then rang up my Aunt and told her about our plan. She was taken by surprise since she had  assumed that we were not coming. Nobody was expecting me to come.

In Joseph Anton, Salman Rushdie writes about a foreword to a book of photographs written by the great Argentinian writer Jorge Luis Borges. (It is curious that a  blind person was asked to write a foreword for a book of photographs.) Borges wrote that a photograph cannot reveal the vastness of the Pampas. It can only show the view till the horizon and what lies beyond is in the imagination of the traveller. It could not capture the tedium of travelling on and on and on through that vast unchanging landscape.

My life after the stroke is in many ways similar to the experience of that hypothetical Borgesian traveler. In these times of rapid change, it is inevitable that my unchanging dreary self will be pushed to the background. I would have been hot news 15 years ago but then people get used to the changed circumstances just like I did. They had seen photographs occasionally but the vastness of the Pampas remained hidden.

So I was a ghost from the past who had suddenly, unexpectedly materialised at the function. One major reason why I was reluctant to go for the function was that I didn't want to shift attention from the marriage ceremony to me as would inevitably happen. This may have been avoided if I had been a regular attendee at such functions but I had never attended a big family function since the stroke about 15 year ago so I would have been something of a curiosity.

I was wondering where I would be parked because I didn't want to be in front of the crowd during the wedding ceremony (which in Kerala weddings is quite short,  lasting for about half an hour) since that would have been a distraction. I also have bouts of cough sometimes which are innocuous but people who are unfamiliar with it may panic. Fortunately I was parked in a room right next to the stage where the wedding took place. Here it was easy for people to come and meet me and there was also some privacy for giving me feeding.

I met a large number of people who I had not met since my stroke. It was like being at one's own wedding - you meet many people, some very familiar, some not so familiar and a lot of people you don't know at all. Sometimes it took me a while to put names and faces together. Father Time had been busy over the years so my brain had to do a lot of processing.

The day after the wedding the nurse left for good citing some illness in her family. 

Tuesday, March 18, 2014

Jaya attends a wedding

Jaya had thought of attending the wedding of a close family friend in Delhi but had almost decided not to go since I had no regular nurse who understood my dumb charades. Then a nurse came who was a quick learner and agreed to stay for a month which covered the duration of the trip and it again seemed a possibility.

I warmed to the nurse initially.I usually watch TV only when lying down and the channels will generally be news, sports or nature which the nurses will not be interested in watching. Once when I was lying on the bed watching TV, I told her to keep whatever channels she wanted since there was nothing that I wanted to watch.  The problem was that she then monopolized the TV for the remainder of her stay. She would keep vague Tamil movies and songs none of which I wanted to watch. When some nice song like this or this came, she would say, 'How boring!' and change the channel much to my frustration. I used to keep quiet since I wanted her to stay till Jaya's Delhi trip was over.

She would mostly keep what are known in Tamil as dapankuttu songs - songs that have loud music and lots of people indulging in vigorous dances eg. this one. Some of these songs are fun to watch sometimes but if you have to watch them for a few hours a day for a month, it becomes trying. She was a big fan of the Tamil actor Vijay and she used to  watch any Vijay song that came. I do like some Vijay songs eg. this one but none of them came during the whole month.

A similar thing happened with the computer. She  wanted to know how to surf and I showed her how to enter the search string in Google. This proved to be my undoing because after that she wouldn't let me use the computer. She would keep looking at the pictures of Tamil film stars. When Jaya was at home, I could ask her to intervene diplomatically but when she had gone to Delhi, I had to keep quiet. I did not want to tell Sujit because he could get into an angry argument with her and I was afraid this might make her leave in a huff which would leave me in the lurch.

Once when Jaya was in Delhi and I was lying on the bed, the nurse turned the monitor away from me, closed and bolted the door and started surfing. This made me suspicious of what she was doing and I was also afraid that some virus might enter the computer because of her random clicking. I told Sujit to switch off the modem when the nurse was not in the room. She could not understand why she  was unable to access the Internet for which we maintained the fiction that it was a BSNL problem which could be solved only after Jaya returned from Delhi.

I also found it difficult to read books because she would be so absorbed in watching TV that I would find it difficult to attract her attention when I wanted to turn the page. Sometimes while turning a page, she will freeze midway through her action mesmerised by the action on TV and will complete the action after a few minutes. I got so exasperated that I stopped reading books when Jaya went to Delhi.

Since now I couldn't read books, watch T.V. or use the computer, I spent the time in another room waiting movies on a laptop with Sujit. I saw two interesting movies  at this time : OMG - Oh My God and Mr. and Mrs. Iyer (which is mostly in English). Although the storyline of the latter movie is different, it reminded me of Ruskin Bond's short story, The Night Train at Deoli.

Tuesday, March 11, 2014

The nurse who mistook me for an overgrown 6-month old child

In Very Good Jeeves, Bertie Wooster tells about his experience of playing golf with the Right Hon. A.B. Filmer:
I played golf with the Right Hon. every day, and it was only by biting the Wooster lip and clenching the fists till the knuckles stood out white under the strain that I managed to pull through. The Right Hon. punctuated some of the ghastliest golf I have ever seen with a flow of conversation which, as far as I was concerned, went completely over the top.... 
I know the state Bertie was in. I experienced it. I had a nurse a few months back who was the Right Hon. to my Bertie. And I didn't have Bertie's advantages of biting the lip and clenching the fists. It was only because her tenure was short that I managed to pull through.

This nurse seemed to be under the impression that I was not more than about 6 months old. Somewhat big for such a small child but a child nevertheless. When I would try to read a book, she would say, "This is English. See, this is 'a'." She would try to attract my attention by clapping her hands, tapping my shoulders or  by interposing her face between the book that I would be reading and my face and making Sreesanth-like expressions.

At first I  used to laugh seeing her antics but then realised that my laughter was encouraging her to continue her weird routines. I then decided to keep maintaining an expressionless face no matter what she did which was a difficult thing to do and I was often unsuccessful.She would not let me read in peace so I took to following Jaya around the house and parking my wheel chair wherever there were some people around because she would keep chatting with them and leave me alone.

In my village in Kerala, there is a fairly big and famous temple very close to where was staying. Legend has it that this temple was built overnight by spooks - one evening there was no temple and the next morning there was this big temple with a compound wall made of huge stone blocks. Everybody believes this, make what you will of  it. I must be among the few people in the village who doesn't know everything there is to know about the temple.

The nurse who stars in this post turned out to be an enthusiastic temple-goer in a land full of enthusiastic temple-goers. And as luck would have it, she was a regular visitor to the afore-mentioned temple. When she found out that I belonged to that village, she started giving me details about various statues, rituals, festivals, etc. associated with the temple, most of which I was unfamiliar with. In Laughing Gas by P.G. Wodehouse, when Reggie is unexpectedly saved from having to make excuses in a particular situation, he says:
The air seemed full of peeling bells. I was saved. No tedious explanation...No issuing of statements...no breaking off of the match because of the lunacy of one of the contracting parties...
I get this feeling frequently because of my inability to speak. The amount of strife this has saved me from! Staring dumbly with a smile again proved effective in dealing with this temple menace..