Musings of a Medical Teacher in the Modern Era

For Kiddu, for reminding me why I need to teach.

After nearly two years on my path as a lecturer in a medical college, I sense it’s the moment to pause and ponder. Have the past two years been fulfilling? Undoubtedly. Will the future hold the same? I’m a tad bit skeptical. Comparing my current position as a lecturer in a medical college to my previous roles at a research institute and an NGO, it’s the least lucrative financially. Yet, even if I’m not directly involved, the sense of fulfillment derived from witnessing someone’s growth in the medical field keeps me motivated. If we examine the principles of Ikigai, the Japanese concept of ‘Reason to live,’ I find myself squarely in the intersecting realm of ‘What you love’ and ‘What you are good at,’ leaning strongly towards Passion. However, there’s a downside to this approach. Ikigai focuses solely on the individual’s fulfillment without considering how society perceives one’s pursuit of passion. While purists may urge boldness and single-minded dedication, the reality, especially in teaching, is quite different. Navigating today’s students’ intricacies and inner thoughts is a constant battle. I’m still grappling with what truly motivates them. Sometimes, engaging in conversations about academics or life feels like drifting without direction, leaving me feeling more lost than the students themselves. Moreover, at times I encounter a group of students who seem to lack strong opinions, adding another challenging layer. It’s like being in a maze of complexity when people withhold their thoughts and feelings.

Then what keeps me going? To understand what is my role as a teacher I remind myself of Kahlil Gibrans famous verses on teaching

No man can reveal to you aught but that
which already lies half asleep in the dawn-
ing of your knowledge.
    The teacher who walks in the shadow of
the temple, among his followers, gives not
of his wisdom but rather of his faith and
his lovingness.
    If he is indeed wise he does not bid you
enter the house of his wisdom, but rather
leads you to the threshold of your own
mind.
- Kahlil Gibran

This is what maintains my sanity during teaching sessions. My understanding stems from interactions with people and extensive reading. Now, my responsibility lies in conveying this knowledge rather than internalizing it. My sole focus is on passing the beacon of enlightenment. I understand that not everyone will resonate with my perspective; rather their outlook on life will largely be shaped by their family and social circles. In this journey, I walk alongside them, carrying the torch yet never positioning myself ahead of them.

Teaching, particularly at the undergraduate level, has its drawbacks. The repetition of topics can feel mundane, prompting questions about the purpose of such endeavors. However, each student represents a unique individual, a fresh opportunity to impart knowledge and inspire growth. Personally, I struggle with remembering names, especially with a batch of 150 students. Yet, I can boast of possessing a talent for recalling their achievements and aspirations, which enriches my teaching experience.

Reflecting on my journey, I realize that the essence of effective teaching lies not solely in the subject matter but in the way it is conveyed. While I may not boast exceptional academic prowess, I take pride in cherishing the intricacies of my students’ lives. Whether it’s acknowledging Ms. X’s beloved dog, Shero, or recognizing Mr. Y’s visit to Pondicherry, these details matter. Ms. A’s prowess in the long jump, Ms. B’s fondness for cheesecakes, and Mr. Z’s remarkable artistic talent—all contribute to the tapestry of human connection within the classroom.

Some may perceive these anecdotes as mere distractions, but I disagree. They are reminders to our shared humanity, changing the landscape of the educational environment and disrupting monotony. Ultimately, it’s these personal connections and emotions which breathe life into our teaching endeavors, fostering a sense of belonging and rapport among us all.

I also had a short stint teaching online. During this time, I struggled with a fundamental issue: the inability to gauge my students’ reactions. How does one engage with a screen for long periods, completely unaware of the expressions on their students’ faces? I yearn for and thrive on those telltale signs – the expressions of awe, delight, and laughter. These cues fuel my passion and drive, empowering me to deliver my best in the present moment.

I must also acknowledge the profound moments when a student becomes a teacher. Such instances have been gratifying beyond measure. Last year, one of our students made a remarkable painting during a camp that we conducted in rural parts of Bangalore.

What made it even more special was when our department chose it as the cover page for our planner. As a result, I started each day with this painting, and its impact was beyond words. It served as a poignant reminder of my purpose.

The power of imagery to convey profound messages comes to light with this canvas. It captures the essence of a trait that I truly believe in; the importance of listening. As depicted, the student leans attentively toward the elderly woman, patiently waiting to know what matters most to her. Thank you Aditi for this remarkable piece of art, which continues to inspire and resonate with all of us. Indeed, I often utilize this unique painting to introduce the field of Humanities and its significance within the medical stream.

So, what ultimately motivates me? This profession is marked by joy and sorrow, but I believe such experiences are universal, regardless of one’s profession. Then, what sets this profession apart? The torch of wisdom is undeniably fierce. Passing it on can be a heavy responsibility for the teacher, but it yields a lasting impact when embraced correctly. Recently, I came across the book “Tuesdays with Morrie,” and I wholeheartedly recommend it to anyone in the teaching profession. There’s a quote from the book that particularly resonates with me, shedding light on the essence of why we do what we do.

“A teacher affects eternity; he can never tell where his influence stops”

– Henry Adams

What Matters Most!

“It’s been 10 years but it still feels like yesterday.” The other day, while I was conversing with my brother, we found ourselves reflecting on our father’s passing. Recalling the time when we were adrift in a sea of despair, our worlds turned topsy-turvy in the blink of an eye, we couldn’t help but acknowledge how far we had come. Time, a relentless force, had undoubtedly played its part in easing our pain, yet it was our resilience, our steadfast refusal to yield to the overwhelming adversity, that I consider our most commendable feat. However, I wish to recount here the sequence of events that inflicted the deepest wounds upon us during the tumultuous early years of our arduous journey.

A year preceding my father’s passing, he received the agonizing diagnosis of cancer. This particular malignancy targeted his platelets, crucial for clotting in the event of injury. It was a cruel twist of fate that led to his suspicion. One evening, as he returned from his jog, a sudden, agonizing pain gripped his toe. Initially dismissed as a trivial injury, we hoped it would subside on its own. However, as the pain persisted, a routine blood test revealed extremely elevated platelet levels, shattering our illusions of normalcy. Moreover, a mutation known as JAK2 mutation turned out positive which was commonly associated with Myeloproliferative Neoplasms such as Polycythemia Vera, Essential Thrombocythemia, and Myelofibrosis, further complicating matters. However, amidst the overwhelming medical jargon, as a medical student at the time, my primary concern was grasping the severity of the condition and understanding the prospects of survival. Despite consulting numerous doctors, clarity remained elusive. Some communicated in abstract terms, others merely stated that time alone would reveal the outcome, while the devout among them cloaked their responses in religious rhetoric. Yet, none provided the solace or guidance we so desperately sought. What we yearned for most were words imbued with tranquility, empathy, and solace. We simply wanted a certain acknowledgment of our plight. Yet, patience seemed a scarce virtue among those we encountered. What cut deepest were the pitying glances from the doctors, their expressions a dagger to our hearts. We didn’t seek their sympathy; all we desired was their unwavering support. If my father was to confront cancer, then let him face it with dignity and serenity. That, at least, was my fervent wish. Furthermore, we found ourselves bereft of opportunities to make informed decisions about his disease. The prevailing approach seemed paternalistic, with many clinicians prescribing treatments based solely on their assumptions. For instance, despite the necessity for my father to undergo multiple bone marrow biopsies, not a single doctor possessed the capacity to elucidate the procedure to him beyond reciting procedural instructions and potential side effects, all while seeking his compliance without genuinely understanding him or his family members. Would it have changed the course of his death? Maybe not. But we would have been more at peace if not for the partially apathetic nature of the medical fraternity.

I do not attribute blame to everyone, as some extended genuine kindness to us, particularly during my father’s passing. Among them were doctors who were our own family and friends, whose support we gratefully embraced, alongside strangers whose empathy transcended the boundaries of familiarity. What set them apart was their ability to comprehend our inner turmoil and simply listen. Their willingness to lend an ear made an immeasurable difference. After almost a decade immersed in the medical field, I find dismayingly minimal progress in the approach adopted by the majority of doctors when it comes to delivering difficult news. Hence, I am compelled to delve into the intricacies, highlighting the foremost shortcomings and merits that have persisted over time.

Exercise vigilance and sensitivity when addressing the deceased or the afflicted individual

To a doctor, it may seem like just another person lying in a hospital bed, but to the family members, it’s a beloved individual who provided both sustenance and affection. In an instant, these two fundamental pillars of their lives are mercilessly snatched away. The moment a doctor broaches the subject of death, they come under intense scrutiny. I can still vividly recall the expression on the face of the doctor who broached the topic of my father’s demise, as clear as if it were a distinct picture etched in my memory. The most heart-wrenching moment was hearing my father referred to as a “body,” whether by family or friends. Just moments ago, he had a name. Why couldn’t they address him as such? He remains vivid in our memories even to this day.

Be patient with bystanders. It only takes a moment.

Reaching the crossroads of breaking bad news often brings uncertainty. The most valuable course of action is to stand alongside those affected, offering a listening ear. If speaking proves fruitless or fails to provide comfort, it’s best to remain silent. Sometimes, words simply cannot convey solace. I recall a poignant moment when a doctor summoned his junior to attend to another case, allowing him to dedicate additional time to us. These may appear trivial to most, but they serve as poignant reminders of his compassion.

Step into their shoes. This can provide valuable perspective.

This is definitly a skill you learn over time and can be influenced by multiple factors including your upbringing, readings, influences. Being in their shoes is difficult if you belong to a different social strata. In such situations, it’s crucial not to rely on imagination alone. Instead, it’s better to inquire and gain insight into their family dynamics. This approach helps break down barriers and prevents false assumptions. For example, in a hospital setting, the person who appears the least emotionally attached may actually be the closest, as they’re able to maintain composure during a crisis. I vividly recall informing one of my father’s colleagues about his passing. He was visibly stunned and unable to react, prompting the doctor to relay further information to distant relatives with whom we were not comfortable. Unfortunately, this led to significant miscommunication between the doctor and our family.

Hospitals need to be homes

It may sound irrational, but when I learned that my father had been hospitalized, the first thing I did was urge my brother to order a sandwich. In the midst of the chaos, I felt a sudden urge to indulge, thinking that once my father passed away, I wouldn’t have the appetite to eat. It was a frantic, almost surreal moment where I felt disconnected from my body, and logic seemed to elude me. Looking back, it seems absurd—I even tossed away my sandwich, momentarily forgetting that I was in a hospital, not at home. Yet, strangely, the hospital cafeteria provided a sense of comfort and familiarity. Had it felt otherwise, I doubt I would have been able to express myself in quite the same manner.

Upon receiving the news of my father’s passing, my initial reaction was to take a stroll in the hospital premises. Standing beneath the sky, I screamed at the top of my lungs. Why? Because at that moment, all I could hear echoing in my mind was the regret of never having the chance to tell him one last time that I loved him. In fact, I couldn’t even recall the last time I uttered those words to him. The hospital garden became my sanctuary, offering a place of solace where I could sit in quiet contemplation. As I observed each passerby, I found myself immersed in memories of the love and affection my father had bestowed upon me.

Your Loving Son

A moment in life when my father thrived in health and vitality.