I have always been a daddy’s girl. My father was my rock, my support, my counselor and my guide. With two very strong clashing personalities in the house—my mom and me—my father was the one who navigated our family out of troubled waters time and again. A medical legend, he started his career with treating blood diseases in children, so it was weird to find that, at the height of his fame and career, he was diagnosed with an end-stage rare and very aggressive cancer that had found its way into his blood.

Despite the poor prognosis, he continued his work as a global advisor for public health and community health projects to national and international governments and non-government agencies. Ironically, he contracted the public menace—dengue—in his weakened post chemotherapy state, and passed away fighting the same diseases he spent a lifetime saving others from.

I had always read that grief has five stages, but you always think that these things are what happen to others. And then, I had to face them myself. Here’s what I learned.

How I Experienced the 5 Stages of Grief

Stage 1 of Grief: Shock

That moment, when the doctor walked out of the ICU to tell me my father had suffered a cardiac arrest, will be etched in my mind forever. Even as they tried to save him in vain, I stood by his inert body in utter disbelief. Three weeks earlier, he had been hale and hearty and his normal self. All kinds of hospital emergencies imaged from movies and TV serials went through my mind. I remembered those scenes where the doctor would tell the loved ones to speak to the patient, and the heart of the patient would miraculously start beating again. I tried cajoling him, pleading with him, shouting at him, even outright threatening him. But the heart monitor did not respond. I thought of scenes where someone would bang on the chest and the heart would start beating again. But no amount of CPR brought him back. In the end, I had to face the fact that he was gone.

It is a moment where different parts of your being seem to operate at different speeds. The past, the present and the future seem to collide in disjointed images, and the overwhelming feeling is that of shock and bewilderment. People around you tell you things, and you are both listening yet not listening at the same time. Perhaps this is the feeling of your soul being ripped apart, as part of you dies with your loved one. And yet, the rest of you is anchored in reality, where there are others to take care of and formalities to get through. And you plunge into a haze of activity as you try to banish your loss to the deepest and darkest recesses of your mind.

I had always read that grief has five stages, but you always think that these things are what happen to others

Stage 2 of Grief: Denial

No one is prepared for death of a loved one, whether it comes suddenly or after a long illness. But time doesn’t give you the luxury of grief immediately. In my case, I was immediately plunged into formalities—getting the hospital paperwork completed, making arrangements for the body to be taken home. These days you have mobile mortuaries that keep the body preserved at home till it is time for last rites.

I remembered my dad telling me stories of when my maternal grandfather had passed away and he had, with much difficulty, arranged for huge blocks of ice, that were salted to keep from melting, so that they could keep the body at home. And it hit me—I was already referring to Dad as a body. The thought seemed to freeze every molecule in me. This could not be happening. This wasn’t true. Dad was not… I could not even bring myself to say the D-word mentally. Someone asked me a question, and I shoved these thoughts away, again into far corners of my mind, in vain hope that if I don’t think of it, it won’t be true. And paradoxically I plunged into the next formality that needed to be completed. The body needed to be dressed properly because if you wait too long, the body goes cold and rigor mortis sets in. In this state, the body goes rigid and inflexible, and it is next to impossible to dress or re-position it. With the clock ticking, all these transactional activities kept me going, till we brought Dad back home, late at night, and there was nothing left to do till morning.

No one is prepared for death of a loved one, whether it comes suddenly or after a long illness

Stage 3 of Grief: Anger

As I lay down in bed, wide awake at 3am, all the thoughts I had been shoving away spilled over. This is the time when you should never be alone, even if the other person is sleeping or doing something else. The sense of loss, of loneliness, of all the things that will never be, hits you with a force that can take your breath away. Indeed, for a while, all I did was sit and count my breaths as time and distance warped in my mind. Snapshots from the past, his voice, his little actions, his idiosyncrasies all tumbled together in a kaleidoscope with what had been an expected future timeline with him, morphing to a timeline without him. And then came the rage, the injustice of it all. My dad, who had spent a lifetime saving others, had been failed by the very people he had taught. He, who treated and cured others, was lost to the very diseases that he had fought. Anger against cancer, against dengue, against the hospital, the doctors, against fate. Rage, disbelief and utter loneliness ripped through me night after night that first week, as sleep remained elusive.

Stage 4 of Grief: Bargaining

Surely it had not been his time yet. His own father had passed away just seven years ago. His own uncles were still alive. Dad easily had another 10 – 15 years in him. He was beyond particular about his health, waging war on salt, sugar and oil at home and at work. He meticulously monitored all his vital signs. When he passed away, apart from his blood report, every other report and organ was normal. He was a prime specimen for his age, even after cancer had decided to strike. In truth, he did not suffer much, as it had been just three weeks when we first discovered something might be wrong, and just one week from final diagnosis to his death.

The sense of loss, of loneliness, of all the things that will never be, hits you with a force that can take your breath away

Stage 5 of Grief: Acceptance

The last stage of grief is acceptance. There are moments where I feel I have accepted his absence. And then something triggers and I find myself back at one of the earlier stages. Sometimes I wonder if I really want to reach acceptance. Would it not be a travesty to not honor his loss? At other times, I tell myself, this is what he would want. To keep his memories alive through practising all that he taught me, and honor his life by living mine to the fullest, just as he did.

Conclusion

I don’t know what the future holds. I just know that I still expect him to walk through the door, with a smile on his face and a project on his mind. And if he saw me crying, he would just sit with me in silent support. In spirit, he will always be with me.

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Consider the trend of making New Year resolutions, which are broken within a few days of making them. Now, metaphysics tells you that just thinking in the right direction and opening yourself up to possibilities will allow the universe to provide you with what you need to realise your dream. What it doesn’t tell you is that while the universe is ready to provide, each of us is sitting in our cage of inertia, which makes us resist any change, however positive. You make a diet plan, an exercise plan, a plan to stop smoking, or a plan to learn a new skill. But, as soon as the initial enthusiasm wears out, you find yourself slipping back to the old, established ways. One extra helping today after being good for a month, one morning of sleeping in instead of going for a run, just one cigarette to take the edge off… the first excuse is always justified. And before you know it, you are back to your old ways, with a little more guilt and a promise to try better next year.

We are, in fact, addicted to inertia. Resistance to change is not a new concept. All teachers tell you that it’s the first step that is the most difficult. But guess what! The second, third and fourth steps are equally difficult. Once the novelty of a new plan wears out, inertia takes over and your plans grind to a halt. This is the moment of truth where you either decide to re-motivate yourself or let it slide away.

Give your inertia a form; picture it as an opposing entity that is stopping you from doing what you want

Breaking the addiction

Just like any other unwanted habit, addiction to inertia can also be broken. Here are some tips to help you win the fight.

1. Acknowledge the addiction

“I’m too stressed”, “There isn’t enough time”, “My head hurts”—the first time and every subsequent time that you make excuses, ask yourself, “Is it inertia?” Sometimes the reasons may be genuine. But most times, all you need to do is name the problem. Keep asking the question why? If your answer ultimately comes down to inertia, you know where the problem lies. Give your inertia a form; picture it as an opposing entity that is stopping you from doing what you want. Have you noticed how in sports, especially body contact sports, the opponents always acknowledge each other first? This is no different.

2. Absorb denial and blame

Denial and blame are frontline weapons of resistance. I like to picture them as boxing gloves on my opponent. “Just one more won’t hurt”, “He offered me a smoke”, “My run buddy didn’t wake me up on time”—these thoughts can pummel you relentlessly. The mental workout can wear you down till you feel the need for the comfort and turn to the very habit you are trying to break. Knowing how to take a punch can mean the difference between winning and losing. So “roll with the punches”, absorb the thoughts and let them flow into you. And then, let them go.

You might have lost a battle, but you will not lose the war—not until you give up on yourself

3. Go back to your why

This is the moment when you can either decide to go on fighting or give up; it is the peak of the climb. If you can crest this, you will win the fight. Remind yourself why you are doing this. Ask yourself what you would gain from this change. Face the alternative of what you would lose if you don’t change. Return to square one and repeat everything that motivated you to take up this change in the first place. Visualise the future, ask your supporters for help, stand tall on your convictions. Take that first step, again and again.

4. Celebrate your successes, accept your losses

If you succeeded, you beat inertia! This is a big deal. There is no bigger opponent to change. Each win provides the energy for more wins and tide you over your losses. If you lost, try again. So what if you lost this time? You gained more information about yourself and your opponent. Knowledge is power and persistence is the foundation of sustained change. You might have lost a battle, but you will not lose the war—not until you give up on yourself.

Persistence is the key

Inertia is a tough opponent, and a very patient one. It will look for opportunities to strike again and again. It will not be one big fight which will decide everything. It will be a series of small skirmishes that will keep hitting you when you are at your lowest. But just as resistance can wear you down, you too can wear it down by persisting. Over time, as its hold weakens, you will find yourself less and less in need of external motivation, because you would be now habituated to your new lifestyle. And one day, what was once a change will become a new and positive way of life.

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Medicine isn’t an exact science. Doctors can have different opinions. Some symptoms may be difficult to diagnose, and some diseases may not be easily treatable. And here we come to the crux of the problem. ‘Buyers beware’ means you start from a position of distrust. In an opinion-driven industry, this is the dichotomy we need to overcome every time we interact with the medical establishment. So let’s look at some ways of meeting this challenge.

Build trust through checking credentials

If you go into a consultation without being prepared to trust your physician, it will be a frustrating and fruitless meeting. One way to counter this is to look for trustworthy references for information on your doctor. So you could go for an annual check-up with an internationally or nationally certified hospital, where you are reasonably assured of the quality of medical care. You can check the educational qualifications of your doctors. Most hospitals have this information on their websites, while clinics will display medical certificates. Similarly, you can also check the certification status of diagnostic centres and hospitals. Health insurance providers may display a set of recommended institutions. These are all verifiable sources, which can assure a standard quality of care.

Trust in your doctor, or the lack of it, can have a profound impact on your wellbeing

Then there are informal sources. Word-of-mouth is a very powerful trust reference. The recommendations of people suffering similar problems, people who’ve had good experiences with certain doctors and hospitals, or simply other people that we trust, are a gold mine of information. Sharing of experiences in an intimate gathering or on social media websites helps us make an informed choice. Of course it is important to take any informal recommendation with a pinch of salt. A close friend’s experience is high on the trust scale but it offers a sample size of one. What if that experience was a one-off situation? On the other hand, an Internet forum is lower on the trust scale but offers a higher sample size. What if the responses in the discussion were not genuine? The trick is to gather your information from multiple sources, balance your trust equation and meet your qualified physician halfway.

Understand patient rights and responsibilities

As a patient, you have certain rights and responsibilities. While these may differ from place to place, some rights are universal. You have rights of access to care, respect, privacy, security and all information regarding your treatment and treating staff. You can ask for the credentials of all your doctors. You can ask for multiple opinions or change of doctors. Any treatment plan needs your consent or that of your chosen nominee. You can refuse treatment. You can and should ask for details for every drug that is given to you, including side effects and expiry dates. If admitted in a hospital, you or your attendant should check every medicine given to you against your doctor’s recommended plan. You can request for an alternative if a medicine does not suit you. The financial estimate of your treatment should be communicated to you before your treatment commences, except of course in emergency situations.

You can and should ask for details for every drug that is given to you, including side effects and expiry dates

Against these rights, you have the responsibility of providing correct information about yourself for accurate diagnosis, and following the consented treatment plan. This important information usually gets lost in a plethora of medical paperwork. Make it a point to read it on any visit to a medical establishment. It will bolster your confidence to demand the care you deserve.

Make an informed decision

A detailed patient history is the starting point. The details of your symptoms come in at this stage. An easily identifiable characteristic of a good doctor is if he/she spends adequate time understanding your problem. The next stage is diagnostic testing—lab and radiology. Remember, diagnostics do have a degree of error. They should always be corroborated by the treating physician and repeated if needed. Different labs may have different techniques and reading ranges. Keep this in mind before you panic on seeing an out-of-range result.

With the identification of the disease, [or possible concern areas], the doctor will recommend a treatment plan. Simply scribbling a set of drugs is not enough. You must know all details pertaining to the plan, including when to take the medicine [e.g. before or after meals], how to take it and for how long, what are the possible side effects, what are the contraindications [i.e. under what conditions should you not take the medicine], is it safe to take with other regular medicines, what reactions would be an emergency and what to do in case that happened. In case of multiple opinions, weigh the information carefully. How qualified is your source? Do you doubt your doctor based on an informal source?

While it is tempting to self-diagnose based on informal sources, it is critical to validate data with a qualified practitioner. Instead, use your research to formulate questions to ask your doctor. Go with an open mind that the doctor could have a different opinion on the information you have gathered. Don’t attack them with your knowledge; instead look for convincing arguments, or take a second opinion from another doctor. In the end, it is always advisable to base your decision on a qualified practitioner’s recommendation, whether it is your first or fifth doctor. Some of this may sound like common sense, but it is not always easy to keep perspective when the doctor is saying things you don’t want to hear.

Remember what is important

Trust in your doctor, or the lack of it, can have a profound impact on your wellbeing. The mind is the most neglected component in standard medical care. Yet, text after ancient text and story after story tell us about the miracles the mind can achieve, even in very difficult medical cases. While there may not be consensus on whether and how the mind heals, a negative mindset can definitely hamper recovery. Stress, anxiety, depression can hinder the best of treatments. If you do not feel comfortable with your doctor, the mind will stress out on each and every little thing. Due diligence and awareness can help you meet your doctor on a strong footing. This will build your confidence that you can trust your doctor and lead a healthier life.

A version of this article was first published in the August 2015 issue of Complete Wellbeing.

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I had such an experience recently, where my 20-year-old niece Priya [not her real name] confided in me about her current romantic relationship. While I was happy to be the recipient of her trust, the situation was full of moral dilemmas: Should I listen or tell her what to do? Should I tell her parents or respect her request for privacy? Should I treat her as an equal adult or a child to be protected? What would I tell her parents when they find out that I knew about the relationship but didn’t tell them? In the end, it all came down to one question—what is my role here?

The answer, I realised, lay in conversation. A conversation that would keep communication channels open. Clear and candid communication helps avoid emotionally charged actions—actions which could, by their nature, break up relationships and families. One difficult conversation goes a long way in preventing heartburn and misunderstandings.

Here are some of the things I learnt about dealing with this awkward and morally fraught situation.

Creating space: Listen without judgment

Nothing shuts down a soul-baring conversation faster than the realisation of being judged. This is especially true when you are talking across generations and across value systems. I find many from the younger generation remarkably astute and mature about their ambitions, both in their career and personal life. They know what they want and when they want it. They want to experiment, to try things out, to see if things ‘fit’, before making any decision. What they don’t want is someone telling them why they ‘can’t’ or ‘shouldn’t’ do something. This is true between parent-child, but becomes even more sensitive if it’s between a child and an adult who was approached. Whether you are the agony aunt or the wise uncle or any other sympathetic adult—what they want is a sounding board, not an authority reiterating the rules. So shrug off your boundaries and give them space. Be the rock for their insecurities and uncertainties. It may not be what you want to be, but it is what they need. Without this, there is no scope for a meaningful conversation.

Building the foundation: Trust, trust, trust

Respect the trust that has been reposed in you. It is a huge leap of faith for a youngster to open up to you. Respect that faith and the courage it took for them to communicate. At the same time, you have a responsibility to everyone who is affected by this conversation. Trust is critical, but it can’t be one-sided. They may ask you to keep the situation a secret, but it might not always be possible. As far as you can, keep their trust. If you feel that their parents need to be involved, tell them that you believe that is the best course of action. But be up front about whatever your decision is, and why you feel so. Give the youngster the space to debate it. If you break their trust, you may end up doing more harm than good.

The biggest pearl of wisdom: teaching responsibility

Being an adult means taking responsibility for your actions. If there is one ‘tell’ in this conversation, it is this. Explain to the young boy/girl the importance of action and consequence, and the fact that the responsibility of both lies with them. If they want to be treated as adults, they must act like adults. Help them make decisions by showing them options and explaining consequences. But be utterly steadfast in letting them make their own decision and taking responsibility for it. Set the example by explaining how you are taking your responsibility by accepting the consequences of your role in this conversation. Let them take ownership of their decisions. Decide together on whether the situation needs intervention, or if the youngster can manage on his or her own with some guidance.

Defining boundaries: Step back or step in?

While respecting the young adult’s need to test the waters, do not forget your responsibility as the mature adult. Giving them space to grow does not mean condoning activities that are harmful, illegal or otherwise undesirable. Make the decision based on your reading of the situation. Is it within moral and ethical boundaries to let them find their way, or do you or some other authority need to step in? If their role is to take responsibility for their behaviour, your role is to ensure that everyone involved, be it their parents, families or significant others, are not harmed. There is a time to step back and a time to step in. This is your action-consequence of commission or omission. Share your decision with the youngster and let them learn from your example.

In my case, my conversation with Priya started out awkwardly, and rather than an agony aunt, I just felt like a very nosy aunt! As we talked, I realised that treating her as an adult and adhering to these cardinal points kept the conversation flowing. As she opened up, I could see her visibly relax in my company. Priya admitted her relief in having an adult she could confide in. She had already thought about her future and all she had really wanted was someone who would listen to her. And all I wanted was for Priya to know that she was not alone. It was a difficult conversation to begin with, but in the end, it was well worth the time.

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My travails through infertility

As someone who has been through the whole process—from deferring having kids to focus on my career to struggling with infertility, to then opting for assisted reproductive techniques [ART] that came with multiple failures and heart-breaking miscarriages, I can attest that this journey turns you inside out—physically, mentally and emotionally. And yet the joy when my daughter was born after five years of soul-searing struggle is indescribable. Sometimes we succeed, sometimes we don’t. In the end, what kept me going was simply that I never stopped trying.

Doing this will help

If you are trying to have a child but have not succeeded yet, let me share here what helped me during my journey.

Have complete belief in your purpose

Steadfast belief in your goal is the one thing that will keep you and your partner together. Without this, you have no anchor and no inspiration. This is the purpose that will make you pick yourself up time and again and just keep trying. It will give you faith and hope in your darkest hours.

Build your support network

The support of the people closest to you, especially that of your partner is critical. Don’t be afraid or embarrassed to ask for help. Identify the people you trust within your family and friends, and share your journey with them. Reach out to other women who have travelled or are travelling the same route. Once you open up, you will find many networks, online and within your circle of friends, to share your anxieties with. Trust me, most women who have been through this journey, will open their arms and hearts without reservation.

Communicate with each other

Most of us don’t make this journey alone. Our significant other struggles with us every step of the way. In some ways, it can be harder for men because their contribution to the process is limited. And sometimes there might be a medical problem with only one of you. These are testing times for your relationship and will challenge the depths of your commitment to each other. One thing that works is communication with respect. Share your thoughts and emotions while respecting what the other is going through. I found that a relaxing holiday, away from all expectations, gives couples a great opportunity to create the support foundation that you will need during difficult times.

Get a preliminary medical check-up

Even if you decide to take the natural route, there is no harm in checking out if everything is fine with both of you. Consult a gynaecologist and urologist. Both of you will feel better knowing rather than not knowing. The rule of thumb is that after six months of trying, if you have not conceived, it’s a good idea to get a preliminary doctor consultation, more so if the woman is over 35 years of age. Fertility science has made so much progress and there are many non-invasive, inexpensive options available, even before you opt for ART. In the future, if you do need more intensive treatment, this check-up information forms a valuable baseline for both you and your doctor to work with. Getting a health check will make your family planning much more focussed and easier.

Stay positive

This is an irony because stress is considered to be a cause for inability to conceive. But menstrual cycles and dealing with the hormonal ups and downs does not come without stress. Some fertility drugs cause depression and mood swings as a side-effect. Staying positive amidst this chaos and dealing with the month on month conception failure can be an incredibly hard thing to do. And this adds to the other stressors of your life. I agree that sounds massively unfair, but it’s the truth. And each of us has to find that Zen in ourselves. The part that will allow us to let go of our attachment to our belief, without letting go of the belief itself. Sounds insane? When you get there, you’ll know what I mean. We don’t know what we are capable of till we are pushed. Just hang in there.

Be patient

Every failed cycle is a month gone. In every year, you get just 12 chances to have a baby, even fewer if you are not regular. And while it may take just one time to get pregnant, there is no guarantee it will be the first, second or even 10th time. And even after conception, you have to nurture your little one for nine months before you get to hold him or her in your arms. There are those who have it smooth sailing from conception to birth, and others like me, who aren’t sure till the very end whether this long road starts a new beginning or loops back to where we started.

This was first published in the September 2014 issue of Complete Wellbeing.

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The first principle—Take responsibility

Having a pet and owning a pet are two different things. Those of us who had dogs as kids might think that we know everything there is to it. But having a dog during your childhood does not automatically mean you will be a good dog owner. As kids, you might have fed your dogs, played with them and walked them. But, it was your parents who ensured the financial and physical support that is required for a dog’s health and wellbeing. They were willing to accept dog hair everywhere in their home, chewed-up furniture, and complaints from neighbours; they paid for dog training, vaccinations, and dog food; and they managed doggy ailments. It does help to have some prior knowledge of dealing with dogs, but nothing that an inexperienced person cannot pick up.

Being prepared to take full responsibility for another living being is the key. Even if you get a dog for your kids or other dependents, you will always be the owner.

Your role as a pet owner can be the most rewarding and the most demeaning of jobs at the same time. You may be the CEO of a company, but if you are not prepared to pick up your dog poop from your neighbour’s garden, then don’t get a dog. Everything the dog does will be your fault and everything the dog needs will be your responsibility. The buck stops with you. Accept this first.

The second principle—Understand your dog

Some of us think that our dog is like our child, a human baby. Others think it is a pet—to be fed, exercised and occasionally coddled. Some think it is a guard, a companion, another mouth to feed. Some put up with it since their kids/partners won’t part with it. It doesn’t matter how you relate to your dog, each of us is different. What is more important is how you expect your dog to relate with you. You may treat your dog as your child, but don’t expect it to become a human child. Dogs are pack animals, and perfectly suited to being a member of your family. You can coddle your dog all you want, but you need to understand its needs.

A guard dog will be territorial. It will defend its space, even against you, especially if you have not established your dominance. That is the way they are, that is how they have been bred, for thousands of years. It doesn’t mean that it has become feral or undisciplined or loves you less. Never go against their instincts or blame them for something that is in their genes. They are animals, so they will obviously have animal instincts.

When you are getting a dog home, understand its breed and the background of its parents. It will give you insight on how it will react to situations. Then you can mould your pet’s behaviour through training and interactions. Dogs love routine and leadership. Cesar Millan, a leading dog behaviourist known as the Dog Whisperer, says, “The most important thing that we have to provide every day is the feeling that we are the pack leader, we set the rules and the boundaries and then we love. Most people get a dog because they need somebody to love. So they are going after what they need, not what the dog needs. And that, to me, creates instability and imbalance. Dogs see humans as a soft energy, they don’t follow a lovable leader or a spiritual leader; they follow a dominant one.”

A dog is a dog is a dog. Even if you love it as you would a human, expect it to behave like a dog.

The third principle—Lay firm roots

Dogs are not easy to transport around. If you are in a transferable job and do not have an established home, a dog might not be the best pet for you. Pet travel is expensive or unreliable, or both. There are many examples of pets dying in transit due to lack of care, as the owners moved cities. Shifting countries is even more difficult, with many countries having stringent animal transfer protocol and quarantines. This is not to say that it can’t be done. But it is such a hassle for the owner that many choose to part with their pets. And while humans have the higher brain power of logic and learn to move on, dogs get traumatised with their expulsion from their pack and from being deprived of all the affection that they gave and received. Some never recover.

If you are not assured of a constant home for the duration of the dog’s life of 10 – 15 years, I would urge you to go to an animal shelter and meet an abandoned dog. You’ll understand that even if you may arrange for the pet to be moved to another family, its life will never be the same.

Having someone to look after the dog when you are not there should be an essential pre-requirement before getting a dog. You will not be around all the time, with work, travel, vacations and other commitments. But your dog will always love you. Whether you have been away for five minutes, five hours or five weeks, no one will give you as rousing a welcome home as your faithful companion. Watch him go giddy with delight at your arrival and you know, you are loved and you are home.

This was first published in the June 2014 issue of Complete Wellbeing.

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