Rip Van Winkle And Other Sleepy Stories..

 

Rip Van Winkle and Other Sleepy Stories..

By

Vivek Hande

“The woods are lovely, dark and deep. But I have miles to go before I sleep”. Beautiful and immortal words from Robert Frost. Inspiring but hugely depressing to someone trying to go to sleep and not the ideal bedtime poetry. And then you have Benjamin Franklin who famously commented, “Early to bed and early to rise makes a man healthy, wealthy and wise”. And the same man on another day wrote, “A life of leisure and a lifetime of laziness are two things. There will be sleeping enough in the grave”. Thomas Edison wrote, “For myself, I never found need of more than four hours sleep in the twenty-four. I never dream. It is real sleep.”

Sleep or the lack of it has forever driven people to divine poetry or deep despair. A good laugh and a long sleep are the best cures in the Doctor’s book goes a famous Irish quote. I cannot agree more and yet it seems easier to laugh if you have had a good night’s sleep. Those were the days... one could stand sleeping; be knocked out before the head hit the pillow; it didn’t matter whether there was a pillow or not; it didn’t matter what time of the day it was and one knew one could have a large cup of coffee with your hostel roommate at midnight and be dead to the world fifteen minutes thereafter and no earthquake could wake you. Sleep patterns and habits change. Nobody really teaches you to sleep – it is one of those ingrained biorhythms. It should be the easiest and most natural thing to do and yet …

Sleep disorders have emerged as the silent epidemic. In a large study, it was reported that 61% Indians report less than six hours of uninterrupted sleep. the figures rose by 6% over just one year.  A third of young Indians report at least one sleep disorder. The incidence of insomnia has doubled over 15 years in the Indian population. An AIIMS study of 2022, showed 52% respondents having poor sleep quality.  

Always 5 Minutes more..

What constitutes normal sleep? Most adults require seven hours of sleep. Babies, children and teenagers require more sleep. Normal sleep cycle has two phases Non rapid Eye Movement (NREM) and Rapid Eye Movement (REM). The NREM phase has three segments N1, N2 and N3. If you have slept through telephone calls, doorbells, earthquakes and loud music, you are probably in the N3 segment. About an hour and a half after going to sleep you enter the REM phase where there is increased brain activity. If you remember having vivid dreams where you vanquished the world or were fighting off goons on the top of a train, you were in REM sleep. Each sleep cycle (NREM & REM) is of about 90-110 minutes and ideally one ought to go through 4-6 cycles to be able to say you slept well.

NREM & REM Sleep

The Normal Sleep Cycle

The benefits of good sleep are myriad and it affects ones’ mental, psychological and physical wellbeing. Good sleep contributes to improved memory, emotional regulation, better mood, cardiac health, stronger immune response and faster muscle recovery and tissue healing. The sleep of Lord Vishnu is regarded as the Cosmic Pause and is rich in symbolism and denotes rest, renewal and the cyclical nature of life. It is the balance between creation and dissolution. Dreams in Upanishadic texts have spiritual significance and the state refers to the bridge between the conscious and the subconscious mind. The Goddess Nidra has an important place in mythology and is associated with spiritual rejuvenation and slumber. She put Lakshman’s wife Urmila to sleep for fourteen years to make it easier for her and enable Lakshman to devote himself to his elder brother Ram. That was considerate.

The Cosmic Pause

Sleep Heals

Sleep Disorders constitute a huge spectrum and include multiple conditions such as Insomnia (inability to go to sleep or stay asleep); Hypersomnia (excessive sleepiness even after adequate sleep); Narcolepsy (waves of Inappropriate sleepiness through the day even after getting up normally); Parasomnia (abnormal movements, behaviours, emotions or dreams during sleep – sleepwalking, nightmares, Night terrors, Sleep related eating disorders). Crimes have been committed by individuals suffering from Parasomnia which have included sexual assaults(sexosmia), murders- a famous case in point is the Kenneth Parker case (Canada 1987) where he sleepwalked; sleep drove and sleep entered his in-laws’ residence and fatally stabbed his mother-in-law and critically injured his father-in-law and was subsequently acquitted on account of the fact that he was asleep!

A Good Night's Sleep

The Best Meditation

Sleep has always been central to many fairy tales and fables. Each of them might have a lesson in sleep management. Princess Aura, better known as Sleeping Beauty and associated with Sleeping Beauty Syndrome went into deep sleep on her sixteenth birthday was obviously suffering from hyspersomnia and would have benefitted by a consistent sleep routine. Goldilocks had three beds to choose from and chose the one which was most comfortable and suited to her back. Snow White also tested out all the seven beds before choosing the most appropriate. It is important to focus on the right mattress and bed linen.  Princess and the Pea – similar issues; difficulty sleeping in new surroundings and needing comfortable bedding to sleep well. In the original Grimm version of Cinderella, her room was cold and bare and had no bed- a sure recipe for insomnia. Rip Van Winkle accepted some liquor from a group of dwarves and went into slumber for twenty years and got up an old man – best to avoid alcohol; caffeinated drinks before sleeping. Closer home, Kumbhakarna was doomed to sleep six months of the year and it well nigh impossible to wake him during this period and when aroused, he was cranky and in a foul temper- obesity; heavy foods and possible obstructive sleep apnea had a role to play.

The Sleeping Giant

Sleep is no sleeping matter and has spawned a global multibillion dollar industry. Conservative figures for 2025 pegged it at 72 billion USD and is projected to increase to 114 billion USD by 2030. These include Stay-Cations and Nap- Cations , vacations tailored to get you rejuvenating sleep and navigate you through sleep hygiene lessons. The industry also focuses on Sleep gadgets and wearables such as AI driven Sleep Trackers; Eye Massagers; White Noise Devices and CPAP machines. Another huge segment is the Over-the-Counter drugs such as Magnesium and Melatonin and prescription drugs. Sleep material which includes weighted blankets, breathable pajamas and smart pillows are the way to go. Sleep deprived folks are guzzling chamomile tea and inhaling lavender oils by the gallon

A good night’s sleep is really a fundamental right and one owes it to oneself to do whatever it takes to allow your mind and body to heal with the curative powers of sleep. ‘Throw Off your worries before you throw off your clothes at night’ said Napoleon and Dalai Lama was spot on when he wrote, “Sleep is the best meditation”. Wise words from Homer, “There is a time for many words and there is also a time for sleep”

Have To Switch Off

Curse; Cuss; Swear

 

Curse ; Cuss; Swear….

By

Vivek Hande

Cuss; Curse; Swear. These words are kind of synonymous. Cuss is a more colloquial American English word. It refers to using expletives or use of profanity, such as a curse word or oath or to swear. Cursing is a more formal and versatile expression which could mean the same as cuss (use of expletives or profane language) or to put misfortune or evil on someone. Etymologically, they all have an origin in the Church. To wish misfortune or evil on someone was considered going against the faith and hence a use of profanity. It is fair to say that as long as language has existed, cursing and cussing has been an integral part of communication.

So much for the origins. A lot of studies have indicated the benefits of cursing. It has been shown to reduce stress, anxiety and depression. It is known to contribute to mental and psychological and social well-being. Interestingly, folks who curse less benefit more when they do curse! It is also been shown in studies to improve physical performance. It might bring people socially closer and feel engendered. It has , in studies, shown to reduce pain or produce hypoalgesia.

There are some friends of mine(especially of a certain community; you know them) who pepper every sentence with the most colourful expletives. In fact, they barely use non expletives to communicate. Yet the tone and tenor of the cursing and cussing can convey wrath, anger, affection, tenderness, warmth, conviction, commitment and myriad other sentiments. They truly seem the happiest folks around.There are some who seem apologetic after using a cuss word and somehow you feel like putting an arm around them to let them know it happens. It is bit of a cultural thing as well. Certain ethnicities seem to use profanities more naturally and it is almost unnatural to see a ‘non cusser’. In some languages, even the curses sound delightfully sweet.  

The English Language has refined the fine art of cursing to another level. It has shades of subtlety, sarcasm, wit, poison, humour all rolled into the lexicon. The mode of delivery can make a mild sounding profanity the worst curse. ‘Bloody’ and ‘Bollocks’ are often used to intensify the impact. Some are fairly mild and actually sound funny and amusing rather than hurtful. Muppet is a foolish or incompetent person; Plonker is someone who makes poor decisions; Turnip is a stupid or slow person; Pudding is an extremely silly person who keeps making mistakes! Tosser; Bugger; Twit; Twat; Wanker are variations used with different intensity. Neek is a new one, often used affectionately to curse someone – a combination of nerd and geek.

There is commerce built around cursing and cussing. There was a very well received Korean reality show a few years ago where the world’s first cursing tournament was held and the rudest person won 20 thousand US dollars. The clear winner was a grandmother who cursed her way past the opponents to her bank. There are multiple books which have been written on this very important subject. I personally liked “Uglier than a Monkey’s Armpit. The Best Curses; Putdowns and Invective from around the world,” by Dr Robert Vanderplank, an unputdownable bestseller. There is an International Cursing Day when one can throw caution to the wind and let the internet sizzle with creative curses. This important day is celebrated on 9 November.

There are some international curses which one must have in one’s vocabulary. It makes you sound worldly wise, well-travelled, sophisticated and erudite. Also, most of the time, the recipient won’t understand it and it adds to one’s personal joy and satisfaction. My personal favourites include Fahr Zur Holle (German – straight; simple, efficient- Go to Hell); Pendejo (Mexican Spanish – Idiot); Crotte De Bique (French had to be – stylish way to call someone Goat poop) and Kurva (Czech/ Polish – best left untranslated but conveys the worst when delivered with vengeance).

And then you have Captain Haddock, the legendary sailor created by Herge. The author circumvented the very strict censorship guidelines on profanity by some very colourful use of vocabulary to create unforgettable curses. There are Tintinologists who meet regularly to analyze these swear words even today. Abecedarians; Anacoulthons; Baltic Beetle; Cercopithecus; Dunderheaded Coconuts; Gibbering anthropoids; Lily Livered bandicoots are just some of the gems Captain Haddock has given us!

 

 

 

 

 

 

 

 

 

 

Coleman Young firmly believes, “Swearing is an art form. You can express yourself much more exactly, much more succinctly with properly used curse words.” And there is another perspective – Paul Begala, well known American political consultant and commentator says “ I am actually pro- cursing. I think it is good. I think we should teach kids to curse so they don’t use drugs. It doesn’t rot your brain. It doesn’t get you pregnant. It doesn’t rot your brain. it doesn’t kill you like tobacco”.

One may have one’s views on this but I do think once in a while a well-timed cuss or curse is soup for the soul. Ostrogoth! Overstuffed water buffaloes! Pestilential pachyderm! Slithering Salamander!

 

List or Lost

 

List Or Lost

By

Vivek Hande

 

Each of us have our own mechanisms to navigate through chaos and attempt to get more out of a day. Some of us use wads of Stick It; others use digital devices to organize everything – from your daily schedule to investments to holiday planning; some use a lot of readily available AI tools to be on top of things. I am an old-fashioned List Maker. Nothing to beat the good old To-Do list on paper. Today is Sunday, start of a new week. I made a very comprehensive list for tomorrow- the only problem is I don’t know who is going to do it!

There are different kinds of Lists. There could be daily; weekly; yearly To- Do Lists. Then there are sub lists- to buy; to loan; to sell; to pack; to wish; to not wish and so on. Sometimes, list making can get very detailed and time consuming leaving no time to actually do these things. But that is a risk one has to take to be organized and meticulous and productive.

It can get obsessive at times and one spends the night conjuring the list to be penned down first thing in the morning. Sometimes one actually looks forward mentally, with a sense of anticipation to the items to be penned down on the all-important list. Of course, compulsive list making can be associated with conditions like Obsessive Compulsive Disorder. List making is associated with positive psychology; enhances capacity to select and prioritize and it most certainly helps to organize and control chaos.

Honestly, at times, I add things to my List just to make it a look a little bulkier (putting things I would anyway routinely do)- the tremendous sense of satisfaction at taking a pen and scoring off an item is pure magic. The ticking off an item on the list activates the hypothalamus and triggers the release of Dopamine and makes you feel good. The intensity of the hypothalamic activation after taking a pen to score off an item on a list far exceeds any that produced by any AI tool or digital device.

List making is not a new phenomenon. It probably dates back to the Middle Ages. Leonardo Da Vinci, who had a finger in several pies made voluminous notes and scribbled To -Do lists on the margins. A lot didn’t get done and would find repetition in subsequent notes as well.

Da Vinci The List Maker

 Benjamin Franklin was a compulsive list maker and set himself a 13-week self-improvement program with traits such as Temperance and Frugality to be practiced every day and tracked his progress meticulously. He had other Lists to ensure he stuck to a strict personal routine every day. Edison, who had 1093 patents to his credit had his List classified as “Doing and To Be Done”. My lists may be more mundane but I definitely find myself in good company.

Franklin's Daily To Do List

Ben Franklin again -List To Track Daily Progress

List making and the business of making the lists has provoked several scientific studies to delve into the psychology of it. George Miller, a cognitive psychologist, proposed the Miller’s Law which suggests that an average adult brain can only deal with five – seven chunks of information at a time and the Lists help deal with cognitive overload and help navigate a chaotic world. Umberto Eco, the famous Italian medievalist and writer famously wrote, “The List is the Origin of Culture. What Does Culture Want? To Make Infinity Comprehensible”. After reading that, I have started regarding my own daily To- Do lists with a great degree of respect and pride…

Lists- The origin of culture

I have a senior colleague and a dear friend who has made the process of making his daily work day lists into a well-practiced ritual and almost an art form. He writes them down in black ink in his diary in different priority classifications and as the day progresses, he scores them off in different coloured inks. Red if the job is done; blue if is partially done and needs to come back in tomorrow’s list (tomorrow it will be written in black); green if it has to be delegated to someone.  It does look quite colourful but it helps keep things in control for him. As long as it works for you..

Woody Allen is supposed to have said, ‘I am always making lists. I don’t procrastinate. I delegate tasks to my future self. I write down things I need to get done, but probably won’t. But making lists makes me feel I have got my act together’….. Let me get back to fine tuning my list for the coming week..

Do Hospitals Have A Soul , A Character?

Do Hospitals Have A Soul, A Character?

 By

 Vivek Hande 

 Very recently, a hospital, I was a part of, for some years, was adjudged the best hospital, in a certain assessment, for a calendar year. It felt good that our team was recognized for its efforts and felt like an incredible pat on the back for our team. There were a rigorous set of parameters which were taken into account by the inspecting team and I am glad we did well on most counts. 

In my honest opinion..

 A lot of patients, relatives, colleagues, peers, seniors called up and messaged and wrote in to congratulate. One recurring theme of the messages was that the hospital deserved to be recognized thus, because of its soul; because of its character and for its unwavering ethos. Not many spoke about the great infrastructure or the state-of-the-art equipment or the excellent results or challenging or complex cases done in the OT or the Cath Lab. Very few commented on the cutting-edge technology in all specialties we had acquired over the years or the very modern ICCUs and NICUs we were so proud of. Hardly any spoke of our impressive Infection Control Practices or our robust teaching program.

Vents; Tubes; Devices

 Almost everyone spoke of the spirit and character and soul of the hospital, which perhaps, set it apart from the others. This made me introspect a bit and coaxed me to do some soul searching. It almost seemed that the hospital was an individual; a living breathing person. 

Primum Non Nocere

The hospital was certainly not brick and mortar; certainly not steel and vents; definitely not infusion pumps and oxygen plants; absolutely not microscopes and endoscopes and CT scans and Dialysis Machines. It would always be all of these and yet there is something intangible that sets apart one hospital from another. And that is definitely the character of the hospital; the human facet of an infrastructure, which almost seems to have a smile; a set of welcoming arms; a caress; a whisper; a nudge; an encouraging pat; a firm handshake and an encouraging voice which tells you that all will be well or an honest admission that in spite of all efforts, things aren’t looking good. It is the human clothing, the human aspect of a great facility that makes a hospital truly special.

 I have now spent more than four decades being a part of a hospital; a medical set up in various capacities as a student; a physician; a sub specialist; an administrator and at times as a patient, a relative, a caregiver. I have had the privilege of seeing government hospitals; private hospitals, corporate hospitals across the country. I have seen small hospitals with basic and rudimentary facilities in far flung places and I do realize they were perhaps the best I have come across. No person really wants to go to a hospital, if it can be avoided. For most, a visit to a hospital is like going to an alien planet. Therefore, at the end of the day, the most important aspect was how the hospital made you “feel”, regardless of its strengths or limitations. 

 

Does a hospital have a character? There are hospitals which are just functional. They are neat and clean and may not be great on aesthetics but they deliver on all counts. They are simple, straightforward and efficient. There are some which just give a positive vibe as soon as you enter. They look bright and cheery and somehow the vibes translate to all the staff, who just seem to have one extra word of positivity to share with you. The hospital inspires confidence. There are hospitals which have an enviable reputation , misplaced at times, that every patient who comes in with a pulse , would be saved and walk out of the hospital. It is just the kind of confidence it evokes. Folks just know that everyone will stretch every sinew to give the very best to the patient.  There are others which somehow come across more as commercial enterprises rather than health care facilities. There are some which are very stiff and bureaucratic and have a lot of rules and regulations and emphasis on a lot many more things other than friendly, supportive health care. Just like the patients who visit the hospital, the doctors and nurses and support staff who work at the hospital, the hospital too has a different and a distinct character.

Caring is Curing

 Each health care facility is driven by the notion of, “Primum Non Nocere”, First Do No Harm. And yet we make mistakes at times. We also dehumanize patients at times. We also behave rudely occasionally. But there is nobody, in the entire system that would deliberately wish to harm anyone who comes to the hospital. You want to do the best for the patient and you want him to walk out of the hospital. And yet certain hospitals make less mistakes; the faculty is perhaps more communicative; more inclusive; make the patient feel more comfortable and helps make the patient take an informed decision. A doctor with a good sense of humour and an ability to see things in lighter hue can be infectious. The Nurses are a little friendlier; a little more patient; a little more encouraging. One such nurse can inspire the entire nursing cadre. Often , the patients or their relatives can be extremely demanding and unreasonable. The ability to take it in your stride and do what you have to for the patient is a vital trait. The Support staff is a little prouder of the incredible job they are doing and can galvanize each other to give their very best. A cheerful and helpful set of receptionists can transform the patient experience. 

 It is truly the character of the men and women who work in a hospital who constitute the character of the hospital. The patient experience begins and ends with compassion. The secret of the care of the patient is caring for the patient...