शरपंजरी

काल आबांना भेटून आलो. आबा म्हणजे डॉ. विजय आजगावकर. मुंबईमध्ये गेली अनेक दशके कार्यरत असे रसिक वाचक. मी एम.बी.बी.एस.ला होतो तेव्हापासूनचा त्यांचा आणि माझा स्नेहबंध. अक्षर या वार्षिकाच्या २०१४ च्या दिवाळी अंकामध्ये मी त्यांचे शब्दचित्र रेखाटले होते. माझ्यासारख्या अनेक विद्यार्थ्यांवर पुत्रवत प्रेम करणारे आबा… माझ्या वडीलांच्या जागी मी ज्यांना पहात आलो असे माझे आबा… तीन महिन्यापूर्वीच आमची भेट झाली तेव्हा ते उत्साहीत होते. ज्या बालमधुमेही मुलांसोबत पस्तीस वर्षांपूर्वी आम्ही आधारगट सुरु केला त्या पहिल्या बॅचेसमधील जवळजवळ वीस मुलेमुली ह्या रियुनियनला आली होती. त्यांच्या सहचर, मुलांना घेऊन. आम्ही खूप गप्पा केल्या. फोटो काढले.प्रसन्न आबांना पाहून आम्ही सर्व सुखावलो.

पण त्यावेळीसुद्धा पोटातला कॅन्सर आपले प्रताप दाखवायला लागला होता. तरीही आबा आठवड्यातून तीन सकाळी क्लिनीकला जाऊन चार तास करून यायचे. काही काळापूर्वी वाहिनी गेल्यापासून आबा दुःखी होते. पण त्या दुःखाचा बाऊ न करता त्यांचे वाचन, लिखाण आणि प्रवासही सुरु होता.

म्हणूनच दहा-बारा दिवसांपूर्वी त्यांचा फोन आला तेव्हा त्यातला स्वर मला कापला आणि दुःखी वाटला. “लवकरात लवकर मला भेटायाला येऊन जा…माझी संपत्ती वाटायची आहे… सगळ्या वारसांमध्ये” संपत्ती म्हणजे पुस्तके. आबांचा वारस होणे अहोभागह्याचे. व्रतस्थ वैद्यकजीवन जगलेला ऋषीच हा. मधल्या सहा दिवसांमध्ये त्यांची केमोथेरपी सुरु झाली. दोन दिवसांचे हॉस्पीटलायझेशन झाले.

कालच्या रविवारी मी, माझी पत्नी सविता आणि मुलगा कबीर असे तिघे त्यांना भेटायला गेलो. आबा खोलीत आले तेव्हाच थकलेले दिसले. हातात एक डायरी. अंगात खादीची बंडी. अगदी माझे वडील घालायचे तशी. मी त्यांच्या शेजारी बसलो. अगदी चिकटूनच म्हणा ना आणि का कोण जाणे… मी माझ्या आयुष्यातला पहिला सेल्फी आबांसोबत काढला.

आबांच्या डायरीमध्ये पुस्तकांची यादी होती. काही पुस्तकांसमोर ‘वारसांची’ नावे लिहिली होती. मी माझी पसंती संगत गेलो आणि तितक्या वेळा आता माझे नाव त्या यादीमध्ये लिहित होते. “आता मी तुझी पुस्तके छान पॅक करुन ठेवतो. तुला कळवतो. मग तू पाठव कुणाला तरी आणायला.” ते म्हणाले क्षणभराच्या शांततेनंतर म्हणाले, “माझी पुस्तके माझ्यानंतर रस्त्यावर यायला नकोत रे मला… त्यांना योग्य घरे मिळू देत.”

पुस्तकांच्या यादीसोबतच त्यांनी कपड्यांची यादी केली होती. त्यांना मी अंशू गुप्ताच्या ‘गूंज’चे नाव सुचवले. आबा तसे व्यवस्थित टेक्नोसॅव्ही असल्याने एव्हाना त्यांची साईट शोधून संवाद सुरूही झाला असेल. अशाप्रकारे एका डायरीचे काम संपल्यावर त्यांनी दुसरी डायरी काढली. त्यात त्यांनी लिहिलेल्या कविता होत्या. काही कविता त्यांनी मेलवर शेअर केल्या होत्या. ” मी वाचतो ना आबा ….”, मी म्हणालो. “नाही … ऐक…. कवीच्या तोंडून परत ऐकायला नाही मिळणार तुला…”, ते म्हणाले. मी चमकलो. हा आबांचा मिश्कीलपणा म्हणायचा कि भविष्याची चाहूल ? कि दोन्ही ?
ते अगदी हलक्या स्वरांमध्ये मला कविता वाचून दाखवत होते. पानाच्या कोपऱ्यामध्ये तारीख आणि वेळ लिहिलेली असायची बहुधा मध्यरात्रीची किंवा पहाटेची. फेब्रुवारीच्या मध्यापर्यंतच्याच कविता होत्या… विविध भावस्थिती रेखाटणाऱ्या. अफाट ज्ञानसागरातील शिंपले वेचायला आता वेळ उरला नाही अशी रुखरुख त्यात होती. राहिलेले क्षण मनस्वीपणे जगण्याची उर्मी व्यक्त होत होती. मी सामान्य आयुष्य जगलो कारण अनेकांच्या सुखदुःखाचा मी केवळ साक्षीदार होतो, ते दुःख मिटवू शकलो नाही ह्याची खंत होती. कधी मृत्यूला मित्र म्हणूनची हाक होती तर कधी अर्थपूर्ण क्षण जगण्याची आंस होती.

“आता मी वाचतो आबा पुढच्या कविता”, असे म्हणत मी ती वही माझ्या हातात घेतली. कारण आबांच्या आवाजातल्या कविता ऐकताना मी जास्तच हळवा व्हायला लागलो होतो. मी माझ्या दांच्या कुशीत बसल्यासारख्या आबांना चिकटून होतो. तिथेच बसून चहा घेतला. कबीरच्या जन्मापासून तो आबांचा लाडका. ‘कबीरराजे’ हे त्यांचे खास नाव. “हे औषध आणत जा रे भेटायला वारंवार”, ते कबीरकडे बोट दाखवत मला म्हणाले. ” आबा तुम्हाला भेटायला तो नेहमी तयार असतो”, सविता म्हणाली. “आबा जून महिन्यातल्या माझ्या संत कबीरावरच्या कार्यक्रमाला तुम्ही नक्की येणार… पहा.”, मी आशेचे वातावरण निर्माण करण्यासाठी म्हणालो. आबा फक्त हसले. मग मला मेडीकलच्या भाषेमध्ये त्यांनी स्वतःच्या पोटातला कॅन्सर समजाऊन सांगितला. त्यावर आता खूप Aggressive उपचार करायला त्यांचा ठाम नकार का आहे ते सांगितले. आणि आश्चर्यकारकपणे त्यांनी मला खूप पूर्वी माझ्या बोलण्यात-लिहिण्यात आलेला एक संदर्भ दिला. त्यांच्यापुढे असलेला आणि त्यांनी नाकारलेला पर्याय आहे ‘कोलेस्टॅामीचा’. म्हणजे मल (आणि आबांच्या संदर्भात मूत्रदेखील) पोटावरच्या पिशवीत साठवायचे.आजाराकडे पाहण्याचा रुग्णाचा दृष्टिकोन सकारात्मक असला तर या ऑपरेशनकडेसुद्धा तो ‘सोय’ म्हणून कसा पहातो त्याची उदाहरणे मी द्यायचो. उदाहरणार्थ ‘प्रवासात घाईची लागण्यापासूनच मुक्तता’ किंवा ‘चित्रपट, नाटक, मॅच बघताना अजिबात न उठण्याची चैन’ …. आबांच्या हे सारे लक्षात होते. ते मला म्हणाले …. “पैलतीर दिसायला लागलाय तर त्याला टाळायचे कशाला आता.”

“आबा…तुम्ही दमलात बोलून. चला आराम करा”, मी म्हणालो. “काही खायची इच्छा नाही रे. बळेच खातो. शिक्षा असल्यासारखा. पाणी पितो. प्रोटीनशेक घेतो.” आबा म्हणाले. संथपणे त्यांच्या खोलीकडे गेले. शरपंजरी भीष्मांनाही हा पैलतीर असाच दिसला असेल का ? शर म्हणजे बाण कि शर म्हणजे गवताची एक जात यावर महाभारताच्या अर्थामध्ये विवाद आहे. पण भीष्मांच्या त्या टप्प्यावर बाण काय आणि गवत काय … सुखदुःखाची सीमारेषा ओलांडल्यावर फक्त एकचित्र होऊन वाट पहायची.

महाभारतात भीष्मांच्या अर्जुन, कृष्णभेटीचे संदर्भ आहेत. ते मला आबांचे घर सोडताना आठवत होते. ह्या घरी पहिल्यांदा आलो तेव्हा वैद्यकीय विद्यार्थी होतो. त्यानंतर माझ्या जगण्यातला प्रत्येक सुखदुःखाच्या क्षणी इथे आलो. ह्या घरातल्या प्रत्येक कडुगोड क्षणीही इथे आलो.

आबा राहतात दुसऱ्या मजल्यावर. खालच्या दोन मजल्यांवर बँकेची शाखा आहे. तिथे जोरदार नूतनीकरण सुरु होते. काही दिवसात ती बँक कात टाकण्याच्या तयारीत आहे….
आणि आबा सुद्धा….मनातला हुंदका किती काळ विरलाच नाही.

ता.क. हा मजकूर लिहिला त्यानंतर मधल्या काळामध्ये आबांचा वाढदिवस झाला. केमोथेरपीचे अजून एक सायकल झाले. त्यांच्या वाढदिवसाला मी फोन केला तेव्हा आवाज फ्रेश वाटला. भूक वाढली आहे. असे म्हणाले. माझा अस्वस्थपणा तात्पुरता तरी कमी झाला आहे.

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My journey and learnings in the field of De-addiction – Final part

Let me share with you my learnings now.

  1. Stay focused on here and now. Give your best. And the dream will unfold.

This is a valuable lesson. As a junior most resident in Psychiatry, I did not know that this work will get institutionalized into a ISO approved and President’s Gold Medal winning organization. But I tried to give my best by being genuine, innovative and hard working. Even today in my monthly visits to Muktangan my role is ‘Value addition’ by ‘generating ideas and alternatives’.

  1. The dream if shared by many is more likely to come in reality.

Had the dream of working in this field been accepted and owned by Sunanda,  Anil, Mukta and all my colleagues in Muktangan it would not have persisted for three decades now. I should not have ‘exclusive rights’ over any dream. When multiple people contribute it gets evolved…….and gets evolved in a better design.

  1. Its not only therapies but relationships help in the recovery of addicts.

There are hundreds and thousands of examples of this. As I am writing, one of my recovered patients, has won a prestigious prize in a technical area of film making. He mailed me the news and his photograph. It’s a story of an emotional turmoil for him and his family during his active days of addiction, and then the efforts for recovery. I have been with them in all those days also as a family friend, not only as a professional. I have actually never ever counted these relationships but each has been extremely special for me. The relationship spans across three or even four generations in a family. These bonds have been my forte in all these years of helping addicts.

  1. Right help at the Right time gives stable recovery.

Definition of ‘Right time’ is the internal unconditional genuine wish of a person to get out of addiction. The person/s who is/are helping have hardly any control over it but by giving non-judgmental support they can be helpful. ‘Right Help’ is the factor within control for the helping person. But the ability to walk that extra mile with the patient and family is important. There are countless incidents when I have crossed all limits as a ‘professional’ and helped such persons and families with whatever I could.

Just today I met one of my ex-addict patients of gambling. He shared with me his ‘Right moment to change’ when almost thirty years back I had confronted him with his reality. Deep in financial debts and defiant as a determined hawk he challenged my plan of treatment, by as asking me, “If I don’t agree and follow what you are saying . . . what else you can tell me?”

“Go up the terrace of this building, jump from it and end this game . . .” I had told him with a cold look and flat tone. But by this time I had walked that extra yard with him and his family so he knew that my intention was to see him recover . . . And so is he for thirty years now!

  1. Leaving the addictive substance is the first step towards recovery. Becoming a better human being is the essence of recovery.

I learnt this from many of my patients but most remarkably from a colleague and close guide of mine. His name is Stany Sequera. Uncle Stan who is no more resides in my conscience along with Sunanda and my father. He was an alcoholic. He lost his job in a company called Larsen and Toubro Ltd. He recovered with the help of AA. He started reemployment with the same company as a addiction counsellor and retired after mentoring numerous patients. From the deck of AA he was instrumental in guiding hundreds of recoveries. I met him first as a senior AA member and then as a senior colleague and guide in the formative years of IPH (Institute for Psychological Health). I plan to write about his impact on me separately some day but he was one person I saw who had changed himself immensely and had become not only more evolved but enlightened.

I have seen my colleagues in Muktangan, evolve like this. As I am writing this, the government of Maharashtra has conferred the Vyasanmukti Seva Puraskar of this year to Prasad Dhawale, our senior staff member at Muktangan. He is one of the chief architects of our follow-up programme across the state. His work is so exhaustive that for our follow-up meetings in South Maharashtra sometimes out active workers have to engage Theatres with huge sitting capacities. Very humble in demeanor but determined in his resolve to help; Tatya (we call him fondly) is a unique worker who was admitted in Muktangan many years back as a patient. Similarly Datta Shrikhande another colleague has become a ‘body builder’ in the age group of ‘Above Fifty’ and also a contestant amongst top fifty in TV show ‘Master chef.’

  1. Recovery from addiction requires ‘Network’ of support.

Over the years, Muktangan has evolved its much acclaimed model of comprehensive treatment with extensive web-work of regular follow-up centres. It runs regular training programmes for our ex-patient turned activists across the state to empower them. There is a similar network of Sahachari group (wives of alcoholics) across the state and a special occupational rehabilitation unit for them at Muktangan. We have marriage counseling programme titled ‘Sahajeevan.’ For children of alcoholics we have support group called ‘Ankur’. We have regular events and get-togethers at all major cities. When Baba, Mukta or me visit a city a follow-up meeting is organized there for us. At all ‘slippary days’ such as 31st December every year, hundreds of our recovering addicts come and stay at Muktangan for two to three days. We publish a trimonthly, magazine titled ‘Anandyatri’ that reaches homes of our patients. Now there are numerous Whatsapp groups of our patients and counselors. All of us are called with a Relationship . . . Anil is Baba, I am Anand kaka, Mukta is Tai, Prasad is Tatya, Prafulla Mohite our coordinator for woman-addicts programme is Phula atya. This is unique. In the days when interventions are becoming more impersonal (called professional) we have been able to integrate the therapeutic interventions with optimum transference.

  1. From Black holes of human fallibility to the blessed light of human development.

My journey in the field of De-addiction had consolidated my belief in human goodness. From the ashes of dark destruction the life-force can resurge with such a sustained and consistent way . . . really amazing. Baba says, “Miracles is an everyday affair at Muktangan.” I have experienced this so many times. Not only my trust in human goodness stands firmly reiterated, this journey makes me humble. My contributions at most times, timely and significant, are a drop in the ocean of the gravity of this problem. Yet when you see, it makes some difference, you feel satisfied. The journey made me think deeply about association of different themes such as REBT, AA recovery program, Spirituality, Neurosciences and gave me many fundamental insights about human nature and recovery from addictions.

The area of de-addiction in mental health is supposed to be extremely tough for a therapist . . . Yes, by all means, it is . . . But the happiness and satisfaction it gives you is so unique that you start really believing what Sunanda used to say, “There is no hopeless case in addictions.”

Understanding Excellence – Part I

I was facilitating an interactive session with school going students under the banner of ‘Shikshak Prabhodhini’ – a project where teachers are being trained to mentor exceptional students. We were discussing ‘emotions’.  A young girl of eighth standard, an aspiring singer, was discussing with me her emotions before a performance, in front of about 80 other students. We talked about the ‘Result’ and the ‘Process’. The ‘result’ was the end of the performance when the audience would clap and appreciate. The ‘Process’ was the actual performance that would lead to this result. We concluded that before starting the actual performance we need to make the ‘result’ ‘out of focus’ that is blurred and bring the actual performance in sharp focus … by sharp focus we meant, we will now focus on every minute of the performance… minute by minute.

The girl visualized aloud the exact moment of starting the performance. She described it as if in a trance, I was helping her to shape her responses … Here she was, as steady as a rock … breathing rhythmically..  Image   of her guru in front of her eyes … and the only overriding thought, I am going to do my best…

“   And who are you? …  what are you? …  at this moment? …”

“I am music …” pat came the reply

“A moment of excellence is born” I said.

It was a very strong experience emotionally for all of us present. A rare, delightful insight into an experience called ‘excellence’ … It was exhilarating in an enlightened manner.

At times, the experiential truth  is so strong that is difficult to catch it in words, however, if one has to consolidate the emotional insight into a  blinding design of wisdom, one has to fall back on words again.

So what is excellence?

I do not think excellence has one single definition. In the future segments of this communication, I will explore different   ways by which this theme can be understood. Here is the first one.

Let us take for example, a popular skill amongst students such as   ‘orator’s skill’.  Translated in school-reality, it means participating and winning elocution and debating competitions.

A student that is generally chosen by teachers for developing this skill is an expressive and communicative one who also has a ‘pleasant’ and ‘smart ‘disposition’.

Suppose there is   an elocution competition and five topics are given, out of which she has to select one. The mentor here will ask her to think and talk about each one of the topics  …  what are the thoughts that come to her mind when she reads topics such as , ‘Protecting My Earth’ or ‘The Life and Times of  Shivaji Maharaj’ .  She is encouraged to explore each topic; in her own way. She has to just go on talking about each topic. The mentor listens keenly.

“Can you now make a choice?” the mentor puts the question unconstructively.  She needs to give her own explanation why she is deciding to opt for a particular topic. If she is confused, the mentor helps her to explore her confusion (please note, not to clear it).

When she makes a choice she has to give justification for it. Having heard that; the mentor poses certain relevant queries regarding her choice. What   is the most important aspect of the topic that she has liked? What according to her is the part of the topic that she may find difficult? If she has ‘liked’ two topics what is one consideration that will help her to choose the one that she has chosen?

At the end, the mentor and student will decide a time interval where the student has to think of all the points raised and come back with a decision.

“But sir, I have already made up my mind” suppose the student says.

“Yes, I appreciate … I want you now to tell me one by one why and how you discarded the other topics. I am interested in knowing how you did it…”

“How I did it? I just did it” student.

“Let us explore, how you could have done it… I am taking a paper and writing all topics. I want you to write all the thoughts that came to your mind … that could help …”

The mentor helps the student to identify consciously the thinking process that went behind her decision.

The topic is now selected.

The mentor now motivates the student to gather information on the topic. The mentor shares the spirit of enquiry, exploration and excitement.

Having adequate ‘database’ the mentor helps the student to evolve the structure of presentation. The structure is not imposed. Any deviation from standard procedure of delivering a speech, is respected and discussed. The mundane use of quotations, use of lofty words, adult and literary phrases is questioned. The originality of expression is encouraged.

A draft is now ready.

The mentor and the student now discuss the style of presentation. The mentor does not impose his or any other’s style on the student.   They make a list of ‘impressive orators’ that they have observed   in media as well as in public life. The student makes note of the qualities that she would like to imbibe from each one of them.

The written draft is taken as a guideline rather than a script.

While rehearsing   the speech, placement of all phrases and points is discussed. The contents are rearranged, realigned and the impact is noted.

Then the student is given different scenarios and told to present the speech

  • Student is the first speaker
  • Last speaker
  • All the points covered by the previous speaker
  • Distracted audience
  • Tired judges
  • Interruption because of electricity / technical faults.

Each performance is discussed.

Then the ‘emotions’ during preparation and rehearsal are discussed. Boredom, anxiety, satisfaction…Each emotion is named and each emotion is acknowledged. The emotions that will help the performance are identified. How can the student continue to generate these helpful emotions? … different strategies are planned by which this can be done.

The issue of ‘ownership’ of performance is now discussed. This ‘ownership’ can be burdening or enjoyable, the way you look at it.

On the day of the performance, the mentor and the student spend a short ‘exclusive time’ together.

After the performance the mentor and the student discuss pros and cons of her own performance. Rather than saying “your delivery was too fast”, it is put as “These were the sentences where your speed was fast” Rather than saying “you need to work on your eye-to-eye contact” it is put as, “you need to cover periodically all corners of the audience by your eyes”.

After the performance is discussed, both mentor and student sincerely sit through some other contestants’ speeches and discuss those. Slowly they evolve a detailed format of performance appraisal which is kept as a record by the student.

After the result of the competition, the mentor explores resultant emotions with the student. They decide on their next goal.

As the time progresses, the student starts becoming more responsible and empowered and the mentor maintains a meaningful presence throughout this journey.

The student now grows confident and starts exploring the experience further. The mentor now focuses on ‘involvement’, ‘commitment’, ‘process satisfaction’ and ‘result satisfaction’ which are psychologically more sophisticated terms. The discussion revolves around, what is the ‘self- talk’ at such times and how different types of self-talk can be either helpful or harmful; how the student can exercise her choice to choose the most helpful self-talk.

As the string of performances continues and each is utilized as a ‘learning’ experience, there will come an experience the mentor is watching for… a memorable moment when the student and the speech being delivered becomes so synchronized that it becomes ONE. The student is at her best at that moment.

This moment is again shared and explored by both. It is a magical moment. A touch of brilliance.             Now, the mentor and the student keep on working further to make this moment appear often as well as how they can make it ‘better’. Here better, means more meaningful, more memorable, more intense…

And slowly, the moments of excellence start trickling… then flowing… Naturally … In a rhythm. The student has discovered her own way of expression.

The mentor watches with his ever-watchful eyes her track-record of glories with moist eyes, with all the memories gathering one by one in his mind… “There was a day when I helped her to make her choice” he says in his mind and smiles.

Dr Anand Nadkarni