Sunday ward rounds are always a leisurely and relatively stress-free activity for a geriatrician like me. My main purpose today is to get consent from Mr. Krishnan. His wife, Padma, has a large bowel growth and needs surgery soon. He is aged 78 and she is 73 and live on their own. Murali, their son, has been known to me for two decades and, no prizes for guessing, is a U.S. resident. I was hoping that he would come soon, enabling us to go ahead with treatment. Mr. Krishnan has early dementia and Parkinson’s disease — not the fittest person to look after a post-operative elderly patient.
My heart sank with one look at Mr. Krishnan. He looked forlorn and dejected. “Looks like he is not coming — some important project deadline. So I will have to go it alone. Do you think I will manage?”
The very question I did not want to hear, but the patient’s health does not permit luxuries. “It is ok, we will arrange for some help after discharge and I will also drop in if required.”
Mr. Krishnan looked marginally better but still the dejection remained. “Why do you think we are in this situation — is there anything that we did not do well, wrong priorities, maybe? Or, is it just our bonding that went awry? Do you see people like us daily?” he paused and added, “Oh, I hope not — we don’t want people like us to be in this situation.”
I was getting a little edgy. “No, Mr. Krishnan, unfortunately you are just a prototype elderly of modern Chennai or for that matter any metro. There are a lot of people who are in a similar situation and unfortunately there are a lot of people much worse.”
Mr. Krishnan persisted, “How do you deal with these helpless souls?”
I sounded rather paternalistic, “Well, we are here to help them!” I know only too well that it is a recurrent nightmare for someone like me. A sick person in the hospital with no next of kin to discuss issues and we have to make all tricky decisions with enormous adverse repercussions. It has always been a puzzle that many people choose to live abroad leaving the elderly parents in their homeland. It is certainly a significant sociological phenomenon impacting adversely many issues of health care of the elderly.
This has led to the mushrooming of old-age homes, or euphemistically christened gated communities, and also services aimed at home care for the elderly. A recent ruling by the government making it compulsory for children to look after their parents makes one wonder at the need for such a high level intervention. One feels ashamed to be an Indian with our much touted cultural values and respect for elders.
Mr. Krishnan must have heard my thoughts as he interjected, “So you think we did not do anything wrong to get into this situation?
With a deep sigh, I told him that we as parents all have to share the responsibility for this sad situation.
“I wish you recall the days when your children were going to school. We were only talking about the U.S. and the U.K. as the places to be, the places where you earned well! More important, you could proudly claim in any family function that your son was pursuing studies in Wharton or Kellogg school. We did not feel bad about wearing T- shirts with ‘I love New York’ written boldly on it.
There was the mad rush to the IIT, a stepping stone to go to the U.S., not among all, but in a significant percentage. The convenient excuse we gave to our friends and relatives was that there were no appropriate jobs here in India. Perhaps, that was true to some extent then but we never attempted sincerely to get a job here. It certainly never occurred to us parents that youngsters should try and build the nation to the level that made us proud.
After all, this is our motherland we are talking about. For us, MIT meant only the one in Boston, not the one at Chromepet! Our kids grew in such biased environs and not surprisingly they looked down on our nation and us. The western media and Hollywood did not help us either.
Mr. Krishnan was softer this time: “Well, maybe it is partly our fault, but what about these smart young chaps? They are mature enough to realise the drawbacks of living in a foreign country. They want to get back when the daughter starts dating foreigners and whenever there is recession, they think of the support of family and friends here. But nowhere in these equations are parents included. After all, we sacrificed so much for their education and well-being. Don’t you think it is totally unjustified?”
I smiled wryly: “Certainly, that is beyond debate. But is there anything we can do about it now? I think what can't be cured has to be endured! Please remember there are still a lot of families where the children coordinate and take turns to look after the parents financially and otherwise. And without hurting your sentiments, I may add that the work ethics are different here, there seems to be a decent level of meritocracy in those countries and more avenues for personal and professional development in many fields. So each individual perhaps has to look at his comfort level and decide on this tricky issue.
Mr. Krishnan was not impressed. “Perhaps, it is a curse that we should suffer in silence and alone when we need people most. Can’t blame you for these. Hope you have planned well for your future!”
I thought he noted my fast receding hairline and, feeling a little depressed, I said: “I hope I have! Only time can tell. Sorry to have talked like that to you. I personally feel that we should think on a broader basis, perhaps each person has a reason to be abroad, however flimsy it may look to you. But there can be no excuse whatsoever for abandoning the care of parents in exchange for a career growth or financial gains. They should realise that without the hard work and affection of parents, no child could hope to grow! And most important, the mutual emotional support and bonding have no financial equivalent!”
Mr. Krishnan smiled for the first time this morning: “Can’t blame you — you have always been diplomatic! Anyway, are you going anywhere today?”
“Well, yes I have to take my grandson to his IIT tuition class at 10.”
“Oh, another IIT-ian in the making? How old is he?”
“He is already six years!” I rushed towards the exit.
(Dr.V. Srinivas, MD, MRCP (UK), has a diploma in Geriatric Medicine (U.K.). He is founder of the Chennai Geriatrics Centre, Adyar, Chennai. His email ID is firstname.lastname@example.org)