Of Nehru and Norwalk

The sweltering heat can shorten anyone’s temper. Ask Mr. Singh (a fictional name). His temper tantrums when people dared park longer than fifteen minutes in front of his Norwalk store were legendary, and vagrants decided that they were better off rummaging through the garbage of the Chinese restaurant next door. His attitude towards customers veered from cloyingly sweet, if you were a curvaceous young girl, to patronizing, if you were a homeless person trying to buy batteries for a CD-player you found in the dumpster next door. Yet once upon a time he had been a bright-eyed and bushy-tailed youngster fresh off the plane from India with his wife and young sons. America was the land of opportunity and, armed with stories of relatives who had struck it rich in Connecticut, he came searching for his dream. An Indian community would be waiting to welcome him and his family into their temples and homes.

The years passed in the blink of an eye and the vigor of youth faded. Mr. Singh invested in the stock market and paid the price. The tax man put a lien on his business and he had to figure out creative ways to pay for the college education of his sons. Mr. Singh kept going, in part because of his delusions.You see, dear reader, everyone else was always to blame for every calamity in his life. The fact that he did not fill out the proper paperwork to have a lottery ticket machine in his shop became the fault of the government. The fact that dear Mrs. Singh’s samoosas landed me in bed with a serious case of food poisoning was the fault of the dough he had purchased at Costco. For a second I found myself more annoyed at the fact that she had not made everything from scratch, before arguing with Mr. Singh about his irresponsibility.

However, Mr. Singh always managed to wiggle his ample girth out of tight corners. When his belligerent explanation that office workers who had purchased the same savory delicacies seemed just fine fell on deaf ears, he tried a different tactic. The heat outside was merciless and he swept away my defenses and a potential lawsuit with peace offerings of Haagen Dasz ice cream and the latest copy of the National Enquirer. Having honed in on my vices, Mr. Singh felt secure that he would not be losing a customer. I could not let him off that easily.

“So,” I interrupted sweetly (as he railed about the indiscretions of American stars discussed in theEnquirer),”Is it true that the first Indian prime minister (Jawaharlal Nehru), had been in love with the last British viceroy’s wife (Lady Edwina Mountbatten)?”

Mr. Singh was thunderstruck. He demanded to know if I had read it in the free copy of “that dirty rag” he had just handed me. No. My source was impeccable. I had googled the information and if anything appears on Google it has to be true. Mr. Singh was quick to set me straight. Nehru was revered in India and, according to Mr. Singh (who had it on good authority from an uncle who had been Nehru’s personal photographer), nothing happened. His opinion that revered men were obliged to have no flaws was not that far removed from our pre-Clinton (or was that pre-Kennedy?) view of charismatic leaders.

The conversation eventually drifted to more neutral terrain. One of his sons was getting married. The kid had been a straight A-student. Thanks to Mr. Singh’s sweat equity, or perhaps in spite of it, the younger Singh had graduated top of his class at Yale University and now held a prominent position at a local investment firm. Mr. Singh informed me that there would be two weddings. One would be held in India and then all the relatives would be shipped over here for a mega-festival that would last a couple of days. Mr. Singh had taken out a loan to foot the bill. I kept my opinion about a son allowing his parents to take on an added financial burden to myself. My ice cream was beginning to melt and there was no need to anger Mr. Singh again.

Summer means vacation time. So I did not see Mr. Singh for a few months. When I returned to Norwalk, I was surprised to see that Mr. Singh’s store had closed. I heard via the grapevine that he was broke and had decided to return to India with his wife. A part of me was sorry to see the old rascal leave and the other part felt happy. Hopefully he found that mythical retirement sanctuary that we all long for, aka the Marigold Hotel. Hopefully he will at long last feel at home.

Bonding over coffee

It feels good to be a Norwalk resident, especially if one runs into neighbors and other familiar faces at one of the recently revamped Dunkin’ Donuts shops. Old friends and friendly strangers can spin tall tales over coffee and engage in debates over issues of the day (eg, the presidential election). The pleasant suburban scene could not have been envisioned centuries ago, when Ludlow and Partrick first independently purchased land from the Indians, and the name, Norwalk, was derived from the name of an Indian chieftain, Naramake (also spelled ‘Naramauke’ or ‘Norwauke’).

However, the past was not on the minds of most customers. For instance, the Haitian cab driver, pausing briefly for his cup of java before heading out for a night shift, had little interest in the question one could pose to Indians today to find out if they were better off than their ancestors. He was only interested in the present and the future. As the night shift loomed ahead, he was contemplating how many Norwalk bar flies would be calling upon his services to take them to their homes. How many fares would equal his economic survival for the next month? When talk inevitably drifted to the recent political conventions, he shrugged his shoulders. He was a first-generation American who did not mind that politicians did not court him in a similar manner as Latin immigrants. Instead, he was grateful that he could pay for food and shelter for his kids.

Tonight he celebrated another milestone in his life that, to him, felt every bit as momentous as the heroic accomplishments of ordinary Americans mentioned at the political conventions. He had chronicled his life story on yellow legal pads, while waiting at the interminable red lights dotted along Norwalk roads. These notes had finally been compiled into one book. Others, who left the coffee shop to stare at the book in his car, were quick to rain on his parade. No one would be interested in his story. No one would care. The cab driver would have none of this negativity. He had already lined up likeminded folks and would be barnstorming the local churches and community groups, preaching the gospel of self-reliance along the way. One felt humbled. Here was someone made stronger and not cowed by political rhetoric or adversity.
Back in the Dunkin’ Donuts shop, Mr. X, an adult approaching his golden years, was happy to sip coffee and chat to other customers about his problems. Mr. X is disabled. More precisely, he is a mentally disabled, non-institutionalized adult. Given the level of his disability, work was never an option. In the absence of a strong family or religious support system, he is also a poster child for entitlement usage or victim of any Medicaid cuts, depending on one’s point of view. It is worth noting that one analysis of 2010 census and budget data estimates that more than 90 percent of the benefit dollars that entitlement and other mandatory programs spend go to assist people who are elderly, seriously disabled, or members of working households — not to able-bodied, working-age Americans who choose not to work.

None of this mattered to Mr. X. He had just spent $15 on a broken Walkman. Someone had obviously taken advantage of him; however, his only complaint was that he could no longer listen to Michael Jackson. His late mother had left him cassettes of his favorite pop singer and somehow Thriller and Bad just did not sound the same unless he was using those cassettes. The political and economic travails of our country remained unsolved, but in an instant, another solution was born. Someone remembered a working portable cassette player at his house. Mr. X would soon have a tangible link to his late mother and Michael Jackson again.

Determination, perseverance, and kindness ruled in a franchise founded by the entrepreneur, William Rosenberg. Some people may crush these moments by pointing out the financial state of the franchise; however, there is only so much information that one can imbibe on a Sunday night. Sometimes one can only focus on what is in front of you and take care of the person next to you. Tomorrow is another day.

Decontamination strategies to curb hospital-acquired infections

Hi everyone,

TB is the leading cause of death in South Africa and drug-resistant TB continues to be a problem, particularly in the province of Kwazulu Natal.  Curbing hospital-acquired infections such as drug-resistant TB may be one aspect of a multi-pronged strategy aimed at controlling the spread of this infectious killer. I blogged about this topic on The Norwalk Patch and am reposting the information here:

While there has been a 45% decrease in tuberculosis death rates since 1990, the growing crisis of drug-resistant tubercle bacilli (480,000 new cases of multi-drug resistant TB in 2013), high mortality rates (1.5 million deaths out of 9 million diagnosed TB cases in 2013), and ongoing HIV/TB co-infected cases (360,000 in 2013) persist across the globe. The post-2015 End-TB strategy from the World Health Organization involves three tiers i.e., integrated, patient-centered care and prevention, bold policies and supportive systems, and intensified research and innovation.

Appropriate disinfection and decontamination of hospitals, clinics, and other medical centers to reduce the prevalence of this airborne pathogen will be an important aspect of any integrated patient-centered care and prevention strategy. The merits and perils of automated systems such as hydrogen peroxide vapor and ultraviolet light disinfection systems to reduce the impact of hospital-acquired infections are discussed in Automated Technologies for Patient Room Disinfection and Decontamination of Biosafety Level 4 Infectious Agents, Including Ebola Virus.

Female scientists

International Women's Day

Happy International Women’s Day, everyone. I wrote a series of posts about female scientists that appeared – you guessed it – in the Norwalk Patch. I am reposting the links here for your reading enjoyment.

1. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-1-0

2. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-2-0

3. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-3-0

4. http://patch.com/connecticut/norwalk/female-pioneers-sciences-part-4-0

Diabetes and pernicious anaemia (Appeared 2013 in The Norwalk Patch)

The Pernicious Anaemia Society members will already be familiar with Martyn Hooper’s book,”Pernicious Anaemia: the Forgotten Disease – the causes and consequences of vitamin B12 deficiency”(1). Briefly,  a complicated immune orchestra destroys cells in the stomach lining, increasing gastric pH, allowing bacteria (normally suppressed by low pH) to thrive, to possibly interfere with absorption of indispensable micronutrients, including vitamin B12 (2). The net result of progressive inflammation is the severe form of vitamin B12 deficiency, pernicious anemia (PA).

What happens when this misguided attack on the stomach lining is accompanied by a a second autoimmune/comorbid disease attacking a different organ in the body? This prospect is increasingly likely, given the rise in chronic diseases in aging populations. Stomach problems that may occur concurrently with the insidious progression from autoimmune gastritis to PA, can sometimes be a clinical signal of damage to another organ tucked behind the stomach, i.e. the pancreas. The pancreas secretes insulin, a critical hormone, that assists the body in absorbing glucose and other nutrients from food. Insulin and its precursors are also targets for autoimmune attack, leading to Type 1 or “juvenile” diabetes, a condition affecting 5-10% (3) of all diabetics. Adult-onset or type 2 diabetes (more information can be found in the Diabetes Portfolio [4]), which accounts for 90% (5) of all diabetic cases, occurs as a consequence of insufficient insulin production or resistance of the body’s tissues to normal or higher amounts of this hormone.

While PA is thought of as an under- or misdiagnosed disease (present in up to 2% of the general population) (6), for a variety of reasons,2 the number of known diabetics total more than 371 million across the globe (7). Autoimmune gastritis and PA are increased up to 5-fold in Type 1 diabetics (6). Moreover, metformin, a popular, oral antidiabetic medication, may contribute to vitamin B12 deficiency (8). These points underscore the need for a holistic approach in the management of PA and co-occurring illnesses.

References

1.   Hooper M. Pernicious Anaemia: the Forgotten Disease – the causes and consequences of vitamin B12 deficiency London: Hammersmith Health Books; 2012.

2.    Neumann WL, Coss E, Rugge M, Genta RM. Autoimmune atrophic gastritis-pathogenesis, pathology and management. Nat Rev Gastroenterol Hepatol. 2013.

3.     Apple J, Aviad Mea. ASweetLife-Diabetes. 2013; http://asweetlife.org/diabetes/. Accessed July, 2013.

4.      Nackerdien Z. Diabetes Portfolio. 2013;http://znacke1.wix.com/diabetesportfolio. Accessed July, 2013.

5.       International Diabetes Federation. Types of Diabetes. 2013;http://www.idf.org/types-diabetes. Accessed July, 2013.

6.       De Block CE, De Leeuw IH, Van Gaal LF. Autoimmune gastritis in type 1 diabetes: a clinically oriented review. J Clin Endocrinol Metab. 2008;93(2):363-371.

7.        International Diabetes Federation. IDF  Diabetes Atlas. 2012;http://www.idf.org/diabetesatlas/5e/Update2012. Accessed July, 2013.

8.        Warner J. Peripheral Neuropathy Patients Who Take Diabetes Drug May Have Vitamin B12 Deficiency. 2009; http://diabetes.webmd.com/news/20090608/metformin-linked-to-b12-deficiency. Accessed July, 2013.

Diabetes and Alzheimer’s disease

Information in this 2013 post (first published in The Norwalk Patch) continues to be relevant today.

Diabetes

Look around you and it seems as if the “healthy body, healthy mind” campaign is in full swing. Adherence to the latest health and fitness mantrasmay seem impossible to people coping with a sluggish economy, a confusing healthcare reform process and their own aches and pains. However, the latest epidemiology data from the International Diabetes Federation about this chronic disease [1] – which is linked to a host of other illnesses, including Alzheimer’s disease (AD) – may serve as an impetus to discard the fog of confusion in favor of pro-active health maintenance. An estimated total of 382 million people had diabetes in 2013 and this number is anticipated to rise to 592 million by 2035 [1]. Additionally, North America and the Caribbean lead other global regions in terms of money spent on the disease [1].

Having a healthy body and mind may empower diabetics awaiting solutions to the American healthcare paradox. The public-health specialists, Elizabeth Bradley and Lauren Taylor, have described the paradox as follows: “American per-capita spending on health far exceeds that of any other country on earth, the results achieved fall well short of other nations that spend much less. This includes such basic measures as life expectancy, maternal and infant mortality, and infant birth weight, for example.” For diabetics focused on also maintaining a healthy mind, these words may sound ominous as they grapple with a national fear of getting AD.

Alzheimer’s disease

A 4-minute captioned video depicting the brain changes characteristic of AD can be viewed at the National Institute on Aging’s  website. While the animation illustrates the advances that has been made in the understanding of AD progression, it does not address the complexities involved in accurately diagnosing the disease, especially within the context of comorbid illnesses such as diabetes. Scientific evidence is accumulating that suggests a link between Type 2 diabetes and AD, the most common form of dementia and the seventh leading cause of death in this country. The data pointing to an association between AD and low brain insulin levels has led some researchers to refer to this dementia sub-type as Type 3 diabetes.

A middle-aged or older diabetic  (≥40 years old) exhibiting one or more AD warning signs is likely to visit a primary care physician. In the absence of a lifelong relationship with a trusted clinician, any patient and family caregiver(s) will have to provide comprehensive medical histories to numerous doctors in order to facilitate optimal AD management in the context of diabetes. This task – usually assigned to caregivers – may be daunting, since recall bias or the presence of significant memory loss may hinder the collection of information. Nevertheless, ascertainment of complete medical histories will aid in the differential diagnosis of AD. Patients and members of their care team also need to remain vigilant about the potential for misdiagnosis and its accompanying excess costs [2].

References

1.       International Diabetes Federation. IDF Diabetes Atlas, 6th edition. Brussels, Belgium: International Diabetes Federation, 2013. http://www.idf.org/diabetesatlas

2.       Jeffrey, S. The High Cost of Alzheimer’s disease Misdiagnosis, 2013.  Medscape Medical News from the Alzheimer’s Association International Conference (AAIC),  2013

Jack and Jill

Hi Everyone!

This is another one of my old Norwalk Patch stories that I thought readers might enjoy:

Robert Frost ended his poem,” Mending Wall,” with the famous line: “Good fences make good neighbors.” In today’s world, it could mean the difference between minding one’s own business or becoming absorbed in the reality TV-antics of one’s neighbors. We all have stories to tell to illustrate the point. One urban legend that I am perpetuating relates to Jack and Jill (the story usually becomes more colorful as time passes). Given my urban surroundings and the anonymity of today’s world, I should really have been unaware of Jack and Jill’s business. Unfortunately, the paper-thin, apartment walls and their late-night arguments that frequently woke me up, meant that I had a front-row seat to the inner workings of their dysfunctional relationship. The fights about money and cheating were fodder for a Jerry Springer show.  On nights when the volume of epithets reached epic proportions, I visualized the Springer audience shouting in unison:”kick him to the kerb.” That would be the course of action of any rational person, but love or co-dependency (call it what you will), rarely goes together with rational thought. Besides, in real life villains are rarely one-dimensional and situations are complicated. Jack was well-loved because he helped little old ladies and did handiwork without insisting on being paid. He also treated Jill to an occasional dinner on the patio or whisked her away for a weekend at the local casino. They were also sickeningly sweet with their public displays of affection. So Jill stayed with Jack for years. During the day I would nod my head and scurry by, fearful of getting dragged into the morass of their problems.

 

One day I woke up in the early hours of the morning. I could hear Jack on the phone. Was he drunk-dialing someone? No. Jill had gone out of town and he was confiding his inner thoughts to a long-lost relative. He sounded simultaneously happy and sad. Apart from catching up, he was also trying to figure out what had happened to his other siblings that were placed in different foster homes. His dream had been to become a rap impresario a la Jay Z, but that sputtered when the talent he had scouted opted for the joys of selling weed instead of entertaining hipsters in a night club. Now he spent his days cleaning the house, cooking or drinking between part-time jobs. I drifted off to sleep. It seemed the preferred option compared with listening to this drama.

 

Jill eventually dumped Jack. Or maybe it was vice versa? After all, there had been many prior occasions where Jill had actually begged Jack not to leave her. In any event, a slammed door and “I’m outta here” followed by the sound of a car engine, heralded the demise of that relationship. Romantics rejoice. Jill is now in a stable relationship. She finally found a quiet guy. They moved out and, in a modern-day twist to the fairy tale ending, they put a deposit down on one of those foreclosed homes that you can get at bargain basement prices these days. Mary J. Blige would approve. Jack has probably found another Jill and will be cooking up a storm for her to prove his love. Thankfully, the new neighbors are discreet and I am finally enjoying a good night’s rest.

Frederick Douglass and “Hide Thou Me”

I am re-posting this 2012 article (based partly on information obtained from the archives at The Norwalk Museum) in remembrance of Black History Month in the USA:

We have just celebrated Black History Month and it is therefore fitting to pay homage to Frederick Douglass (February 1818 – February 20, 1895) , an African-American social reformer and statesman who was the antithesis of the notion that slaves “did not have the intellectual capacity to function as independent American citizens.”

Wikipedia provides one with an overview of  his life, from his birth in Talbot County, Maryland to his successful escape across the Susquehanna River and final arrival in the house of the abolitionist, David Ruggles, in New York. His abolitionist activities, involvement in women’s rights, travels, fight for emancipation and suffrage during the Civil War years, role as a statesman during the Reconstruction era and writings (including his celebrated autobiography [Narrative of the Life of Frederick Douglass, an American Slave, published in 1845]) are cataloged online and in print at the Schomburg Center in Harlem, New York as well as at other locations. Schools, prizes, stamps and a bridge bear his name.

In today’s fast-paced, attention-deficit-prone world one could be forgiven for thinking of him as a bronze statue in a park or a remote historical figure of interest to only specific segments of society. However, even a cursory interest reveals glimpses of a charismatic man who defied the status quo in every possible way. After burying Anna  (his wife of more than four decades with whom he had five children) in 1882,  Douglass married a white woman, Helen Pitts (a graduate from Mount Holyoke College) in 1884. His response to the outrage at the time was that his first marriage had been to someone the color of his mother and the second had been to someone the color of his father.

It is in the yellowing pages of  the Norwalk Gazette dated 27 February 1895 that one comes across another facet of the man. Douglass apparently loved the hymn, “Hide Thou Me,” and sang it the day before he died. Part of the lyrics reads as follows:

Sometimes I feel discouraged

And I think my works in vain

I’m tempted oft(en) to murmur

To grumble and complain

But then I think of Jesus

And all he’s borne for me

Then I cry

Oh rock of ages

Hide thou me

Ohh rock of ages

Hide thou me

This was a powerful reminder how a hymn helped to sustain a former slave in his daily life and fight for disfranchised countrymen, just as it continues to strengthen peoples’ faith and resolve today.

Flipping back through the archived newspapers, it was interesting to note how Douglass was viewed through the prism of his own generation. Upon his death, the Norwalk Gazette of 23rd February 1895 felt the need to temper their effusive praise for Douglass by mentioning that he “lacked the scholarship” of a noted editor, Wendell Phillips, or the “masterful rhetoric” of the prominent American abolitionist, Lloyd Garrison.

However, in the vein of “a famous person passed through our town,” the article ended with a mention of Douglass visiting Norwalk a couple of times, where he was once the guest of Senator and Mrs. O.S. Ferry. The Norwalk Gazette redeemed itself with a moving description of the Douglass funeral on 27 February 1895. One could imagine being there as the train bearing his coffin entered Central Station in Rochester, New York. Throngs of people watched the funeral procession wound its way first to City Hall, where the body rested in state for several hours, and then to the Central Church, where the invocation was delivered by Dr. H. H. Stebbins. A male quartet sang his favorite hymn, “Hide Thou Me,” before the service concluded and Douglass was finally laid to rest.

 

 

 

Of Nehru and Norwalk (First appeared on The Norwalk Patch)

The sweltering heat can shorten anyone’s temper. Ask Mr. Singh (a fictional name). His temper tantrums when people dared park longer than fifteen minutes in front of his Norwalk store were legendary, and vagrants decided that they were better off rummaging through the garbage of the Chinese restaurant next door. His attitude towards customers veered from cloyingly sweet, if you were a curvaceous young girl, to patronizing, if you were a homeless person trying to buy batteries for a CD-player you found in the dumpster next door. Yet once upon a time he had been a bright-eyed and bushy-tailed youngster fresh off the plane from India with his wife and young sons. America was the land of opportunity and, armed with stories of relatives who had struck it rich in Connecticut, he came searching for his dream. An Indian community would be waiting to welcome him and his family into their temples and homes.

The years passed in the blink of an eye and the vigor of youth faded. Mr. Singh invested in the stock market and paid the price. The tax man put a lien on his business and he had to figure out creative ways to pay for the college education of his sons. Mr. Singh kept going, in part because of his delusions.You see, dear reader, everyone else was always to blame for every calamity in his life. The fact that he did not fill out the proper paperwork to have a lottery ticket machine in his shop became the fault of the government. The fact that dear Mrs. Singh’s samoosas landed me in bed with a serious case of food poisoning was the fault of the dough he had purchased at Costco. For a second I found myself more annoyed at the fact that she had not made everything from scratch, before arguing with Mr. Singh about his irresponsibility.

However, Mr. Singh always managed to wiggle his ample girth out of tight corners. When his belligerent explanation that office workers who had purchased the same savory delicacies seemed just fine fell on deaf ears, he tried a different tactic. The heat outside was merciless and he swept away my defenses and a potential lawsuit with peace offerings of Haagen Dasz ice cream and the latest copy of the National Enquirer. Having honed in on my vices, Mr. Singh felt secure that he would not be losing a customer. I could not let him off that easily.

“So,” I interrupted sweetly (as he railed about the indiscretions of American stars discussed in the Enquirer),”Is it true that the first Indian prime minister (Jawaharlal Nehru), had been in love with the last British viceroy’s wife (Lady Edwina Mountbatten)?”

Mr. Singh was thunderstruck. He demanded to know if I had read it in the free copy of “that dirty rag” he had just handed me. No. My source was impeccable. I had googled the information and if anything appears on Google it has to be true. Mr. Singh was quick to set me straight. Nehru was revered in India and, according to Mr. Singh (who had it on good authority from an uncle who had been Nehru’s personal photographer), nothing happened. His opinion that revered men were obliged to have no flaws was not that far removed from our pre-Clinton (or was that pre-Kennedy?) view of charismatic leaders.

The conversation eventually drifted to more neutral terrain. One of his sons was getting married. The kid had been a straight A-student. Thanks to Mr. Singh’s sweat equity, or perhaps in spite of it, the younger Singh had graduated top of his class at Yale University and now held a prominent position at a local investment firm. Mr. Singh informed me that there would be two weddings. One would be held in India and then all the relatives would be shipped over here for a mega-festival that would last a couple of days. Mr. Singh had taken out a loan to foot the bill. I kept my opinion about a son allowing his parents to take on an added financial burden to myself. My ice cream was beginning to melt and there was no need to anger Mr. Singh again.

Summer means vacation time. So I did not see Mr. Singh for a few months. When I returned to Norwalk, I was surprised to see that Mr. Singh’s store had closed. I heard via the grapevine that he was broke and had decided to return to India with his wife. A part of me was sorry to see the old rascal leave and the other part felt happy. Hopefully he found that mythical retirement sanctuary that we all long for, aka the Marigold Hotel. Hopefully he will at long last feel at home.