Saturday, January 28, 2012


To  understand many things in Hinduism and the symbolism we should try to understand how this universe was born and came to existanse , and we as human being are made by the God . Adi Shankaracharya had written this in two books  called  Atmabodh and Tatwabodh..
   So let me state as I understand. There 3 bodies , one causal, one astral, one physical . As the neme imolies the causal boby is the cause of rest of them. The astral body is behind the physical body and causal body acts through astral body and the impressions are stored in to it . No need to explain physical , though it will need to be  when we will talk about it.
   There are 3 ' Gunas ' or the qualities', Satwik ',' Rajasik' and' Tamasik.'

Friday, January 27, 2012


When I saw her for the first time I  felt bad . She was 37 years old white female who was admitted with pneumonia. She smoked only on few occasions. and was not alcoholic . , but was admitted on few occasions in the hospital. She had pneumonia and phlebitis in upper extremity on 2 previous occasions and was treated with meds . On exam she obese , weighed almost 250 lbs. was not in any distress . Her lungs sounded almost clear and her oxygen level was slightly lower. Her x-ray showed small nodular densities. I was not sure what was the cause of her recurrent pneumonia.
     I ordered ct scan . I also ordered some blood tests to check on her immunity, IgG , IgM, IgA etc. I also ordered test to r/o autoimmune disorders like lupus etc. The ct scan confirmed nodules -present in both lungs . So I decided to do bronchoscopy with biopsy--an endoscopy to get some lung tissue without any surgery. I also send samples for various micro organisms. The all cultures came back negative . So there was no infectious cause for the nodules-not at least on these cultures. The biopsy showed 'grannuloma ' i.e. cells in inflammation are seen in particular way as if the are surrounding 'culprit' in battlefield. These kind of arrangement is seen in conditions  like  TB, fungal infections, a disease called sarcoidosis or even in rheumatoid arthritis. But this lady had none of the other blood tests suggesting any of the conditions that I mentioned . She also had left hand phlebitis for no known reason.
     She was married and had a daughter age 6yrs . I decided to get chest surgeon.There was no way to treat this lady without definitive diagnosis. I could start steroids, thinking that this could be sarcoidosis.But I was reluctant to do this as she was Young and was obese.
       So the surgeon saw her did open lung biopsy . The report shocked me. The biopsy showed the granuloma    ,but the detail description was shocking . In the center of this inflammatory structure usually there cheesy material. Instead in this one there was TALK . Now I called the pathologist to confirm this .and he was quite sure. How could talk get in lung? We know that there are cases described where talc  granulomas,. have occurred in babies whose mother were using too much talcum powder on their babies after bathing them . Only real explanation that I had was not very palatable.  T had seen something like this when I was in training. Some drug addicts used to inject tablets dissolved in water in the vein ,thinking that this will give them kick that they could not get by taking narcotic mouth.But how can I ask this lady with husband and a child , that are you injecting pills ?. This would explain the phlebitis that she got 2 or 3 times . When one inject this kind of material it is likely to cause inflammation in the vein hence the phlebitis in left arm in this right handed lady.
       I discussed this with surgeon . He had no doubt about this cause as the possible explanation. So I talked to her and told her the biopsy report and the explanation . She did not accept . Did not want accept the strong evidence that she was injecting , so was discharged in couple of days. I had asked her to do the follow up in the office , as expected she did not come.

Wednesday, January 25, 2012


  When I saw Mary for the first time , there was nothing uncommon or unusual about her or her history. She was  34yrs old white woman  with history of asthma . She had it since childhood.,was treated by her pediatrician and as she grew older was followed by primary care M.D. She had lot of allergies and so with 'bad ' asthma was refer ed to allergist. After doing allergy testings she was refer ed to me .For me asthma and cough and cold are very common re feral . So there was nothing unusual about it . ( I sometimes call " cough" and " cold " as my " bread " and " butter " . )She had bad cough and she told me that it 'never' goes away. Her physical examination was unremarkable., except for 'harsh ' breath sounds. I reviewed  her old records.
     I ordered chest x-ray and complete pulmonary function test. I was not sure that any change in medications at this stage was needed .
     When I saw her pulmonary function tests I was surprised . I noticed that her flow volume loop , which part of  pulmonary test was abnormal ,. I had noticed the abnormality in previous test but had not paid attention thinking that it was technical variation. With history of asthma from " birth " I was concerned . I was suspicious of some kind of obstruction in upper airway , as there was flattening of flow volume loop . I was concerned , but also thought that it is impossible to have this not detected in last 34 years . I had to rule it out ( or rule it in )
     I ordered CT scan of trachea . and decided to do endoscopy . CT scan came back with report of 'Trachial steno sis with at one point trachea was 8 mm. ;' ( normal size is 20 mm. ) So my thinking was correct . I called several thoracic surgeons  . With the cat scan findings no one wanted to do surgery.
      I called around got tel no. of Tracheal specialist in Boston . He agreed to look at the ct scan and see patient . He wanted  me to do video bronchoscopy and mail him the cassette . I did it .
      She was seen by him and operated by him  and then came to me . Her 'asthma ' was cured .
       During her development she had abnormal blood vessel and it  was crossing over the trachea , it got scared--fibrosed and the pressure from it caused the narrowing of the trachea .

Sunday, January 22, 2012


     Let us look at some more stories in Mahabharata. In Mahabharata when Bhishma falls down in the war , it was 'Dakshinayan ' i.e. Son is moving towards south . According to the Hindu scriptures this not a good time to die . ( As if there is any 'good time ' to die . )Bhishma was given a boon by his father that he can decide the time when he wants to die --when he can allow his soul to leave the body. So he decides to hold on to life till the Son starts ' Uttarayan' -son's movement towards north. This entire story does not make any sense . So it does not matter , 'what ' you did in your life but it matters more as to  the 'time 'when you die.
     Now let me try to explain . The Son ts not the one in the sky. nor is uttarayan and dakshinayan is not the movement of the star son . It has to do with spiritual eye and Son means  self realization . Northward movement is our attention to be towards higher centers while southward movements is our attention towards lower centers. i.e.procreation, excretion , hunger  are lower centers . Think about it . The sexual 'love' is lower than love from 'heart'. So when we are still involved and attached to sex , food indulgence we should not expect to get 'mukti' or ' Nirwana'. But if we start getting better then only we have some chance .So now the story makes some sense.
      Now let us take story of Arjuna winning Draupadi in swayamwar . When he comes home and Kunti knows that Arjuna won Something then she tells him to 'share ' it with other brothers . So then Draupadi stayes with each of the 5 Pandawas as their wife . Second story is that of Amba ,  Ambalika , Bhishma  and, Vyas. In the story Bhishma's half brother Vichitravirya  becomes king  and dies then it is up to Bhishma to get heir to the throne . Since he , Bhishma had vowed to celibacy , he asked Vyas to help. Bhishma kidnaps 2 girls - Amba and Ambalika . Then Vyas the great sage sires Pandu from Ambalika and Dhritarashtra from Ambika . When Amba sees Vyas in her bed room she closes her eyes with fear so the child born is blind , that is Dritarashtra and Ambalika turns white seeing Vyas so Pnadu the child born is White. .
       In these stories there is no respect  or freedom for the women . If this our religion then it is worst than many others. So how do you make any sense out of this . Let me try, The 5 Pandawas represent 5 chakras and 5 elements . Draupadi represents  the Kundalini , the energy that is coiled up in lowest part or the spine .
During the meditation the Kundalini shakti is awakened and rises from one center to other to the highest centers. So this Draupadi staying with each of the Pandawas for part of the time and being their shared wife. Now about Amba and Ambalika . Vichitravirya is Divine Ego , It dies , means it is covered by outside deformities of the consciousness . Amba represents perception without clear discrimination  while Ambalika is perception with clear discremination . So from union of Vyas -the consciousness in relativity  with Amba  'BLIND MIND ' is produced and with Ambalika 'WHITE -PURE  INTELLIGENCE' is produced. . This at least gives us some understanding of the symbolism in Hinduism . May be this will help one to think in terms of symbolism when we try to understand these stories.

Saturday, January 21, 2012

Mahabharata -continue.

     As I said before not much can be explained if one takes these stories at there face values. Let us take the story of Dronacharya. He was born when sperms were dropped in a 'drona' - a container made out of dry leaves. He was main teacher of Pandawas and Kaurawas. He was married and had a son . , Ashawathhama . Per our our understanding he is immortal .  Drona  was friends with Drupada. Drupada became  king of Panchala. When Drona asked him for favors, cows etc , Drupada refused, .Drona asked Pandawas to help and they defeated drupada. Drona then  allow Drupada to retain 'southern half ' of the kingdom but not the northern half . So Drupada decided to do tapa and 'Yadnya ' . He was blessed with a son which came out of sacrificial fire . He was the Senapati --named Drishtadyumna. Now how do you make any sense out of this ?
      Drona represents stored up karma or their lasting impression . let me explain , I call it circle of mind . Lets say ,I am offered slice of pizza , and I have never seen pizza nor tested it . I will have no reaction to it  . i/e. I will neither feel like eating it or not eating it . But then you say that it's good , so I try it . and I like it ( or dislike it ) . So next time I am hungry I may think of eating pizza or if i see pizza I will have desire to eat it . Again if I eat it it will solidify my impression . S o my 'action ' of eating pizza leads to an 'impression ' -good or bad - bad- that leads to desire  which in turn leads to action and so on so forth. These lasting impressions are stored in Astral body  at death and after death when you are reborn they direct our actions . So they 'guide' us or 'teach' us . So these SAUNSKARAS are what is Dronacharya .Since we do not stop action and continue to have desires these are immortal . So the son of Drona is immortal. These desires can not be destroyed easily . and they will demand  favors from time to time . You will have to 'fight ' with them . This is the fight between Drona and Drupada. In this fight when one looses , he may still have 'control ' over 'southern part of the kingdom '( body is kingdom and southern part is lower centers .) Then one can further meditate and do sacrifice ( yadnya) and it will give the son that will destroy stored up desires--Drona . So this symbolism explains Drona teaching both Pandawas and Kaurawas --the desires and their impressions are directing our good and bad actions. Also why Ashawathhama is immortal and why Drrishtadyumna is mentioned in verse 3 of 1st chapter of Geeta, as leading Pandawas' army.

Saturday, January 14, 2012

Unusual Patient 1

When I saw Terry -not her real name , she was a nurse who worked in PCU and ICU . She was quite good , knew medicine and was quite concered about patient's wllfair.She lived with her boy friend and was golng to get married soon . She was married and her first marrriage was not a good experience. So she was was careful - to stste in her own words.Ihad worked with her without knowing any medical history  about her .
  So when I was called to see her in ICU I was surprsed.I did not expecy her to be admitted to ICU. In fact even before I saw her I had 2 phone calls , one from admitting doctor, telling me her' story' and asking me to look at her and see if she was ready to be discharged. Other call came from her Insurence com. doctor asking me to give him a call if I " find " anything , otherwise get her out soon 
   I went to see her in ICU . I still remember her room no. My consultation was to evaluate for 'low' respratory rate. Usually I get consult because some one is breathing too rapidly , not too slow. When I entered the room I saw her siting upright , not in any ditress with eyes open , She talked to me , answered all questions , though slowly. She was not on any drugs, narcotics  and her urine drug screen was negative . Her lungs sounded cler and heart sounds were normal , Her heart rate was 48 per min anad respiratory rate was 5. Oxygen saturation was 98% . There was no positive finding in her labs. She had seen a neurologist as out patient for passing out spell, and his work up which included cat scan of brain and some blood work was negative .  She was seen by cardiologist for low heart rate , his evaluation was negative . Echocardiogram was normal and she had not shown any cardiac arrythmia during her stay in ICU.
   I was not too sure what would Lung specialist   do .There was something wrong . One can not reduce heart rate and respiratory rate --unless you are Yogi . Something struck me . I don't know why , but I thought of vertebro basiler migraine or something to do with centers of respiration and heart rate . As I was sitting at the desk pondering on what to do , I thought of something , I had allready talked to local neurologist whom she had seen , he had not much to add. There was asocial worker siting next to me . I asked her if she had Mayo clinic tel no . She said I don't have it now but I will get you the no in no time . True to her word she came back in less than 5 mins and handed me the no . I dieled the no. hospital operator piched it up . I told her to connect me to chief of neurologist office . She did . That must be my lucky day as not only I got throgh but he was there and came on phone . I explained him my concers and told him that I was thinking about vertebrobasiler migrain. I asked him how could I confirm it . He said it was a good thought and told me to get EEG -a brain wave recording . This was  exciting . I called EEG tech. I knew her well  as I had ordered sleep studies through her . She came to do EEG very quickly and it confirmed the diagnosis.
  Ltter on work up showed that she had antibody positjve for phospolipids/cardiolipids, so she must be throwing small clots which was causing her symptoms , both black out spells and low respirstory rate----for which I was consulted. She was put on anticoaglent and did very well.


Symbolism in Mahabharat

As mentioned before there are too many stories in Mahabharata , that can not be explained on the basis of commonsense . So on e has to understand how this was thought about . The explanation that I am writing is one that was given by Paramahansa Yogananda. Shantanu in the story of Mahabharata is the Parabrahma --or the Creator. At the beginning of the universe He split in to matter and the energy . The primordial nature is Satyawati--as matter, while Ganga represents the consciousness---also called Chaitanya or the energy. ( It will be the Holy Ghost ) . From chatanya Universal Ego or Ahankar is born --this self consciousness which reflection of universal consciousness. The 6 drowned children are the governing intelligence of 3 universes, each having micro and macro forms . These are not obvious so they are 'drowned'. All pervading one is 7th and Bhishma , the universal ego is 8th one .  As God is singularity and he has to create universe which is separate from him , He must cloak this consciousness in relativity --this is Vyas. When Vyas marries Ambika- doubt Druthrashtra is born . When he marries positive discriminating faculty --Ambalika -Pandu is born. Pandu represents. Buddhi--intelligence , so he 'white ' as pure is white. Drutarashtra is blind as he represents Mind which is blind . Bhishma had power that he could determine when he would die , ego can die only when you want it to die , no one can kill it. The 5 Pandawas represent 5 chakras, and Draupadi is Kundalini . As Kundalini ascends it meets with each chakra -pandawas - who also represents 5 element  i.e akash, vayu , tejas , aap , (water ), and pruthwi.  We Hindus put ashes in Ganaga river , the meaning  of this was to dissolve our consciousness in the universal consciousness.

Sunday, January 8, 2012

Indian Gods and mythology of Mahabharat

There are many stories in Hindu Mythology , and not all of them make sense -at least to one who is looking from outside, without knowing symbolism used in these stories.Take for example story of Lord Ganesha's birth . Parwati, Lord Shankara's wife created Ganesh to keep a watch while she was taking shower. When lord Shankara comes in , he does not recognise Ganesh . Ganesh does not allow him to get in . So Lord Shankara  fights and he kills Ganesh . When Parwati realises this , she wants Shankara to bring back Ganesh to life.Shankara sends his Gana to get new head for Ganesh , .they get an elephant's head and Lord Shankara attaches it , to the Ganesha's body and thus Gajanan --one with elephant head is born .This story has too many questions , why did Parwati need protection , why did Shankara - who is God , did not recognise his own son , how can you justify killing of child -Balhatya, and animal -Pashuhatya ..  why did they not attach Ganesha's own head, rather than looking for and getting elephant head, etc I do not pretend to know the answer , but have some thoughts. Lord Shankara and Parwati are typical Indian couple Gods--along with Lord Vishnu and Lakshmi, Lord Brahma and Saraswati . Brahma is creator , Vishnu the sustainer and Shiva the destroyer.To  create one needs knowledge , to sustain one needs money and to destroy one needs strength. So these Gods and their wives are gods and goddesses of knowledge , money and strength. So when Parwati created Ganesh, who represents source of power. He is controller deity of lowest chakra the Muladhar chakra. This one --needs strength to open -conquer, so Ganesh needs to be strong. The strongest animal --stronger than man is elephant, so symbolically we have elephant head , the head represents Ahankar , so the Lord Shankara cut it off. Since Muladhar  chakra is first to to be conquered Lord Ganesha is worshiped first.

There are many stories in Mahabharata. that do not make any sense . The Mahabharata's story starts with King shantanu  falling in love with Ganga . She agrees to be married  with one condition , that Shantanu  would never question her decision . Once they are married she has a baby  which she drows in ganges. Shantanu can not ask any question. But when she does it repeatedly, he questions her motive. So she leaves with her son . This is Bhishma. Then Shantanu falls in love with Matsyagangha--Satyawati. She was fisherman's daughter and had odor of fish. She had a child with Parashar rhishi  named Vyas, one who wrote The Mahabharat. Satyawati agrees to marry Shantanu only if her son would become the King after Shantanu. so Bhishma  promosis  never to claim for the throne and never to get married , so there would be no question of his children claiming kingship. Satywati has 2 children , one dies and other one is impotent. So Bhishma snatches 2 women and forces them to marry his stepbrother.Vyas sires Pandu and Drutharastra --one white and on blind . Drutharastra has 100 kids and they are Kaurawas and Pandu has 5 kids--padawas. These are taught by Dronacharya on e who is borne in  drona- pot made out of dry leaves.Pandawas  all 5 of them marry one princes Draupadi as their mother tells them to share whatever Arjuna has one . So there is no value to women , they can be treated as object of pleasure . This all does not make any sense . So how can we make any any valid meaning out of this mess?

Monday, January 2, 2012


Lord Ganesh has been worshiped by allmost all the Hindues. He is the 'elephant head god ' for those who are not familial with the hindu mythology. He is the son of Lord  Shiva and Parwati . The story of his birth and of his elephant head does not make sense as are many mythological stories in Hinduism. Parwati wanted to take shower  and needed someone to guard, on lookout for enemies. So she created Ganesh from the body 'mal' -dirt. While she took shower , Lord Shiva came in . Genesh would not allow him to go in . Lord Shiva cut off the head of Ganesh. When Parwati came out and found this she was upset and ask Shiva to correct his mistake . So Shiwa's Gana went out and got head of the 1st animal they saw --happened to be an elephant and brought it . Then Lord Shiva attached it to the ganesha's body . Now the questions arise . Why did Shiva not recognise his son Ganesh? Why did he not attach Ganesha's head that he had chopped off and look for the new one ? Is killing child ( balhattya ), and killing elephant --not major sins ? Certainly there are no valid reasons that one could have.