Matka Medicine and Atmasvasth

The premise of Matka Medicine is that we can control our health, lengthen our healthspan and lifespan, and be atmasvasth, on our own, with just a little help, if at all, from doctors and the healthcare system. The very first article that I published last December explains this in detail. The article on atmasvasth takes this concept forward as does the one on healthspan. The site is structured like a loose book and the Index or Table of Contents can help you navigate the site. 

The 13 point guide takes the concept further with a specific set of instructions on how to do this on your own.

I recently came across the preface of a new book titled “Four Weeks to be a Doctor”, which is about to be released in 3 months, written by Dr. Jaali Daktar, on behalf of CHADDI - the Char Hafta Association of Different Doctors of India. 

The preface is quite disturbing because it describes a four-week roadmap for anyone who wishes to become a doctor in India. The reason I am putting it out here now, is to make you, the unsuspecting public, aware of the existence of this organization so that hopefully you can identify these 4-week doctors, if you run into them.

Here is the preface.

This book is aimed at those who want to become doctors and earn more than physicians and surgeons of modern or traditional medicine. Unlike the 4-5 years or more training they go through, which we believe is all humbug, you need only 4 weeks to learn how to be a doctor. Some of you may take longer, depending on how easily you can pronounce the word “diagnosis” correctly and some may take less time, but the average time it takes to learn the tricks is 4 weeks.

Before I start, I would like to thank my English teacher from school, who has helped with the words, the grammar and the spelling and with the podcast.

The first thing as I have already said, is to learn how to pronounce the word “diagnosis”. Only regular doctors are able to do this correctly and to be taken seriously by clients, you have to practice saying “diagnosis” at least 10 times every day.

Then, start with the online reiki course on the CHADDI website. It takes a week to become a CHADDI endorsed reiki master. You have to understand the nuances of the posturing and hand movements and learn the correct jargon. Once this has been mastered, take the next course in pranic-healing. Weeks 3 and 4 are devoted to craniosacral treatment, gem therapy, aromatherapy and magnetotherapy. You will also have to do course work on vastushastra and feng-shui. In the last two days, you will learn some basic anatomy; that the brain is in the skull, that the liver is below the ribs on the right and the difference between arm and forearm, and thigh and leg and how to confidently use words like CT scan, MRI, laboratory, pathology, microbiology and tuberculosis. You will also learn the names of trendy food items like chia, quinoa, goji-berry, etc to impress your clients.

At the end of the four weeks, there will be a theory exam. It is a multiple choice, 20 question paper, which you have to answer over 8 hours after referring to the answer sheet on the website, for which we will give you the link. Your degree will be sent to you over WhatsApp the moment we get the answer sheet.

You are now ready to see clients.

First start with your friends and family. Initially, take on only those people who have coughs and colds, vague aches and pains, backache, general discomfort, heartburn, and similar conditions, which generally don't get enough attention from practitioners of conventional medicine. Spend time with them, while practicing the various movements and spouting the correct jargon you have learnt in the last four weeks. Encourage them to talk about themselves and don't be surprised when they come up with a lot of repressed feelings, buried fears and angst about their lives and the futures of their families and themselves. Impress them by correctly pinpointing their problems, such as lack of sleep and physical activity, faulty diet, "fast" lives, toxin build-up in the body, low immunity, etc., all of which will be present to some degree or another in the majority of your clients. Always give them a “diet” sheet that includes quinoa, chia and old grains like bajra and jowar and tell everyone to reduce “carbs” and increase proteins and if they ask more questions, recommend a dietician friend of yours. Also tell your clients that they should walk for at least 30 minutes and sleep for 8 hours a day and not drink alcohol and not smoke. This covers all bases, as they say in American baseball.

In no time, they will recommend you to their friends and family and you will start becoming known. You should cultivate a serious air and adopt a slightly superior but not condescending or patronizing attitude and charge a lot. Find out how much the local general practitioner in your locality charges…you should charge at least double if not more. The more expensive you are, the better people will think you are. Get yourself a small consulting room, either in your house or elsewhere and design it to look extremely ethnic with low-settees, earthy colors, flower pots, curtains, brocade, zari, malas and the like. Oh, and don’t forget the fancy agarbattis. 

When the first really serious client comes in, give an impression that you understand the problem. Ask for all the papers, read the doctors' notes, the pathology and radiology reports and make some comments like, "Hmm...Whew...Tough...". Even if you don't have the foggiest idea of where the adrenal gland is, or what the function of the pancreas is or can't pronounce medulla oblongata, don't worry. Just keep muttering "modern medicine...tch tch" and keep shaking your head. When the patient or the relatives look at you wide-eyed with expectation and hope, tell them "Don't worry...we'll set things right". Don't ever tell them to stop the treatment they have been advised by the conventional doctors they are seeing, whether it involves medicines or surgery, whether Ayurvedic, homeopathic or modern medicine related. If the treatment is successful, take the credit for it, by saying that it worked only because of the reiki that you performed remotely. If the treatment is unsuccessful and the client worsens, blame it on "allopathic" medicine and its ills and the "hard" drugs and "cutting" surgery. You can't go wrong!  

You can further impress the clients by keeping their pathology reports and x-rays and scans and doing reiki on them saying that by targeting the diseases mentioned in the reports, you can heal them faster.

You will get disbelievers and relatives trying to expose you. The more educated they are, the easier it is to convert them. Drop words like "cosmic energy", "positive biofeedback", "yin and yang", "forces of life", "negative and positive energy", "environmental pollution”, “detoxification”, “immune boosts” and if you are a little more confident, "global warming, "ozone hole", "man ruining Gaia, earth's life force”,  "El Nino", “metaverse”,  etc, mix everything into a bhel that is so complicated, it just cannot be challenged. 

You must also have a well-designed website by now, which links to the various pages on the CHADDI website. Make sure you have heart-rending and emotional testimonials of miraculous healing from friends and family.  Start posting regularly on Instagram, Twitter and Facebook. After a year or two, try and publish a book.  

Never promise too much! Don't say that you can make a man who is paralyzed for 20 years, walk, but do say that "I can make him feel better and maybe in the future he might start walking". Who knows what miracles modern medicine might throw up in the future...at that time, if you are still around, you can take the credit for everything. Don't ever tell them to stop taking their conventional treatment, or you will get into a lot of trouble. And anytime a client complains that the treatment is not working, ask “Did you follow my diet plan, walk for 30 minutes every day, sleep for 8 hours and not drink alcohol?”. Except for one client in a year or so, no one will be able to say “Yes”. Then you can tell them, “Sir, if you don’t help yourself, even God cannot help you, and I am just a mere mortal serving as her guide.”

Add a "Dr" before your name to make you sound big. No one will say anything to you in India. Also add a few initials like MR (master of reiki), PHE (pranic healing expert), VC (vastu consultant) and get an MRSPH (Member of the Royal Society of Public Health), a certificate from Britain (the foreign stamp) which anyone who pays the fees (only 109 pounds) can get.

Without the ten to fifteen years of solid hard work that conventional doctors have to go through, without exams, without the struggle to establish a practice and a name, without any knowledge of anatomy or physiology, without even knowing how to pronounce most medical words, apart from “diagnosis”, you can become a successful doctor. It just needs some savvy and street-smarts.

All this with just four weeks of the CHADDI course, which only cost Rs. 1 lakh! 

Before I end, let me repeat. Never compromise on your charges. Ever! Always charge more than conventional doctors, to justify your rapport with the universal soul. Always tell everyone to follow your diet plan or that of your dietician friend, to walk or exercise for 30 minutes every day, to sleep for 8 hours and to not smoke and drink. You can never go wrong.

Lastly, many of you ask where to pay more money and get an MBBS/GFAM/LCEH certificate. We are a legitimate association and will never indulge in such fraud, so if you do this, it has to be on your own. But remember, you can only use a fake certificate in an obscure place where no one knows that you haven't actually done an MBBS or GFAM or LCEH. 

The next 200 pages of this book go into more details about how to achieve all this. This book is your Bible…make sure you keep it by your side at all times. Happy reading and all the best!

Background: This is a “funny” spoof I wrote in a lighter vein in November 2000, in a different avatar, but still relevant today. I have made some changes. 

Addendum: While this is a spoof, the underlying problem of unqualified doctors is a definite issue, especially in the under serviced and poorer parts of our country, where access to regular healthcare is difficult or expensive or time-consuming. It is estimated that there are close to 10 lakh unqualified doctors, who fill the gaps in the rural areas and even in the urban poor areas like Dharavi and Deonar. One of my colleagues once told me after meeting both qualified and non-qualified doctors in a village in Karnataka that it was easier to work with the non-qualified ones, because they had no ego, were eager to learn and would follow instructions and guidelines without any deviation, and had better rapport with the villagers, while the qualified doctors always wanted to add their two-bits and subvert the system and kept their distance from the locals.

In case you’ve missed these

The Mid-Week Ones (All Free)

Physical Activity and Poor Sleep and Stroke - 25 Aug 2021

Measuring Your Own Blood Pressure at Home - 18 Aug 2021

Polyphenols, Cardiovascular Risk and Cognitive Decline - 11 Aug 2021

Earlier Sundays (All Free)

A Day without Coffee is No Day at All - 22 Aug 2021

The 13 Point Atmasvasth Guide to Living Long, Healthy - 15 Aug 2021

The Super-Rubbish of Superfoods - 08 Aug 2021

Get on the email list at www.matkamedicine.com

The premise of Matka Medicine is that we can control our health, lengthen our healthspan and lifespan, and be atmasvasth, on our own, with just a little help, if at all, from doctors and the healthcare system. The very first article that I published last December explains this in detail. The article on atmasvasth takes this concept forward as does the one on healthspan. The site is structured like a loose book and the Index or Table of Contents can help you navigate the site. 

The 13 point guide takes the concept further with a specific set of instructions on how to do this on your own.

Question:

Which is the most common psychoactive, addictive drug in the World?

Answer:

Caffeine

Both tea and coffee contain caffeine, but today, it’s all about coffee.

I drink a lot of coffee by Indian standards. At least 2-3 single espresso shots, one cappuccino and 1-2 pour-overs per day. I am quite particular about my coffee. I get my coffee beans and pour-over grind from BlueTokai. I use the freshly roasted beans for the espressos in my Gaggia machine and I make the pour-overs in my Hario V70.

But I don’t drink any coffee or tea after 5.30 PM, 4 hours before my bedtime. 

Caffeine is a stimulant. It binds to the adenosine receptors in the brain. Increasing adenosine levels during the day cause drowsiness and by blocking adenosine, in the short term, caffeine increases focus and concentration.

Many people, including the author Michael Pollan, whose new book “This is Your Mind on Plants” devotes a third of its pages to caffeine, believe that caffeine was responsible for jump-starting the Industrial Revolution by increasing the workers’ focus and concentration. 

The challenge is that in today’s world where we want to pack in as much as we can in a 24-hours day, the extra time we need is usually borrowed from our sleep time. Then, if we sleep less, we are groggy during the day, which we try to offset with caffeine, which in turn affects our sleep adversely, which then sets up a vicious Catch-22 where we drink coffee to remain alert because we are sleeping badly because we are over-caffeinated. Since the average half-life of caffeine is 2 1/2 to 5 hours, one of the things that helps with good sleep is to have the last caffeinated beverage not later than 4-6 hours prior to bedtime, come what may.

So, what are the downsides of coffee?

1. Sleep issues

2. Addiction

I have thrice in my life stopped caffeine, each time when I was doing a Jain “athai”. The first time, I had not prepared for the fast and landed up with severe withdrawal symptoms on days 2 and 3 including headache, loss of focus and lack of energy. However, from day 5 onwards, unlike the experience Michael Pollan had when he stopped caffeine and became listless with a shroud enveloping his mind, I developed razor-sharp focus from days 6-8, likely because the “fasting” overcame the effects of the lack of caffeine. For the next two athais, I prepared in advance by gradually reducing my coffee intake over 10 days and the withdrawal symptoms, if at all, were very mild.  

There are really no other downsides, which is why culturally, of all the psychotropic drugs available, caffeine has become the most socially acceptable drug, unlike say opium which became taboo in the early 20th century, or marijuana, which is now slowly coming back into public life, though ayahuasca and psilocybin are still banned in most parts of the world. Nicotine is a survivor and while cigarettes are on their way out, nicotine will likely continue in non-cigarette forms. And as I wrote and spoke about a few weeks ago, alcohol has no real health upside except for making us feel good about ourselves. 

Are there benefits to drinking coffee over and above the increased focus and concentration and the “feel-good” factor?

A review article by Dr. Rob van Dam and his colleagues in the New England Journal of Medicine published in July 2020 [1] concludes that coffee does not increase the risk of cardiovascular disease and cancer, but in fact, the consumption of 3-5 standard cups daily is associated with a reduced risk of several chronic diseases. The reason is not known, though it has been shown that coffee contains polyphenols and lignans among other substances, which as we saw last week do reduce cardiovascular risk and cognition loss. Coffee’s ergogenic effect also makes it a popular, acceptable, performance enhancing drug, which is often used by both, athletes and non-athletes [2].

So what is your matka here? If you are a coffee drinker and dependent on caffeine, fine. Coffee has been around now for more than 300-400 years and has no real ill-effect, apart from sleep disturbances, so do try and have your last drink not later than 4, preferably 6 hours prior to your bedtime. If however, you are not addicted to caffeine in any of its forms (coffee, tea, aerated beverages, etc), you don’t need to start.

In case you’ve missed these

The Mid-Week Ones

Measuring Your Own Blood Pressure at Home - 18 Aug 2021 - (free till tomorrow morning)

Polyphenols, Cardiovascular Risk and Cognitive Decline - 11 Aug 2021 - (free till tomorrow morning)

Atrial Fibrillation - An Important Controllable Condition You May Not Have Heart Of - 04 Aug 202

Last Sunday

The 13 Point Atmasvasth Guide to Living Long, Healthy - 15 Aug 2021 - Free

Earlier Sundays (All Free)

The Super-Rubbish of Superfoods - 08 Aug 2021

To Drink or Not to Drink…The Light Alcohol Drinking Conundrum - 01 Aug 2021

The Hype and Promise of the Polygenic Risk Score (PRS) - 25 Jul 2021

Footnotes

1. van Dam RM, Hu FB, Willett WC. Coffee, Caffeine, and Health. Campion EW, editor. N Engl J Med. 2020 Jul 23;383(4):369–78.

2. Pickering C, Grgic J. Caffeine and Exercise: What Next? Sports Medicine 2019;49:1007

Get on the email list at www.matkamedicine.com

The premise of Matka Medicine is that we can control our health, lengthen our healthspan and lifespan, and be atmasvasth, on our own, with just a little help, if at all, from doctors and the healthcare system. The very first article that I published last December explains this in detail. The article on atmasvasth takes this concept forward as does the one on healthspan. The site is structured like a loose book and the Index or Table of Contents can help you navigate the site.

I would love to hear from you in the Comments section, but you will need to subscribe with your email ID, which you can do for free.

It’s now been almost 8 months since I started Matka Medicine adding the concept of atmasvasth halfway through, as a way to live long, healthy.

While I still have a lot of ground to cover, it is time to take stock of what it entails to have a long healthspan and a healthy lifespan.

If this concise 13-point guide seems overwhelming…that is what living long, healthy entails. Most of us grow up believing that our health is not ours to manage, but should be left to experts like doctors and the healthcare system, which is fine when you are sick and ill, but of no help when you want to be free from disease. 

We know more about our cars than we do about our own bodies and health. That needs to change. 

1. Move

150-300 minutes of moderate physical activity per week or 500-1000 mets per week. Walk, run, do strength training and mix it all up along with some high-intensity training (HIIT) at least once a week.

2. Eat smart, eat less

Calories should be in check and less than or around 2000 per day.

5 portions of fruits and vegetables per day.

Plant based eating as much as possible.

Avoid ultra-processed foods and individual superfoods.

Some form of fasting or calorie restriction, either time-restricted or intermittent, daily or once or twice a week.

3. Manage cardiovascular risk, including hypertension and diabetes

Measure your own risk using calculators at least once a year. One CT calcium score study after the age of 45.

The LDL should be less than or equal to 100 mg/dl and less than 70 mg/dl, if there is any risk factor.

The blood pressure should be 130/80 mm Hg or less and definitely below 140/90 mm Hg. 

The HbA1c should be less than 5.6 with a fasting blood sugar less than 100 mg/dl. 

For these 3 points, if the values are abnormal, and if physical activity and eating sensibly do not bring them to normal, medication should be used after consulting an appropriate doctor.

ECG yearly for cardiac issues, and definitely after 65 years of age for atrial fibrillation.

4. Sleep well

Between 7-9 hours a day.

If you snore, or are sleepy or groggy during the day, please see a sleep specialist.

5. Address deficiencies and take supplements

Adequate proteins (at least 20% of the daily calorie intake and between 0.5 to 0.8 g / kg body weight) is needed. If your food doesn’t provide this, then supplements should be used.

Vitamin D3 supplementation - 60,000 IU sachet at least once a month.

Vitamin B12 supplementation, especially for vegans and Jains.

Others such as omega-3, based on your individual situation.

6. Take vaccines

Protect from Covid-19, flu, zoster, DTP, pneumococcal and varicella.

In the future, we will likely have vaccines for tuberculosis, dengue and malaria. They should be taken as and when available.

7. Improve balance, and not fall and not fracture if you fall

Physical activity as in point 1.

Balancing exercises with yoga or tai-chi, as part of the daily/weekly physical activity routine.

8. Screen for cancers

Yearly mammography for all women above the age of 45 years.

Lung cancer screening with low dose CT scan if you smoke or have been a smoker, yearly or once in two years, depending on the amount of smoking.

Pap smear for cervical cancer every 5 years.

Stool for blood for colorectal cancer. In India, colonoscopy is not yet advocated for routine screening.

Physical examination once a year to look for lumps and bumps.

DO NOT screen for other cancers, unless you are specifically genetically at high risk, in which case your oncologist will guide you.

9. Maintain good hygiene, including dental, vision, hearing and time

Oral hygiene matters - see a dentist at least once in two years.

Vision matters - see an ophthalmologist at least once in two years for cataract and macular degeneration.

Good hearing is important - see a doctor if you can’t hear well and use appropriate hearing aids.

Time - use your time wisely.

10. Prevent cognitive decline

Apart from physical activity and eating smart and less, keep the mind active.

Meditate - a stable mind helps reduce cardiovascular and other risks.

11. Reduce, control or eliminate addictions

Drink alcohol sensibly, if you have to.

Give up smoking completely, if you smoke.

Control caffeine intake. Definitely no caffeine in any form at least four hours prior to bed time.

12. Reduce the pollution in our lives

Air - in whichever way possible, including changing residence or migrating, if that is an option.

Noise - use earphones when traveling but not when walking or driving. Don’t make noise, for e.g. don’t honk when you are driving. 

Digital - reduce dramatically the use of gadgets, and time spent on social media, unless that is your profession. Most of what we see on Twitter or Facebook or WhatsApp is just noise.

13. Manage the logistics of your health like you would manage any other major long-term project

Make sure you have enough money to last till the age of 90 years, inclusive of catastrophic spending at least once in that timespan. Good financial planning and management are a must.

Get good health insurance up to the maximum amount you can afford for yourself and the family.

Identify a health coach who can guide you through points 1 to 12. The health coach does not have to be a doctor.

Identify a good family physician you can reach out to when sick, to guide you through the process of meeting other specialists, navigating hospitals, making sense of different reports, etc.

If you are lucky to know a good geriatric doctor, please see them once a year and definitely once in two years.

Get a health check-up every year based on points 1 to 12, but also manage as much as you can on your own. Remember, in India, you don’t really need prescriptions for getting blood tests done.

This is a dynamic guide, which will change over the months and years with additions and subtractions as our understanding of how to live long, healthy advances and improves. 

In case you know anyone who would benefit from reading this, especially above the age of 45-50 years, please do share.

In case you’ve missed these

The Mid-Week Paid Ones

Polyphenols, Cardiovascular Risk and Cognitive Decline - 11 Aug 2021

Atrial Fibrillation - An Important Controllable Condition You May Not Have Heart Of - 04 Aug 2021

Physical Activity - Forming a Protective Troika along with Vaccines and Masks Against Covid-19? - 28 Jul 2021

Last Sunday

The Super-Rubbish of Superfoods - 08 Aug 2021 - Free

Earlier Sundays (All Free)

To Drink or Not to Drink…The Light Alcohol Drinking Conundrum - 01 Aug 2021 - Free

The Hype and Promise of the Polygenic Risk Score (PRS) - 25 Jul 2021 - Free

Runnnn…not Race - 18 Jul 2021 - Free

Get on the email list at www.matkamedicine.com

The premise of Matka Medicine is that we can control our health, lengthen our healthspan and lifespan, and be atmasvasth, on our own, with just a little help, if at all, from doctors and the healthcare system. The very first article that I published last December explains this in detail. The article on atmasvasth takes this concept forward as does the one on healthspan. The site is structured like a loose book and the Index or Table of Contents can help you navigate the site.

A few months ago, a cousin living abroad messaged asking for an Indian diet plan. I told her she doesn’t need one, but she anyway found an Indian site that apparently "reverses" diseases with food (that itself should have been a big red flag) and then sent me an exotic, expensive meal plan that she had been prescribed, full of items like chia, quinoa, kale and other new age, yoga asana-like meme foods. Seriously !

A similar thing happened a month or so ago. Someone who runs a health site asked me to contribute an article. Out of curiosity, I checked out the site and found articles on superfoods like "kale", etc. That was my cue to say sorry.

Superfoods are foods that are supposed to miraculously improve your health, but keep changing color depending on the fashion of the day. A few years ago, it was all about quinoa and chia. Then kale. At some point, arugula. Weird kinds of berries including goji berries. Turmeric. Strawberries and blueberries. The names and lists keep changing faster than the conspiracy theories behind the origin of the Covid-19 virus. For example, the India Today list from 2015 is different from the Economic Times list for 2021, those superfoods not making the cut looking like Big Boss losers that no one really misses or remembers after two days.

It's not a recent phenomenon. The Roots of Ayurveda, a book by Dominic Wujastyk that traces the history of Ayurveda through the ages describes how garlic became a superfood in the middle of the last millennium and then how the fruit of the poppy plant (opium) became part of virtually every doctor's armamentarium in the 16th to 19th centuries (though once you ingest an opium preparation, every food will anyway look, taste and feel like a superfood).

If you like kale, by all means go for it. If turmeric incites your passion, then sure, have it. If chia seeds tickle your fancy and make you happy, go ahead. But that would be for the joy of having that particular food item, not because you believe these are "superfoods”, whose intake will suddenly and magically make you healthier. 

Websites and advertisements and articles in the “entertainment” or similar supplements of even serious newspapers keep coming out with these superfood lists depending on the influencer and the writer. All of them follow the same pattern and use a combination of the words below to describe the advantages of these so-called superfoods.

Nutrient dense

Antioxidant

Immune booster

Detoxifying (as if our body has toxins that accumulate and need to be purged - this only happens if you can't s**t or piss as a medical condition - toxins don’t build up in normal individuals).

Increased energy and vitality (more ReVitals?)

Anti-cancer

A typical statement describing a superfood will usually sound like this, "the poppy berry (I've just made this up) is an amazing nutrient dense superfood that boosts immunity while flooding the body with antioxidants, removing toxins without adding calories, increasing energy and vitality and preventing cancer".

And this problem is not just restricted to nirvana and sinewy body promoting sites.  Even websites like WebMD and Harvard Health, which should really know better, have lists of superfoods…which can then make you question the veracity of the rest of the stuff on those sites. 

But the problem is really with us, isn’t it? We all want a magic bullet to bite, that one thing that will magically make us healthier, or help us lose weight or control our diabetes or hypertension or our high LDL levels or prevent cancer or give us immunity against Covid-19…a bullet that the big guns (companies and influencers) are able to exploit so beautifully. 

And they are so experienced at making you feel inadequate, as if by not partaking of these superfoods, you are doing something terribly wrong and neglecting your body. The guilt trip then gets you to spend money, by buying these superfoods and change your eating patterns, instead of just focusing on a balanced plant-based sensible eating plan while keeping the calorie intake in check.

There is no such thing as a superfood. No single food item can make you suddenly healthy. What does help is eating vegetables and fruits and avoiding ultra-processed foods with some form of calorie restriction. To repeat, a balanced, predominantly plant-based diet is pretty much all that you need. And in some instances, supplementation with vitamin B12, vitamin D, protein, creatine, omega-3, etc., depending on your specific circumstances, something that I will explore in the future. That’s it. 

Unfortunately, sensible plans are not really glamorous. Between someone who told you to add avocado and walnut and blueberry to your meals as against an apple or chikoo or bajra, who would you be more inclined to follow?

Having a healthy balanced diet unfortunately needs work. Making sure you don't overeat or go overboard with food also needs work. Physical activity, which is actually a magic pill, also needs work, which 80% of us are not even willing to try.

What is your matka here? Simple. If you find any food item that has words like "immunity", "detox", "antioxidant", "nutrient-dense", in their packaging or advertising, raise your eyebrows like Jeeves, give a half smirk that says you know better, drop it and walk away. 

And by the same token, the moment any person, whether it be a doctor or a dietician or nutritionist or health influencer or trainer or just about anyone who fancies themselves as an expert on diet and nutrition brings up the word “superfood”….BE A SKEPTIC AND QUESTION…find out if this person is truly knowledgeable and quotes research from peer-reviewed papers published in reputable journals that can be found on Pubmed, or is just regurgitating the same nonsense using the same rubbish buzzwords like antioxidant, detox and immunity, that are found in the lay press and on popular websites…in which case…RUN AWAY.

Have a good and healthy and superfood free, but balanced and physically active Sunday.

Please do comment below. It’s always nice to read different viewpoints and interact. You will have to subscribe with your email though to be able to comment.

In case you know anyone who would benefit from reading this, especially above the age of 45-50, please do share.

In case you’ve missed these

The Mid-Week Ones

Atrial Fibrillation - An Important Controllable Condition You May Not Have Heart Of - 04 Aug 2021 for paid subscribers

Physical Activity - Forming a Protective Troika along with Vaccines and Masks Against Covid-19? - 28 Jul 2021 for paid subscribers

Walking to Improve the Brain’s White Matter - 22 Jul 2021 for paid subscribers

Last Sunday

To Drink or Not to Drink…The Light Alcohol Drinking Conundrum - 01 Aug 2021 - Free

Earlier Sundays

The Hype and Promise of the Polygenic Risk Score (PRS) - 25 Jul 2021 - Free

Runnnn…not Race - 18 Jul 2021 - Free

Healthspan over Lifespan - 11 Jul 2021 - Free

If you would like to read some non-medical pieces by me.

Time Tax

The Dangerous Three-Four in a Row Road Runners in Matunga

Get on the email list at www.matkamedicine.com

“One peg of whiskey a day or one glass of red wine a day is good for the heart”, is a statement we hear quite often, both from the lay press as well as sometimes, doctors. 

I like a drink now and then and it is always nice to believe that what we like can also help us live long, healthy. 

So when a study [1] by Ding C and colleagues in the BMC Medicine, published last week concluded that drinking up to 7-8 gm of alcohol per day (a glass of wine a day or equivalent) has beneficial effects on all-cause and cardiovascular mortality, with a J-shaped curve, where the highest benefit accrues to those who drink lightly (7-8 gm/day) as compared to those who don’t drink or drink heavily, I decided I must write about this. 

I then decided to go through all the recent literature on the benefits of drinking alcohol. 

Clearly I was deluding myself. 

Here is the current evidence. 

The cardioprotective effect, if at all,  is seen mainly in high income countries [2], and not in low and low middle income countries like India, where though the incidence of alcohol consumption as a percentage of the population is lower, the drinking pattens and habits are different and there are likely other environmental or genetic or unknown confounders at work. Perhaps the middle to high income population within India may behave like those in high income countries, but there is no evidence of that.

It is possible that there is a genomic influence [3] that links alcohol to improved risk, but is not truly “causal”…this means that a particular genomic pattern may make a person prone to drink and but may be associated with reduced risk, not the other way around. 

Daily drinking is associated with increased mortality [4] even if we stick to the apparent low-risk limit of 7-8 gm/day or 100 gm/week. The lowest risk (and there is risk at all levels, which means the absolute “no risk” is when we don’t drink) is when the drinking (one glass of wine or equivalent) is restricted to 2-3 times / week, which is a stance also endorsed by the UK Chief Medical Officers’ Low Risk Drinking Guidelines.

Alcohol intake increases risk of injury [5], both accidents and self-harm.

Alcohol intake increases risk of cancer [6], especially esophageal, buccal, breast and colon, a statement endorsed strongly by the American Society of Clinical Oncology (ASCO). It also goes onto say that reducing alcohol consumption at a population level would lead to a considerable reduction in the worldwide incidence of cancer.

Resveratrol, found in in red wine has been linked with increased longevity in some studies in animals, but drinking red wine for the benefits of resveratrol [7] (which may explain the French paradox) has not shown any mortality or longevity benefit. Perhaps resveratrol supplementation orally may show a benefit in the future, if at all, but this would not be linked to alcohol intake.

Alcohol intake, especially in the poor, is associated with other habits such as eating fried food and smoking, which are both in turn deleterious to health.

The Global Burden of Disease paper [5] on alcohol use across 196 countries showed no benefit of alcohol consumption at any level. Alcohol is the 7th leading cause of death worldwide across all age groups and the 9th commonest cause of death in India in the 50-69 years age group. It is the third most important reversible cause of cancer. Above the age of 50, cancers are the commonest cause of death and disability due to alcohol, whereas in the younger population, it is injury. In low income countries, associated tuberculosis makes a difference. 

So what is your matka here? If you like drinking, you should drink really light, which would mean not more than 2-3 times a week and not more than 1 glass of red wine or equivalent. If you drink more (which I do sometimes as well), then do it without getting drunk and without binging. However, you cannot justify drinking alcohol from a health perspective…there is no evidence that drinking at any level helps us live longer, healthier. This is one of those situations where we have to balance a fun activity with what is good for our health in a practical and common sensical manner. 

Having said that…being drunk is not the same as “drinking”.  I will leave you with this prose from Charles Baudaliere for something to think about this Sunday morning…those who get drunk on air know what I am saying…

“One should always be drunk. That's all that matters; that's our one imperative need. So as not to feel Time's horrible burden that breaks your shoulders and bows you down, you must get drunk without ceasing.

But what with? With wine, with poetry, or with virtue, as you choose. But get drunk.

And if, at some time, on the steps of a palace, in the green grass of a ditch, in the bleak solitude of your room, you are waking up when drunkenness has already abated, ask the wind, the wave, a star, the clock, all that which flees, all that which groans, all that which rolls, all that which sings, all that which speaks, ask them what time it is; and the wind, the wave, the star, the bird, the clock will reply: 'It is time to get drunk! So that you may not be the martyred slaves of Time, get drunk; get drunk, and never pause for rest! With wine, with poetry, or with virtue, as you choose!’”

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Footnotes

1. Ding C, O'Neill D, Bell S et al. Association of alcohol consumption with morbidity and mortality in patients with cardiovascular disease: original data and meta-analysis of 48,423 men and women. BMC Med. 2021 Jul 27;19(1):167. doi: 10.1186/s12916-021-02040-2. PMID: 34311738; PMCID: PMC8314518.

2. Smyth A, Teo KK, Rangarajan S, et al; PURE Investigators. Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study. Lancet. 2015 Nov 14;386(10007):1945-1954. doi: 10.1016/S0140-6736(15)00235-4. Epub 2015 Sep 17. PMID: 26386538.

3. Millwood IY, Walters RG, Mei XW et al; China Kadoorie Biobank Collaborative Group. Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China. Lancet. 2019 May 4;393(10183):1831-1842. doi: 10.1016/S0140-6736(18)31772-0. Epub 2019 Apr 4. PMID: 30955975; PMCID: PMC6497989.

4. Hartz SM, Oehlert M, Horton AC et al. Daily Drinking Is Associated with Increased Mortality. Alcohol Clin Exp Res. 2018 Nov;42(11):2246-2255. doi: 10.1111/acer.13886. Epub 2018 Oct 3. PMID: 30281161; PMCID: PMC6214719.

5. GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018 Sep 22;392(10152):1015-1035. doi: 10.1016/S0140-6736(18)31310-2. Epub 2018 Aug 23. Erratum in: Lancet. 2018 Sep 29;392(10153):1116. Erratum in: Lancet. 2019 Jun 22;393(10190):e44. PMID: 30146330; PMCID: PMC6148333.

6. LoConte NK, Brewster AM, Kaur JS et al. Alcohol and Cancer: A Statement of the American Society of Clinical Oncology. J Clin Oncol. 2018 Jan 1;36(1):83-93. doi: 10.1200/JCO.2017.76.1155. Epub 2017 Nov 7. PMID: 29112463.

7. Semba RD, Ferrucci L, Bartali B et al. Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Intern Med. 2014 Jul;174(7):1077-84. doi: 10.1001/jamainternmed.2014.1582. PMID: 24819981; PMCID: PMC4346286.

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Persis, a friend, is of Parsi (Zoroastrian) origin, a community in India that has a higher risk of breast cancer than the general population [1]. Her mother had breast cancer and so did one aunt. She got herself tested for BRCA1 and BRCA2 gene mutations that carry a high risk (50-87%) of developing breast as well as ovarian cancer [2]. Ms. Angelina Jolie has a similar family history of breast cancer and BRCA1 and BRCA2 mutations, for which she had a double mastectomy done, followed 2 years later by oophorectomy (removal of the ovaries), to reduce her risk of breast and ovarian cancer. She explained these decisions of hers in a New York Times opinion piece. 

Unlike the Mendelian inherited genetic diseases like thalassemia that I wrote about some time ago, where the presence of one copy (dominant) or two copies (recessive) of the abnormal gene, will always cause the disease to occur, in these “genomic” situations, there is a “risk”, which may either be absolute or relative and may in turn manifest with disease or not. It is likely that Persis would never have landed up with breast cancer, but with a greater than 50% absolute risk, she took an informed decision in conjunction with a geneticist and other experts in breast cancer and then opted to have a double mastectomy. 

Genomics  therefore, as against “genetics” “is the study not just of single genes but the functions and interactions of all the genes in the genome.” [3]

While the promise of genomics has gone through its own crests and troughs, the polygenic risk score (PRS) is creating excitement across multiple branches of medicine. Unlike BRCA1 and BRCA2, which are individual genes (monogenic) that are evaluated to assess risk, in a polygenic risk score, the cumulative risk conferred by mutations in multiple (hence …poly) genes across a person’s genome (hence ...genic) is called the polygenic risk score or PRS [4]. 

Over the last decade, PRSs have been assessed for many conditions including schizophrenia, coronary artery disease and diabetes [5].  If the score is high, then the premise is that steps could be taken to mitigate the effects of these genetic mutations to reduce risk or hopefully prevent the disease from occurring or like Covid-19 vaccines, reduce the symptoms and severity if the disease does occur. 

This postulate also forms the basis of P4 medicine [6]; predictive, preventive, personalized and participatory. There has been considerable excitement about P4 medicine in the fields of engineering, biotechnology, genomic and information technology (IT), given the anticipated promise of genomics to change the way medicine is practiced and to consequently improve overall survival and quality of life, across the globe. Unfortunately, we are not there yet, except in very specific situations like BRCA testing for breast and ovarian cancer, and that too is hardly ever done routinely in India [7]. 

The ultimate test of the power of a diagnostic study is whether it can change the end-points of either survival or lead to a better quality of life. These studies usually take a long time to come to fruition, something that clearly frustrates engineers and those involved with big data, who believe that it is possible to reduce the time frame of these studies by analyzing large population datasets to get statistical inferences. But statistical and mathematical inferences are no substitutes for on-the-ground, patient and people based clinical data as we have seen with the Covid-19 vaccine trials. 

For any PRS to become a routine risk assessment tool, it has to be validated in a trial where the PRS is used to stratify individuals into randomized groups for prevention or treatment as the case may be and the results unequivocally show that basing management decisions on the PRS improves survival or prevents disease. We have a long way to go before such trials and their results come out. 

Many start-ups, however are not willing to wait, and are already offering PRSs directly to consumers bypassing traditional medical pathways. If you just Google “polygenic risk score India” you will find such companies.

There are other problems. Most of the data currently available is from European ancestry studies. There been only one study validating a PRS for coronary artery disease in South Asians, and this too is just the first step [8] that now needs clinical validation with a large population based trial. 

More alarming is the commercial availability of services in the Western countries that do embryo selection based on the PRSs of the parents, siblings and the embryos, to then choose those embryos with the highest chance of being intelligent or the least risk of developing schizophrenia or coronary artery disease or breast cancer [9]. I can’t even get my head around this, but maybe its just me and the fact that my kids are already past their 20s. Would young parents be willing to do this? I guess so, otherwise I don’t see how these companies could flourish. At this moment in time, in any case, since PRSs for Indian/South Asian ancestry do not exist, this service really cannot be used for and by Indians/South Asians. 

On the other hand, you can argue with me that if the goal of atmasvasth is to live long healthy and to have as long a healthspan as possible, then anything we do to be healthy and prevent disease including embryo selection, should be acceptable. After all, if the fetus or embryo has thalassemia major or Down’s syndrome, we anyway don’t implant such an embryo or allow the pregnancy to proceed. Using a PRS to select embryos with the best chance of a good healthspan is then just the next step, isn’t it?

So what is your matka? Your genes and your genome are the matkas you are born with and have no control over in most instances. It is what you get from your parents, unless of course your parents (assuming you are reading this 20 years from now) have pre-selected your genetic profile to give you the best chance of a long healthspan.

In the future, once we have more clarity about PRSs for prevention of disease in those with Indian/South Asian ancestry and there is actual clinical data that using these PRSs does help mitigate risk, it is possible that PRSs, just like our blood sugar, blood pressure, LDL and triglyceride levels, will become routine and commonplace.

Until then, you could just be physically active, eat sensibly and sleep well and use traditional methods to identify risks if any and take steps to reduce these as the case may be.

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Footnotes:

1. Yeole BB, Kurkure A, Advani S et al. An Assessment of Cancer Incidence Patterns in Parsi and Non Parsi Populations, Greater Mumbai. Asian Pac J Cancer Prev. 2001;2(4):293-298. PMID: 12718621.

2. Gupta S, Rajappa S, Advani S et al. Prevalence of BRCA1 and BRCA2 Mutations Among Patients With Ovarian, Primary Peritoneal, and Fallopian Tube Cancer in India: A Multicenter Cross-Sectional Study. JCO Glob Oncol. 2021 Jun;7:849-861. doi: 10.1200/GO.21.00051. PMID: 34101484.

3. Guttmacher AE, Collins FS. Genomic Medicine — A Primer. Guttmacher AE, Collins FS, editors. N Engl J Med. 2002 Nov 7;347(19):1512–20. 

4. Sugrue LP, Desikan RS. What Are Polygenic Scores and Why Are They Important? JAMA. 2019 May 14;321(18):1820-1821. doi: 10.1001/jama.2019.3893. PMID: 30958510.

5. Slunecka JL, van der Zee MD, Beck JJ et al. Implementation and implications for polygenic risk scores in healthcare. Hum Genomics. 2021 Jul 20;15(1):46. doi: 10.1186/s40246-021-00339-y. PMID: 34284826; PMCID: PMC8290135.

6. Flores M, Glusman G, Brogaard K, Price ND, Hood L. P4 medicine: how systems medicine will transform the healthcare sector and society. Personalized Medicine. 2013 Aug;10(6):565–76. 

7. Hunter DJ, Drazen JM. Has the Genome Granted Our Wish Yet? N Engl J Med. 2019 Jun 20;380(25):2391–3. 

8. Wang M, Menon R, Mishra S et al. Validation of a Genome-Wide Polygenic Score for Coronary Artery Disease in South Asians. J Am Coll Cardiol. 2020 Aug 11;76(6):703-714. doi: 10.1016/j.jacc.2020.06.024. PMID: 32762905; PMCID: PMC7592606.

9. Turley P, Meyer MN, Wang N et al. Problems with Using Polygenic Scores to Select Embryos. N Engl J Med. 2021 Jul 1;385(1):78-86. doi: 10.1056/NEJMsr2105065. PMID: 34192436.

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A man said to the universe: 

“Sir, I exist!”

“However,” replied the universe, 

“The fact has not created in me 

A sense of obligation.”

A Man Said to the Universe, By Stephen Crane

Last month, the 95-years old grand-mother of a friend of mine passed away. When I asked what had happened, they said “she died of old age”. Over the last 5 years she had gradually become more and more frail and then one fine day, she just died. She was one of just 12 lakh (1.2 million) people in India who have lived past the age of 90 years, constituting just 0.1% of India’s population. There are 10 times more people over the age of 80 (i.e. 1% of the population), but with a life-expectancy of just 6.8 years at the age of 80, only 10% of them reach the age of 90.

Jain and other similar philosophies accept “old age” as a cause of death…this is not true of many parts of the world where the authorities always ask for a specific cause of death that often does not include “aging”. Intuitively however, we know that aging itself can eventually lead to death, a concept that is now scientifically finding a resurgence across the world with the thinking that if we delay the aging process, we could live longer, healthier lives. 

We already know that despite Covid-19, there has been no better time period to live in, when it comes to living long. The average life expectancy at birth has significantly risen in virtually every country of the world, including India. This increased lifespan is mainly because children are not dying early for a variety reasons that I have written about earlier and are explained beautifully in a new book by Steven Johnson called Extra Life.

But there is a current upper limit to our lives. Very few people in India make it above 80 and a minuscule number makes it to above 90. There is an exponential death rate after the age of 65, which is why, as we age, we keep seeing people around us dropping off faster and faster. 

Moreover, the longer we live, the more is the morbidity associated with chronic diseases that afflicts those of us above the age of 50. We live longer but many of us suffer through that longer life. 

What is therefore more important than just the lifespan is the healthspan, which is the time period lived until a major disease, such as stroke, heart attack, cancer, etc occurs, which then usually results in an overall reduction in the lifespan, the remaining lifespan often lived with suffering and disability.

Effectively, the longer we live, the more is the chance that we will live with disease and disability.  This is the Faustian bargain we have made by adding years to our lives and by significantly reducing childhood mortality. We live longer, but with disease. 

As this diagram shows, in India, our average lifespan is almost 70 years. However, the current healthspan is just 60 years, by which time half of us who have managed to reach the age of 60 will have at least one or more chronic disease with some disability/morbidity. 

If however, the healthspan were to go up to 65 years, then two things could happen. First, if the overall lifespan continues to remain at 70 years, then the morbidity and disability due to disease would be compressed into a shorter span of just 5 years. Or, more likely, the overall lifespan would be pushed further up to  80 years, with again 10-15 years of life with disease.

The trick would be to increase both healthspan and lifespan, but healthspan relatively more, so that we reduce the number of years with disease to as less as possible, as I have shown at the bottom of the diagram. If we could increase our lifespan to 100 years and healthspan to 95 years, we could compress our years of disease before death to a very short period of time of just 5 odd years.

The upper limit of life though continues to remain a quandary. Despite the overall longevity increase, the number of people that cross 100 years continues to be minuscule, irrespective of whether they have significant disease or continue to remain healthy…and virtually no one reaches 115 years of age. 

The presence of an upper limit implies that our bodies have an “aging” process that causes tissues and organs to degenerate, such that eventually we have to die. 

While being atmasvasth is about living long, healthy, our focus has generally been to prevent diseases and if they do occur, to try and control them and to avoid disability. But, what if our focus were to change from preventing disease to preventing aging and frailty, with the assumption that if we increase our healthspan, we automatically live long, healthy lives?

Eventual research (which may not pan out in our lifetime), may identify genetic manipulations or senolytic drugs that kill old cells and delay aging and allow us to live longer, healthier lives. In the meantime though, physical activity in any form, eating sensibly, sleeping well, not falling, getting vaccinated, meditating and avoiding tobacco are all steps that can potentially increase our healthspan. David Sinclair has written a fascinating  book titled Lifespan on this subject, but more about that in another post.

Maybe therefore it is time to talk about our healthspans rather than just lifespans and do everything we can to have longer healthspans, than just longer lifespans. That is really our atmasvasth quest in the end…to live long, healthy. 

And one day we could even add two more lines to Stephen Crane’s poem

A man said to the universe: 

“Sir, I exist!”

“However,” replied the universe, 

“The fact has not created in me 

A sense of obligation.”

“That may be fine sir”, the man retorted,

But I may no longer need anything from you.”

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Srinivas, a 50-years old doctor, had a mild backache that he thought was due to his workouts. When it didn’t settle, he had an X-ray done, which showed a spot in one of the vertebrae, which then turned out to be multiple spots on an MRI. A PET/CT showed a mass in the lungs, that was proven to be cancer. With no risk factors (he was a non-smoker with no exposure to passive smoking and no family history), he suddenly turned out to have metastatic Stage IV lung cancer and after 3 1/2 years of fighting it out, passed away recently.

I could go on and on. Your life could be sailing along fine when suddenly, a truck comes from the side at night and bangs into your car and a dear one dies. Or the plane that you are traveling in crashes. Or you fall into a pothole during the monsoons…which actually happened to a colleague of mine. Or a cement brick falls on you from a height. Or you happen to be crossing the Elphinstone Station over-bridge and it collapses (though this is a form of structural violence on those using local trains in Mumbai by those in power who do not believe that their safety is important). 

Deepa is a close friend. We were doing our internship at Bhagwati Hospital in Borivali in 1986. She stepped off the footpath to go to the restaurant across the road, when a scooter carrying a large rod at 90 degrees just banged into her and she fell down and hit her head on the curb. She was unconscious for 40 days and suffered from post-traumatic changes and her personality changed overnight. She is today an amazing family physician, loved by her patients, but if the accident hadn’t happened, she may have been a leading light in the field of psychiatry. We will never know!

Seema was my neighbor. I had just entered medical college when one day I was told that she had been admitted to Hinduja Hospital for acute liver failure. The next day she was dead. She was my age; we had grown up together and none of this made sense. Apparently, she had taken a paracetamol tablet for a non-specific fever and within 24 hours landed up with that one in million complication and died. 

Covid-19 is also an example of this. It came out of nowhere (though some people now believe it’s man-made), swept the world, affected a large number of people and has killed a seven-digit number (3.9 million or 39 lakhs as of writing this) till date, multiple times more than deaths due to any natural disaster or war.

While who we are (genetics, genes) and where we live (environment) often determine our “fate”, the examples I have quoted illustrate something completely different. There are some things that are so completely out of our control, that all we can assume is that someone with a perverse sense of humor is pulling our strings, leaving us completely helpless and perhaps even leading us to believe that “what is destined is destined”and that therefore everything is pre-determined, which can then lead us to be fatalistic.

Noorjahan was a 56-years old lady who was one day detected to have a breast lump that on biopsy turned out to be a malignant cancer. A PET/CT showed axillary lymph nodal metastases, so she was advised a combination of chemotherapy, surgery and radiotherapy. She refused everything saying, “apne taqdeer main jo likha hai, wahi hoga” (“whatever is my fate, that will happen”).  The cancer kept progressing and she died a painful death when it finally spread to the bones. 

“Fatalism” is not the same as “fate”.  Fate is what randomly happens to us, though it can sometimes be traced back to our circumstances. Fatalism assumes that all events are pre-determined and that we humans do not have the power to change them.

Many societies and people have fatalistic attitudes; these may be selective, as with pregnancy or conception or diabetes or cancer or may apply to everything they do. And like with Noorjahan, this often results in premature deaths or significant morbidity in life.  

Even with Covid-19, I know people who have been very careful but at some point just give up and say “whatever has to happen will happen”, especially if there is a wedding of a near and dear one or if someone close has died and they can’t stand not being there. The situation and context thus matter and rarely is anything an all or none situation. 

And then we have cases like these.

Raghu was the Indian CEO of a multinational bank, who landed up with lung cancer. He came from a deep spiritual and cultural background that believed strongly in traditional medicine…his sister was an Ayurveda physician as well. Despite all the evidence put in front of him that his Stage I cancer could be contained by surgery, he opted for traditional treatment for over a year, which gave the cancer enough time to spread and jump from Stage I to Stage IV. At this time, realizing his folly, he finally agreed to his oncologist’s plan of action, but it was too late. He died the next year, though morphine spared him the pain that Noorjahan had to go through.

That is when you want to hit someone. Srinivas landed up with Stage IV cancer through no fault of his and fought it with whatever we have in our armamentarium currently. Noorjahan could have lived long, but believed that the Universe would take care of her…which it didn’t. Raghu, highly educated and intelligent would have done well (Stage I lung cancer has a 90% 5-years survival after surgery), but opted for an alternate pathway that hasn’t worked in such situations for over 5000 years and then died. 

Many situations that we now believe are due to “fate” are perhaps just problems waiting for their cause to be discovered that could then perhaps be prevented or treated better in the future. 300 years ago, people believed that small-pox was due to bad miasma and that it was acceptable for many of their children to die. And then just like that, vaccination changed everything, and today small-pox has been eradicated. 

Yes, we can’t fight random shitty events that happen to us, but we could try and get over fatalism, depending upon our cultural milieu and socio-economic and educational backgrounds, but stupidity…how do we handle that?  

So, what is your matka here? If s**t happens, there is not much we can do, except to try and get over it or fight it in the best possible way we can. But, to say that the disease is the will of your God or the Universe, and then do nothing, is to forfeit without a fight, the chance to cure, manage or control it and live longer. And worst of all, if you decide to follow unproven pathways, traditional or otherwise that have no evidence that they work…then I guess only your God or the Universe will be able to help you…and then perhaps not!

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What is Matka Medicine? The introduction explains it all. Matka Medicine has two broad sections. The first where I discuss the various “matkas” or factors that affect our health and the second where I write and talk about how we can empower ourselves and take steps to live long, healthy, using current, validated data and science in our journey on the road to atmasvasth.

In the end, our health is our responsibility and no doctor or healthcare system, especially in India, is really going to take the time out to help us live long, healthy, unless or until we fall sick - the idea is to try and not become ill in the first place.

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