Saturday, March 19, 2011

Interview with Nandita Shah



AH: Nandita, how did you come to practice homeopathy in Bombay?
 Shah: Yes. It is because of homeopathy that I live in Bombay. I feel the only way for me to grow in homeopathy is to practice homeopathy in Bombay. I would love to be in a more rural area, but you can't go to a village and grow in homeopathy because there is no interaction with other homeopaths. I found that the interaction was very important. I've learned a lot from my colleagues.
 AH: Tell me about your colleagues.
 Shah: We try to meet at least once a month. Rajan Sankaran, Sujit Chatterjee, Sunil Anand, Jayesh Shah, and myself. When we all start to think about something together, we have beautiful results. Sometimes we have disasters, but, even so, the thought process is interesting.
 AH: Do you each contribute to the group?

 Shah: Rajan has been an inspiration because he has been a step ahead. But we also do things in our practice which we can report back to the others, it's not just one way, of course. Each of us is a part.
 AH: How does the study group work?
 Shah: Rajan is able to see things deeper than I am able to. But we pick up the ideas quickly and are able to confirm them in our own practice. He couldn't have developed his ideas as well without the confirmation of other people. And we're growing from him, and amongst ourselves. For instance, one of us will take a case and will really understand it, and then we have a meeting and share our cases among the five of us. Very often we solve cases together which we couldn't solve alone.
 AH: How has the study group been helpful to your growth as a homeopath?
 Shah: I think I've learned a lot from them, and their enthusiasm, and the good work has been the inspiration to me to try to do better in my own cases. Every patient requires a certain remedy, and we as homeopaths should be able to find the this remedy, irrespective of the process we use. I think there will be one correct, or most suitable remedy, whichever way you find it -through the understanding of the dreams, the mental state, the physicals, or the gestures -it doesn't matter. It could even be through hair analysis. But we should come to the same remedy ultimately if we are to cure. When we discuss a case together, more and more we can come to a similar remedy. It gives us all confidence that we are working in the right direction. Of course, it doesn't work all the time, but we can aim towards understanding the patient to the point that there is no dispute. We can see a video case, and someone comes up with the remedy, and the rest can say, Oh yes, that's true, because through a well-taken case, you can really understand the central point. And though we still make mistakes, hopefully we will learn from them. You know, initially when you are a homeopath, you have a lot of uncertainties. You prescribe a remedy and you are not sure what will happen. You are waiting for the results. Eventually you know more what to expect. You know what is likely to happen to the patient when you give the remedy. Other colleagues also have study groups of 5 to 10 people -they too are doing provings and consult to together.
 AH: Have you seen changes from this in Bombay?
 Shah: Most definitely. You can feel the change in homeopathy in Bombay. You can see a new direction. Now many people are really enthusiastic about homeopathy. Before, people went to homeopathic colleges so they could practice general medicine when they got out. In my class or Rajan's class, only 10 to 15% did practice homeopathy, after going through the college. Now it's something like 75 to 80%. There's a large rebirth in homeopathy in Bombay, and the whole world, don't you think?
 AH: Tell me something about the way you prescribe. How do you decide what potency to use?
 Shah: It depends on how clearly you see the picture of the remedy in the case. The sharper you see the remedy, the higher the potency. If you can just about see the mental state, as is common in deeper pathologies, then you start with a lower potency. Of course, there are times when I have the remedy only in 30c, so I give it and it works, even when the case is very sharp.
 AH: How long is the interval between follow-up visits for your patients?
 Shah: It depends. Sometimes I have them call that same evening, but usually two weeks, or one month. Most of my patients live nearby. As there are so many homeopaths in Bombay, no one needs to travel far to see a homeopath. What we do usually is spend lot of time on the new case and very little time for the follow-up. Often the follow-ups are just to check that everything is going as expected. I see a follow-up in 5 minutes, 3 minutes, maybe 10 minutes.
 AH: What do you ask in follow-up?
 Shah: We just ask, "How are you?" A patient doesn't need a change of remedy very often, unless of course one hasn't found the right remedy in the first place. It usually takes a long time for the patient's state to change that much. So the follow-up visit is just to check whether the first prescription is correct, whether a repetition is required, or to handle an acute problem.
 AH: Do you always prescribe during the first visit? Do you always know the remedy right away?
 Shah: I try to not prescribe until I feel I really understand the patient, until I know what to give them, because a wrong prescription may add confusion. If I can't do it in the first one and a half or two hours that I interview them, I give them another appointment and I see them again. Once I prescribe, I usually don't change the remedy for a while. But there are still occasions when I'm not sure of the prescription I give to the patient.
 AH: For follow-ups do you give placebo?
 Shah: Yes, it's very common. Our way of practice is totally different than what you see in the west because most of the patients don't know much about homeopathy, nor do they care to know. They just know sometimes that it doesn't have the side effects that allopathy has. We tell them not to take any other medicine when they are being treated homeopathically, but if they were given only a single dose and no placebo, they may not be aware that they are under treatment and may take medicines for acutes, for instance. So placebo is something to keep them aware that they are under treatment. And if they have a headache and you don't want to prescribe for the acute disease, it is very easy to say, "Put some pills in water," or "take an extra dose of your medicine." Then they feel they've done something, and you're not pressured to give them medicine for all their complaints, because they feel they are already taking something. I feel it works very well in India. It's also our method of payment. We don't charge by appointment. We charge by the number of days we are giving medicine for. And if we see a patient for 5 minutes or 25 minutes, we still charge the same. They don't feel they have more right to your time, either, because they will be paying the same amount if they stay for 5 minutes or 25. You can spend with them the time they need. I personally like to have little check on my patients more often and not spend too much time with it. So I am happy with this method.
 AH: There is a movement on in the United States for homeopathic education of the patient, how do you feel about this?
 Shah: I don't feel it is helpful for a person to read his remedy without understanding homeopathy. When I treat a colleague, I don't always tell him the remedy. How does it help to know what the remedy is? In fact, I think it could prejudice the patient. The patient comes to us for treatment, and we are doing an honest job of treatment. Placebo never hurts anybody, and if it can help, why should you feel guilty about giving placebo. I cannot understand this. I feel if it can help, then there is nothing wrong with it, and I find it definitely helps my patients. Because it's a form of reassurance. If they have some problem, they take some placebo, they feel they are on some medicine, and don't have to go for the pain killer. Very often when I am weaning my patients off pain killers or palliative allopathic drugs, I give them placebo and it works very well. If you feel that something is wrong, it becomes wrong, but if you really don't feel that it is wrong, you can go ahead and do it. There are some people you can tell their remedy to. It depends on the patient and his level of understanding of homeopathy.
 AH: Tell me about your assistants.
 Shah: They are new homeopaths. They are students who have passed their college exams and who have begun their practice. Maybe they practice in the evening and sit in with me in the morning. Or vice versa. They work with me for a whole year. They see all the patients and follow-ups for one year. They see one new case every day. The assistants see all the cases. So they know what to expect. Some of my assistants are really great homeopaths, and I refer my patients to them if they live closer to one of my assistants.
 AH: Do you feel it affects your case taking to have your assistant in the room when you take the case?
 Shah: A few patients won't open up as much. It's always nice to have a break without the assistant, because then some patients do feel freer. It does slightly affect case taking, but I also feel that when we have someone watching over what we do, we are more cautious about every step we take. So it also improves our own practice. There are good and bad things about it.
 AH: You don't feel that you ever miss a case because of the presence of the assistant?
 Shah: No, I take the liberty of sending my assistant out for a few patients here and there.
 AH: Do you feel you have to change your case-taking in any way when your assistant is present?
 Shah: Not really. My assistants don't participate in the case-taking until the end. Then if they have something to ask, they may. Most patients are quite OK when they know this is an assistant .
 AH: Do you ask the patient's permission for the assistant to sit in before hand?
 Shah: No. When you don't make an issue of it, they don't think about it either. Occasionally someone will ask to speak to me alone.
 AH: Are there pros and cons to having students sit in on your clinic?
 Shah: How are people going to learn without sitting in? How would students learn to do an operation without watching? It is not possible. How will you train other good homeopaths? I feel it has also helped me, because it has made me conscious of everything I do in practice. I have to have a reason for it. Sometimes I might prescribe, saying probably this is going to work, or I feel it's right. But with the student's watching, you have to have a reason. Every time you do something, it makes things clearer for you too. I'm very comfortable with it. In fact, I think it can bring out the best in me.
 AH: Do you do other teaching in India?
 Shah: I haven't taught in a formal way in the college, because I just can't go twice a week -it's too far. The students have a kind of union where they invite people to give lectures on Saturdays or Sundays. So I go then, speak, and show cases.
 AH: Do you have any hobbies?
 Shah: I have a lot of other interests. But there is very little time. I wish I had time for some fine art. Pottery and painting are things I would really like to do. I love to learn languages. I am learning Italian right now on the side and I studied French earlier.
 AH: How will you apply your new use of the Italian language?
 Shah: It's just something I really enjoy. When you read a book in French, it's totally different from how a book would be written in English, so you get a totally different outlook on another culture and you can get that only really through the language. I love traveling, and seeing different cultures. Italy is a country I love, and as most Italians don't speak English, I decided to learn it. I would like also to learn German but fortunately most Germans speak English so it can wait.
 AH: What else interests you?
 Shah: I like to garden organically. Ideally I would like to live in a rural area, and live a more natural life. Isn't it ironic that we are advocating a system of healing based on nature's laws, but everything else we are doing is against nature's laws!
 AH: Organic gardening in India is not common!
 Shah: It's getting more popular than it was before. There are a few health food stores, and people are growing things without chemicals. It's becoming more popular, but the Indian farmers feel as the Indian patients do: any medicine is good. The farmers feel that any pesticides can only do good, so sometimes they use much more than they should. The awareness is coming and it's good. Organic gardening is just beginning on a mass scale, because people are realizing they can get more money for the produce.
 In 1985, I read a book called The One Straw Revolution and what really struck me is that the author, Masanobu Fukuoka, was writing about agriculture, but his philosophy was the same as our homeopathic philosophy. While I was reading this book I felt I could have been reading a book of homeopathy. He called his method of farming, "do-nothing farming." He said that man is always trying to do more and more, but is causing, through his efforts, his own destruction. You can see this in general in the world today. It looks like we have made a lot of progress, but in actuality life has become more and more stressful. To summarize his views on farming: he says that plowing the fields (done to aerate the soil) destroys the microorganisms in the soil, that would have naturally aerated the soil. But not only do the microorganisms aerate the soil, they also fertilize it naturally. Plowed soil needs fertilizer. When plants grow on fertilizers instead of natural nutrients, they are more vulnerable to disease. That's why we need pesticides and herbicides. And plants brought up this way are not only harmful to us, but lack flavor, and nutrients. As a result, we add vitamins to our diet and so the chain goes on... Crops should be grown intermingled with one another, as they occur in nature, so they have a symbiotic relationship with the soil and its nutrients. The soil doesn't get depleted of any one mineral, and they are not easy prey to pests which multiply very fast in a field which contains solely their favorite food. But man makes everything more complicated through modern methods of farming. In fact, natural farming is also more economical because although something may be lost to pests, and the fact that harvesting is more labor intensive, there is still substantial savings on fertilizers pesticide, herbicides, etc. In terms of man, to use an analogy, fertilizers are similar to vitamins, required when we switch to an unnatural diet of chemically processed foods. This weakens our immune response, and to counteract that, we use vaccinations and antibiotics, similar to the herbicides and pesticides used on plants. But are we really getting anywhere?
 AH: This "more is better" is the philosophy of allopathy.
 Shah: Yes, but it is also the way we homeopaths see the world. I think it's the basic quality of man as opposed to the rest of nature. I remember many years ago I was walking with Jeremy Sherr, and I said the basic problem of India is the population, that maybe compulsory family planning as in China would be the solution. Jeremy said, "But reproduction is natural. The solution must lie somewhere else." A couple of years later, I went to Senegal, and I found the answer. Senegal is a small country with not a very high population, but it seemed that 90% of the population was young. There must be at least 10 kids to every adult.
 Northern Senegal is desert, and Southern, on the border of tropical rain forest. All over Senegal are projects for safe drinking water, medical aid, road building, development in various ways. These are undertaken by western countries as aid. But the Senegalese, who are basically village people, don't even know what to do with themselves in the city and there are plenty of beggars. They are basically rural people. Then we went off the only road that encircles the country into a village in the interior, where the western influence was just beginning to reach. (They had just been gifted a machine to polish rice!). There the population (child to adult ratio) was normal. The people were happy, smiling. Three French-speaking boys who had returned from a city school took us around their village. They did not practice agriculture but they had the sweetest mangoes and pineapples we ever tasted. They would kill a monkey or wild boar whenever they needed food and the forest was filled with gourds, and yams and other edible vegetables that could be found by a brief search. Every evening they made merry with music and dance and all their needs were met by the environment. This was in contrast with the rural communities accessible from the roads. These were acres of barren land -the villagers had been taught agriculture through various projects, and they needed it to feed their multitudes -the gift of modern medicine -but they had no concept of this and so they would move from one plot of forest land to another, cutting down the trees, but not having the skills to keep the land from erosion and barrenness after. Another reminder of the way we humans destroy ourselves with our greed for more. In a few years this country, facing rapid desertification, will be struck by drought and famine -which it never knew before. I think we have to think of ways to go back to nature, and we, as homeopaths, need to work in this direction too, because medicine only cannot cure the sickness of this world. We need to look for homoeopathic solutions for the non-medical problems too. There have been many situations in my life where I have done things in an allopathic way. We try to solve the problem by opposing it. For instance, once my father was very depressed and his house was also looking very broken down. So I thought the way to help him get out of this depression would be to fix up his house. He moved into the last room while the rest of the house was being renovated. And when it was finished, he stayed in the last room. I realized then what an allopathic method I had used to help him get better. Before he had a reason to feel depressed. Now he had no reason, and was still depressed.
 AH: You would like to be an organic farmer?
 Shah: I would like to live in a place where I could be more in tune with nature in every way. I am far from that now. I live in Bombay. I've been thinking about moving for a long time. I feel that if you are a homeopath, then you need to look at other aspects of life which have to do with health. I feel that you have to include everything, that is, things that are for healthful living. I think and hope the whole world is slowly moving in this direction, at least beginning to think about it, because there is a limit to what materialism can bring you. When you get saturated with materialism, you have to go back to the other side. Someone has to begin. This is something that I would really like to do.
 AH: The draw to a more natural life is becoming more attractive to many.
 Shah: This reminds me of an article I read called "The Farmer and the Industrialist." There was a very poor farmer living in an underdeveloped country. The sun was hot and he had worked hard in the fields all morning. So after a hearty lunch he took a little nap in the shade of the old tree. To this underdeveloped country came a very rich industrialist from a technologically advanced country to establish whether it would be worth his while to invest a huge sum of money in some industry. After driving several miserable hours in the hot sun, he saw the poor farmer asleep under the shade of the old tree, and it was just too much for him to bear. "Stop the car," he shouted to the driver and stormed across the road as fast as his heart condition would allow, and woke up the poor farmer by shouting, "What do you think you are doing?" "I was taking a nap in the shade of this old tree," replied the farmer as politely as he could, thinking it was quite obvious. "Don't you know there is work to be done?" "I've been working all morning..." But the industrialist stormed, "If you people were to get a hold of yourselves and change your ways, work harder and longer you might be able to save money and invest it in a profitable business, branch out, install a plant, automation, get your capital back, buy out your competitors and climb to the top." "What I would do then, sir?" said the perplexed farmer. "Do?" shouted the industrialist. "Why, you could delegate responsibility to subordinates, relax for a change. Live on the income, with a house in the country; good food, pretty girls. Soak up a little sunshine." "Sir, my house is already in the country; the food cooked by my mother is the envy of every woman in the district; my sweetheart prettier than any girl I've seen; and was I not asleep in the sunshine when you awoke me?"
 Nandita Shah
 22 Matru Chhaya, 70 Marine Dr
 Mumbai 400020
 India
 Tel 2064949
 Fax 3680414
 email - nanditagiasbm01. vsnl. net. in

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